european society of lingual orthodontists · sagittal jaw relation a-n-pg -3.4° 2º ± 2.5º...

EUROPEAN SOCIETY

OF LINGUAL

ORTHODONTISTS

CANDIDATE NUMBER: 13 Dr. Masatoshi Sana

CASE NUMBER: 3

Year: ２０１０

ESLO 01

NAME:

BORN:

SEX:

PRETREATMENT RECORDS:

CLASSIFICATION: 　

TEETH MISSING BEFORE TREATMENT:

APPLIANCE:

TREATMENT STARTED:

TREATMENT ENDED:

ACTIVE TREATMENT TIME:

POSTTREATMENT RECORDS:

RETAINERS:

RETENTION ENDED:

AGE:43.4years

RETENTION TIME:

(POST-) RETENTION RECORDS:

TIME OUT OF RETENTION:

DATE16/4/2005

AGE:43.7years DATE:09/07/2005

AGE:46.1years DATE09/01/2008

a)Upper : Begg type retainer

a)upper:

b)lower:

DATE:29/01/2010

AGE:48.1years DATE: 29/01/2010

ESLO 02

03.12.1961

DATE09/01/2008

b)Lower : Begg type retainer

AGE:46.1years

RÉSUMÉ OF CASE 6

CLASS Ⅲ MALOCCLUSION CASE CATEGORY:

Chieko.I

F

0.6years

Adult malocclusion – Skeletal Cl Ⅲ malocclusion

18,28,38,48

Upper and lower lingual fixed orthodontic appliance( Kurz 7th)

2.6years

2.0years

DIAGNOSTIC DESCRIPTION

OF THE MALOCCLUSION

A. SUMMARY

B. EXAMINATION OF HEAD AND FACE

C. FUNCTIONAL EXAMINATION

D. INTRAORAL EXAMINATION

E. DENTAL CASTS

Maxillary arch: Arch length discrepancy: +2.6mm

Mandibular arch: Arch length discrepancy: +14.1mm

Occlusion Sagittal: Angle Class R)Ⅰ L) Ⅱ , Overjet -1.9mm

Occlusion Vertical: Overbite 3.6mm

Occlusion Transversal : Unilateral crossbite,menton was shifted to left 2.0mm

CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4years

ESLO 03

From latelal view,lower lip was protruded.

From frontal view,mandibular position was shifted to left.

Smile view was asymmetry.

TMJ mobility was no problem.

Patient’s mastication was dysfunction.

Speech was not clear.

CASE NUMBER: 3

Patient’s chief complaint is dysfunction of mastication.

Patient’s smile was disharmony.

1. Angle class R: ClⅠ,　L: ClⅡ

2. Overjet -1.9mm , Overbite 3.6mm

3. Crossbite (11,21,22,26 / 31,32,33,36,41)

4. Spacing on the upper and lower arch (upper +2.6mm, lower +14.1mm )

5. 14,15,21,22,31,32,41 was supraversion

FRONTAL

45° PROFILE

ESLO 04

FACIAL PHOTOGRAPHS BEFORE TREATMENT

SMILE

CANDIDATE NUMBER:13 DATE: 16/04/2005 AGE: 43.4yearsCASE NUMBER: 3

vvvv

vvv

Right Buccal Left Buccal

Center

Upper Occlusal Lower Occlusal

ESLO 05

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT


ESLO 06

LATERAL SKULL RADIOGRAPH BEFORE TREATMENT


ESLO 07

TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT


CEPHALOMETRIE

ANALYSE TWEED MERRYFIELD

ESLO 08!1

SNA 82°±２ 80.5°

SNB 80°±２ 83.0°

ANB 2°±２ -2.5°

FMA 25°±3 18.1°

IMPA 87°±3 86.5°

OP/F 10° 4.4°

Debut Tt


CEPHALOMETRIC MORPHOLOGICAL

ASSESSMENT 1

Pretreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

80.5° 82º ± 3.5º

Mandibular Position S-N-Pg 83.9° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -3.4° 2º ± 2.5º

Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS

10.2° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 27.8° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 25º ± 6.0º

Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS

117.3° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 86.6° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 2 ± 2.0

Dental Relations Overjet (mm) -1.9mm 3.5 ± 2.5

Overbite (mm) 3.6mm 2 ± 2.5

Interincisal Angle 1 / 1 137.8° 132º ± 6.0º

ESLO 08-2


PERIAPICAL OR PANORAMIC RADIOGRAPHS

BEFORE TREATMENT

ESLO 09


ANY OTHER RADIOGRAPHS BEFORE TREATMENT

ESLO 10


RADIOGRAPHIC ANALYSIS

BEFORE TREATMENT

A. INTRAORAL / PANORAMIC RADIOGRAPH

B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

ESLO 11

Upper and lower alveolar bone was resorbed.

36,37,46,47, were mesial tipping

18,28,38,48 were absence


1. Sagittal Skeletal Relations:

Maxillary position was in the normal range, but retrognathic tendency.

Mandibular position was protrusive.

( SNA 80.5°, SNB 83.9° ANB -2.5°)

2.  Vertical Skeletal Relations:

Vertical jaw relation at ANS-PNS / Go-Gn was close.

3. Dento- Basal Relations:

Maxillary incisor was slightly, inclined to labial related ANS-PNS line.

( 1-ANS-PNS 17.3°)

Mandibular incisor was protrusive position related A-Pg line and inclined to

lingual related Go-Gn line.

　　　( 1-Go-Gn: 86.6°, 1-A-Pg : 5.6mm)

4.  Dental relations:

Anterior crossbite (11,21,22,26 / 31,32,33,36,41).

Overbite 3.6mm, Overjet -1.9mm.

At the end of jaw closing movement, premature contact was founded at

upper and lower incisors.

　　 Mandibular was functional shifted to left.

5.  Esthetic Profile:

Patient’s profile was concave.

　　　 Lower lip was protrusive.

TREATMENT PLAN

AND THE REASON FOR IT

ESLO 12-0


1, Indirect bonding both arches with lingual appliance.

(Kurz 7th brace)

2, Bite rising

3, Leveling

4, Expand upper arch and contract lower arch

5, Torqing

6, Detailing

This case was skeletal ClassⅢ, and patient’s chief complaint was

dysfunction of mastication.

The mesurement of sagittal skeletal relation ( ANB-2.5°) was mandibular

set back surgery indication.

On the other hand, dysfunction was caused from anterior cross bite with

functional jaw shift.

This treatment plan (without surgery) that contraction mandibular arch

and expand maxillary arch considered lead to improve patient’s dysfunction.

On the set up model before treatment space was remained on lower

arch, because of stable interdigitation and ideal incisal relation.

Treatment plan

The reason

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT

ESLO 12-1


Center


Upper : Ni-Ti (.014)

Lower : Ni-Ti (.012)


INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT

ESLO 12-2


Center


Upper : TMA (.016!.022)

Lower : Ni-Ti (.016)


RÉSUMÉ OF THE TREATMENT CARRIED OUT

INCLUDING

ANY DIFFICULTIES ENCOUNTERED

ESLO 13

28.05.2005 Diagnosis

07.09.2005 Indirect binding to maxillary arch

　　　　　　　　　 (Kurz 7th brace / Ni-Ti.012 )

03.09.2005 Indirect bonding to mandibular arch

　　　　　　　　 (Kurz 7th brace / Ni-Ti.012)

25.02.2006 Alignment maxillary and mandibular arch

(Ni-Ti.012~TMA.0175!.0175)

11.11.2006 Expand of maxillary arch

(Ni-Ti .016 !.022)

　 Contraction of mandibular arch

(TMA.0175!.0175~TMA.016!.022)

20.12.2006 Torqing (TMA.016!.022)

03.02.2007 Detailing (Ni-Ti .016~S.S.016!.016)

09.01.2008 Remove the appliances

Started retention


ESLO 14

FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT

FRONTAL

45° PROFILE

SMILE


vvvv

vvv

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT

ESLO 15


Center



ESLO 1６

LATERAL SKULL RADIOGRAPH

AT COMPLETION OF TREATMENT CANDIDATE NUMBER:13 DATE: 09/01/2008 AGE: 46.1yearsCASE NUMBER: 3

TRACING OF LATERAL SKULL RADIOGRAPH

AT COMPLETION OF TREATMENT

ESLO 17-1


SUPERIMPOSITION AT SN-S

ESLO 17-2


ESLO 17-3

SUPERIMPOSITIONS of MAXILLA , MANDIBULE , PROFILE


Palatal Plane at ANS

Mandibular Plane at Me

S-N at S

ESLO 18!１

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 80.5° 80.7°

SNB 80°±２ 83.0° 82.9°

ANB 2°±２ -2.5° -2.2°

FMA 25°±3 18.1° 19.0°

IMPA 87°±3 86.5° 83.1°

OP/F 10° 4.4° 4.8°



ASSESSMENT 2

ESLO 18-2

Pretreatment Posttreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

80.5° 80.7° 82º ± 3.5º

Mandibular Position S-N-Pg 83.9° 84.3° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -3.4° -3.6° 2º ± 2.5º


10.2° 10.0° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 27.8° 28.5° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 19.1° 25º ± 6.0º


117.3° 119.8° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 86.6° 83.3° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 3.0mm 2 ± 2.0

Dental Relations Overjet (mm) -1.9mm 1.6mm 3.5 ± 2.5

Overbite (mm) 3.6mm 1.9mm 2 ± 2.5

Interincisal Angle 1 / 1 137.8° 137.7° 132º ± 6.0º



AT COMPLETION OF TREATMENT

ESLO 19


ESLO 19-1


ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT

RADIOGRAPHIC ANALYSIS AT

COMPLETION OF TREATMENT



ESLO 20


・ Teeth were consolidated on the maxillary and mandibular arch.

・ Maxillary arch was expanded (16~26 :42.6mm" 43.7mm )

・ Mandibular arch was contracted (36~46 :42.9mm" 39.2mm)

・ Alveolar bone level was no change.

・ No root resorption

1.  Sagittal Skeletal Relations:

No significant change compared with before treatment.

　　 ( SNA 80.5°"80.7°, SNB 83.0°"84.3°, ANB -2.5 °" -2.2°)

2.  Vertical Skeletal Relations:

Vertical relation related ANS-PNS / Go-Gn was slightly increased.

　　 (18.3°"19.1°)

3.  Dento-Basal Relations:

Maxillary incisor inclined to labial.

Mandibular incisor inclined to lingual.

　　 ( 1-ANS-PNS 117.3°"119.8°, 1-Go-Gn 86.6°"83.3°)

4.  Dental relations:

　　　Overbite 3.6mm"1.9mm, Overjet -1.9mm"1.6mm,

　　　Midline discrepancy was improved.

5.  Esthetic Profile:

Patient’s profile was changed to straight.

DESCRIPTION OF THE

TREATMENT RESULT

ESLO 21-1

1)  Patient’s smile is harmonious.

2)  ClassⅠ relationship

3)  Midline discrepancy was improved

4)  Crossbite was corrected

5)  Retention: Upper : Begg type retainer

　 Lower : Begg type retainer with artificial tooth for

space retain


TREATMENT RESULT ORIENTATION

DESCRIPTION OF THE

POST-TREATMENT EVALUATION

OF RETENTION

ESLO 21-2

1) Retaining goal : Begg type retainer was two years totally.

( upper and lower)

After 6 months retention , prosthetic restoration

to the mandibular arch.

2) Occlusoin is stable

3) Teeth positions are stable


RETENTION RESULT ORIENTATION

ESLO 22

FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION

FRONTAL

45° PROFILE

SMILE


vvvv

vvv

INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION

ESLO 23


Center




AT RETENTION / POSTRETENTION

ESLO 24-1


ESLO 24-2


ANY OTHER RADIOGRAPHS AT RETENTION / POSTRETENTION

RADIOGRAPHIC ANALYSIS

AT RETENTION/POSTRETENTION



ESLO 24-3


Teeth positions and roots stay parallel.

Alveolar bone level was stable.

1. Sagittal Skeletal Relations:

ldem page 20 = stable

2. Vertical Skeletal Relations:


3. Dento- Basal Relations:


4. Dental relations:

ldem page 20 = normal and stable overjet & overbite

5. Esthetic Profile:


ESLO 24-4


LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION

ESLO 25-1


TRACING OF LATERAL SKULL RADIOGRAPH

AT RETENTION / POST-RETENTION

SUPERIMPOSITION AT SN-S

ESLO 25-2


SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE

Palatal Plane at ANS

Mandibular Plane at Me

S-N at S

ESLO 25-3


ESLO 26-1

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 80.5° 80.7° 80.8°SNB 80°±２ 83.0° 82.9° 82.7°ANB 2°±２ -2.5° -2.2° -1.9°FMA 25°±3 18.1° 19.0° 18.6°IMPA 87°±3 86.5° 83.1° 84.0°OP/F 10° 4.4° 4.8° 5.4°

Fin Cont



ASSESSMENT 3

ESLO 26-2

Pretreatment Posttreatment Retention/ Postretention

Mean SD

Sagittal Skeletal Relations Maxillary Position S-N-A

80.5° 80.7° 80.8° 82º ± 3.5º

Mandibular Position S-N-Pg 83.9° 84.3° 84.0° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg -3.4 -3.6 -3.2 2º ± 2.5º


10.2° 10.0° 10.1° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 27.8° 28.5° 28.1° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 18.3° 19.1° 18.3° 25º ± 6.0º


117.3° 119.8° 119.5° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 86.6° 83.3° 83.9° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 5.6mm 3.0mm 2.6mm 2 ± 2.0

Dental Relations Overjet (mm) -1.9mm 1.6mm 2.0mm 3.5 ± 2.5

Overbite (mm) 3.6mm 1.9mm 2.0mm 2 ± 2.5

Interincisal Angle 1 / 1 137.8° 137.7° 138.3° 132º ± 6.0º


DESCRIPTION OF RETENTION /

POST-RETENTION FINDINGS

ESLO 27

1) Occlusion is stable

2) Teeth positions are stable

3) Patient dysfunction of mastication and speech were improved


LONG TREM RETENTION RESULT ORIENTATION

european society of lingual orthodontists · sagittal jaw relation a-n-pg -3.4° 2º ± 2.5º...

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