Presented byLatheef Sk Saheb
3rd Yr PGOMFS
Case presentation
Patient name : Charan
Age / sex : 19Yr Male
Chief complaint : Patient C/o forwardly placed lower front teeth
HOPI :
CASE HISTORY
CASE HISTORYPre-natal history
Post-natal history:
Childhood History:
Personal History
Drug history:
PRE ORTHODONTIC TREATEMENTEXTRA ORAL PHOTOGRAPHS
POST ORTHODONTIC TREATEMENT
EXTRA ORAL PHOTOGRAPHS
Height : 5feet 6 inches
Weight : 60 kgs
Gait & Posture : Normal
Body type : Mesomorphic
CLINICAL EXAMINATIONGeneral examination
CLINICAL EXAMINATION CONTD..
Extraoral examination
Head shape: mesocephalic
Facial type: mesoprosopic
Facial symmetry: No gross asymmetry seen
Upper 1/3rd -52 mm
Middle 1/3rd – 57 mm
Lower 1/3rd -- 61 mm
CLINICAL EXAMINATION CONTD..
Stomium line to nose: 18 mm
Stomium line to chin :41mm Lips :Potentially competent. Interlabial gap : 2mm
CLINICAL EXAMINATION CONTD..
Incisor exposure at rest : 2mm
Incisor exposure during smile: Full crown exposure + 2mm of gingiva
CLINICAL EXAMINATION CONTD..
Facial profile : Convex
Facial divergence : Posterior
Profile view
Nasolabial angle - Acute
Mentolabial sulcus - Shallow
Chin - Prominent
Nose - Normal -
SOFT TISSUE EXAMINATION
Oral hygiene status : Fair Gingiva :NormalOral Mucosa : NAD
Tongue : Normal
INTRAORAL EXAMIINATION
Hard tissue examination
Teeth present : 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
HARD TISSUE EXAMAMINATION
Skeletal mid line : Dental mid line Upper – coincides Upper- Coincides
Lower - coincides Lower – Coincides
Upper arch : U –Shape
Lower arch : U- shape
RIGHT LEFT
Molar relation – Class IIICanine relation – Class III
Molar relation –Class IIICanine relation – Class III
Overjet of – reverse 5mm
Overbite - Negative
Curve of spee - 2mm on right and 1mm on left side
Incisor relation – class III
Freeway space : 3mm
Respiration : Nasal
TMJ Exam : NAD
Maximum mouth opening : 43 mm
FUNCTIONAL ANALYSIS
OPG
Restored 26,36.
LATERAL CEPHALOGRAM
CEPHALOGRAM ANALYSIS
DIAGNOSIS skeletal
Dental
•Angles class III molar relationship with proclined upper anteriors,
A 26 yr old male patient with skeletal class III bases with retrognathic maxilla and prognathic mandible, Normodivergent.
Soft tissueMesoprosopic face with convex facial profile, protrusive lower lip and soft tissues matching with skeletal bases.
PROBLEMS LIST
1. Skeletal class III
2. Dental Class III
3. Overjet 5mm
4. Concave profile
TREATMENT OBJECTIVES
1. Correction skeletal and dental class III relationship
2. Correction of forwardedly placed lower incisors.
3. Attaining ideal overjet and overbite
4. Attaining pleasing facial profile.
TREATMENT PLAN
Extraction of 14,24,35,45 or vice versa (accordingly)
•Lefort I osteotomy maxillary advancement of 4mm
•Mandibular set back of 6mm
•Reduction Genioplasty (if required)
THANK YOU