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7/28/2019 nazeer PPT
1/23
NAME NAZEER MOHAMMED
Ortho No. 20130329
OPD NO 16797
Date of birth 8/12/1985
Age / Sex 28/M
Address VASALPUR
,NARAINGARH,AMBALA
Phone No. 09813583319
PATIENT CASE HISTORY
7/28/2019 nazeer PPT
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28/M,FARMER R/O VASALPUR,NARA
INGARH/
C/C PATIENT COMPLAINS OF
FORWARDLY PLACED ANERIOR TEETH
Family history
N.R
Medical historyN.R
Dental history N.R
Pretreatment 28/1/13
7/28/2019 nazeer PPT
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EXTRA ORAL FACIAL VIEW
Apprantly bilaterally
Symmetrical
leptoprosopic face
Convex profile
Potentially competent
lips
Interlabial gap 5 mm
Incisor show at rest
4mm
acute nasolabial angle
deep mentolabial
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4/23
Molar relation ;END ON ON
RT,CLASS II
Canine relation :END ON,CLASS
I
Incisor ;CLASS II
Faciomaxillary midline
concordant
Maxilo-mandibular midlines are
concordant
Overjet 9mmOverbite 4 mm
Intra oral examination
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Pretreatment 28/01/13
Max arch:
Arch form: U shape
HIGH arched palate
Mand arch:
Arch form: U SHAPE
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Pretreatment OPG 24/12/12
P t t t C h l 28/01/13
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Pretreatment Cephalogram 28/01/13
Skeletal Class II jaw bases
l
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SNA82
SNB80
ANB3.12+/-1.8
Wits-0.01mm
App-Bpp+5mm
MM bisector-1.5mm
AB Plane angle (-4.6 3.67)
SKELETAL ANALYSIS
Pt is skeletal Class
Discrepancy in Sagital plane
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SN length(72mm) mm
Maxillary length(ANS
toPNS)(49mm)mm
Mandibular length (GoTO
PoG)(76mm)mm
Maxillary and mand length is increased
N perpendicular to
A point (-4.46mm) mm
B point (-11.03mm) mm
Pog (-10.5mm) mm
Both the mand and
max are proportionally
Enlarge.
A and B point are
placed normal to
N perpendicular.
7/28/2019 nazeer PPT
10/23
FMA
(24)
SN-MP (32)
Y-axis (59)
Gonial angle (123)
Lower gonialangle
(70)
J-ratio (62 %)
UFH / LFH (45 : 55)
Discrepancy in Vertical dimensions
Indicating normal growth pattern
7/28/2019 nazeer PPT
11/23
LI- A-Pg ( -2mm to2mm)
+7mm
LI-NB (61.7mm) 6mm
LI-NB (274.3 ) 25
IMPA (90) 95-
UI -A-Pg:
6.741.3mm
+6mm
UI-NA:
4.922.05mm +7mm
UI-NA:
24.025.82
27
UI-Palatal Plane (
110) 118
UI-SN 112
Pretreatment 24/12/12
Upper incisors are proclined and protruded
Lower incisors are proclined
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E line (mm) Upper lip
(-4mm)
mm
Lower lip(-2 mm)
mm
S line (mm) Upper lip
(0 mm)
mm
Lower lip(0 mm)
mm
Soft tissue analysis
Nasolabial angle
Inter labial gap 0 mm
Lip strain 2mm
Upper and lower lip are protruded w.r.t E & S line
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Model Analysis
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14/23
Boltons Analysis
Indicates mandibular tooth material excess
maxillary anteriorexcess
7/28/2019 nazeer PPT
15/23
S.I. = 25.5 M.P.V. = 35 M.M.V = 46
C.P.V = 42.5 indicating no need for expansion.C.M.V = 39.84 indicating no need for expansion.
Ponts Analysis
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T.T.M=83 P.M.D=41 P.M.B.A.W=43.37
P.M.B.A.W.% = 43.37 %indicating borderlinecase
Ashley Howes Analysis
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UPPER LOWER
a) Arch perimeter 79mm 67mm
space availableb) Tooth material 83mm 55.5mm
Discrepancy b/w 4 mm 11.5mm
arch length andtooth material
Carey Indicating
Arch perimeter indicating
Careys Analysis
7/28/2019 nazeer PPT
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CASE SUMMARY
A 20 yrs old female patient shows Skeletal Class I jaw bases ..
Dentoalveolar: Malocclusion irregularly placed teeth.
Soft tissue: convex profile,acute nasolabial angle, average
mentolabial sulcus,potentialy competent lips, crossbitepresent.
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PROBLEM LIST
Skeletal Class I jaw bases
ANGLES CLASS II DIV I malocclusion missing lower firs canine
class I and Class I incisor relationship.
acute nasolabial angle
competent lips
DEEP mentolabial sulcus
7/28/2019 nazeer PPT
20/23
DIAGNOSIS
SKELETAL CLASS I Normodivergent GROWTHPATTERN .
INCRESED OVERJET
ANGLES CLASS II DIV IMALOCCLUSION
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DISCREPANCY CALCULATION
Mandibular Arch
FMA 24
IMPA(95)
IMPA correction =5
intraarch correction =4
Maxillary Arch
Overjet due to IMPA correction= 2mm
Total overjet=2+2=4mm
Space required for correction of total overjet= 4x2=8mm
(maxillary arch)
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TREATMENT OBJECTIVE
Correction of molar and incisor relationship
Correction of crowding ,spacing.
Correction of crossbite
CORRECTION of overjet and overbite
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TREATMENT PLAN
FIXED MECHANOTHERAPY
No EXTRACTION
ANCHORAGE-GROUP C
TYPE OF APPLIANCE-PREADJUSTED
APPLIANCE
MECHANICS-ROTH .022 SLOT