Case Pre-tx

8/8/2019 Case Pre-tx

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(Initial/Progress/Completed)(Initial/Progress/Completed)

Case PresentationCase Presentation

Rene S. Johe, DMD

NJDS Orthodontic Dept.

Chart #Chart #

Presentation DatePresentation DateInitial Records DateInitial Records Date


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Before starting the presentation, please startBefore starting the presentation, please start

and have running in the background:and have running in the background:

Orthocad 5 panel model view (only if modelsOrthocad 5 panel model view (only if modelsare digital)are digital)

Dolphin with Digitized CephalometricDolphin with Digitized Cephalometric

Radiograph loadedRadiograph loaded


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(Chart Number)(Chart Number) Age / SexAge / Sex

Chief Complaint:Chief Complaint:

Ethnicity:Ethnicity:

Medical History:Medical History: Dental History:Dental History:

(Orthodontic History)(Orthodontic History)

HabitsHabits

Social HistorySocial History Family HistoryFamily History

Attitude towards txAttitude towards tx

(if additional space is needed,(if additional space is needed,place on identical pictureplace on identical pictureslide for all slides)slide for all slides)


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FrontalFrontal

FrontalFrontal

Facial typeFacial type FacialFacial

ProportionsProportions

Facial SymmetryFacial Symmetry

Competency ofCompetency oflips at restlips at rest

Lip balance /Lip balance /widthwidth


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ProfileProfile Soft Tissue Convexity / ConcavitySoft Tissue Convexity / Concavity

Retro / Prognathic jawsRetro / Prognathic jaws

GG--SnSn--PgPg

Vertical patternVertical pattern

Lip size (thick/thin)Lip size (thick/thin)

Upper Lip LengthUpper Lip Length Lip Position:Lip Position:

Lip AttachmentLip Attachment

List at least 2 soft tissue valuesList at least 2 soft tissue valuessuch as:such as:

Rickets Esthetic Plane (ERickets Esthetic Plane (E--line)line) Holdaway (HHoldaway (H--line)line) Steiner (SSteiner (S--line)line) Burstone (Sn to Pg)Burstone (Sn to Pg)

Sulcular depthSulcular depth

Nose sizeNose size

Midface positionMidface position

Chin prominenceChin prominence

Throat angle / neck drapeThroat angle / neck drape


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SmilingSmiling Smile lineSmile line

Incisor displayIncisor display

Broadness of smileBroadness of smile(buccal corridors)(buccal corridors)

Maxillary midline toMaxillary midline tofaceface

Chin to facial midlineChin to facial midline

Occlusal cantOcclusal cant


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Dental (front)Dental (front) Dentition type (mixed, adult,Dentition type (mixed, adult,

etc)etc)

Angles ClassificationAngles Classification

Overjet, OverbiteOverjet, Overbite

Cross bitesCross bites

Anterior teeth Present /Anterior teeth Present /AbsentAbsent

Maxillary to MandibularMaxillary to Mandibularmidlinemidline

Oral hygieneOral hygiene

Incisor morphology (short,Incisor morphology (short,chipped, etc)chipped, etc)

Gingival health / defectsGingival health / defects


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Dental (Right)Dental (Right) Molar relationshipMolar relationship

Canine relationshipCanine relationship

Cross bites presentCross bites present

Posterior teeth Present /Posterior teeth Present /AbsentAbsent

Lateral open bites presentLateral open bites present

Gingival health / defectsGingival health / defects

Upper/Lower Curve of SpeeUpper/Lower Curve of Spee


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Dental (left)Dental (left) Molar relationshipMolar relationship

Canine relationshipCanine relationship

Cross bites presentCross bites present

Posterior teeth PresentPosterior teeth Present/ Absent/ Absent

Lateral open bitesLateral open bitespresentpresent

Gingival health /Gingival health /defectsdefects


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MaxillaryMaxillary

OcclusalOcclusal

Maxillary Crowding /Maxillary Crowding /SpacingSpacing

Present / Absent /EruptingPresent / Absent /Eruptingteethteeth

Rotated teethRotated teeth

Displaced teethDisplaced teeth

Arch shapeArch shape

Bolton DiscrepanciesBolton Discrepancies

Buccolingual axialBuccolingual axialinclination of posterior teethinclination of posterior teeth

Caries / RestorationsCaries / Restorationspresentpresent


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MandibularMandibular

OcclusalOcclusal Mandibular Crowding /Mandibular Crowding /

SpacingSpacing

Present / Absent /EruptingPresent / Absent /Erupting

teethteeth Rotated teethRotated teeth

Displaced teethDisplaced teeth

Arch shapeArch shape

Bolton DiscrepanciesBolton Discrepancies

Buccolingual axialBuccolingual axial

inclination of posteriorinclination of posteriorteethteeth

Caries / RestorationsCaries / Restorationspresentpresent


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Digital ModelsDigital Models

Necessary only if models are digitalNecessary only if models are digital

At this point, either switch to Orthocad 5At this point, either switch to Orthocad 5

panel view or have an imported version ofpanel view or have an imported version ofthat screen on the slidethat screen on the slide


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Dental AgeDental Age Erupting teethErupting teeth

Tipped / axially inclined teethTipped / axially inclined teeth

Impacted teethImpacted teeth

Supernumerary / Missing teethSupernumerary / Missing teeth

Lesions associated with teeth (including caries)Lesions associated with teeth (including caries)

Third molar position / developmentThird molar position / development

Other notable pathologyOther notable pathology

TMJ / Condylar morphologyTMJ / Condylar morphology


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Incisor root position / morphology / lengthIncisor root position / morphology / length

Other notable pathologyOther notable pathology

(should be digital, photographed if necessary)(should be digital, photographed if necessary)


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GrowthGrowth

AnalysisAnalysis(CVM)(CVM)

(untraced)(untraced)

PathologyPathology

presentpresent


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Hard Tissue / DentalHard Tissue / Dental

Cephalometric AnalysisCephalometric Analysis

(SHOW TRACING(SHOW TRACING --List atList at

least two supportingleast two supportingmeasurements, any twomeasurements, any twoyou feel are appropriateyou feel are appropriatefor the case, for each,for the case, for each,including norms, sampleincluding norms, sampletable next slide, pleasetable next slide, pleaseuse this table!)use this table!)

Anteroposterior MaxillaryAnteroposterior Maxillaryjaw positionjaw position

AnteroposteriorAnteroposteriorMandibular jaw positionMandibular jaw position

AnteroposteriorAnteroposteriorIntermaxillary relationshipIntermaxillary relationship

Vertical jaw relationshipsVertical jaw relationships MaxillaMaxilla MandibleMandible

Upper incisor positionUpper incisor position

Lower incisor positionLower incisor position

Occlusal plane (Wits)Occlusal plane (Wits)

Switch to Dolphin ifSwitch to Dolphin iffaculty / resident requestsfaculty / resident requestsother measurementsother measurements


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Value Norm

A/P Maxilla:

SNA 84.7 82.0

A-Na Perp 4.3mm 3.1mm

A/P Mandible:SNB 82.8 80.9

Pg-Na Perp 4.9mm -4.0mm

A/P Intermaxillary:

ANB 1.9 1.6

Max/Mand Diff 36.9mm 25.4mm

Vertical Maxilla:

AUFH/ALFH 1.2 1.2

Upper Face Ht 50.6mm 50.0mm

Vertical Mandible:

FMA 34.3 24.1

Lower Face Ht 76.5mm 65.0mm

Upper Incisor:

U1-A Perp 5.9mm 6.0mm

U1-PP 110.4 110.0

Lower Incisor:IMPA 75.7 95.0

L1-APo 6.1mm 2.7mm

Occlusal Plane:

Wits -6.4mm -1.0mm

PP-Occ Plane 15.3 10.0


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Additional radiographsAdditional radiographs

Pathology / FindingsPathology / Findings

(should be digital, photographed if necessary)(should be digital, photographed if necessary)


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Problem ListProblem List

Priority BasedPriority Based

Chief complaintChief complaint

FunctionFunction Soft TissueSoft Tissue

Hard TissueHard Tissue

DentalDental

OtherOther

DISCREPANCY INDEXDISCREPANCY INDEX


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Treatment Objectives / GoalsTreatment Objectives / Goals

Priority BasedPriority Based

Facial aestheticsFacial aesthetics

FunctionalFunctional DentalDental

OtherOther


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Treatment OptionsTreatment Options

Treat?Treat?

Dentofacial Orthopedics?Dentofacial Orthopedics?

Surgical?Surgical? Extraction or NonExtraction or Non--extraction?extraction?

(justification and benefits for each)(justification and benefits for each)


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Treatment PlanTreatment Plan

Extraction choice (if at all)Extraction choice (if at all)

Appliance typeAppliance type

Removable typeRemovable type Prescription typePrescription type

Appliance Accessories (Bite Turbos,Appliance Accessories (Bite Turbos,Plates, etc)Plates, etc)

Timing of treatmentTiming of treatment

Retention ProtocolRetention Protocol


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Mechanical and other TreatmentMechanical and other Treatment

ConsiderationsConsiderations Special Banding / Bonding order (if required)Special Banding / Bonding order (if required)

Alignment mechanicsAlignment mechanics

AnchorageAnchorage

Retraction / Protraction mechanicsRetraction / Protraction mechanics Space closure mechanicsSpace closure mechanics

Special Wire selection (if required)Special Wire selection (if required)

Bite Opening / Closing mechanicsB

ite Opening / Closing mechanics ElasticsElastics

Finishing / Detailing mechanicsFinishing / Detailing mechanics


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End of Initial Case PresentationEnd of Initial Case Presentation


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Prior PresentationPrior Presentation

Read Faculty and Residents comments andRead Faculty and Residents comments and

treatment plans from previous presentationstreatment plans from previous presentations


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ProgressProgress

Time in TreatmentTime in Treatment

Stages of Treatment completedStages of Treatment completed

Stage of Treatment currentlyStage of Treatment currently


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Progress DetailsProgress Details

Major treatment time points (limit to 5 orMajor treatment time points (limit to 5 or

less)less)

Mechanics utilizedMechanics utilized

Problems encountered and how they wereProblems encountered and how they were

addressedaddressed

Changes in Tx plan and whyChanges in Tx plan and why


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Progress PicturesProgress Pictures

Show initial and then progress picturesShow initial and then progress pictures


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Progress PanProgress Pan

Show initial and then progress panShow initial and then progress pan


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Progress CephProgress Ceph

Show initial and then progress cephShow initial and then progress ceph

Include major angular and linearInclude major angular and linear

measurement changesmeasurement changes


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SuperimpositionsSuperimpositions

Overall SOverall S--N superimpositionN superimposition

Maxillary superimpositionMaxillary superimposition

Internal cortical plate of palateInternal cortical plate of palate Mandibular superimpositionMandibular superimposition

Internal cortical plate of symphysisInternal cortical plate of symphysis

Mandibular canalMandibular canal


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Future ProgressFuture Progress

Anticipated treatment time remainingAnticipated treatment time remaining

Anticipated problems to be addressedAnticipated problems to be addressed

Anticipated problems not addressedAnticipated problems not addressed Mechanics to be utilizedMechanics to be utilized


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End of Progress Case PresentationEnd of Progress Case Presentation


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Prior PresentationPrior Presentation

Read Faculty and Residents comments andRead Faculty and Residents comments and

treatment plans from previous presentationstreatment plans from previous presentations


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Completed CaseCompleted Case

Total Time in TreatmentTotal Time in Treatment

Major treatment time points (limit to 5 orMajor treatment time points (limit to 5 or

less)less) Mechanics utilizedMechanics utilized

Problems encountered and how they wereProblems encountered and how they were

addressedaddressed Changes in Tx plan and whyChanges in Tx plan and why


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End of Treatment PicturesEnd of Treatment Pictures

Show intial and then final picturesShow intial and then final pictures

Include type of retention utilized and whyInclude type of retention utilized and why


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End of Treatment PanEnd of Treatment Pan

Show initial, progress, and then final panShow initial, progress, and then final pan


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End of Treatment CephEnd of Treatment Ceph

Include major angular and linearInclude major angular and linear

measurement changesmeasurement changes

Show initial, progress, and then final cephShow initial, progress, and then final ceph


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SuperimpositionsSuperimpositions

Overall SOverall S--N superimpositionN superimposition

Maxillary superimpositionMaxillary superimposition

Internal cortical plate of palateInternal cortical plate of palate Mandibular superimpositionMandibular superimposition

Internal cortical plate of symphysisInternal cortical plate of symphysis

Mandibular canalMandibular canal


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RetentionRetention

Anticipated retention timeAnticipated retention time

Anticipated retention problemsAnticipated retention problems


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Final AnalysisFinal Analysis

Overall treatment resultOverall treatment result

Patient satisfaction with treatmentPatient satisfaction with treatment

Treating Resident satisfaction with treatmentTreating Resident satisfaction with treatment Treatment lessons learnedTreatment lessons learned

Objective Grading System ValueObjective Grading System Value

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Case Pre-tx