EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS · european society of lingual orthodontists ... vertical jaw relation ... treatment result orientation 1)

EUROPEAN SOCIETY

OF LINGUAL

ORTHODONTISTS

CANDIDATE NUMBER: 13 Dr. Masatoshi Sana

CASE NUMBER: 5

Year:　２０１０

ESLO 01

RÉSUMÉ OF CASE 8

TRANS / VERTICAL

DISCREPANCY

CASE CATEGORY:

NAME:　　　　

BORN :

SEX:

PRE-TREATMENT RECORDS:

CLASSIFICATION:

TEETH MISSING BEFORE TREATMENT:

APPLIANCE:

TREATMENT STARTED:

TREATMENT FINISHED:

ACTIVE TREATMENT TIME:

POST-TREATMENT RECORDS:

RETAINERS:

RETENTION ENDED:

AGE: 32.5years

RETENTION TIME:

(POST-) RETENTION RECORDS:

DATE:11/10/2005

AGE: 32.9 year DATE : 15/12/2005

AGE: 35.0 years DATE: 05/04/2008

a) Dynamic positioner

a) upper : not ended

b) lower: not ended

DATE: 05/04/2008

DATE: not ended

AGE: 37.2 years DATE: 24/05/2010

AGE: 35.0 years DATE: 05/04/2008

ESLO 02

2.3 years

2.2 years

Akiko T.

15/03/1973

F

Adult malocclusion Angle Cl II - open bite

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

TIME OUT OF RETENTION: still in retention

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 was -8.4mm

Madibular arch: Arch length discrepancy was -2.4mm

Occlusion Sagittal: Angle ClassⅡ , Overjet＋2.7mm

Occlusion Vertical: Anterior open bite (Overbite -1.1mm)

Occlusion Transversal: Upper midline shifted 0.5mm left

CANDIDATE NUMBER: 13 AGE: 32.5years

ESLO 03

DATE: 11/10/2005 CASE NUMBER: 5

Patient’s chief compliant was dysfunction of mastification caused by anterior

open bite.

From lateral view , upper and lower lip were protruded.

From frontal view , symmetry was no-problem , but muscle strain of mentalis was

shown.

From smile view , upper incisor was protruded and severe crowding was shown.

Patient’s mastication shows disfunction.

Tongue thrust habit was shown.

1, Angle class Ⅱ

2, Anterior open bite (11,12,13,21,22,23 / 31,32,33,41,42,43)

3, Overjet ＋2.7mm

4, Overbite !1.1mm

5, Crowding

FRONTAL

PROFILE

ESLO 04

FACIAL PHOTOGRAPHS BEFORE TREATMENT

SMILE

45°

CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5

vvvv

vvv

Right Buccal Left Buccal

Center

Upper Occlusal Lower Occlusal

ESLO 05

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT

CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER:5

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 84.2°

SNB 80°±２ 76.5°

ANB 2°±２ 7.7°

FMA 25°±3 29.8°

IMPA 87°±3 105.0°

OP/F 10° 18.9°

Debut Tt


CEPHALOMETRIC MORPHOLOGICAL

ASSESSMENT 1

Pretreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

84.2° 82º ± 3.5º

Mandibular Position S-N-Pg 75.5° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg 8.7° 2º ± 2.5º

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

6.7° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 37.2° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 30.5° 25º ± 6.0º

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

103.8° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 105.9° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 6.7mm 2 ± 2.0

Dental Relations Overjet (mm) 2.7mm 3.5 ± 2.5

Overbite (mm) -1.1mm 2 ± 2.5

Interincisal Angle 1 / 1 119.9° 132º ± 6.0º

ESLO 08-2


ESLO 09

PERIAPICAL OR PANORAMIC RADIOGRAPHS

BEFORE TREATMENT CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5

ESLO 10

ANY OTHER RADIOGRAPHS BEFORE TREATMENT CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5

RADIOGRAPHIC ANALYSIS

BEFORE TREATMENT

A. INTRAORAL / PANORAMIC RADIOGRAPH

B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

ESLO 11


18.28.38.48 was impacted.

Alveolar bone was no-problem.

1. Sagittal Skeletal Relations:

　 Maxillary position was in the normal range.

　Mandibular position was retruded.

Skeletal classⅡrelation was shown.(SNA 84.2°, SNB 76.5°, ANB 7.7°)

2. Vertical Skeletal Relations:

Mandibular Inclination (S-N/Go-GN 37.2°) beyond the range of normal.

3. Dento-Basal Relations:

Inclination of Maxillary incisor was normal , position was protrusive

relative to line of A-Pg .

Mandibular incisor inclined to labial , position was protruded relative to line

of A-Pg .

4. Dental relations:

11.12.13.21.22.23 / 31.32.33.41.42.43 open bite

overjet 2.7mm, overbite -1.1mm

Molar relation was classⅡ

5. Esthetic Profile:

　　Upper and lower lip to E-line was protruded.

Patient’s profile was convex.

TREATMENT PLAN

AND THE REASON FOR IT

ESLO 12-0


1, Extraction (14.18.24.28.38.48)

2, Indirect bonding both arches with lingual appliances

(Kurz 7th brace)

3, Myofunctional therapy (MFT)

4, Leveling

5, Retraction of upper incisor

6, Torqing

7, Detailing

Treatment plan

This case was skeletal classⅡopen bite caused from retruded mandibular.

And, patient’s chief compliant was dysfunction of mastication.

So, mandibular advancement osteotomy was one of the treatment plan.

But , patient refused osteotomy, so only orthodontic treatment

(without surgery) plan was selected.

For correct of crowding , upper 1st bicuspids extraction was needed.

The reason

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT

ESLO 12-1


Center




ESLO 12-2


Center




ESLO 12-3


Center



RÉSUMÉ OF THE TREATMENT CARRIED OUT

INCLUDING

ANY DIFFICULTIES ENCOUNTERED

ESLO 13

10.11.2005 Diagnosis

15.12.2005 Indirect bonding to maxillary arch

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

17.12.2005 Extraction the right 1st bicuspid

07.01.2006 Extraction the left 1st bicuspid

20.02.2006 Indirect bonding to mandibular arch

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

17.04.2006 Started Myofunctional Therapy (MFT)

09.05.2006 Alignment maxillary and mandibular arch

(TMA .016~ TMA .0175".0175)

15.08.2006 Started space closing of upper anterior retraction

(TMA .016".022)

07.09.2006 Started classⅡelastics

23.01.2007 Continued space closing

Started box elastics

30.07.2007 Detailing (TMA .0175".0175)

05.04.2008 Removed 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 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5

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 MeS-N at S

ESLO 18!１

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 84.2° 84.1°

SNB 80°±２ 76.5° 76.8°

ANB 2°±２ 7.7° 7.3°

FMA 25°±3 29.8° 30.2°

IMPA 87°±3 105.0° 100.4°

OP/F 10° 18.9° 17.2°



ASSESSMENT 2

ESLO 18-2

Pretreatment Posttreatment Mean SD Sagittal Skeletal Relations

Maxillary Position S-N-A

84.2° 84.1° 82º ± 3.5º

Mandibular Position S-N-Pg 75.5° 75.8° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg 8.7° 8.3° 2º ± 2.5º


6.7° 7.9° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 37.2° 37.8° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 30.5° 30.0° 25º ± 6.0º


103.8° 102.0° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 105.9° 100.9° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 6.7mm 5.6mm 2 ± 2.0

Dental Relations Overjet (mm) 2.7mm 2.3mm 3.5 ± 2.5

Overbite (mm) -1.1mm 2.3mm 2 ± 2.5

Interincisal Angle 1 / 1 119.9° 127.1° 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

14.18.24.28.38.48 were extracted.

Lower molar were uprighted.

12 root was slightly resorbed.


1. Sagittal Skeletal Relations:

　 Maxilla and mandibular position were no change.

Maxilla and mandibular relation was no change.

(SNA 84.2°#84.1°, SNB 76.5°#76.8°, ANB 7.7°#7.3°)

2. Vertical Skeletal Relations: Mandibular Inclination still beyond the range of normal. (S-N/Go-Gn 37.2°#37.8°)

3. Dento-Basal Relations:

Maxillary incisor inclination was no-change.

From superimposition of lateral X-ray, maxillary incisor was extruded 1.1mm.

Mandibular incisor inclined to lingual. (1/Go-Gn 105.9°#100.9°)

From superimposition of lateral X-ray, mandibular incisor was extruded 2.5mm.

4. Dental relations:

Normal overjet and overbite.

(overjet 2.7mm#2.3mm , overbite -1.1mm#2.3mm)

From superimposition of lateral X-ray, maxillary molar moved mesial 1.6mm,

and mandibular molar was tip backed to distal.

5. Esthetic Profile:

Upper lip protrusion was improved.

(Upper :1.0mm#-1.5 mm / Lower : 1.4mm#0.5mm)

DESCRIPTION OF THE

TREATMENT RESULT

ESLO 21-1


TREATMENT RESULT ORIENTATION

1)  ClassⅠcuspid relationship

2)  ClassⅡmolar relationship , because of upper 1st bicuspid extractions.

3)  Anterior open bite was improved

4)  Dysfunction of mastication was improved

5)  Tongue thrust habit was improved

6)  Retaining goal : lifelong

DESCRIPTION OF THE

POST-TREATMENT EVALUATION

OF RETENTION

ESLO 21-2


2)  Occlusion is stable

3)  Teeth position 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


Roots were stable.

Alveolar bone was stable.

1, Sagittal Skeletal Relations:

Idem page 20 =stable

2, Vertical Skeletal Relations:

Idem page 20 = stable

3, Dento-Basal Relations:


4, Dental Relations:

From superimposition of lateral X-ray upper incisor was

extruded 0.2mm and lower incisors was extruded 0.7mm.

5, Esthetic Profile:


LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION

ESLO 24-4


ESLO 25-1

TRACING OF LATERAL SKULL RADIOGRAPH

AT RETENTION / POST-RETENTION CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5

SUPERIMPOSITION AT SN-S

ESLO 25-2


SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE

Palatal Plane at ANS

Mandibular Plane at MeS-N at S

ESLO 25-3


ESLO 26-1

CEPHALOMETRIE


Debut Tt Fin Tt

SNA 82°±２ 84.2° 84.1° 83.8°SNB 80°±２ 76.5° 76.8° 76.1°ANB 2°±２ 7.7° 7.3° 7.7°FMA 25°±3 29.8° 30.2° 30.0°IMPA 87°±3 105.0° 100.4° 101.0°OP/F 10° 18.9° 17.2° 17.3°

Fin Cont



ASSESSMENT 3

ESLO 26-2

Pretreatment Posttreatment Retention/ Postretention

Mean SD

Sagittal Skeletal Relations Maxillary Position S-N-A

84.2° 84.1° 83.8° 82º ± 3.5º

Mandibular Position S-N-Pg 75.5° 75.8° 75.2° 80º ± 3.5º

Sagittal Jaw Relation A-N-Pg 8.7° 8.3° 8.6° 2º ± 2.5º


6.7° 7.9° 8.0° 8º ± 3.0º

Mandibular Inclination S-N / Go-Gn 37.2° 37.8° 37.7° 33º ± 2.5º

Vertical Jaw Relation ANS-PNS / Go-Gn 30.5° 30.0° 29.7° 25º ± 6.0º


103.8° 102.0° 101.3° 110º ± 6.0º

Mandibular Incisor Inclination 1 - Go-Gn 105.9° 100.9° 101.9° 94º ± 7.0º

Mandibular Incisor Compensation 1 - A-Pg (mm) 6.7mm 5.6mm 5.1mm 2 ± 2.0

Dental Relations Overjet (mm) 2.7mm 2.3mm 2.7mm 3.5 ± 2.5

Overbite (mm) -1.1mm 2.3mm 2.3mm 2 ± 2.5

Interincisal Angle 1 / 1 119.9° 127.1° 127.2° 132º ± 6.0º


DESCRIPTION OF RETENTION /

POST-RETENTION FINDINGS

ESLO 27


LONG TERM RETENTION RESULT ORIENTATION


2)  Occlusion is stable

3)  Teeth positions are stable

4)  Patient’s mastication shown no-problem.

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EUROPEAN SOCIETY OF LINGUAL ORTHODONTISTS · european society of lingual orthodontists ... vertical jaw relation ... treatment result orientation 1)