ORTHODONTIC CASE

PRESENTATION
Marwa Ibrahim Halalmeh
Eman Khalid Nazzal
Rahaf Hasan Ibrahim
Malak Ali Abu-aquleh

PATIENTS BIOGRAPHY

- Name : Rula Yaseen Wardat

- Age : 22
- Gender : Female

HISTORY
Chief Complaint :
-She doesnt like her teeth shape
-crowding anteriorly
-facial asymmetry
History of Chief Complaint :
-With eruption of permanent teeth

Medical History :
- Patient denied any medical problems
Dental History :
- She wear a removable appliance 4 years
ago for 1 year to expand her upper jaw
- Uncomplicated previous extraction 3
years ago
- Previous restoration 3 months ago
Social History & Habits :
-None

Extra Oral Examination

Frontal view
-Symmetrical:
Asymmetrical face
- LFH ratio:
increased

Profile View
Profile angle: Convex
Skeletal Class: Class II
FMPA: average

Soft Tissue Analysis

Lip: incompetent
Nasolabial angle: average
Upper lip: average
Lower lips: prominent

 View

Intra Oral Examination

Oral Hygiene:
Fair

Intra-arch:
Teeth number :
Upper: 14 lower: 12
Crowding :
Upper: severe crowding
Lower: mild crowding
Incisor inclination :
Upper: proclined
Lower: average
Other :
Buccally erupted upper canines

Inter-arch/occlusion:
Anterior-posterior relation:
Overjet: increased 4mm
Incicor relation: II division 1
Canine relation:
Right: II by unit
Left: II by unit
Molare relation:
Right: II by unit
Left: II by unit

Vertical relation:
Anterior Open bite

Transverse relation:
Unilateral Cross bite without
displacement
Central line :
Lower non-coincident with the
upper to the right by 2 mm

Upper occlusal

Lower occlusal

Study Cast

Study Cast
Lowe
r

Upper

Space analysis

Space analysis on upper cast

Space available : 68 mm
Space required : 79.5 mm
There is deficiency 10.5 sever crowding

Space analysis on lower cast

Space available : 63 mm
Space required : 65.5 mm
There is deficiency 2.5 mild crowding

Total Bolton ratio : 86.51% ( normal 91% )

Anterior Bolton ratio : 80.5% ( normal
77.3% )

Panaromic Radiograph

Cephalometric
Radiograph

Cephalometric Analysis
Measurem
ents

Norma
l

Pts

result

Antero-Postero Skeletal Relations

SNA

823

86

Prognathic
maxilla

SNB

793

75

Retrognathic
mandible

ANB

31

Increased

Increased

93

normal

Wits
measurem
ent
A-B
FOP

0 female

905

Vertical Skeletal Relationship

MM Angle

275

24

Normal

LFH/TFH

50-55%

60
%

Increased

Gonial
angle

1265

134

Increased

Diagnosis
Patient has Class II Division I incisors relation based on
skeletal class II relationship.
Complicated by :
Class II canine relationships
Class II molar relationships
Convex profile angle
Anterior open bite
increased overjet
Midline of lower teeth is not coincident with the upper to the
right by 2 mm
Unilateral cross bite (right)

Treatment Plan
Aims of treatment:
1- achieve Class I incisors relationship
2- relief crowding
3- achieve Class I molar and canine relationships
4- correct the cross bite
5- increase overbite
6- overjet reduction

Means of achieving aims:

-fixed appliance (upper and lower) :
- anchorage control by:
Nance for upper arch
Fixed for lower arch

- with extraction of:

5 and 7 are badly
destructed teeth

- retention by :
Vaccum-formed Essix Retainer

4
5

4 7

Thank you