Post on 03-Sep-2018
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
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
ESLO 07
TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 32.5years DATE: 11/10/2005 CASE NUMBER: 5
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
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER: 13 AGE: 32.9years DATE: 15/12/2005 CASE NUMBER: 5
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-2
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER: 13 AGE: 32.11years DATE: 20/02/2006 CASE NUMBER: 5
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-3
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER: 13 AGE: 33.5years DATE: 15/08/2006 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
ESLO 14
FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT
FRONTAL
45° PROFILE
SMILE
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
vvvv
vvv
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT
ESLO 15
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
SUPERIMPOSITION AT SN-S
ESLO 17-2
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
ESLO 17-3
SUPERIMPOSITIONS of MAXILLA , MANDIBULE , PROFILE
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
Palatal Plane at ANS
Mandibular Plane at MeS-N at S
ESLO 18!1
CEPHALOMETRIE
ANALYSE TWEED MERRYFIELD
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°
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
CEPHALOMETRIC MORPHOLOGICAL
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
Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS
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
Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS
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
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT COMPLETION OF TREATMENT
ESLO 19
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
ESLO 19-1
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
ANY OTHER RADIOGRAPHS AT COMPLETION OF TREATMENT
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
ESLO 20
14.18.24.28.38.48 were extracted.
Lower molar were uprighted.
12 root was slightly resorbed.
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
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
1) Retaining goal : lifelong
2) Occlusion is stable
3) Teeth position are stable
RETENTION RESULT ORIENTATION
CANDIDATE NUMBER: 13 AGE: 35.0years DATE: 05/04/2008 CASE NUMBER: 5
ESLO 22
FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION
FRONTAL
45° PROFILE
SMILE
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
vvvv
vvv
INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION
ESLO 23
Right Buccal Left Buccal
Center
Upper Occlusal Lower Occlusal
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT RETENTION / POSTRETENTION
ESLO 24-1
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
ESLO 24-2
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
ANY OTHER RADIOGRAPHS AT RETENTION / POSTRETENTION
RADIOGRAPHIC ANALYSIS
AT RETENTION/POSTRETENTION
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
ESLO 24-3
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
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:
Idem page 20 =stable
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:
Idem page 20 =stable
LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION
ESLO 24-4
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
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
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
SUPERIMPOSITIONS of MAXILLA,MANDIBULE,PROFILE
Palatal Plane at ANS
Mandibular Plane at MeS-N at S
ESLO 25-3
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
ESLO 26-1
CEPHALOMETRIE
ANALYSE TWEED MERRYFIELD
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
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
CEPHALOMETRIC MORPHOLOGICAL
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
Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS
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
Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS
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
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
DESCRIPTION OF RETENTION /
POST-RETENTION FINDINGS
ESLO 27
CANDIDATE NUMBER: 13 AGE: 37.2years DATE: 24/05/2010 CASE NUMBER: 5
LONG TERM RETENTION RESULT ORIENTATION
1) Retaining goal : lifelong
2) Occlusion is stable
3) Teeth positions are stable
4) Patient’s mastication shown no-problem.