3. PATIENT INFORMATION
Name: Shahid Hidayatullah
Gender: Male
Age:18 years
Occupation: labour
Chief Complaint:
“problem during speech and
demands better profile”
3
4. PATIENT HISTORY
PMH: Insignificant
PDH: Generalized staining of all teeth
Medications: None
Habits: Betel nut chewing since 4 to 5 years
Family History: Insignificant
Motivation: Both Internally & externally
motivated
Expectation: Long treatment
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5. EXTRA ORAL EXAMINATION
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• Head and Neck:
•TMJ:
-- Max incisal opening of =41mm
-- Lat excursion Right = 4mm
Left = 7mm
-- Protrusion = 10mm
• Path of Closure is displaced anteriorly
10. FRONTAL VIEW
Oral Hygiene: Poor.
Bleeding gums on
brushing. Gingiva of lower
anterior region inflammed
and blunt.
Midline :
Upper is On
Lower is 4mm off
towards left side to upper
dental midline.
Crossbite: Anterior 3 to 3
10
11. OCCLUSAL VIEWS
Rt. Upper 1 to 7 present, Unerupted right upper 8
Lt. Upper 1 to 8 present
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12. OCCLUSAL VIEWS
Rt Lower: 1 to 8 present
Lt Lower: 1 to 7 present, Unerupted left lower 8
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13. BUCCAL VIEWS
Incisor: Class III
Canine:
Class III bilaterally
Molar:
Supra class III right side
Class III on left side
Over jet:
Reverse. 7mm
Over bite:
Reverse
Cross bite:
Bilateral posteriorly 7 to 7
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15. SPACE ANALYSIS
MAXILLA
Space Available = 69.5mm
Space Required = 78.5mm
TSALD = -9.0 mm
MANDIBLE
Space Available = 60.5mm
Space Required = 70mm
TSALD = -9.5mm
CURVE OF SPEE: 2mm on average
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16. BOLTON ANALYSIS
Amount of Anterior excessive Mandibular
tooth material = 1.18 mm
Amount of Overall excessive Mandibular
tooth material = 0.42 mm
→Bolton Analysis Finding: Bolton is
insignificant.
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30. 30
Measurements Standard SD Readings Interpretation
CRANIAL BASE
Ar-ptm(parallel to HP) 37.1 2.8 31 Decreased Post.
Cranial base
length
Ptm-N(parallel to HP) 52.8 4.1 54 Normal Ant.
Cranial base
length
HORIZONTAL SKELETAL
Na-A-Pog 3.9° 6.4 -11° concave
Na-A (parallel to HP) 0.0 3.7 1mm Normal Maxilla
Na-B (parallel to HP) -5.3 6.7 12mm Prognathic
Mandible
Na-Pog (parallel to
HP)
-4.3 8.5 17mm Protrusive chin
31. 31
VERTICAL SKELETAL & DENTAL
N-ANS (Perp to HP) 54.7 3.2 57mm Normal Ant. Middle
third of face
ANS-Gn (Perp to HP) 68.6 3.8 87mm Long Ant. lower third
of face
N-PNS (Perp to HP) 53.9 1.7 60mm Long Post. Middle
third of face
MP-HP (Angle) 23° 5.9 31° Slightly increased
Vertical
U1-NF (Perp to NF) 30.5 2.1 35.5mm Increased Ant. Max.
Dental height
L1-MP (Perp to MP) 45 2.1 50mm Increased Ant. Mand.
Dental height
U6-NF (Perp to NF) 26.2 2.0 31.5mm Increased Post. Max.
Dental height
L6-Mp (Perp to MP) 35.8 2.6 35.5mm Normal Post. Mand.
Dental height
32. 32
MAXILLA MANDIBLE
ANS-PNS 57.7 2.5 55mm Normal
horizontal
max.base
length
Ar-Go (Linear) 52.0 4.2 53mm Normal
Mand.ramal
length
Go-Pog (Linear) 83.7 4.5 100.5mm Increased
Mand. Body
length
B-Pog (Parallel to
HP)
8.9 1.7 4mm Chin is
recessive?
Ar-Go-Gn 119.1° 6.5 127° Slightly
increased
angle
33. 33
DENTAL
OP upper to HP 6.2° 5.1 14° Increased occlusal
plane angle
OP lower to HP °
AB parallel to OP -1.1 2.0 -23mm Prognathic Mandible
U1-NF 111.1° 4.7 118° Slightly increased
Max. incisor
inclination
L1-MP 95.9° 5.2 74° Reteroclined Mand.
incisor inclination
34. 34
COGS INTERPRETATION
•Concave facial profile
•Prognathic mandible
•Protrusive chin position
•Long posterior middle third of face
•Long Anterior lower third of face
•Slightly increased vertical and Gonial angle
•Increased Mandibular Body length
•Increased Anterior mandibular dental height
35. PROBLEM LIST
General:
Poor oral hygiene. Bleeding gums on brushing. Gingiva of
lower anterior region inflammed and blunt
Skeletal:
Prognathic mandible
High angle
Dental:
Incisor Class III,
Canine Class III bilaterally.
Molar Class III on left side and Supra class III right side
Deviated lower dental midline
Reverse overjet and overbite
Proclined upper incisors
Retroclined lower incisors
Bilateral crossbites
Soft Tissue:
Reterocumbent upper lip.
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36. TREATMENT OBJECTIVES
Improve & maintain the oral hygiene status
Correction of lower jaw prognathism and chin
position
Correction of lower dental midline.
Correction of incisor inclinations
Correction of reverse overjet and overbite
Correction of increased vertical
Correction of incisor, canine and molar relation.
Correction of bilateral crossbites
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