Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

1. MANDIBULAR
PROGNATHISM
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2. INDIAN DENTAL ACADEMY
Leader in continuing dental education
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3. NAME: Sabeer Ali
AGE : 19 YEARS
SEX
: MALE
CHIEF COMPLAINT : Forwardly placed lower jaw,
patient is not satisfied with his appearance.
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4. CLINICAL EXAMINATION RECORDS
•
ATHLETIC BUILT , MESOMORPHIC BODY TYPE,NORMAL GAIT
AND ERECT POSTURE
EXTRAORAL EXAMINATIONS:
•
•
•
•
•
•
•
•
•
SHAPE OF THE HEAD
FACIAL FORM
FACIAL PROFILE
FACIAL DIVERGENCE
FMA
MAXILLA
MANDIBLE
LIPS
MENTALIS
- DOLICHOCEPHALIC
- DOLICHOFACIAL
- CONCAVE
- ANTERIOR DIVERGENCE
- HIGH
- NORMAL
- PROTRUSIVE
- 7 mm of Lip incompetency
- HYPERACTIVE
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5. EXTRA ORAL PHOTOGRAPHS
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6. INTRAORAL EXAMINATION
•
•
•
No. of teeth present -29
Periodontal status –normal
Tongue size-normal
Maxillary Arch • Canines and premolars are rotated
• U- shaped symmetrical arch,
MandibularArch • mild crowding and premolar rotations
• U- shaped symmetrical arch,
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8. Antero-Posterior Relationship
Molar relationship - Angle’s Class III
Incisor relationship:
Overjet - REVERSE OVERJET – 8mm
Canine relationship: Class III
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9. LATERAL CEPHALOGRAM
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10. OPG
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11. STEINER’S ANALYSIS
ANGLES
82°
85 °
80°
91°
2°
- 6 °
Go Gn to SN
32°
37°
Occl. Pl to SN
DENTAL
SNA
ANB
SKELETAL
PRE
TREATMENT
SNB
NORMAL
(RANGE)
14°
U1 to N-A(mm)
4mm
11mm
U1 to N-A (Angle)
22°
41 °
L1 to N-B (mm)
4mm
8 mm
L1 to N-B (Angle)
25°
23°
Int. Inc. Angle
134°
122°
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12. LANDMARKS
MALES
MEAN
S.D
CRANIAL BASE
Ar PTM (HP)
PTM-N (HP)
37.1 ± 2.8
52.8 ± 3.0
48 mm
N-A-Pg angle
N-A (HP)
N-B (HP)
N-Pg (HP)
3.9 ± 6.4
0.0 ± 3.7
-5.3 ± 6.7
-4.3 ± 8.5
- 13º
+ 3 mm
+17 mm
+ 20mm
VERTICAL (Sk. and DENTAL)
N-ANS (HP)
ANS-Gn (HP)
PNS-N (HP)
MP-HP angle
Upper incisor –NF
Lower incisor-MP
Upper molar-NF
Lower molar-MP
54.7 ± 3.2
68.6 ± 3.8
53.9 ± 1.7
23.0 ± 5.9
30.5 ± 2.1
45.0 ± 2.1
26.2 ± 2.0
35.8 ± 2.6
56mm
81mm
56 mm
28º
27 mm
43 mm
25 mm
31 mm
57.7 ± 2.5
52.0 ± 4.2
83.7 ± 4.6
8.9 ± 1.7
119.1 ± 6.5
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52 mm
58 mm
89 mm
8 mm
145º
PATIENT VALUE
38 mm
HORIZONTAL (Sk.)
MAXILLA –MANDIBLE
PNS-ANS (HP)
Ar-Go (linear)
Go-Pg(linear)
B-Pg (MP)
Ar-Go-Gn angle

13. WITT’S APPRAISAL:
Pretreatment:: AO ahead of BO by 20 mm
Inference : Sk. Cl III
Male: BO ahead of AO by 1.7mm
SOFT TISSUE ANALYSIS
MEAN
VALUE
PRE
TREATMENT
In class III
20.9
22 mm
Upper lip thickness
15mm
18 mm
Upper lip strain
14 - 16
3 mm
90 - 110°
90º
ANGLES
Upper lip length
Naso Labial angle
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17. Diagnosis :
•
Angle’s Cl III molar relationship with Cl III Skeletal base due to retruded maxilla and
prognathic mandible,
•
Anterior Open bite,
•
Reverse overjet,
•
Mild crowding and rotations in the upper and lower anteriors,
•
Concave facial profile with lip incompetence,
•
High FMA.
Treatment Objectives:
•
Alignment of upper/lower arches.
•
Correction of the Skeletal base.
•
Achievement of Lip competency.
•
Enhancement of facial esthetics.
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18. Treatment Plan:
•
Alignment using 0.22 Roth prescription bracket system.
•
High Lefort I osteotomy for maxillary advancement.
•
Bilateral Sagittal Split Osteotomy for mandibular setback.
•
Post surgical Orthodontics for finishing and detailing.
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Leader in continuing dental education
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