Case

CASE HISTORY
Name: Asha
Age: 18 years
Chief compliant: complains of irregularly
placed front teeth.
Pre- natal and post-natal history:
nothing significant.
Childhood diseases and habits: nothing
significant.
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Reasons for taking orthodontic
treatment: esthetics
Pubertal status: adult
Clinical examination
Build: moderate
Height: 5.2 ft
Weight: 47 kg
Body type: endomorphic

Extra oral examination
Extra oral examination revealed
mesocephalic, mesofacial, straight
profile and inter labial gap of 5mm.
Functional examination : respiration-
nasal, mastication, deglutition, speech
and TMJ were normal

7 6 5 4 3 C 2 1
7 6 5 4 3 2 1 1 2 3 4 5 6 7
1 2 3 4 5 6 7

Buccally erupted 13
Retained 53

Crowding in
anterior

Cephalometric analysis
SOFT TISSUE ANALYSIS
Facial angle (90°)-90°
Nose tip to H line (12mm)- 2mm
Upper sulcus depth (5mm)- 8mm
Projections to TVL
Upper lip anterior (3.7 ±1.2mm)- 5mm
Lower lip anterior (1.9±1.4mm)- 3mm
A’ point (-0.1±1.0mm)- 0
B’ point (-5.3±1.5mm)- -1mm
Pog’ (-2.6±1.9mm)- -8mm
Nasolabial angle (90-110°)- 96°

SKELETAL
RELATION OF MAXILLA
SNA (82°)- 84
N⊥Pt. A (0±2mm)- 3mm
NA-TH (90±3°)- 88
Skeletal convexity at Pt. A (-
2±2mm)- 4mm
PNS-ANS-TH (3.5±3°)- 1
Extent of maxillary base-
51mm(47.1)
RELATION OF MANDIBLE
SNB (80°)- 79°
N⊥Pog (0±-4mm)- 4mm
Npog-TH (87.5±2.5°)- 86°
Extent of mandibular base-
78mm(79.4)
Extent of ascending ramus-
50mm(54.6)

RELATION OF MAXILLA, MANDIBLE & ANTERIOR CRANIAL
BASE

ANB (2°)- 5°
Wits appraisal- BO ahead of AO by 1mm
Go Gn-TH (24±4°)- 33°
Go Me-TH (32°)- 27°
Saddle angle (123±5°)- 129°
Articulare angle (143±6°)- 140°
Gonial angle (128±7°)- 126°
Basal plane angle (25°)- 22°
COGS
N-ANS (⊥HP)(50± 2.4mm)- 56
ANS-Gn (⊥HP)(68.6 ± 3.3mm)- 65
PNS-N (⊥HP)(50.6 ± 2.2mm)- 54
Upper1-NF (⊥NF)(27.5 ± 1.7mm)- 28
Lower 1-MP (⊥MP)(40.8 ± 1.8mm)- 40
Upper 6-NF (⊥NF)(23 ± 1.3mm)- 22
Lower 6-MP (⊥MP)(32 ± 1.9mm)- 30

DENTAL
Upper incisors:
1to NA( 4mm)- 8mm
1 to NA(22° )- 29°
1 to Pt. A(4mm)- 7mm
1 to 1SN(102 ±2 °)- 113°
1 to PP(70 ± 5 °)- 58°
Mx 1 to TVL(-9.2 ± 2.2mm)-
-6mm
Lower incisors:
1 to NB(4mm)- 8mm
1 to NB(25°)- 32°
1 to Apo line(1-2mm)- 4mm
IMPA(90 ± 3 ° )- 98°
Md 1 to TVL(-12.4 ± 2.2mm)-
-11mm

INTER INCISAL ANGLE (131°) -
115°

Model analysis
Bolton's tooth ratio- anterior: 81.1%
posterior: 94.5%
Mandibular anterior excess: 1.8mm
Overall mandibular excess: 5.8mm
Carey’s arch perimeter analysis:
Upper- space of 2.3mm
Lower- crowding of 3.8mm present

Diagnosis
Female patient named Asha aged 16yr.
is diagnosed of Class I malocclusion
characterized by normal skeletal
relation, class I molar relation bilaterally,
buccally erupted 13, scissor bite w.r.t
24, 34, crowding in lower anterior,
proclined upper incisors and lower
midline shift to left by 2mm.

Treatment objectives
To achieve lip competency
To achieve class I canine relation
To relieve crowding & scissor bite
To correct midlines

Treatment plan
Extraction of 53
Segmental canine retraction and
alignment of upper arch
Proximal stripping in lower arch to
relieve crowding

Dental VTO
Crowding 1.5 1.5
Protrusion -3 -3
Curve of
spee
0 0
Midline 0 0
Total -1.5 -1.5
R L
2»
0 00«3
0 0

Lower arch
Lower arch R L
Crowding -2 -2
Protrusion 0 0
Curve of spee -0.5 -0.5
Midline 2 -2
Total -0.5 -4.5

Case

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