This document presents a case study for a 33-year-old male patient seeking orthodontic treatment. Key findings from the clinical examination include class II malocclusion with 9mm overjet, proclined upper and lower incisors, severe crowding in both arches, and constricted maxillary arch form. Cephalometric and model analysis indicate the patient has a Class II skeletal pattern with normal vertical proportions. Treatment goals are to retract upper anterior teeth, expand the maxillary arch, and relieve crowding to achieve ideal occlusion.
The 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.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in implants/ cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
The 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.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in implants/ cosmetic dentistry trainingIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Pre & post surgical orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Copy of jc presentation 29 oct o9 /certified fixed orthodontic courses by Ind...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Pre and post surgery final /certified fixed orthodontic courses by Indian den...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Bioprogressive therapy /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Description :
The 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.for more details please visit
www.indiandentalacademy.com
Appliances in presurgical orthognathic surgery /certified fixed orthodontic ...Indian dental academy
Welcome to Indian Dental Academy
The 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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Used in the right conditions, SFOA is highly successful and has a positive impact on the patients psychosocial status.A combined orthodontic and orthognathic surgery approach is accepted as the standard of care for patients who have a severe skeletal jaw discrepancy with facial asymmetry.
But some disadvantages have been recognized.
One drawback is the long presurgical treatment time that typically worsens facial appearance and exacerbates the malocclusion. In some countries, these disadvantages have caused patients to seek plastic surgeons who are willing to perform orthognathic surgeries without collaboration with orthodontists or consideration for the final occlusion.
Recently, to address patient demand and satisfaction, the surgery-first approach was introduced to overcome some disadvantages associated with the conventional surgical orthodontic approach.1991-Brachvogel et al. suggested the potential advantages of a surgery-first approach.
In that article the advantages of post-surgical orthodontics are outlined as follows:
1) Orthodontic movement does not interfere with compensatory biological responses.
2) Dental movements can be based on an already corrected skeletal pattern.
3) Some surgical relapse can be managed during treatment.
2009: Nagasaka et al., popularized SFOA54. Nagasaka et al1 were among the first to actually carry out SFOA using miniplates for post-surgical orthodontic treatment
The 2011 symposium presented the surgery‑first approach and created broader interest in the complete elimination of time‑consuming preoperative orthodontic treatment
PRE-EXTRACTION RECORDS ARE RELIABLE TOOL FOR COMPLETE DENTURE FABRICATION: AN...Kumari Kalpana
Pre-extraction records provide important clinical data for the continuing treatment of the complete denture patient. These data reveal the progressive changes which occur when natural teeth are extracted. Many methods of recording pre-extraction data have been advocated. Dentists use arbitrary methods while determining the vertical dimension of occlusion and arranging the maxillary anterior teeth. Though there are many advances in techniques and materials employed in the field of prosthodontics for recording vertical dimension at occlusion; still, there is no accurate method for assessing vertical dimension of occlusion in edentulous patients and henceforth difficulty is faced by clinician during denture fabrication. Prosthodontists who do not make use of pre-extraction records and consider the natural findings of the patient while denture fabrication lack the scientific component in denture fabrication, translating into compromised patient‟s satisfaction. Every denture should be characterized according to existing state rather than performing a pearl like arrangement of artificial teeth. Pre-extraction records provide a useful guide while fabricating denture and it should be preferred over arbitrary methods which are commonly used. Therefore, pre-extraction records serve as a reliable tool during denture fabrication.
The malocclusion mostly come from:
Incisor protrusion
Jaw protrusion
Both of them
Author: https://www.linkedin.com/in/drdunghanquoc/
Facebook: https://www.facebook.com/drdunghanquoc
The 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.for more details please visit
www.indiandentalacademy.com
The 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.for more details please visit
www.indiandentalacademy.com
The 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.for more details please visit
www.indiandentalacademy.com
Pre & post surgical orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Copy of jc presentation 29 oct o9 /certified fixed orthodontic courses by Ind...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Pre and post surgery final /certified fixed orthodontic courses by Indian den...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Bioprogressive therapy /certified fixed orthodontic courses by Indian dental ...Indian dental academy
The 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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Description :
The 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.for more details please visit
www.indiandentalacademy.com
Appliances in presurgical orthognathic surgery /certified fixed orthodontic ...Indian dental academy
Welcome to Indian Dental Academy
The 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.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Used in the right conditions, SFOA is highly successful and has a positive impact on the patients psychosocial status.A combined orthodontic and orthognathic surgery approach is accepted as the standard of care for patients who have a severe skeletal jaw discrepancy with facial asymmetry.
But some disadvantages have been recognized.
One drawback is the long presurgical treatment time that typically worsens facial appearance and exacerbates the malocclusion. In some countries, these disadvantages have caused patients to seek plastic surgeons who are willing to perform orthognathic surgeries without collaboration with orthodontists or consideration for the final occlusion.
Recently, to address patient demand and satisfaction, the surgery-first approach was introduced to overcome some disadvantages associated with the conventional surgical orthodontic approach.1991-Brachvogel et al. suggested the potential advantages of a surgery-first approach.
In that article the advantages of post-surgical orthodontics are outlined as follows:
1) Orthodontic movement does not interfere with compensatory biological responses.
2) Dental movements can be based on an already corrected skeletal pattern.
3) Some surgical relapse can be managed during treatment.
2009: Nagasaka et al., popularized SFOA54. Nagasaka et al1 were among the first to actually carry out SFOA using miniplates for post-surgical orthodontic treatment
The 2011 symposium presented the surgery‑first approach and created broader interest in the complete elimination of time‑consuming preoperative orthodontic treatment
PRE-EXTRACTION RECORDS ARE RELIABLE TOOL FOR COMPLETE DENTURE FABRICATION: AN...Kumari Kalpana
Pre-extraction records provide important clinical data for the continuing treatment of the complete denture patient. These data reveal the progressive changes which occur when natural teeth are extracted. Many methods of recording pre-extraction data have been advocated. Dentists use arbitrary methods while determining the vertical dimension of occlusion and arranging the maxillary anterior teeth. Though there are many advances in techniques and materials employed in the field of prosthodontics for recording vertical dimension at occlusion; still, there is no accurate method for assessing vertical dimension of occlusion in edentulous patients and henceforth difficulty is faced by clinician during denture fabrication. Prosthodontists who do not make use of pre-extraction records and consider the natural findings of the patient while denture fabrication lack the scientific component in denture fabrication, translating into compromised patient‟s satisfaction. Every denture should be characterized according to existing state rather than performing a pearl like arrangement of artificial teeth. Pre-extraction records provide a useful guide while fabricating denture and it should be preferred over arbitrary methods which are commonly used. Therefore, pre-extraction records serve as a reliable tool during denture fabrication.
The malocclusion mostly come from:
Incisor protrusion
Jaw protrusion
Both of them
Author: https://www.linkedin.com/in/drdunghanquoc/
Facebook: https://www.facebook.com/drdunghanquoc
The 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.for more details please visit
www.indiandentalacademy.com
The 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.for more details please visit
www.indiandentalacademy.com
The 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.for more details please visit
www.indiandentalacademy.com
Treatment of a young female patient wit a combination of Invisalign and distalizing appliance. Well treated by one of our students under my supervision.
Please comment
The 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.for more details please visit
www.indiandentalacademy.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Chhom Karath
1. A Clinical Conference Case
Presented in Partial Fulfillment of the
Requirements for the Degree of
Master of Science in Dentistry,
m.s. (Orthodontics)
CHHOM KARATH
2. Chief Complaint:
•I wants to retract anterior teeth
•Don’t like tooth appearance
Medical History:
- Patient denied any medical problems
Dental History:
•Regular check up every 6 month
•Filling #11M,#21M
•Extracted #47
Family History: Unremarkable
Social History and Habit: unconfident on smiling and no self-motivation
Expectation: Realistic expectation
1. Interviews / Questionnaire
Patient Initial: C LV Age: 33 years Sex: M Birth Date: 2-June-1986
Heigh:1.68 m Weigh:64 kg Occupation: company staff
6. Soft-tissue assessment
•Lower facial width=17.7mm
(Min=16.75mm, Max=29.64mm)
•Lower face=50%, middle
face=50%(1/3:1/3:1/3)
•Facial assymetry angle(N’-Fl’)=2o
(Min=0.1o, Max=4.6o) acceptable
•Facial aperture modified
angle=41.07o acceptable
(Min=36.53o, Max=48.76o)
•V-angle=52.59o Unpleasant
(Min=62.51o, Max=80.38o)
•Symmetry of left and right side of
the face=19.27o-13.4o=5.87o Not
asymmetry left and right size
2. Extra-Oral Finding: Analysis of the soft tissue anterior profile
Gl
N’
Exd Exe
End Ene
V
SnAld
Ale
Ls
Fl
EsAbd Abe
Li
Me
b
Zid Zie
a
11
13 14
15
16
17
God’
Goe’
12
Middle face
Lower face
Facial high
13.350
83.780
52.940
41.360
7. 2. Extra-Oral Finding: Analysis of the soft tissue anterior profile
Facial Index
•(n-gn)/zy-zy=2.63/2.91=90.3
•F(N=86.2(4.6)), M(N=88.5(5.1))
•Mesoprosopic- average
•Euryprosopic- broad and short
•Leptoprosopic –long and narrow
8. Soft-tissue assessment
•1/5 x 5 vertical lines=unbalance
•1/3 x 3 horizontal lines=unbalance
2. Extra-Oral Finding: Analysis of the soft tissue anterior lateral profile
9. 2. Clinical Examination
Smile Aesthetics assessment
•Upper lip curvature: downward
•Smile arch: downward-pleasing
•Upper lip and smile arch parallel
•Negative space: right small
•Smile: asymmetry
•Deviation of dental and facial
midline
•Asymmetry face during smile
•High smile
2. Extra-Oral Finding: Analysis of the soft tissue anterior profile
10. 2. Dental appearance: Micro-esthetics
Smile Aesthetics assessment
•Unlevel on left canine , central incisor
•Unwell contact area(50%,40%,30%)
•Embrassure not well(20%,30%,40%,50%)
•Bad Tooth width ratio(x,x-1mm,x-2mm)
•IOTN: 2(Moderate/borderline need)
65% 65% 50% 50%50%50%50%
Cervical line
Papillary line
Contact points line
Incisal line
11. 3
2. Intra-Oral Examination: Intra-oral assessment
•Oral hygiene: Fair
•Buccal exostosis
•Gingival condition: Normal
•Incisor proclination
•Upper: average
•Lower: average
13. • Incisor Relationship: class 2
•Exostosis on upper both buccal parts
• Canine relationship
Right: class 2
Left: class 2
• Molar relationship: class 1
Right: class 1
Left: class 1
• Over jet: 9mm
• Over bite:120%
2. Intra-Oral Examination: Inter-Arch/Occlusion
14. 1
4
TMJ
•No signs of TMD(No clicking, crepitus, and tenderness to palpation)
•Normal range of opening, lateral movement and no displacement.
•No erosion
•TMJ space obliterated on the left side. Also associated with mild
condylar resorption on left side.
3. Intra-Oral Examination: Intra-oral assessment
23. AREA OF STUDY YAS MEASUREMENT STANDARD INITIAL INTERPRETATION
Cranial Base BA–S-n 136o 133.5o
Normal face
Maxilla to Cranial Base SNA 82 o 83.56o
Pragmatism of maxilla
N-A-FH 90 o 96.52o
A-Nas Vert. (mm) -2mm 3mm
Mandible to Cranial Base SNB 80 o 78.69o
Orthognathic mandible
NPog-FH 88 o 91.91o
Po-N Vert. (mm) -6mm -8mm
Maxillo-Mandibular Relationship ANB 2 o 4o
Class II TendencyA-NPog 1mm 2.5mm
Wits 2mm 3mm
Vertical Height SN-MPA 32 o 30.96o
Normal facial
proportion with skeletal
deep bite
FMA 25 o 18.67o
N-ANS (%) 45% 46%
ANS-Me (%) 55% 54%
Maxillary & Mandibular Incisor Position U1-SN 104 o 112.28o
Procline Upper and
lower normal relation
U1-NA (mm) 4mm 4mm
U1-NA 22 o 28.33o
IMPA 90 o 99.22o
L1-NB (mm) 4mm 4mm
L1-NB 25 o 30.66o
L1-APog 2mm 4.21mm
U1-L1 130 o 117o
Soft Tissue E-line-Lower lip -2mm 2mm Protrusion of lip
24. Facial angle(84.04 3.42)=91o
Y-axis(66.36o+-3.85o)=56.53o
Gonial angle(118o+6.10o)=120o
FMA(30o)=17.77o
IMPA(103o)=99.88o
FMIA(68o)=62o
OCC(13o)=3.73o
Z(74o)= 69.5o
Po
Ba
S
Co
N
Or
pt
ANS
PNS
Go
A
B
Me
Gn
Pog
Bo
Ar
FMIA=62o
FMA=17.77o
IMPA=99.88o
6. Clinical Examination: Tweed’s Analysis
31. 3. Model Analysis
Standard Patient’s index
Overall ratio 87.5-94.8 87/111.5=78%
(Man/Max)
Anterior ratio 74.5-80.4 36/44.5=80%
(Man6/Max6)
4. Bolton Index
Mandible<Maxilla(12 teeth)
Mandible(6 teeth)=Maxilla(6
teeth) normal ratio
33. 3. Model Analysis
6. Pont’s Analysis
ON MAXILLA
•SI=sum of incisor 4= 5.5+9+8.5+6.5=29.5mm
•MPV(Measured premolar value)=33mm
•MMV(Measured molar value)=44mm
•CPV(Calculated premolar value)=SIx100/80=29.5 x 100/80=36.87mm
•CPV(36.87mm)>MPV(33mm) Arch form need to expand the arch on incisor
and premolar area
•CMV(Calculated molar value)=SI x 100/64=29.5 x 100/64=46mm
•CMV(39.3mm)<MMV(44mm) Arch form on molar area no need to expand
the arch
ON MANDIBLE
•SI=sum of incisor 4= 6+5.5+5.5+5.5=22.5mm
•MPV(Mesured premolar value)=23mm
•MMV(Mesured molar value)=30mm
•CPV(Calculated premolar value)=SIx100/80=22.5 x 100/80=28mm
•CPV(28mm)<MPV(30mm) Arch form is normal so no need to expand the arch
on incisor and premolar area
•CMV(Calculated molar value)=SI x 100/64=22.5 x 100/64=35mm
•CMV(35mm)>MMV(30mm) Arch form is narrow so need to expand the arch
34. 3. Model Analysis
7. Korkhaus analysisis
Man Value=Max value -2mm
19.5mm=29mm-2mm=27mm
=> Procline upper incisor 7mm
30mm
19.5mm
34mm
23mm
35. Diagnosis summary
C L is a 31 year olds Male, denied any medical problem , complains of crowding on upper and lower anterior
and posterior teeth. He has a class II incisor relationship bi-protrusion base on class I skeletal pattern, normal
upper and lower facial height. Over jet of 9 mm, deep over bite 120%, incompetent lip, impacted on #45,#35
and missing #37,#47. Canine is class II on both side, actually molar class I on both sides.
3. Transverse
- Anterior Cross bite
- Increase over-jet
4. Sagittal (A-P)
- Canine class II both side
1. Dentofacial Appearance
- Mild asymmetric
Disproportionate
2. Teeth/Arch form
- Constricted v shape upper
and lower arch
Crowding
- Moderate lower
- Inadequate lower
incisor display
Profile
- Straight
Lip
- Incompetent lip
5. Vertical
- Increase dental over bite
- LFH ratio: decrease lower
facial profile
36. Aim of treatment
1. Improve patient’s oral hygiene, esthetic and function
2. Impacted remove #18,#28
3. Accept non extraction to maintain patient’s facial profile and fill buccal
corridors
4. Achieve class I incisors relationship
5. Relieve crowding #41,#42,#43,#31,#32,#33 and align
6. Upright #47,#37
7. Correct procline upper anterior teeth
8. Achieve right canine class 1
9. Flatten curve of spee
10. Archive positive overbite
11. Archive positive over-jet
12. Retain corrected result
43. Mechanotherapy
Stage :
• Lower teeth, open coil spring between #34 and #35 to open space,
T-loop to upright #38 0.017 × 0.025 stainless steel wire
• Set 1 (0.017 x 0.022 maxillary)
First molar not banded and lateral incisor not ligated
1 st order bends: small lateral inset, cuspid curvature
3 rd order bend: -12 -12 -12 -7 +7 +7
Teeth #7 #6 #5 #3 #2 #1
2 nd order bends: 20 0 0 0 0 0 degree
10 mm
10 mm
2 mm
1 mm
44. Mechanotherapy
Stage :
• Upper arch
• Retract #13,#23, and maximum anchorage continue tie from #5 to #7
• Elastic chain #3 to #5
• Read-out: confirm 20o on 2nd molar tip
10 mm
10 mm
2 mm
1 mm
45. Mechanotherapy
Stage :
• Maintained incisor position
• Processing open space and uprigh on lower teeth
• Set 2 on maxilla 0.019 x 0.025, Readout: confirm 20o second molar tip,
ligate incisor, 10o 1st molar distal tip;
5 2nd bicuspid distal tip
• Finish cuspid retraction; 7,6,5 continuous tie, place the elastic chain 5 to 3
• Incisor position has been maintained
• A curve of occlusion is present
10 mm
10 mm
2 mm
1 mm
46. Mechanotherapy
Stage :
• Maxillary arch 0.020 x 0.025 closing loop
• Closing loops 1.5 mm distal to lateral
• Loop stop distal to the 1st molar bracket
• Place 1st, 3rd , and 2nd order bend
• 1st order bends: 1. lateral insets, 2. Cuspid curvature(no offset), 3. 1st molar offset distal to 2nd bicuspid
bracket, 4. small amount of 2nd molar toe in
• 3rd order bends:closing loop 1.5mm distal lateral bracket, omega loop stop distal flush to 1st molar bracket
• Prescription 20 10 5 0 0 0 degree
#7 #6 #5 #3 #2 #1
10 mm
10 mm
2 mm
1 mm
4 mm
8 mm
1 mm
1 mm
1 mm
150 gm-200gm
47. Mechanotherapy
Stage :
• 4 incisor single ties
• Active closing loop 1mm
• Tie rest of teeth with single ties
• Anterior vertical elastic: Maxilla and mandible closing loops at night
10 mm
10 mm
2 mm
1 mm
4 mm
8 mm
1 mm
1 mm
1 mm
150 gm-200gm 150 gm-200gm
50. Mechanotherapy
Stage : Set 3
• 0.020 x 0.025 archwire
• 1st order bends: 1. lateral insets, 2. Very small cuspid offset, 3. 1st molar offset: just mesial to mesial
bracket of the first molar; 3rd order ends: incisor 7o LRT, cuspid 7o LCT, Molar 12o LCT;
• Second order bend: 20 10 5 0 0 0
#7 #6 #5 #3 #2 #1
• Helical bulbous loops contact with 2nd molar tubes: 20o distal tip, Gingival spir: 1mm distal 2nd bicuspid
• Archwire need to reactivated 1mm each month
• After 2nd molar distalized into class I, open coil spring is trapped between
2nd bicuspid spur and 1st molar bracket to move 1st molar distally into class I
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
51. Mechanotherapy
Stage : Set 3
• Helical bulbous loop move the 2nd molar distally
• Archwire need to reactivated 1mm each month
• After 2nd molar distalized into class I, open coil spring is trapped between
2nd bicuspid spur and 1st molar bracket to move 1st molar distally into class I
• Sequential distal movement of maxillary buccal segment is supported by mandibular stabilizing arch wire
and proper directional force system.
10 mm
10 mm
2 mm
1 mm
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
52. Mechanotherapy
Stage : Set 3
• Open each bulbous loop 1mm
• Increase bulbous opening 1mm per month until maxillary 2nd molar in class 1
• Class 2 elastic, anterior vertical elastics
• Open coil spring between second bicuspid and 1st molar to make 1st molar relationship
• Chain elastic from #6 to #7
10 mm
10 mm
2 mm
1 mm
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
53. Mechanotherapy
Stage : Set 3
• Continuous tie from #5 to #7
• Chain elastic from #3 to #5
• Open coil spring from #2 to #3
10 mm
10 mm
2 mm
1 mm
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
54. Mechanotherapy
Stage : Set 4
• The same arch wire set 3, 0.020 x 0.025 closing loop wire
• 1st order bends: 1. lateral insets, 2. cuspid curvature, 3. 1st molar offset distal to 2nd bicuspid bracket
small amoung of 2nd molar toe in; 3rd order bend: incisor 7 LRT, cuspid 7 LCT, Molar 12 LCT
• Second order bend: 20 10 5 0 0 0
#7 #6 #5 #3 #2 #1
• Omega loop stop distal flush to the 1st molar bracket
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
55. Mechanotherapy
Stage : Set 5
• The same arch wire set 3,4 maxillary arch 0.0215 x 0.28
• 1st order bends, 2nd order bends, 3rd order bends
• Class 2 elastic, anterior vertical elastics, 0.028 spir distal to lateral for anterior elastic
• Ligate mesial bracket of 1st molar to 2nd bicuspid bracket
• Ligate and cinch around the molar tube to omega loop and continue tie to distal bracket of 1st molar
1 mm
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
3 mm
3 mm
4 mm
4 mm
56. Mechanotherapy
Stage : Set 6
• The same arch wire set #3,4,5
• Attachments add cusp seating spir distal to cuspid
• 1st order bends, 2nd order bends, 3rd order bend
• Cusp seating and anterior vertical elastic first month 24 hours, then reduce at night
• Over correction
4 mm
8 mm
4 mm
3.5 mm
3.5 mm
3 mm
4 mm
4 mm
57. Stage
•Mandibular
•Lingual bonded retainer from canine to canine
•Removable retainer to be worn during night time only for 1-year.
•Maxillary
•Removable retainer with anterior inclined plane to be worn full time for initial 6-month followed by
night time wear for another 6-month
N-SN-Pog=1610
Nfull soft tissue profile=M 1470, F 1330
N-SN-Pog=1610
Nfull soft tissue profile=M 1470, F 1330
Photometric Points: Gl’ – soft tissue glabella; N’ - soft tissue nasion; Exd-right external corner of the eye; Exe – left external corner of the eye; End – right internal corner of the eye; Ene – left internal corner of the eye; V – Point V; Sn – subnasale; Ald – right alar poit; Ale – left alar point; F- lower philtrum; Ls- upper philtrum; Li- lower lip; Abd- right mouth angle; Abe – left mouth corner; Es- stomium; Zid – right zigion; God’- right gonion; Goe’- left gonion; Me’- Menton.
Photometric Points: Gl’ – soft tissue glabella; N’ - soft tissue nasion; Exd-right external corner of the eye; Exe – left external corner of the eye; End – right internal corner of the eye; Ene – left internal corner of the eye; V – Point V; Sn – subnasale; Ald – right alar poit; Ale – left alar point; F- lower philtrum; Ls- upper philtrum; Li- lower lip; Abd- right mouth angle; Abe – left mouth corner; Es- stomium; Zid – right zigion; God’- right gonion; Goe’- left gonion; Me’- Menton.
Photometric Points: Gl’ – soft tissue glabella; N’ - soft tissue nasion; Exd-right external corner of the eye; Exe – left external corner of the eye; End – right internal corner of the eye; Ene – left internal corner of the eye; V – Point V; Sn – subnasale; Ald – right alar poit; Ale – left alar point; F- lower philtrum; Ls- upper philtrum; Li- lower lip; Abd- right mouth angle; Abe – left mouth corner; Es- stomium; Zid – right zigion; God’- right gonion; Goe’- left gonion; Me’- Menton.
Upper lip curvature: straight, downward, upward
Smile arch: straight, consonant, non consonant
Negative space: increase, decrease, normal
Facial angle=Frankfort to N-Pog
AB plane angle=AB-Npog
- Inter canine width វាស់ពីTip of canine to other tip of canine
- Intermolar width: measure from central pit of molar to other central pit of molar
Arch length: measure from most distal of #5 to central of incisor
Arch Length Discrepancy=Avialable space-Required space
If (-) Crowding
If (+) Spacing