Pacific Coast Society of Orthodontists Bulletin Spring 2013 - (Page 17)
Case Report
Pre-TreaTmenT
PROFILE RELAXED
RELAXED
SMILING
How would you treat
this malocclusion?
Case E.P. 13 years, 5 months
INTRODUCTION
A
13-year-old Caucasian male presents
with a chief complaint of crowding and
crooked teeth. His growth and development were not monitored. There is
no mention of premature extractions due to decay or
ectopic eruption.
DIAGNOSIS AND ETIOLOGY
EXTRAORAL
The patient presents with balanced facial proportions
and ideal lip support. There is slight mentalis strain on
lip closure. He displays 4 to 5mm of gingival tissue
when smiling. No TMD symptoms are reported, and he
displays a normal mandibular range of motion. There is
slight mandibular asymmetry to the right.
INTRAORAL
A class II division 2 subdivision right is noted. The
maxillary left cuspid is erupting high and labial. The
SPRING
2013 • PCSO BULLETIN
maxillary midline is 1mm to the left of the facial midline and the mandibular is 2mm to the right. There is
mild to moderate crowding in the maxillary arch, and
the mandibular arch has adequate archlength. There is
excessive overbite (75%) and 1mm overjet. The maxillary right central incisor has suffered attrition and is
reduced in length. The maxillary anterior gingival margins are irregular. There is excess buccal overjet on the
right and left posterior segments. However, the width of
the maxilla is ideal. Enamel hypoplasia is noted in all
first molars.
RADIOGRAPHIC
The panoramic radiograph is within normal limits and
the cephalometric analysis reveals a protrusive maxilla and large mandible measurement from Gonion to
Gnathion (+10mm). ANS to Menton is excessive, but
is balanced by the patient’s large ramus. This helps
balance the anterior to posterior facial heights. The
maxillary incisors are retroclined, and the mandibular
incisors are in ideal position.
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Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2013