Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 49

Case Report
Case Report
How would you treat this malocclusion?
Pretreatment
Case A.F., 14 years, 6 months
A video of this case can be found at www.
pcsortho.org/case-reports/
Diagnosis and Etiology
A female patient aged 14 years and 6 months
with permanent dentition presented to the
graduate orthodontic clinic of the University
of British Columbia. She presented with Class
II, Division 2 subdivision left malocclusion. Her
general dentist referred her for appropriate
treatment of impacted mandibular left second
and third molars. Upon initial interview, the
patient presented no esthetic concerns other
than mildly crowded maxillary front teeth. The
patient was otherwise healthy with no significant
medical history, family history, history of
trauma, or allergies. Her oral hygiene was fair.
The patient was deemed to be past her peak
pubertal growth spurt.
Extraoral and Intraoral Findings
Extraorally, the patient had a convex profile.
Vertical facial thirds and transverse facial fifths
were proportional, and no apparent facial
asymmetries were noted. The patient had lip
incompetence with protrusive upper and lower
lips to the E-line. She had a consonant smile arc
with 100% upper incisal display and some gingival
display. Maxillary central incisors appeared
to be extruded in relation to the adjacent upper
anterior teeth.
Intraorally, the patient presented end-on Class
II molars on the right side and full-cusp Class II
molars on the left side. Canines were bilaterally
Class II, with the left side being more Class II
than the right. The overjet was 3 mm, and the
overbite was 50%. The curve of Spee was flat,
and the curve of Wilson was within normal
limits. The upper midline was shifted to the right
side by 1 mm, and the lower midline was shifted
to the left side by 2 mm in relation to the facial
midline. The maxillary arch was tapered to omega-shaped,
whereas the mandibular arch was
ovoid. There was moderate crowding in both
Figure 1. Pretreatment extraoral and intraoral photographs (A.F., 14 years, 6 months)
Figure 2. Pretreatment digital dental models (A.F., 14 years, 6 months)
Fall 2022 PCSO Bulletin
49

http://www.pcsortho.org/case-reports/

Pacific Coast Society of Orthodontists Bulletin Fall 2022

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Fall 2022

Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 1
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 2
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 3
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 4
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 5
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 6
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Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 47
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 48
Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 49
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Pacific Coast Society of Orthodontists Bulletin Fall 2022 - 64
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