clinical orthodontics // feature
Continued from p. 26
Anteroposterior: Molar canine relationships are a half-step Class II. The overjet
measurement is 4mm, measured at the left
central incisor. The skeletal relationships are
mildly Class II. The mandible is posterior
divergent, and the lower anterior face height
is larger than average.
Vertical: An anterior open bite of 5mm
is measured at the right maxillary lateral
incisor. The maxilla shows posterior vertical
maxillary excess-upon smiling, there is
5mm of gingival display.
Perimeter: Moderate crowding is present
in both arches.
Transverse: A constricted maxillary arch
form relative to the lower arch is present,
resulting in buccal-cusp-to-buccal-cusp
relationships extending from the second
molars to the first bicuspids on both sides,
a bilateral posterior crossbite tendency.
However, the patient does have adequate
lip competence at rest.
Fig. 7
Fig. 8
Case 2
Patient (Figs. 7 and 8) presented with
a chief complaint of not being able to
function adequately due to an open-bite
malocclusion. The patient reported being
prescribed Ortho-Novum birth control pills
at age 14 to alleviate menstrual cramping.
She reported a progressive worsening of her
open bite that was first noticeable at age 16.
Anteroposterior: Class II skeletal/dental
malocclusion. Loss of mandibular condyle
anatomy secondary to birth control pills.
Class II molar half-step. Excess overjet.
Convex profile.
Vertical: Open bite of 6mm measured at
the upper-left lateral incisor. Dolichofacial
facial pattern.
Transverse: Within normal limits.
Perimeter: Moderate upper and lower
crowding.
Additional note: The patient in Case 2
required monitoring of mandibular condyle
anatomy for the cessation of resorption once
birth control pills had been discontinued.
A baseline CBCT image was captured of
both condyles (Fig. 9) and assessed by a
28
SEPTEMBER 2016 // orthotown.com
Fig. 9
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Table of Contents for the Digital Edition of Orthotown September 2016