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    Case Presentation Orthodontics

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    HadiaDurrani
    This document presents a case study of a 16-year-old female patient named Kinza Khurshid who presented with facial asymmetry and crowding. Clinical examination revealed dental crowding, rotated and displaced teeth, and a deviated midline. Radiographs showed a supernumerary tooth and bone loss. The diagnosis was a skeletal Class I malocclusion with anterior crowding. The proposed treatment plan is to extract the supernumerary tooth, gain space, and use fixed appliances to align and level the teeth to correct the asymmetry and crowding.

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    Case Presentation Orthodontics

    Uploaded by

    HadiaDurrani
    474 views54 pages
    This document presents a case study of a 16-year-old female patient named Kinza Khurshid who presented with facial asymmetry and crowding. Clinical examination revealed dental crowding, rotated and displaced teeth, and a deviated midline. Radiographs showed a supernumerary tooth and bone loss. The diagnosis was a skeletal Class I malocclusion with anterior crowding. The proposed treatment plan is to extract the supernumerary tooth, gain space, and use fixed appliances to align and level the teeth to correct the asymmetry and crowding.

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    Case Presentation orthodontics

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    This document presents a case study of a 16-year-old female patient named Kinza Khurshid who presented with facial asymmetry and crowding. Clinical examination revealed dental crowding, rotated and displaced teeth, and a deviated midline. Radiographs showed a supernumerary tooth and bone loss. The diagnosis was a skeletal Class I malocclusion with anterior crowding. The proposed treatment plan is to extract the supernumerary tooth, gain space, and use fixed appliances to align and level the teeth to correct the asymmetry and crowding.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    474 views54 pages

    Case Presentation Orthodontics

    Uploaded by

    HadiaDurrani
    This document presents a case study of a 16-year-old female patient named Kinza Khurshid who presented with facial asymmetry and crowding. Clinical examination revealed dental crowding, rotated and displaced teeth, and a deviated midline. Radiographs showed a supernumerary tooth and bone loss. The diagnosis was a skeletal Class I malocclusion with anterior crowding. The proposed treatment plan is to extract the supernumerary tooth, gain space, and use fixed appliances to align and level the teeth to correct the asymmetry and crowding.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 54

    Case presentation

    PATIENTS NAME : KINZA KHURSHID


    PRESENTED BY :
    HADIA DURRANI
    FATIMA- TU -ZAHRA
    SYEDA UME RUBAB

    CONTENTS

    Case history
    Clinical Examination
    extra-oral
    intra-oral

    Photographs
    extra-oral
    intra-oral

    Cast analysis
    Radiographs
    orthopantomogram (OPG)
    lateral cephalogram

    Problem list
    Diagnosis
    Treatment planning

    HISTORY

    HISTORY TAKING
    BIODATA : Patients name : Kinza Khurshid
    Patients age : 16
    Fathers name : Khurshid Anwar
    Address : Qalandrabad
    Chief complaint : face asymmetric
    Social status : Good
    Motivation : patient motivated by parents

    EXAMINATION

    EXTRA-ORAL EXAMINATION
    Face type : Dolichofacial
    Facial symmetry : Asymmetric , deviated

    towards right
    Facial form : leptroprosopic

    Facial profile : Straight/orthognathic

    Lips thickness : average seal : incompetent


    Nose : medium
    Chin : deviated towards right
    Upper dental :1mm shifted to right
    to facial midline
    Incisor stomion : 1mm
    Path of closure : deviated

    INTRA-ORAL EXAMINATION
    Oral hygiene : Fair
    Gingival health : Gingivitis
    Periodontal status (gingival display): no

    gingival display
    Labial frenum : Normal
    Palate : Deep
    Tongue : Normal
    Dentition : Permanent
    Supernumerary teeth : Upper left 3

    PHOTOGRAPHS

    Extra oral photographs

    Frontal profile with lips closed

    Frontal profile with lips relaxed

    Frontal profile smiling

    Three quarter profile smiling

    Lateral profile

    Intra oral photographs

    Frontal intra oral view

    Right buccal view

    Left buccal view

    Upper occlusal view

    Lower occlusal view

    CAST ANALYSIS

    MAXILLARY ARCH
    Arch form : V-shaped
    Arch symmetry : Asymmetric
    Dentition : Permanent
    Palate : Deep
    Teeth present : 7654321 12334567
    Space available : 71
    Space required : 78.5
    TSALD : -7.5mm
    Inter-arch findings:
    Left central incisor mesio-palatally rotated
    Left lateral incisor palatally displaced
    Supernumerary tooth bucally displaced
    Left canine bucally displaced

    MANDIBULAR ARCH

    Arch form : V-shaped


    Arch symmetry : Asymmetric
    Dentition : permanent
    Teeth present : 7654321 1234567
    Space available : 63
    Space required : 68
    TSALD : -5mm
    Inter-arch findings:
    central incisors overlapped
    lateral incisors lingually displaced
    Canines buccally displaced

    CAST IN OCCLUSION
    INCISOR RELATIONSHIP

    Class I

    MOLAR RELATIONSHIP
    Right side : Class I

    Left side : Class I

    CUSPID RELATIONSHIP
    Right side : Class II
    II

    Left side : Class

    OVERJET:

    2mm

    OVERBITE :
    33% (2mm)

    DENTAL MIDLINE RELATIONSHIP


    lower dental midline 6mm deviated to right

    BOLTON ANALYSIS
    OVERALL BOLTON :-

    Normal = 91.5
    Overall Bolton =sum of mandibular 12 x 100
    sum of maxillary 12
    = 90 x 100
    98
    =91 which is normal
    mandibular tooth material is relative to maxillary
    tooth material

    ANTERIOR BOLTON :Normal value : 77.2


    Anterior Bolton = sum of mandibular 6 x 100
    sum of maxillary 6
    = 38 x 100
    49
    = 77.5 which is normal i-e
    mandibular and maxillary anterior teeth
    material is
    relative to each other.

    RADIOGRAPHS

    ORTHOPANTOMOGRAPH
    OPG findings
    Supernumerary teeth : upper left 3
    Peridontium : bone resorption in upper and lower
    anterior region
    Un-erupted upper
    third molars

    Identification of supernumerary
    tooth
    We have considered upper left bucally placed
    second tooth as supernumerary on the basis of :
    Clinical examination
    Form of the tooth
    Gingival health
    Position of the tooth in the arch
    Radiographs
    Periodontal status
    Root position

    CEPHALOGRAM
    Land marks lines and
    planes

    COMPOSITE ANALYSIS
    There are four components of Composite
    analysis : Sagittal analysis
    Vertical analysis
    Dental analysis
    Soft tissue analysis

    SAGITTAL ANALYSIS
    < SNA = 80
    <SNB = 78
    <ANB = 2
    Wits = 1mm
    Point A to N =7mm
    Pog to N = 8mm
    Facial angle = 92

    INTERPRETATION
    SKELETAL COMPONENT
    Sagittal analysis :
    skeletal class I

    VERTICAL ANALYSIS
    <Go-Gn-SN= 39
    FMA = 22
    <Y- axis = 59
    PFH/AFH = 62%
    LAFH/AFH = 53%

    INTERPRETATION
    Vertical analysis :
    normal vertical angle

    DENTAL ANALYSIS
    UI-NA distance : 2mm
    angle : 11
    LI-NB distance : 6mm
    angle : 30
    Inter-incisor angle = 130
    UI-SN = 98
    IMPA = 95

    INTERPRETATION
    Dental Analysis :
    Slightly retroclined upper incisors
    Slightly lower incisors proclined

    SOFT TISSUE ANALYSIS


    E-line: Upper lip = -2mm
    Lower lip = +1mm
    S-line :Upper lip = 1mm
    Lower lip = 3mm
    Z-angle = 70
    Hold-away ratio= 2.5 : 1
    Nasio-labial angle = 106

    INTERPRETATION
    Lower lip protrusive

    PROBLEM LIST

    PROBLEM LIST
    Facial asymmetry
    Supernumerary tooth upper left 3
    Crowding upper and lower anterior
    Slightly retroclined upper incisors
    Slightly proclined lower incisors
    Lower dental midline deviated towards right
    Left central incisor mesio-palatally rotated
    Left lateral incisor palatally displaced
    Supernumerary tooth bucally displaced
    Left canine bucally displaced
    Central incisors overlapped
    Lateral incisors lingually displaced
    Canines buccally displaced

    DIAGNOSIS
    Skeletal class I with anterior upper and lower

    arch
    crowding due to anterior arch discrepancy.

    TREATMENT PLANNING

    Treatment objectives
    Esthetic :
    Correction of facial asymmetry
    Alignment and leveling of teeth

    Treatment planning
    Extraction of supernumerary upper left bucally

    placed second tooth


    Space gain through extraction 4

    4
    4 4
    Alignment of crowded upper and lower anterior
    teeth

    METHODS
    Removable orthodontics
    Fixed orthodontics

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