1. FL Case. 1 Presented by Hyunjung Park New York Smile Orthodontics

2. History Date of Records: 5.17.10 CC: My teeth stick out and I want to get braces Age: 14 years. Ethnicity: Hispanic Med Hx: none Allergy: no allergies DH: RDV. Ortho Hx: No Habits: NSF TMJ Exam: WNL D.S. 515034

3. Frontal View Facial Type: Asymmetric: Lips are competent:

4. Smile Photo Show 50% of incisors Maxillary midline 1 mm Rt. to facial midline Mand. midline shift 1 mm Lt. to maxillary midline. Mand. midline on to facial mi dline Chin left

5. Profile View Retrognathic Convex. Decreased lower face height Soft Tissue: –NLA: –MLS: Lips: –Competent. –Both lips are on the E line.

6. Cephalometric Radiograph

7. Cephalometric Tracing

8. Alexander Analysis MeasurementReference NormalPatient SNA (angle) 82 SNB (angle) 80 ANB (angle) 2 U1 to SN (angle) 103 L1 to APo (mm) U1 to L1 (angle) 135 IMPA (angle) 95 FMA (angle) 25 FMIA (angle) 60 MP to Occl. (angle) 10 MP to SN (angle) 32 Convexity (NA to Apo) (angle) 3 Holdaway ratio (PO &L1 to NB) 1:1 Y-axis (SN-SGn) (angle) 60 Lower lip to H-line (mm) 0 Wits Appraisal (mm)

9. ABO Analysis MeasurementReference NormalPatient SNA (angle)82 SNB (angle)80 ANB (angle)2 SN to Go-Gn (angle)32 FMA (angle)25 U1 to NA (mm) U1 to SN (angle)103 L1 to NB (mm) Upper lip to E-line (mm) Lower lip to E-line (mm)

10. Cephalometric Diagnosis

11. Cervical Vertebral Maturation

12. Panoramic Radiograph

13. Intraoral Frontal View

14. Intraoral Buccal Views RIGHT LATERAL VIEW LEFT LATERAL VIEW

15. Intraoral Occlusal Views Maxillary Arch Mandibular Arch

16. Cast Analysis CROWDING Upper : mm..Lower : mm. OVERBITE : mm. OVERJET : mm. COS : mm.

17. Bolton Analysis. 3-3 Excess Man/Max tooth mass: 6-6 Excess Man/Max tooth mass: 6-6 Excess Man/Max tooth mass:

18. 0 mm. (edge to edge)=1 pt. 1 – 3 mm.=0 pts. 3.1 – 5 mm.=2 pts. 5.1 – 7 mm.=3 pts. 7.1 – 9 mm.=4 pts. > 9 mm.=5 pts. Negative OJ (x-bite) 1 pt. per mm. per tooth = Total= OVERJET OVERBITE 0 – 3 mm.=0 pts. 3.1 – 5 mm.=2 pts. 5.1 – 7 mm.=3 pts. Impinging (100%)=5 pts. Total= ANTERIOR OPENBITE LATERAL OPENBITE 2 pts. per mm. per tooth Total= 0 mm. (edge to edge)=1 pt. then 2 pts. per mm. per tooth Total= CROWDING 0 – 3 mm.=1 pt. 3.1 – 5 mm.=2 pts. 5.1 – 7 mm.=4 pts. > 7 mm.=7 pts. Total= OCCLUSION Class I to end on=0 pts. End on Class II or III=2 pts. per side Full Class II or III=4 pts. per side Beyond Class II or III=1 pt. per mm. Additional Total= LINGUAL POSTERIOR X-BITE 1 pt. per tooth Total= BUCCAL POSTERIOR X-BITE 2 pts. per tooth Total= CEPHALOMETRICS ANB > 5.5 or <-1.5=4 pts. Each Additional Degree=1 pt. SN-GO-GN 27 deg. – 37 deg. =0 pts. SN-GO-GN > 37 deg.=2 2 pts. per degree SN-GO-GN < 27 deg.1 pt. per degree IMPA > 98 deg.=41 pt. per degree Total= OTHER 2 pts.= TOTAL = Discrepancy Index INDICATE PROBLEM:

19. Diagnosis

20. FL 14 years old

21. Cephalometric Radiograph

22. Problem List Treatment Objectives

23. Limitations - Therapeutic Modifiability

24. Dr. Alexander Chart ExtBorderlineNon-Ext 1. Soft Tissue ProfileConvexNormalConcave 2. Mandibular Incisor PositionProclinedNormalRetroclined 3. Attached Periodontal Tissue Thin CompromisedHealthy 4. Growth PotentialPastEndingPresent 5. Skeletal PatternHigh angleMedium angleLow angle 6. ALDSevereModerateMild 7. Maxillary Intermolar Width>33mmModerate<33mm 8. Patient compliancePoorModerateExcellent

25. RightLeft Lower crowding Lower midline Lower incisor position Curve of Spee Space needed Extractions L6 space left Molar relationship Move U6 Dental VTO

26. Treatment Plan Option 1 : Option 2 : Option 3 :

27. Option 1 : Treatment Plan

28. Option 2 : Treatment Plan

29. Option 3 : Treatment Plan

30. Literature Review Article 1 : Article 2 : Article 3 :

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