Post on 08-Aug-2018
EUROPEANSOCIETY
OF LINGUALORTHODONTICS
CANDIDATE NUMBER: Dr. Stefan Blasius
CASE NUMBER: 1
Year: 2010
WBLO 01
EUROPEANSOCIETY
OF LINGUALORTHODONTICS
CANDIDATE NUMBER: Dr. Stefan Blasius
CASE NUMBER: 1
Year: 2010
WBLO 01
RÉSUMÉ OF CASE 1
ADULT MALOCCLUSION
NAME: Daniel S.
BORN: 21-02-1978
SEX: male
PRE-TREATMENT RECORDS:
CLASSIFICATION: Adult malocclusion
TEETH MISSING BEFORE TREATMENT: Maxillary whisdom teeth
APPLIANCE: Maxillary and mandibulary fixed lingual appliances
TREATMENT STARTED:
TREATMENT FINISHED:
ACTIVE TREATMENT TIME: 19 months
POST-TREATMENT RECORDS:
RETAINERS:
RETENTION ENDED:
AGE: 30/0
RETENTION TIME: Permanent retention
(POST-) RETENTION RECORDS:
TIME OUT OF RETENTION: Permanent retention
DATE: 22-02-2008
AGE: 30/2 DATE: 07-05-2008
AGE: 31/10 DATE: 21-12-2009
a)upper: fix retainer, Hawley
a)lower: fix retainer, Hawley
a)upper:
a)lower:
DATE: 21-12-2009
DATE: permanent
AGE: - DATE: -
CASE CATEGORY:
WBLO 02
TREATMENT PLAN:
AGE: 31/10 DATE: 21-12-2009
DIAGNOSTIC DESCRIPTION
OF THE MALOCCLUSION
A. SUMMARY
B. EXAMINATION OF HEAD AND FACE
C. FUNCTIONAL EXAMINATION
D. INTRAORAL EXAMINATION
E. DENTAL CASTS
Mandibular arch: severe rotation of 14, moderate dental crowding, rotation 12, 22
Maxillary arch: mild arch perimeter tooth mass discrepancy, accentuated curve of spee
Occlusion sagittal: right - Class II canine and molar, left - Class I canine and Class III molar
Occlusion vertical: Anterior deep bite 3,5 mm
Occlusion transversal: scissors-bite tendency of upper right first premolar
WBLO 03
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
Patient´s chief complaint: unesthetic smile, rotation of maxillary lateral incisors
• Patient´s pogonion is shifted slightly to the right
• No signs of severe disproportions
No presence of difficulty in oral function
• Right side: Class II, left side: Class I canine and Class III molar relationship
• Midline discrepancy (mild maxillary dental midline shift to left)
• Anterior deep bite 3,5 mm
• Rotation and scissors-bite tendency of upper right first premolar
• Space deficiency and rotation of maxillary lateral incisors
• No crossbite
FRONTAL SMILING
PROFILE
WBLO 04
FACIAL PHOTOGRAPHS BEFORE TREATMENT
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
WBLO 05
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
WBLO 06
LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
WBLO 07
TRACING OF LATERAL SKULL RADIOGRAPHBEFORE TREATMENT
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
WBLO 08
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
Pretreatment Mean SD
Sagittal Skeletal Relations
Maxillary PositionS-N-A
82,7° 82º± 3.5º
Mandibular PositionS-N-B
80,6° 80º± 3.5º
Sagittal Jaw RelationA-N-B
2,1° 2º± 2.5º
Vertical Skeletal Relations
Maxillary InclinationS-N / ANS-PNS
13,3° 8º± 3.0º
Mandibular InclinationS-N / Go-Gn
24,1° 33º± 2.5º
Vertical Jaw RelationANS-PNS / Go-Gn
10,9° 25º± 6.0º
Dento-Basal Relations
Maxillary Incisor Inclination1 - ANS-PNS
116,0° 110º± 6.0º
Mandibular Incisor Inclination1 - Go-Gn
92,2° 94º± 7.0º
Mandibular Incisor Compensation1 - A-Pg (mm)
0,1 2± 2.0
Dental Relations
Overjet (mm) 2,9 3.5± 2.5
Overbite (mm) 3,6 2± 2.5
Interincisal Angle1 / 1
140,9° 132º± 6.0º
PERIAPICAL OR PANORAMIC RADIOGRAPHS
BEFORE TREATMENT
WBLO 09
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
ANY OTHER RADIOGRAPHS BEFORE TREATMENT
WBLO 10
If needed
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
No need for other radiographs
RADIOGRAPHIC ANALYSIS
BEFORE TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
WBLO 11
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
Panoramic Radiograph:
• Absence of maxillary wisdom teeth
• Impaction of mandibular wisdom teeth
• Moderately decreased bone level according to patients age
1. Sagittal skelettal relations: position of the maxilla and the mandible within
the normal range, skelettal Class I maloccusion
2. Vertikal sklettal relations: brachyfacial pattern, posterior impaction of the
maxilla, decreased lower anterior face height
3. Dento-basal relations: proclination of the maxillary incisors, mandibular
incisors slightly uprighted
4. Dental relations: increased interincisal angle, absence of tooth 18,28,
visibility of tooth 38, 48
5. Esthetic profile: mild posterior divergent profile, increased nasolabial angle
TREATMENT PLAN
AND THE REASON FOR IT
WBLO 12
CANDIDATE NUMBER: SB DATE: 07-05-2008 AGE: 30/0CASE NUMBER: 1
Treatment Plan:
1. Bonding maxillary and mandibulary arch with lingual fixed appliances
2. Correct Class II on the right side
3. Derotation of upper right first premolar
4. Distalisation of upper right canine
5. Correct midline discrepancy
6. Establish proper incisor angulation
7. Eliminate maxillary and mandibulary crowding
8. Detailing and Finishing
9. Retention
The reason for this treatment is
1. to improve facial appearance and smile esthetics and
2. to achieve functional balance due to elimination of the scissors-bite
tendency of upper right first premolar
TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS
UPPER ARCH
WBLO 12-1
CANDIDATE NUMBER: SB DATE: div. AGE: div.CASE NUMBER: 1
WBLO 12-2
CANDIDATE NUMBER: SB DATE: div. AGE: div.CASE NUMBER: 1
TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS
LOWER ARCH
RÉSUMÉ OF THE TREATMENT CARRIED OUT
INCLUDING
ANY DIFFICULTIES ENCOUNTERED
WBLO 13
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Treatment Gouvernance:
1. Bonding maxillary and mandibulary arch with lingual fixed appliances
2. Correct Class II on the right side with Class II elastics
3. Derotation of upper lateral incisors appeared to being more difficult than
expected (problem solved by alastic lasso-technique)
4. Establish proper incisor angulation
5. Eliminate maxillary and mandibulary crowding
6. Establish correct overjet and overbite (including levelling curve of spee)
7. Detailing and Finishing
8. Retention
FRONTALSMILING
PROFILE
WBLO 14
FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS OF THEOCCLUSION AT COMPLETION OF TREATMENT
WBLO 15
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
WBLO 16
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
TRACING OF LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
WBLO 17
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
WBLO 18
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Pretreatment Posttreatment Mean SD
Sagittal Skeletal Relations
Maxillary PositionS-N-A
82,7° 82,5° 82º± 3.5º
Mandibular PositionS-N-B
80,6° 80,7° 80º± 3.5º
Sagittal Jaw RelationA-N-B
2,1° 1,8° 2º± 2.5º
Vertical Skeletal Relations
Maxillary InclinationS-N / ANS-PNS
13,3° 13,0° 8º± 3.0º
Mandibular InclinationS-N / Go-Gn
24,1° 24,7° 33º± 2.5º
Vertical Jaw RelationANS-PNS / Go-Gn
10,9° 11,6° 25º± 6.0º
Dento-Basal Relations
Maxillary Incisor Inclination1 - ANS-PNS
116,0° 118,2° 110º± 6.0º
Mandibular Incisor Inclination1 - Go-Gn
92,2° 93,4° 94º± 7.0º
Mandibular Incisor Compensation1 - A-Pg (mm)
0,1 2,1 2± 2.0
Dental Relations
Overjet (mm) 2,9 2,8 3.5± 2.5
Overbite (mm) 3,6 1,9 2± 2.5
Interincisal Angle1 / 1
140,9° 133,0° 132º± 6.0º
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT COMPLETION OF TREATMENT
WBLO 19
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
WBLO 20
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Panoramic Radiograph:
• Moderate distal root angultion of upper right first premolar
• Absence of maxillary wisdom teeth
• Impaction of mandibular wisdom teeth (extractions will be performed by
prescription in the near future)
1. Sagittal skelettal relations: position of the maxilla and the mandible within
the normal range, skelettal Class I maloccusion
2. Vertikal skelettal relations: brachyfacial pattern, posterior impaction of the
maxilla, decreased lower anterior face height
3. Dento-basal relations: proclination of the maxillary incisors, mandibular
incisors in a favourable position, correct overjet and overbite
4. Dental relations: normal interincisal angle, absence of tooth 18,28,
presence of tooth 38, 48
5. Esthetic profile: mild posterior divergent profile, increased nasolabial angle
DESCRIPTION OF THE
TREATMENT RESULT
WBLO 21
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Treatment Result Orientation:
1. Improved smile esthetics and facial harmony
2. Occlusal relationship: Super Class I (Class I canine and mild Class III
Molar relationship)
3. Correct interincisal angulation
4. Normal overjet and overbite
5. Retention objectives: permanent / lifelong retention
DESCRIPTION OF THE
POST-TREATMENT EVALUATION
OF RETENTION
WBLO 21-1
CANDIDATE NUMBER: SB DATE: 21-12-2009 AGE: 31/10CASE NUMBER: 1
Retention Result Orientation:
1. Retention objectives: permanent / lifelong retention
2. Check stability of correct rotational position of maxillary lateral incisors
and maxillary right first premolar in short intervals
3. Control stability of occlusion and stability of overjet and overbite