1
EUROPEAM SOCIETY
OF LINGUAL
ORTHODONTISTS
APPENDIX 1
CASE PRESENTATION FORMS
EUROPEAN SOCIETYOF LINGUAL
ORTHODONTISTS
CANDIDATE NUMBER:
CASE NUMBER:
Year:
ESLO 01
NAME:
BORN:
SEX:
PRETREATMENT RECORDS:
CLASSIFICATION:
TEETH MISSING BEFORE TREATMENT:
APPLIANCE:
TREATMENT STARTED:
TREATMENT ENDED:
ACTIVE TREATMENT TIME:
POSTTREATMENT RECORDS:
RETAINERS:
RETENTION ENDED:
AGE:
RETENTION TIME:
(POST-) RETENTION RECORDS:
TIME OUT OF RETENTION:
DATE:
AGE: DATE:
AGE: DATE:
a)upper:
a)lower:
a)upper:
a)lower:
DATE:
DATE:
AGE: DATE:
ESLO 02
RÉSUMÉ OF CASE 6RÉSUMÉ OF CASE 6
CLASS III MALOCCLUSIONCASE CATEGORY:
DIAGNOSTIC DESCRIPTION
OF THE MALOCCLUSION
DIAGNOSTIC DESCRIPTION
OF THE MALOCCLUSION
A. SUMMARY
B. EXAMINATION OF HEAD AND FACE
C. FUNCTIONAL EXAMINATION
D. INTRAORAL EXAMINATION
E. DENTAL CASTS
Mandibular arch:
Maxillary arch:
Occlusion Sagittal:
Occlusion Vertical:
Occlusion Transversal:
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 03
FRONTAL45°
PROFILE
ESLO 04
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
FACIAL PHOTOGRAPHS BEFORE TREATMENT
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
ESLO 05
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT
ESLO 06
LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
Print on transparent support
ESLO 07
TRACING OF LATERAL SKULL RADIOGRAPHBEFORE TREATMENT
Print on transparent support
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 07-1
Pre-treatment
Mean SD
Sagittal Skeleatal
Maxillary PositionS-N-A
82º ±3.5º
Mandibular PositionS-N-Pg
80º ± 3.5º
Sagittal Jaw RelationA-N-Pg
2º ± 2.5º
Vertical Skeletal
Relations
Maxillary InclinationS-N/ANS-
PNS
8º ± 3.0º
Mandibular Inlination
S-N/Go-Gn
33º ± 2.5º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
ESLO 08
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
Pre-treatment
Mean SD
Vertical Jaw Relation
ANS-PNS/Go-Gn
25º ± 6.0º
Dento-Basal
Relations
Maxillary Incisor
Inclination1-ANS-PNS
110º ± 6.0º
Mandibular Incisor
Inclination1-Go-Gn
94º ± 7.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
ESLO 08-1
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
Mandibular Incisor
Compensation
1 –A-Pg (mm)
2 ± 2.0
Dental Relations
Overjet (mm) 2º ± 2.0
Overbite (mm)
2 ± 2.5
Interincisal Angle
1/1132º ± 6.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
ESLO 08-2
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
PERIAPICAL OR PANORAMIC RADIOGRAPHS
BEFORE TREATMENT
ESLO 09
Print on transparent support
ÊSLO 09-1
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ANY OTHER RADIOGRAPHS BEFORE TREATMENT
ESLO 10
If needed
Print on transparent support
ESLO 10-1
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
RADIOGRAPHIC ANALYSIS
BEFORE TREATMENT
RADIOGRAPHIC ANALYSIS
BEFORE TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 11
TREATMENT PLAN
AND THE REASON FOR IT
TREATMENT PLAN
AND THE REASON FOR IT
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 12
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-1
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
ESLO 12-2
RÉSUMÉ OF THE TREATMENT CARRIED OUT
INCLUDING
ANY DIFFICULTIES ENCOUNTERED
RÉSUMÉ OF THE TREATMENT CARRIED OUT
INCLUDING
ANY DIFFICULTIES ENCOUNTERED
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 13
FRONTAL45°
PROFILE
ELO 14
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
INTRA-ORAL COLOUR PHOTOGRAPHS OF THEOCCLUSION AT COMPLETION OF TREATMENT
ESLO 15
LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
ESLO 16
Print on transparent support
TRACING OF LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
ESLO 17
Print on transparent support
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 17-1
Pre-treatment
Mean SD
Sagittal Skeleatal
Maxillary PositionS-N-A
82º ±3.5º
Mandibular PositionS-N-Pg
80º ± 3.5º
Sagittal Jaw RelationA-N-Pg
2º ± 2.5º
Vertical Skeletal
Relations
Maxillary InclinationS-N/ANS-
PNS
8º ± 3.0º
Mandibular Inlination
S-N/Go-Gn
33º ± 2.5º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 18
Pre-treatment
Mean SD
Vertical Jaw Relation
ANS-PNS/Go-Gn
25º ± 6.0º
Dento-Basal
Relations
Maxillary Incisor
Inclination1-ANS-PNS
110º ± 6.0º
Mandibular Incisor
Inclination1-Go-Gn
94º ± 7.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 18-1
Mandibular Incisor
Compensation
1 –A-Pg (mm)
2 ± 2.0
Dental Relations
Overjet (mm) 2º ± 2.0
Overbite (mm)
2 ± 2.5
Interincisal Angle
1/1132º ± 6.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 18-2
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT COMPLETION OF TREATMENT
ESLO 19
Print on transparent support
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 19-1
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 20
DESCRIPTION OF THE
TREATMENT RESULT
DESCRIPTION OF THE
TREATMENT RESULT
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 21
FRONTAL45°
PROFILE
ESLO 22
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION
Right Buccal Left Buccal
CenterUpper Occlusal Lower Occlusal
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
INTRA-ORAL COLOUR PHOTOGRAPHSAT RETENTION / POST-RETENTION
ESLO 23
LATERAL SKULL RADIOGRAPH AT RETENTION / POSTRETENTION
ESLO 24
Print on transparent support
TRACING OF LATERAL SKULL RADIOGRAPH
AT RETENTION / POST-RETENTION
ESLO 25
Print on transparent support
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 25-1
Pre-treatment
Mean SD
Sagittal Skeleatal
Maxillary PositionS-N-A
82º ±3.5º
Mandibular PositionS-N-Pg
80º ± 3.5º
Sagittal Jaw RelationA-N-Pg
2º ± 2.5º
Vertical Skeletal
Relations
Maxillary InclinationS-N/ANS-
PNS
8º ± 3.0º
Mandibular Inlination
S-N/Go-Gn
33º ± 2.5º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 26
Pre-treatment
Mean SD
Vertical Jaw Relation
ANS-PNS/Go-Gn
25º ± 6.0º
Dento-Basal
Relations
Maxillary Incisor
Inclination1-ANS-PNS
110º ± 6.0º
Mandibular Incisor
Inclination1-Go-Gn
94º ± 7.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 26-1
Mandibular Incisor
Compensation
1 –A-Pg (mm)
2 ± 2.0
Dental Relations
Overjet (mm) 2º ± 2.0
Overbite (mm)
2 ± 2.5
Interincisal Angle
1/1132º ± 6.0º
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 26-2
DESCRIPTION OF RETENTION /
POST-RETENTION FINDINGS
DESCRIPTION OF RETENTION /
POST-RETENTION FINDINGS
CANDIDATE NUMBER:
CASE NUMBER:DATE: AGE:
ESLO 27
Top Related