13. orthognathicdr. rahul vc tiwari, sibar institute of dental sciences, guntur, andhra pradesh,...

Presented byLatheef Sk Saheb

3rd Yr PGOMFS

Case presentation

Patient name : Charan

Age / sex : 19Yr Male

Chief complaint : Patient C/o forwardly placed lower front teeth

HOPI :

CASE HISTORY

CASE HISTORYPre-natal history

Post-natal history:

Childhood History:

Personal History

Drug history:

PRE ORTHODONTIC TREATEMENTEXTRA ORAL PHOTOGRAPHS

POST ORTHODONTIC TREATEMENT

EXTRA ORAL PHOTOGRAPHS

Height : 5feet 6 inches

Weight : 60 kgs

Gait & Posture : Normal

Body type : Mesomorphic

CLINICAL EXAMINATIONGeneral examination

CLINICAL EXAMINATION CONTD..

Extraoral examination

Head shape: mesocephalic

Facial type: mesoprosopic

Facial symmetry: No gross asymmetry seen

Upper 1/3rd -52 mm

Middle 1/3rd – 57 mm

Lower 1/3rd -- 61 mm

CLINICAL EXAMINATION CONTD..

Stomium line to nose: 18 mm

Stomium line to chin :41mm Lips :Potentially competent. Interlabial gap : 2mm

CLINICAL EXAMINATION CONTD..

Incisor exposure at rest : 2mm

Incisor exposure during smile: Full crown exposure + 2mm of gingiva

CLINICAL EXAMINATION CONTD..

Facial profile : Convex

Facial divergence : Posterior

Profile view

Nasolabial angle - Acute

Mentolabial sulcus - Shallow

Chin - Prominent

Nose - Normal -

SOFT TISSUE EXAMINATION

Oral hygiene status : Fair Gingiva :NormalOral Mucosa : NAD

Tongue : Normal

INTRAORAL EXAMIINATION

Hard tissue examination

Teeth present : 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8

HARD TISSUE EXAMAMINATION

Skeletal mid line : Dental mid line Upper – coincides Upper- Coincides

Lower - coincides Lower – Coincides

Upper arch : U –Shape

Lower arch : U- shape

RIGHT LEFT

Molar relation – Class IIICanine relation – Class III

Molar relation –Class IIICanine relation – Class III

Overjet of – reverse 5mm

Overbite - Negative

Curve of spee - 2mm on right and 1mm on left side

Incisor relation – class III

Freeway space : 3mm

Respiration : Nasal

TMJ Exam : NAD

Maximum mouth opening : 43 mm

FUNCTIONAL ANALYSIS

OPG

Restored 26,36.

LATERAL CEPHALOGRAM

CEPHALOGRAM ANALYSIS

DIAGNOSIS skeletal

Dental

•Angles class III molar relationship with proclined upper anteriors,

A 26 yr old male patient with skeletal class III bases with retrognathic maxilla and prognathic mandible, Normodivergent.

Soft tissueMesoprosopic face with convex facial profile, protrusive lower lip and soft tissues matching with skeletal bases.

PROBLEMS LIST

1. Skeletal class III

2. Dental Class III

3. Overjet 5mm

4. Concave profile

TREATMENT OBJECTIVES

1. Correction skeletal and dental class III relationship

2. Correction of forwardedly placed lower incisors.

3. Attaining ideal overjet and overbite

4. Attaining pleasing facial profile.

TREATMENT PLAN

Extraction of 14,24,35,45 or vice versa (accordingly)

•Lefort I osteotomy maxillary advancement of 4mm

•Mandibular set back of 6mm

•Reduction Genioplasty (if required)

THANK YOU