Pacific Coast Society of Orthodontists Bulletin Spring 2015 - (Page 27)
case report
pre-treatment
A video of this cAse cAn be found on our website:
http://www.pcsortho.org
How would you treat
this malocclusion?
Patient J.H. 61 years
T
his 61-year-old male presents with two chief
complaints: "I am having trouble chewing"
and "my bite seems to be getting worse."
The patient is also motivated by a daughter who
works in the dental field and has concerns that he
could experience tooth loss if his malocclusion is not
addressed. His medical history is non-contributory. He
has a history of routine dental visits, but only recently
started seeing a new dentist, who recommended an
orthodontic consultation. A clinical TMJ evaluation
displays normal range of movement without any pain,
popping, or clicking. The patient is very motivated to
improve his occlusion.
PROFILE
The patient presents in the permanent dentition with
significant maxillary and mandibular incisal wear. His
maxillary midline is coincident with his facial midline,
and the mandibular midline is deviated 3 mm to the
left of the maxillary midline. His maxillary arch is
relatively U-shaped. There is 2 to 3 mm of maxillary
arch length discrepancy. His mandibular arch is
significantly omega-shaped, with lingually displaced
mandibular premolars. There is 13 mm of mandibular
arch length discrepancy and an exaggerated curve of
2015 * PCSO BULLETIN
On the frontal facial photograph, the patient appears
symmetric, with thin lips and 0 to 2 mm interlabial gap
at rest. When smiling, the patient displays 90% of his
maxillary incisors and has lingually inclined maxillary
premolars, creating prominent buccal corridors.
His smile is symmetric, and wear is evident on the
maxillary incisors and canines. He has a convex profile
and a strong chin button.
FRONTAL
INTRAORAL FINDINGS
SPRING
EXTRAORAL FINDINGS
SMILING
Spee. He presents with complete buccal crossbites of
the mandibular premolars and an impinging deep bite.
He has Class I molars on both sides, with severely
worn mandibular incisors and moderately worn
mandibular canines. His mandibular premolars have
erupted lingually and he has 2 to 3 mm of exposed
root surfaces. Due to the position of the mandibular
premolars, his maxillary first premolars have
supererupted 2 to 3 mm, and his second premolars
have supererupted 1 to 2 mm. His maxillary and
mandibular molars display very little wear.
27
http://www.pcsortho.org
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2015
The Whole is Greater Than Its Parts
The Land of Opportunity
Donated Orthodontic Services Program — AAO-DOS
Trustee Report
AAO Council on Scientific Affairs (COSA) Report
Component Reports
AAOF Report
AAO Leaders Complete Terms in San Francisco: The End of an Era for PCSO
Preparing for the Unexpected: Your Emotional SOS Plan Part I
Resident Spotlight: Dr. Mona Afrand, Orthodontic Resident, University of Alberta Department of Orthodontics; Younger Member Spotlight: Dr. Mostafa Altalibi, Calgary, Canada
PCSO At A Glance
The AEODO Research Data Portal: Restructuring Workflow
The Aveolar Bone Housing — The Orthodontist’s World
Case Report Pre-Treatment
Smile and Appliance Esthetics — New Understandings
How to Remember Names and Places: A Dale Carnegie Program
The Latest Trends in Orthodontic Treatment: Part I
Training and Giving Feedback to The Clinical Staff to Ensure a Well-Tuned Team
Treatment Possibilities with Invisalign®
Class III Treatment: Timing and Protocol
Orthodontics: The Key to Successful Interdisciplinary Treatment
CBCT: Assessment of Anatomical Boundary Conditions Important to Orthodontists
Case Report Post-Treatment
Sectional Mechanics for Class II Correction
Dr. Donald Poulton
Pacific Coast Society of Orthodontists Bulletin Spring 2015
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