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: 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

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