Pacific Coast Society of Orthodontists Bulletin Winter 2019 - 33

Case Report
Table 1. Initial lateral cephalometric
measurements from the cephalogram taken in centric occlusion
Variable

SNA (°)
SNB (°)
ANB (°)
FMA (FH-MP) (°)
SN-MP (°)
U1-NA (mm)
U1-SN (°)
L1-NB (mm)
IMPA (L1-MP) (°)
Upper Lip-E line (mm)
Lower Lip-E line (mm)

Norm Pretreatment

82.0
80.0
2.0
25.0
32.0
4.0
102.0
4.0
90.0
−4.0
−2.0

83.9
88.2
−4.3
16.6
23.8
4.0
103.6
4.8
89.7
−11.0
−3.2

bony defect following recent extraction of
#19. In addition, there is a mild generalized
bone loss, carious #16, root canal treatment
in #17, and periapical radiolucency seen in
#32.
Lateral cephalograms are taken both in CO
and CR positions to diagnose the skeletal
discrepancy. From the lateral cephalogram
taken in CR, the tracing shows a mild skeletal
Class III pattern (ANB = −0.4°) with orthognathic maxilla (SNA = 83.9°), prognathic
mandible (SNB = 84.3°). A Wits appraisal of
−4.2 mm, however, indicates a more severe
Class III skeletal pattern compared with ANB
(since the lateral cephalogram was made in
CR, the occlusal plane may not be correct).
Both his upper and lower lips are retruded in
reference to the E-line: upper lip -12.6 mm
and lower lip -6.6 mm. From the cephalogram taken in the CO position, the patient
presents a hypodivergent (SN-MP = 23.8°) facial type, while his maxillary and mandibular
incisors are normally positioned and inclined
(U1-NA = 4 mm, U1-SN = 103.6°, and IMPA =
89.7°; Figure 3; Table 1). His ABO Discrepancy
Index score is 30 (Figure 4).

Winter	2019	 	 PCSO	Bulletin	

Figure 3. (A) Initial lateral cephalogram (in CO), (B) tracing, and (C) panoramic radiograph

33



Pacific Coast Society of Orthodontists Bulletin Winter 2019

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