Pacific Coast Society of Orthodontists Bulletin Winter 2021 - 40

Case Report

Case Report

How would you treat this malocclusion?
Pretreatment
Case E.B., 12 years, 2 months
A video of this case can be found at https://
www.pcsortho.org/case-reports/.
A 12-year, 2-month-old Caucasian girl presents to the Arizona School of Dentistry &
Oral Health Postgraduate Orthodontic Clinic
with the following chief complaint: " I have
underbite and my teeth are crooked. " During
the initial examination, the patient reports
that she has menorrhagia, depression, and
anxiety. She is taking fluoxetine (Prozac) and
Adderall. No abnormal habits are reported.
Diagnosis and Etiology
Extraoral and Intraoral Findings
The patient has a mesocephalic face with
competent lips. Her smile arc is consonant,
and her incisal display at smile is about 95%.
Her profile is almost straight with an obtuse
nasolabial angle, average labiomental fold,
and a strong chin.

Figure 1. Pretreatment facial and intraoral photographs (12 years, 2 months)
Intraorally, she presents end-on Class III
molar and Class III canine relationships on
both the left and right sides. Displaying an
overall mild-to-moderate curve of Spee,
she has a negative overbite of −1.0 mm and
a minimal overjet of 0.2 mm because of
her edge-to-edge, anterior open bite. The
patient exhibits posterior crossbite at UR4
and UR5 and edge-to-edge from UL3 to UL5.
There is about 1 mm of functional shift from
the central relation to central occlusion, and
the mandibular dental midline shifts to her
right by about 1 mm; however, both maxillary and mandibular midlines are coincident
with her facial midline upon smiling. Bolton
analysis and clinical findings of diminutive
maxillary lateral incisors demonstrate a
deficiency in the mesial-distal width of her
maxillary anterior teeth. Her maxillary arch
is V shaped with moderate (5 mm) crowding, Figure 2. Pretreatment digital study models (12 years, 2 months)
and her mandibular arch is ovoid with mild
(2 mm) crowding (Figures 1 and 2).

40	

PCSO Bulletin    Winter 2021


https://www.pcsortho.org/case-reports/ https://www.pcsortho.org/case-reports/

Pacific Coast Society of Orthodontists Bulletin Winter 2021

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Winter 2021

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