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1、正畸B組第1小組 SummaryKey information long face16-year-old girl from northeastfamilyhistory taciturnityCome with her momWeekend-opendmain troubleHyperosteogenied Mandibular mandibular protrusionAll above?High Angle underbiteHereditycircumstance :Congenital(Macroglossia disease)Acquired(1)hyperpituitarism(
2、2)maxillary deciduous teeth early-missed、retention、Inadequate canine abrasion (3)early maxillary permanent teeth eruption(4)functional factor :suckle、hypertrophyoftonsil、muscle dysfunction(5)bad haditOther information needed(1)Inquiry:systemicdisease、bad hadit、already treatment、Duration、family histo
3、ry、psychologicalguidance(2)inspection :inside check:tooth count 、tooth shape、Oral hygiene 、dental arch shape、occlusal status 、Soft tissue lesionsoutside check:photograph、Symmetric face?proportion ?overlength lowed 1/3?auxiliaryexamination:X-ray:Panoramic radiograph examinationlateral cephlometricsCT
4、Other check:model analysisTMJ checkmuscular tension checkExtra oral photographs:Frontal view: horizontal:Facial is asymmetry, and it moves to right side vertical:partial length is in the 1/3 lower faces lip : the degree of closure、underlip is thicker than upper Lateral view : facial morphology :conc
5、ave type lip : the degree of closure、H line ,E linementolabial sulcus:shallow 、 Mandibular advancement Intra oral photographs:Frontal view : overbite in anterior 22、23、32、33 open bite distema in 11 and 21 crowded in maxillaryLateral view :angle , anterior teeth is reverse overjet and reverse overbit
6、e maxillary anterior teeth :labial inclination mandibular anterior teeth :lingual inclination Occlusal view: dental archs are oval,crowding in the maxillary. maxillary central incisor :torsionoral hygiene :poorPeriodontium:healthy gingivaAlveolar bone :the labial bone of mandible is thinLabial frenu
7、m 、 linguae frenum : normalsoft and hard tissuesPantomography:impacted teeth:18、28、38、48 normalThe measurement itemsPermanent teeth periodsignificancemeasured value normal valueSNA 88 82.8 maxillaryprotrusionSNB 94 80.1 Mandibular protrusionANB -6 2.7 Negative,mandibular protrusionWits-17mm 85.4 man
8、dibular protrusionY axis67 66.3 mandibular protrusion; Growth before the bottomNA-PA-7 31.1 Steepness of mandibular body, large mandibular Angle, high facial heightThe measurement itemsPermanent teeth period significancemeasured value normal value Max1-SN128 105.7 maxillary central incisor is labial
9、 inclinationMand1-MP66 22.8 maxillary central incisor is labial inclination and bulgingMax1-NA9mm 5.1mmmaxillary central incisor is labial inclination and bulging is largeMand1-NB16.7 125.4 Up and down the front of the dental arch degree is relatively smallThe measurement items Permanent teeth perio
10、d significance measured value normal valueN-Me122mm 119.7mmThe height of the face is more than normalN-ANS52mm 65.8mmpartial length is in the 1/3 lower faces N-ANS/ N-Me 43% 55%partial length is in the 1/3 lower faces1、maxillary retrusion ,mandibular protrusion2、maxillary central incisor is labial i
11、nclinationmandibular central incisor is lingual inclination3、The height of the face is more than normal, maxillary growth is Inadequate, partial length is in the 1/3 lower facesConclusiontherapeutic regimenORTHODONTIC-ORTHOGNATHIC SURGERY option1Indication Class III ,mesioclusion (ANB-4,upper inciso
12、r is obviously labial tilted,lower incisor lingual tilted,anterior of deep reverse overjet)Pre-surgical orthodontic treatment AlignmentLevelingIncisal position and space closure Coordination of dental arches and coorrection of posterior crossbiteAccording to movements and decompensation of teeth , i
13、ts benificial to move bones.orthognathic surgerySagittal splint ramus osteotomyPost-surgical orthodontic treatmentAlignmentSpace closingLevelingAdjustment of anteropoetreior position incisorsCoordination of dental archesRetention MaintainerChincap CAMOUFLAGEoption2Tooth extractionincluding 2 maxillary second premolar and third molar 2 mandibular first premolars extraction and third molarcould prevent upper incisors from uprighting and change the incisor positionmaxillar protractionImplant as skeletal anchorage for maxilla protraction is an effective and stable cl
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