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**Chief Complaint:
-Patient complained of his forwardly placed and misaligned upper incisors.
**Medical history:
-His dad claimed that Faris is medically fit and he doesn't take any medications.
**Dental history:
- multiple previous restorations, and primary teeth extractions, with no
complications
**Social history & habits :
Extra-Oral Examination
Extra-Oral
photos
Extra oral
Examination
Frontal View
Frontal view
Facial symmetry
Extra oral
Examination
Profile View
?????????????????
profile view
Profile view
Average FMPA.
(about 30)
Extra oral
Examination
Soft tissue analysis
Intra-Oral Examination
Intra-oral
photos
Intra-Oral
Examination
Upper Arch
Upper Arch:
Teeth Number: 12 teeth. 6
teeth/ side
Cs, Ds, Es were still present
U shaped arch
Multiple restorations
Average upper incisors
inclination
mild crowding (4 mm)
clinically ????????????
Intra-Oral
Examination
Lower Arch
Lower Arch:
Intra-Oral
Examination
Inter-arch relation ships
Vertical Relation:
Increased Overbite
Hyper active upper lip muscle
Gummy smile
Transverse Relation
Normal
Upper midline is coincident
with the midfacial axis
Upper and lower midline is
not concident ( lower
midline is shifted to the
right by 2mm)
Study
casts
Space Analysis
Jonhston and Tanaka
Upper Jaw
Space available: Rt 24
Space Predicted: Rt 22
Spacing
+2 mm
Lf 25
Lf 22
+3mm
Space Analysis
Johnston and Tanaka
Lower Jaw
Space available: Rt 27 Lf 27
Space Predicted: Rt 21.5
Lf 21.5
Spacing
+5.5 mm +5.5 mm
Panoramic Radiograph
Late mixed dentition
All teeth are present
No pathology
Rotated lower premolars
Lateral cephalogram
Cephalometric Tracing
Normal value
interpretation
Pre- Treatment
Variable
82 3
82
SNA
79 3
mandible
retrognathic
75
SNB
13
skeletal class II
ANB
105
UI - Mx
101
LI - Mn
5126
127
Gonial angle
27 5
30
MM angle
27 5
31
FM angle
2 AO ahead of
BO
Wits measurements
50%-55%
52%
0-2
1.5
905
93
A-B/FOP
13310
123
Interincisal angle
76
SN-Po
108 5
92 5
1-
873
proclined
skeletal class II
retrognathic
Diagnosis
Functional appliance
Andreasen with maxillary torquing spurs
Retention
possibly
Continue wearing the functional appliance
during phase 1
Thank you