Transcript Class III Malocclusion

EUROPEAM SOCIETY
OF LINGUAL
ORTHODONTISTS
APPENDIX 1
CASE PRESENTATION FORMS
1
EUROPEAN SOCIETY
OF LINGUAL
ORTHODONTISTS
CANDIDATE NUMBER:
CASE NUMBER:
Year:
ESLO 01
RÉSUMÉ OF CASE 6
CASE CATEGORY:
CLASS III MALOCCLUSION
NAME:
BORN:
SEX:
PRETREATMENT RECORDS:
AGE:
DATE:
TREATMENT STARTED:
AGE:
DATE:
TREATMENT ENDED:
AGE:
DATE:
CLASSIFICATION:
TEETH MISSING BEFORE TREATMENT:
APPLIANCE:
ACTIVE TREATMENT TIME:
POSTTREATMENT RECORDS:
RETAINERS:
a)upper:
DATE:
a)lower:
RETENTION ENDED:
a)upper:
DATE:
a)lower:
RETENTION TIME:
(POST-) RETENTION RECORDS:
AGE:
DATE:
TIME OUT OF RETENTION:
ESLO 02
DIAGNOSTIC DESCRIPTION
OF THE MALOCCLUSION
A. SUMMARY
B. EXAMINATION OF HEAD AND FACE
C. FUNCTIONAL EXAMINATION
D. INTRAORAL EXAMINATION
E. DENTAL CASTS
Mandibular arch:
Maxillary arch:
Occlusion Sagittal:
Occlusion Vertical:
Occlusion Transversal:
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 03
45°
FRONTAL
PROFILE
FACIAL PHOTOGRAPHS BEFORE TREATMENT
CANDIDATE NUMBER:
CASE NUMBER:
DATE:
AGE:
ESLO 04
Right Buccal
Upper Occlusal
Left Buccal
Center
Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 05
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LATERAL SKULL RADIOGRAPH BEFORE TREATMENT
ESLO 06
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TRACING OF LATERAL SKULL RADIOGRAPH
BEFORE TREATMENT
ESLO 07
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 07-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
Pretreatment
Mean SD
Sagittal
Skeleatal
Maxillary
Position
S-N-A
82º ±3.5º
Mandibular
Position
S-N-Pg
80º ± 3.5º
Sagittal Jaw
Relation
A-N-Pg
2º ± 2.5º
Vertical
Skeletal
Relations
Maxillary
Inclination
S-N/ANSPNS
8º ± 3.0º
Mandibular
Inlination
S-N/Go-Gn
33º ± 2.5º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 08
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
Pretreatment
Mean SD
Vertical Jaw
Relation
ANSPNS/Go-Gn
25º ± 6.0º
DentoBasal
Relations
Maxillary
Incisor
Inclination
1-ANS-PNS
110º ± 6.0º
Mandibular
Incisor
Inclination
1-Go-Gn
94º ± 7.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 08-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 1
Mandibular
Incisor
Compensati
on
1 –A-Pg
(mm)
2 ± 2.0
Dental
Relations
Overjet (mm)
2º ± 2.0
Overbite
(mm)
2 ± 2.5
Interincisal
Angle
1/1
132º ± 6.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 08-2
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PERIAPICAL OR PANORAMIC RADIOGRAPHS
BEFORE TREATMENT
ESLO 09
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ÊSLO 09-1
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ANY OTHER RADIOGRAPHS BEFORE TREATMENT
If needed
ESLO 10
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 10-1
RADIOGRAPHIC ANALYSIS
BEFORE TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 11
TREATMENT PLAN
AND THE REASON FOR IT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 12
Right Buccal
Upper Occlusal
Left Buccal
Center
Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 12-1
Right Buccal
Upper Occlusal
Left Buccal
Center
Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BETWEEN TREATMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 12-2
RÉSUMÉ OF THE TREATMENT CARRIED OUT
INCLUDING
ANY DIFFICULTIES ENCOUNTERED
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 13
45°
FRONTAL
PROFILE
FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT
CANDIDATE NUMBER:
CASE NUMBER:
DATE:
AGE:
ELO 14
Right Buccal
Upper Occlusal
Left Buccal
Center
Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS OF THE
OCCLUSION AT COMPLETION OF TREATMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 15
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LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
ESLO 16
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TRACING OF LATERAL SKULL RADIOGRAPH
AT COMPLETION OF TREATMENT
ESLO 17
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 17-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
Pretreatment
Mean SD
Sagittal
Skeleatal
Maxillary
Position
S-N-A
82º ±3.5º
Mandibular
Position
S-N-Pg
80º ± 3.5º
Sagittal Jaw
Relation
A-N-Pg
2º ± 2.5º
Vertical
Skeletal
Relations
Maxillary
Inclination
S-N/ANSPNS
8º ± 3.0º
Mandibular
Inlination
S-N/Go-Gn
33º ± 2.5º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 18
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
Pretreatment
Mean SD
Vertical Jaw
Relation
ANSPNS/Go-Gn
25º ± 6.0º
DentoBasal
Relations
Maxillary
Incisor
Inclination
1-ANS-PNS
110º ± 6.0º
Mandibular
Incisor
Inclination
1-Go-Gn
94º ± 7.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 18-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 2
Mandibular
Incisor
Compensati
on
1 –A-Pg
(mm)
2 ± 2.0
Dental
Relations
Overjet (mm)
2º ± 2.0
Overbite
(mm)
2 ± 2.5
Interincisal
Angle
1/1
132º ± 6.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 18-2
Print on transparent support
PERIAPICAL OR PANORAMIC RADIOGRAPHS
AT COMPLETION OF TREATMENT
ESLO 19
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 19-1
RADIOGRAPHIC ANALYSIS AT
COMPLETION OF TREATMENT
A. INTRAORAL / PANORAMIC RADIOGRAPH
B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 20
DESCRIPTION OF THE
TREATMENT RESULT
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 21
45°
FRONTAL
PROFILE
FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION
CANDIDATE NUMBER:
CASE NUMBER:
DATE:
AGE:
ESLO 22
Right Buccal
Left Buccal
Upper Occlusal
Center
Lower Occlusal
INTRA-ORAL COLOUR PHOTOGRAPHS
AT RETENTION / POST-RETENTION
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 23
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LATERAL SKULL RADIOGRAPH
AT RETENTION / POSTRETENTION
ESLO 24
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TRACING OF LATERAL SKULL RADIOGRAPH
AT RETENTION / POST-RETENTION
ESLO 25
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 25-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
Pretreatment
Mean SD
Sagittal
Skeleatal
Maxillary
Position
S-N-A
82º ±3.5º
Mandibular
Position
S-N-Pg
80º ± 3.5º
Sagittal Jaw
Relation
A-N-Pg
2º ± 2.5º
Vertical
Skeletal
Relations
Maxillary
Inclination
S-N/ANSPNS
8º ± 3.0º
Mandibular
Inlination
S-N/Go-Gn
33º ± 2.5º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 26
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
Pretreatment
Mean SD
Vertical Jaw
Relation
ANSPNS/Go-Gn
25º ± 6.0º
DentoBasal
Relations
Maxillary
Incisor
Inclination
1-ANS-PNS
110º ± 6.0º
Mandibular
Incisor
Inclination
1-Go-Gn
94º ± 7.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 26-1
CEPHALOMETRIC MORPHOLOGICAL
ASSESSMENT 3
Mandibular
Incisor
Compensati
on
1 –A-Pg
(mm)
2 ± 2.0
Dental
Relations
Overjet (mm)
2º ± 2.0
Overbite
(mm)
2 ± 2.5
Interincisal
Angle
1/1
132º ± 6.0º
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 26-2
DESCRIPTION OF RETENTION /
POST-RETENTION FINDINGS
CANDIDATE NUMBER:
DATE:
AGE:
CASE NUMBER:
ESLO 27