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- Case 1 - M.K. Congenitally missing 12

| September 2012 |. - Case 1 - M.K. Congenitally missing 12. September 2012. - Intake consult -. Patient profile: Marieke K, female , 11.7 years Oral habit: thumsucking until 7 years Good oral hygiene Motivated patient and parents No medical history

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- Case 1 - M.K. Congenitally missing 12

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  1. | September 2012 | - Case 1 - M.K.Congenitally missing 12

  2. September 2012

  3. - Intake consult - Patient profile: • Marieke K, female , 11.7 years • Oral habit: thumsucking until 7 years • Good oral hygiene • Motivated patient and parents • No medical history • Chief complaint: congenitally missing 12 September 2012

  4. Initial records:- Missing 12- Midline deviation of 2mm to right- Upper jaw is shifted- Class I molar occlusion right- Class II molar occlusion left

  5. Upper jaw:- Central diastema- 16 and 26 mesial rotation- 4 milk molars and 53 in place -> 13 is moved to the place of congenitaly missing 12Lower jaw:- Mild front crowding- 2 milk molars in place diastema 44-85 September 2012

  6. Analysis of the models:- Angle Class II/1- Neutrorelation, normodivergent- Occlusion: R ¼ disto-occlusion L ¾ disto-occlusion- Overjet 5mm - Overbite 3mm- Midline deviation of the upper jaw 2mm to the right- Congenitally missing 12- Mesiogression of 13 September 2012

  7. - Ceph - Norm: SNA 82.3 82 SNB 77.4 80 ANB 4.9 * 2.0 Wits 3.1 ** 0.00 Maxskel A-Na perp -1.0 0.00 Mand skel Pg- Na perp -10.5 * -4.0 Vertikal skeletal MP-FH 23.5 26.0 MP- SN 30.2 33.0 Pal Mand angle 24.6 28.0 Anterior dental U1 –occ plane 58.8 57.5 L1- occ plane 61.0 ** 72.0 September 2012

  8. - Congenitally missing 12- Mesial shifted 13- Distally kipped 35 and 45 in eruption proces- All 4 wisdom teeth present- No abnormalities of the TMJ - OPG - September 2012

  9. - Problem list - • Congenitally missing 12, parents and patient do not want an implant at 12 • Persistent 53 • Spacing upper incisors with 12 missing and closure is preferred by parents • Midline deviation • Class II molar relation left September 2012

  10. - Treatment plan - • Correct 13 to fit at the place of 12 • Extraction of 53,55 so 14,15,16 can drift mesial • Space closure of 12 and correct midline deviation • Accept a class II molar occlusion left and class I molar occlusion right September 2012

  11. - Treatment sequence - Extraction 53,55 start treatment when all permanent teeth are present Upper jaw: • Level and Align 16-26 with SWT • Correct 13 mesial contact area to fit 11 • Class II elastics left, than class III elastics right • Close diastemas with chain • Coordinate and finish Lower jaw: • Level and align 36-46 with SWT • Coordinate and finish Retention Bonded retainer C-C lower jaw Clear overlay retainer for the upper jaw September 2012

  12. September 2012

  13. Norm:SNA 85.4 82.0SNB 79.3 80ANB 6.1 * 2.0Wits 2.9 ** 0.00Max skel ( A-Na perp) -0.2 0.00Mand skel (Pg-Na perp) -11.7 * -4.0Vertikal skeletalMP-FH 24.3 26.0MP SN 29.6 33.0Pal Mand angle 20.0 * 28.0Anterior dentalU1-occl plane 59.7 57.5L1-occl plane 57.2 *** 72.0 - Final records - September 2012

  14. September 2012

  15. September 2012

  16. - Result - September 2012

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