Title Name Date

1. Please include as much of the information listed as possible. TitleNameDate Case Study Contest

2. Doctor Bio • Dental School • Areas of CE Study • Areas of Advanced Clinical Training • Name/location of practice • Specialty (if applicable)

3. Patient’s Presenting Complaint • Chief Complaint • Any contributory or significant medical history • History of dental care problems • History of recurrent dental care issues

4. Intra-Oral Observation • Oral Health status • Periodontal Findings/charting details • Dentition description/presence of caries • Skeletal Occlusal Analysis– Angle’s Classification

5. Intra-Oral Observation (Cont’d) • Oral Health status • Periodontal Findings/charting details • Dentition description/presence of caries • Skeletal Occlusal Analysis– Angle’s Classification

6. Records: Pre-Treatment • Occlusal Images • T-Scan Images/files (FSX files)/Screenshots • Panos/CBCTs • Full- face views (if applicable) • Postural views (if applicable)

7. Records: Pre-Treatment (Cont’d) • Occlusal Images • T-Scan Images/files (FSX files)/Screenshots • Panos/CBCTs • Full- face views (if applicable) • Postural views (if applicable)

8. Treatment Plan • Briefly discuss the Treatment Plan and its’ Rationale • Discuss alternative Treatment Plans and other proposed solutions, and why they were not pursued

9. Case Outcome Blurred Facial Images are preferred • Treatment Final Result • Intraoral Case Images- Pre and Post Treatment-both should be full frontal retracted view with teeth intercuspated • Complications/risks • Post treatment final T-Scan data files and images

10. Case Reflection • Please discuss how the T-Scan was utilized in the case, and how the T-Scan contributed to its success • Were there any other technologies used that contributed to the case’s success?