1、 正畸B组第1小组 Summary Key information long face 16-year-old girl from northeast family history taciturnity Come with her mom Weekend-opend main trouble Hyperosteogenied Mandibular mandibular protrusion All above？High Angle underbite Heredity circumstance：Congenital（Macroglossia disease）Acquired（1）hyperp
2、ituitarism（2）maxillary deciduous teeth early-missed、retention、Inadequate canine abrasion （3）early maxillary permanent teeth eruption（4）functional factor：suckle、hypertrophy of tonsil、muscle dysfunction（5）bad hadit Other information needed（1）Inquiry：systemic disease、bad hadit、already treatment、Duratio
3、n、family history、psychological guidance（2）inspection：inside check：tooth count、tooth shape、Oral hygiene、dental arch shape、occlusal status、Soft tissue lesions outside check：photograph、Symmetric face？proportion?overlength lowed 1/3？auxiliary examination：X-ray：Panoramic radiograph examination lateral ce
4、phlometrics CT Other check:model analysis TMJ check muscular tension check Extra 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 morp
5、hology：concave type lip:the degree of closure、H line，E line mentolabial 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 maxillary Lateral view：angle ，anterior teeth is reverse overjet and reverse ove
6、rbite maxillary anterior teeth：labial inclination mandibular anterior teeth：lingual inclination Occlusal view：dental archs are oval，crowding in the maxillary.maxillary central incisor：torsion oral hygiene：poor Periodontium：healthy gingiva Alveolar bone：the labial bone of mandible is thin Labial fren
7、um 、linguae frenum：normal soft and hard tissues Pantomography：impacted teeth：18、28、38、48 normal The measurement items Permanent teeth period significance measured value normal value SNA 88 82.8 maxillary protrusion SNB 94 80.1 Mandibular protrusion ANB -6 2.7 Negative，mandibular protrusion Wits-17mm
8、 85.4 mandibular protrusion Y axis 67 66.3 mandibular protrusion;Growth before the bottom NA-PA-7 31.1 Steepness of mandibular body,large mandibular Angle,high facial height The measurement items Permanent teeth period significance measured value normal value Max1-SN 128 105.7 maxillary central inci
9、sor is labial inclination Mand1-MP 66 22.8 maxillary central incisor is labial inclination and bulging Max1-NA 9mm 5.1mm maxillary central incisor is labial inclination and bulging is large Mand1-NB 16.7 125.4 Up and down the front of the dental arch degree is relatively small The measurement items
10、Permanent teeth period significance measured value normal value N-Me 122mm 119.7mm The height of the face is more than normal N-ANS 52mm 65.8mm partial length is in the 1/3 lower faces N-ANS/N-Me 43%55%partial length is in the 1/3 lower faces 1、maxillary retrusion，mandibular protrusion 2、maxillary c
11、entral incisor is labial inclination mandibular central incisor is lingual inclination 3、The height of the face is more than normal，maxillary growth is Inadequate,partial length is in the 1/3 lower faces Conclusion therapeutic regimen ORTHODONTIC-ORTHOGNATHIC SURGERY option1 Indication Class III,mes
12、ioclusion(ANB-4,upper incisor is obviously labial tilted，lower incisor lingual tilted，anterior of deep reverse overjet)Pre-surgical orthodontic treatment Alignment Leveling Incisal position and space closure Coordination of dental arches and coorrection of posterior crossbite According to movements
13、and decompensation of teeth,its benificial to move bones.orthognathic surgery Sagittal splint ramus osteotomy Post-surgical orthodontic treatment Alignment Space closing Leveling Adjustment of anteropoetreior position incisors Coordination of dental arches Retention Maintainer Chincap CAMOUFLAGE opt
14、ion2 Tooth extraction including 2 maxillary second premolar and third molar 2 mandibular first premolars extraction and third molar could prevent upper incisors from uprighting and change the incisor position maxillar protraction Implant as skeletal anchorage for maxilla protraction is an effective and stable clinical treatment for Class III malocclusion，which avoids the dental compensation.Straight wire appliance relieving dental crowding Compensatory move the upper and lower front teeth,to conceal the jaw deformity.Thank you.
