Fig.3 Fig.4 ANS is significantly behind the Ante-rior Arc (Fig. 11-A). The maxillary incisor angle to the palate is 98° (norm is 110°) and the incisal edge is -3.9 mm behind the ANS Arc (Fig. 11-A). Constructed Gonion is 13 mm behind the Posterior Arc. At this age constructed gonion should be coin-cident with the Posterior Arc 7 (Fig. 12). These factors are all point for potential TMJ problems particularly if the case is not treated properly. Fig.5 Skeletal Vertical and Dental Vertical: The patient’s age related skeletal vertical dimension is mildly deficient (Fig. 11-A). The patient’s dental verti-cal is slightly deep (Fig. 7). Growth Direction: The patient’s upper gonial angle (UGA) (Fig. 11-B) is 41° (norm is 52-53°). The UGA is weak. The patient’s lower gonial angle (LGA) is 74° (norm is 70-75°). The LGA is normal. Therefore the patient is a mild clockwise grower. The predicated treatment response in this case is positive. The straightwire appliance should correct the mild deep dental bite as well as increase the skeletal vertical dimension close to a normal level. Assessing a patient’s skeletal verti-cal dimension and growth direction is of paramount importance. A patient who presents with an open skeletal vertical dimension, a normal to deep dental vertical and a clock-wise growth pattern presents a chal-lenging dilemma (Figs. 13 and 14). Fig. 6 www.orthodontics.com Fall 2023 13
Journal of the American Orthodontic Society Fall 2023: Page 13
