CASE STUDY Table 1 Levi had a severe Class III skeletal relationship (ANB -8°, WITS -13mm). The SNA was 74° (Norm 82 +/-4°). The SNB was 82° falling within the norm of 80° +/-4. He had a mesocephalic growth pattern (SN-GoGN 34°, Y axis-SN 64°). (Fig. 4) His upper lip support is poor (Modified E-plane -9mm) the mandibular incisors retro-clined at 15° (L1-NB) and the IMPA was 79°. ( Table 1) Diagnosis • • • • Skeletal Class III (maxillary deficiency) Dental Class III Bilateral posterior crossbite (narrow maxilla) Maxillary anterior crowding/blocked out UR2 (patient’s chief concern) • Proclined maxillary anterior segment (except UR2) • Retroclined mandibular anterior segment • Poor maxillary lip support Fig. 3 Treatment Objectives •Expand maxillary arch 6-8mm •Create space for UR2 and align in arch •Procline mandibular incisors •Align maxillary and mandibular dentition within their respective arches •Correct midline discrepancy • Improve overall esthetics Fig. 4 www.orthodontics.com www orthodontics com Summer 2014 39
Journal of the American Orthodontic Society Summer 2014 / Buyer's Guide: Page 39
