CASE STUDY Diplomate Case Summary & Analysis: EXCESSIVE OVERJET IN A TEENAGE PATIENT By Roy Rogers, DDS Fig. 1 A 13-year-old female patient Arianne B. reported to our office with a chief complaint of “I want to fix my front teeth.” She presented with an excessive overjet and was concerned about how her front teeth looked. An excessive overjet occurs when the upper front teeth are significantly further forward than the lower front teeth. But there were additional risks to her teeth due to her overjet that needed to also be addressed beyond just the cosmetic issue. An excessive overjet greatly increases the risk of injuring the protruded upper front teeth. The misaligned teeth can also make biting into food difficult or impossi-ble. If the excessive overjet is severe enough, it may result in speech impediments. An excessive overjet can also make it difficult for the lips to fully close around the front teeth. The patient may have to strain to cover their front teeth leaving these teeth vulnerable to injury. A study undertaken at the University of Adelaide 1 of more than 50,000 children under 19 years old was published in the Journal of Dental Traumatology which confirmed a direct link between the degree to which a young patients tooth protrudes and the chance of damaging them. “Traumatic dental injuries have been identified as the fifth most prevalent disease or injury globally,” said Dr. Esma Dogramaci, Senior lecturer in Orthodontics at the University of Adelaide. “If young teeth are broken or knocked out, long term issues may occur like the need for root canal treatment or even tooth loss, Fig. 2 requiring a lifetime commitment for general treatment.” “Also, if orthodontic treatment is carried out on teeth that have previ-ously suffered from trauma, further complications can occur during orthodontics that could lead to the loss of these teeth.” So, after appro-priate histories, orthodontic records and treatment planning were completed (Fig. 2), then consulta-tions and patient/parent acceptance of treatment planning occurred. Medical & Dental History Arianne was first seen in our office as a current patient. She had a full dental examination, radio-22 Summer 2019 JAOS
Journal of the American Orthodontic Society Summer 2019: Page 22
