CASE STUDY Fig. 4: Gerety tracing at time of diagnosis presents with +1 ANB class I relationship, but a -6 Class III Wits relationship. The central incisors have an increased Interincisal angle of 119, caused by both the maxillary and mandibular incisors. The Go-GN angle locates the growth as upper range of vertical growth in the mesocephalic range. This indicates the potential for vertical growth and mandibular clockwise growth. Fig. 7: EDC diagnosis and treatment plan template recording all information collected from clinical examination, cephalometric tracings and values, model examination, TMJ and airway. Fig. 8 & 9: Tooth #6 is ectopically located on buccal and slightly distal of #5. An incision with the diode laser and gingival displacement with a periosteal instrument allow uncovering of the buccal coronal aspect of #6. Fig. 5: Ricketts’s tracing confirmed the ANB measurements but also adds the A-PO Class III classification. Fig. 6: Study models showing diastemas in area of maxillary incisors and mandibular teeth. Presence of maxillary second primary molars help create a Class III molar relationship, while canines are in a Class I relationship. Ricketts tracing analysis (Figs. 4, 5). Gerety tracing at time of diagno-sis presents with +1 ANB Class I relationship, but a -6 Class III Wits relationship. The central incisors have an increased Interincisal angle of 119, caused by both the maxil-lary and mandibular incisors. The Go-GN angle locates the growth as upper range of vertical growth in the mesocephalic range. This indicates the potential for vertical growth and mandibular clockwise growth. Due to the patient’s age, it was important to control mandibular growth and match the growth of the maxillary arch. Patient’s soft tissue profile showed both lips on the soft tissue line. The analysis indicated a mesocephalic leaning towards vertical growth and Class III skeletal and dental classification class with transverse constriction. This transverse maxillary constric-tion diagnosis if seen in the discrep-ancy between the positive ANB (+1) and the high negative Wits numbers (-6). 32 Summer 2023 JAOS
Journal of the American Orthodontic Society Summer 2023: Page 32
