Lastname, Firstname

Lastname, Firstname

XX yrs. X mos. File #Xxxxxx

Chief Complaint: “A little crooked"

Health History:

• WNL

Facial Pattern:

Lastname, Firstname

XX yrs. X mos. File #Xxxxxx

• Profile:

–NasolabialAngle:

–Labiomentalfold:

• Chin:

• Lips:

• MuscleStrain:

• FrontalSymmetry:

• Mx.IncisorDisplay at Rest:

• Mx.IncisorDisplay at Smile:

• GingivalDisplayonSmile:

Lastname, Firstname

XX yrs. X mos. File #Xxxxxx

Teeth Present:

RL

Antero-Posterior Relationship:

• Angle’sClassification:

• Overjet:

• ArchSymmetry:

–Maxilla:

–Mandible:

• Anterior Crossbites:

RL

–Functional Shift:

Vertical Relationship:

• Overbite:

• CurveofSpee:

• MandibularPlaneAngle:

• Open Bite:

Transverse Relationship:

Lastname, Firstname

XX yrs. X mos. File #Xxxxxx

• Midlines:

–Maxilla:

–Mandible:

•PosteriorCrossbites:

RL

Lastname, Firstname

XX yrs. X mos. File #Xxxxxx

Arch Perimeter/Dentition:

• Space Assesment:

–Maxilla:

–Mandible:

• Arch Shape:

–Maxilla:

–Mandible:

• Missing:

RL

•Spaces:

RL

• Rotated:

RL

• Caries: (clinical or radiographic)

RL

• Ankylosed:

RL

• Bolton Analysis:

Occlusion:

• CR/CO Discrepancy:

• Shift:

–A/P:

–Vertical:

–Transverse:

Growth Expected:

•

Soft Tissue/Hygiene:

• Hygiene:

• Frenum Problems:

• Attached Gingiva:

• Spot Probings:

Temporomandibular Joint:

• History of Pain/Trauma:

•Deviations:

• Sounds:

• RangeofMotion:

–Max. Opening:

–Lateral Excursions:

-Right:

-Left:

–Protrusive:

Habits:

• Thumb/Finger Sucking:

• Bruxism/Clenching:

Behavior:

•

Cephalometric Analysis

ANB: ° (2)

SNA: ° (81)

SNB: ° (79)

%NH: % (43)1 NA: ° (22) 1 NA: mm (4)

YSN: °(67) 1 NB: ° (25) 1 NB: mm (4)

1–1: ° (135)OJ: mm (2)

OB: mm (3)

MPSN: ° (32) PgNB: mm (3)

MPFH: ° (24)

1 MP: ° (91)

• HarvoldAnalysis: female

MeasuredMean (12 yr)Mean (16 yr)

Maxillary Unit (mm)90 (SD=4.07)93 (SD=3.45)

Mandibular Unit (mm)113 (SD=5.2)119 (SD=4.44)

LFH (mm)62 (SD=4.36)65 (SD=4.67)

Unit Difference (mm)23 (16<X<36)26 (19<X<39)

• WitsAnalysis: (AO – BO = 0 ± 1.75) =

Radiographic/Cephalometric Findings:

Cephalometric Analysis

Area of Study /

Measurements

/ Range / Mean / Patient
Maxilla to / SNA / 75–87 / 81 / Position of Maxilla is:
Cranial Base / NA – FH / 84–96 / 90 / ProtrusiveNormalRetrusive
Mandible to / SNB / 72–87 / 79 / Position of Mandible is:
Cranial Base / SN – Pg / 72–88 / 80 / PrognathicNormalRetrogn
FH–NPg (Facial angle) / 82–95 / 87
Maxilla – Mandible / ANB / -1–5 / 2 / Skeletal:ClassIIIIII
SN – MP / 22–42 / 32 / Mandibular Plane Angle:
FH – MP / 18–30 / 24 / HighNormalLow
Vertical / Y axis – SN / 61–72 / 67 / Mand growth direction:
Relations / Y axis – FH / 53–66 / 59 / VerticalNormalHorizontal
UAFH (N–pal pl) mm / Lower Anterior Face Height:
Total FH (N–Me) mm / ShortNormalLong
% nasal height / UAFH/ total FH Ratio / 40–46% / 43%
Chin / Pog - NB (mm) / 2–5 / 3mm / ProminentNormalRecessive
Maxillary / U1 to SN (deg.) / 92–114 / 103 / Pos'n of Max Incisors is:
Incisors / U1 to NA (deg.) / 3–31 / 22 / ProclinedNormal
U1 to NA (mm) / -2–6 / 4mm / UprightRetroclined
Mandibular / L1 to NB (deg.) / 8–40 / 25 7 / Pos'n of Mand Incisors is:
Incisors / L1 to NB (mm) / 1–10 / 4mm / ProclinedNormal
L1 - MP (deg) / 81–97 / 91 / UprightRetroclined
Max. to Mand. / Interincisal Angle / 130–150 / 135 / Inter-incisal Relationship:
Incisors / Overjet (mm) / 1–4 / 2 / OpenNormalDeep
Overbite (mm) / 1–6 / 3 / Edge–EdgeNeg Overjet
Facial Pattern / Upper lip – E-plane / 4 / Lips:
RetrusiveNormProtrusive
Lower lip – E-plane / 2