Pacific Coast Society of Orthodontists Bulletin Fall 2017 - 32
Case Report
How would you treat this malocclusion?
Pre-Treatment
Case B.Q. 13 years, 11 months
A video of this case can be found
at www.pcsortho.org.
Extraoral and Intraoral Findings
The patient presents to the orthodontic clinic at
the University of California, San Francisco, with
the following chief complaint: "I want perfect
teeth." He reports no history of trauma to his face
or teeth and denies any oral habits.
The patient is still expected to experience a significant amount of growth; the growth analysis
shows CVMS II, with the peak of mandibular
growth expected within the next year. The
patient's mother reports that he has not yet gone
through a growth spurt.
The patient's medical history is non-contributory.
He reports no medications or allergies, but his
mother states that he is developmentally delayed;
she is unsure whether he can tolerate orthodontic appliances. The patient has habitual open
mouth posture and is unable to clench his teeth
with force.
The patient has mild facial asymmetry, with
slight chin point deviation to the left, and bimaxillary protrusive profile due to protrusive incisors.
At rest, he demonstrates an open mouth posture
with lips 20 mm apart. He shows 90% of his incisors with a fully animated smile.
The clinical TMJ exam is unremarkable with no
reports of TMJ symptoms and no CO-CR shift
detected.
Skeletally, the patient has an increased vertical
jaw relationship due to a hyperdivergent growth
pattern. Dentally, he has end-on Class II molar
relationship on the right and Class I molar rela-
Initial photos
13 years, 11 months
32
PCSO Bulletin Fall 2017
http://www.pcsortho.org
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