DeMaio V a, Abdullah Fa, Sangsuwon Ca, Teixeira CCb, Alikhani Ma,c
Figure 1: Pre-treatment portrait and intra-oral photographs. Frontal extraoral photograph shows lip competence at rest and facial symmetry. Frontal smiling portrait shows a straight smile line with buccal corridors within normal limits , and 75% upper incisor display. Intraoral photographs show an anterior crossbite spanning the maxillary central and lateral incisors and the six lower anterior teeth, and the lower midline is 0.5 mm to the right of the upper midline. The anterior gingival margins are not aligned, and the gingival heights of contour are not properly positioned. Intraoral photographs reveal no severe rotations.
Figure 2: Pre-treatment digital casts evaluation. Digital casts show a mild Curve of Spee and a mild Curve of Wilson. Crowding was measured on the maxillary (-2.6 mm) and mandibular (-3.4 mm) arches. A Bolton discrepancy was present due to a deficiency of 1.8 mm in the maxillary anterior region. Cast measurements show an overjet of -2.5 mm and an overbite of 2.1 mm.
Figure 3: Pre-treatment panoramic radiograph. The pre-treatment panoramic radiograph shows a complete dentition. No root resorption was present, and no significant findings were noted for the maxillary sinuses. Condyles shows some degree of remodeling and asymmetry.
Figure 4: Pre-treatment lateral cephalometric radiograph and analysis. The pre-treatment lateral cephalogram (A) and cephalometric analysis (B) reveal a prognathic mandible, proclined upper incisors and uprighted lower incisors, and lower mandibular plan angle among other findings
Table 1: Cephalometric Analysis of Pre- and Post-treatment lateral cephalograms. Angular and linear measurements were taken on craniofacial skeletal, dental, and soft tissue landmarks identified on pre- and post-treatment lateral cephalograms (° – degrees, mm – millimeters).
Figure 5: Post-treatment portrait and intra-oral photographs. Post-treatment lateral portrait photograph shows an improved facial profile and upper and lower lip positioning relative to the E-plane. The post-treatment frontal resting photo shows maintained facial symmetry, maintained lip competence, and maintained even facial thirds. Intraoral photographs show correction of the anterior crossbite and Class I canine and molar bilaterally.
Figure 6: Post-treatment digital casts. Post-treatment digital cast analysis showed a correction of the negative overjet (3.0 mm), overbite (2.8 mm), coincidental midlines, tooth alignment, and Class I canine and molar relation.
Figure 7: Post-treatment panoramic radiograph. The post-treatment panoramic radiograph shows good root parallelism and no additional condyle remodeling compared to the pre-treatment radiograph.
Figure 8: Post-treatment lateral cephalometric radiograph and analysis. Post-treatment lateral cephalometric radiograph (A) and cephalometric analysis (B) reveal a general enhancement in the relationship between the maxilla and mandible, an increase in mandibular plane angle, correction of the anterior crossbite, as well as an optimal overjet and overbite.
Figure 9: Superimposition of pre- and post-treatment cephalometric tracings. Superimposition of pre-treatment (black) and post-treatment (red) tracings using best fit on cranial base (A), best fit of the maxilla profile (B), and posterior contour of the symphysis and mandibular canal (C) reveal both dental and skeletal changes in response to treatment.
