1. بسم الله الرحمن الرحیم

2. Case presentation by : Zohre roozbahani

3. Diagnosis Treatment plan Mechanotherapy history Chief complaint Clinical Examination Paraclinical Examination Cast analysis radiography Photography Medical Dental Extra oral Intraoral

4. 14 years old girl Chief complaint : crowded teeth MH: - DH: - TMJ Exam: -

5. Bilateral symmetry facial height(long) Lips: * together at rest * normal lip tension Tooth show : - Mentolabial sulcus: normal Extra oral examination Concave profile (Max retrusion/ man protrusion) High nasolabial angle

6. Intraoral Examination Interarch relationship - AP: *right molar(cl 3) *left molar(cl 3) *right canine cl 1 *left canine cl 1 * anterior cross bite : 1mm 21 1 - vertical:* overbite ( 4mm) - transverse * midline( upper & lower ok) * post. Right Cross bite

7. * functional shift on closure : anteroposterior * tooth size/arch size : maxillary anterior crowding

8. Intraoral Examination Intraarch assessment _ stage : permanent _ no asymmetry in dental arches _ TS/AL: maxillary space deficiency _oral hygiene _ periodontal status _ restorative status

9. Panoramic Analysis

10. Cephalometric Analysis parameterMeanPatien t SNA82±1 67 SNB80±1 73 ANB2 -6 NA-Pog0-17 Facial angle88.7 89 S-N69±369 Body length73±5 78 Sagittal : class3 skeletal due to maxillary retrognatism and mild mandibular prognatim

11. Cephalometric Analysis Vertical : ParameterMeanPatient saddle>123±5 136 Articular>143±6 138 Gonial>130±7130 Sum of Bjork 396404 SN-Go.Gn3240 FMA2527 Y-axis6057 S-Ar35±327 Jaraback index 62-6556 Ramus height 43±541

12. * Vertical: long face vertical growth

13. Cephalometric Analysis parameterMeanPatie nt 1 to NA22 18 1 to NA4mm 9 1 to FH112110 1 to SN103100 upper : parameterMeanPatie nt 1 to NB2522 1 to NB4mm3 IMPA9087 FMIA6567 Inter incisal> 135 Lower : upper incisal retrusion lower incisal retrusion

14. interpretationpatientmeanparameter Lip retrusion8-1 to 4mmUpper lip to E-line Lip retrusion2-2 to 2mmLower lip to E-line

15. Mandibular space analysis - total space available: 64mm - total space required:64mm - discrepancy:0mm

16. Maxillary space analysis - total space available:66mm - total space required:71mm - discrepancy:-5mm

17. Bolton analysis : Discrepancy : ant. Ratio : 2.6 mm

18. class 3 skeletal long face upper ant. Teeth crowding and retrusion ( space deficiency : 5mm)

19. Non extraction anterior upper aligning and by protraction Face mask therapy Evaluation for fixed treatment and surgery

20. Thank you