1. Dr. Brad Fulton (General Dentist) Dr. Jeff Shirck (Orthodontist) Dr. Dave Smeltzer (OMFS) May 7 th, 2015

2.  40 yo Male  Chief Complaint: “I keep breaking my teeth”

5. Mandible 5mm left of MSP Decreased incisal display on smile Right gonion 7mm sub left gonion

6. Missing #1/2/16 Crown #7 with endo treatment Multiple anterior composite restorations Discoloration #8 Maxillary crowding Narrow maxillary arch Crown #19 Fractured #25 Endo treated #26 Mandibular crowding #17/#32 present

7. Class III malocclusion right and left Crossbite #8-#15 Mandibular midline 4mm left MSP

9. 1. Extract #17, 25, 32 2. Comprehensive orthodontics (Estimated treatment time 18 months) 3. Orthognathic Surgery approximately 12 months into treatment (Asymmetric BSSO to rotate mandible back to the right to get chinpoint onto face and a 2-piece Lefort with downgraft)  Goal will be to get middle of lower incisor on to the midpoint of face 4. Post-surgical orthodontics 5. Restorative work on #7-10 (discussed whitening and crowns/veneers)

10. 6/12/13: Orthodontic treatment started 10/13/14: Surgical hooks placed for orthognathic surgery 11/25/14: Three weeks post orthognathic surgery 3/18/15: Day of debond