Last, First yrs mos. File #



Download 87.84 Kb.
Date conversion21.11.2016
Size87.84 Kb.

Last , First

_____ yrs. _____ mos. File # __________


Chief Complaint:
Health History:


Facial Pattern:

Profile: convex WNL concave

Nasolabial Angle: acute WNL obtuse

Labiomental fold:

Chin: weak normal excessive

Lips: thin WNL protrusive

Frontal Symmetry: symmetric asymmetric


Teeth Present (palmer notation):



R L


Antero-Posterior Relationship:

Angle’s Classification:



Molar Class

Right

Left

I







II







III







Canine Class




I







II







III







Overjet (mm)




Minimal







Excessive







Negative






Overall Angle's class: [i.e. Class II, div. 2]

Arch Asymmetry?: maxilla mandible none

Anterior Crossbites?:



R L


Vertical Relationship:

Overbite: #mm

Curve of Spee (mandibular cast): mild moderate severe

Open Bite present?: no tendency yes


Transverse Relationship:

Midlines: on off

Maxilla: on ?mm R L

Mandible: on ?mm R L

Posterior Crossbites:


R L



Arch Perimeter/Dentition:

Space Assesment

Maxillary

Mandibular

Adequate







Excess (mm)







Borderline







Deficient (mm)






Bolton Analysis Results:


Missing:



R L

Rotated:

R L

Caries: (clinical or radiographic) (assess risk)





R L
Occlusion:

CR/CO Discrepancy: no yes (see below)

Shift:

A/P:

Vertical:

Transverse:


Growth Expected: no minimal yes
Soft Tissue/Hygiene:

Hygiene: WNL mild inflam moderate inflam severe inflam

Frenum Problems: none yes/location:

Attached Gingiva: WNL minimal absent where?:


Habits:

Thumb/Finger Sucking: none yes



Bruxism/Clenching: no yes
Behavior/Attitude: good neutral poor
Cephalometric Analysis


Area of Study



Measurements



Mean s.d.


Patient



Summary


Maxilla to

SNA

82  3




Position of Maxilla is:

Cranial Base

NA–FH

90  4



Protrusive Normal Retrusive

Mandible to

SNB

79  3




Position of Mandible is:

Cranial Base

SN – Pg

80  3



Prognathic Normal




NPg – FH

87  4



Retrognathic

Maxilla to Mandible

ANB

3  2



Skeletal: Class I II III




SN - MP

32  5




Mandibular Plane Angle:




FH – MP

24  3



High Normal Low

Vertical

Y axis – SN

66  3




Mandibular growth direction:

Relations

Y axis – FH

59  3



Vertical Normal Horizontal




UAFH (N-ANS) mm







Lower Anterior Face Height:




LAFH (ANS-Me) mm






Short Normal Long




UAFH/LAFH Ratio

0.8






Chin

Pog–NB (mm)

3  2



Prominent Normal Recessive

Maxillary

U1 to SN (deg.)

103  6




Position of Maxillary Incisors is:

Incisors

U1 to NA (deg.)

22  6



Proclined Normal




U1 to NA (mm)

3  2



Upright Retroclined

Mandibular

L1 to NB (deg.)

25 7




Position of Mandibular Incisors is:

Incisors

L1 to NB (mm)

3 2



Proclined Normal




L1–MP (deg)

90 5



Upright Retroclined

Max. to Mand.

Interincisal Angle (p.32)

135 11



Inter-incisal Relationship:

Normal


Excess OJ

Incisors

Overjet (mm)

2 2



Edge/Edge

Negative OJ


Open bite Normal Deep bite




Overbite (mm)

3 2




Treatment Objectives
Facial:

  • Profile:





Skeletal:

  • Maxilla:

  • Mandible:




Dental:





















Functional/Occlusion:

  • Obtain maximum intercuspation





Other:








The database is protected by copyright ©dentisty.org 2016
send message

    Main page