EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS APPENDIX 1 CASE - - PDF document

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EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS APPENDIX 1 CASE PRESENTATION FORMS

EUROPEAN SOCIETY OF LINGUAL ORTHODONTICS

CANDIDATE NUMBER: CASE NUMBER: Year:

WBLO 01

RÉSUMÉ OF CASE 1

ADULT MALOCCLUSION

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE:

CASE CATEGORY:

WBLO 02

TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 2

CLASS I MALOCCLUSION

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 3

CLASS II DIV. 2 MALOCCLUSION

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED : ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 4

CLASS II DIVISION 1 MALOCCLUSION

CASE CATEGORY:

HIGH FRANKFORT MANDIBULAR PLANE ANGLE, MINIMUM FM ANGLE OF 30° AND/OR SN TO Go-Gn ANGLE OF 37°

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 5

CLASS II DIVISION 1 MALOCCLUSION

CASE CATEGORY:

A MALOCCLUSION WITH SIGNIFICANT MANDIBULAR ARCH LENGTH DEFICIENCY In at least one of the two Class II 1 cases the treatment must involve extractions in both dental arches °

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 6

CLASS III MALOCCLUSION

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 7

A SEVERE SKELETAL DISCREPANCY

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 8

A SIGNIFICANT TRANSVERSE DISCREPANCY

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

WBLO 02

RÉSUMÉ OF CASE 9

REPLACEMENT CASE

CASE CATEGORY:

NAME: BORN: SEX: PRE-TREATMENT RECORDS: CLASSIFICATION: TEETH MISSING BEFORE TREATMENT: APPLIANCE: TREATMENT STARTED: TREATMENT FINISHED: ACTIVE TREATMENT TIME: POST-TREATMENT RECORDS: RETAINERS: RETENTION ENDED: AGE: RETENTION TIME: (POST-) RETENTION RECORDS: TIME OUT OF RETENTION: DATE: AGE: DATE: AGE: DATE: a)upper: a)lower: a)upper: a)lower: DATE: DATE: AGE: DATE: TREATMENT PLAN: AGE: DATE:

DIAGNOSTIC DESCRIPTION OF THE MALOCCLUSION

• A. SUMMARY
• B. EXAMINATION OF HEAD AND FACE
• C. FUNCTIONAL EXAMINATION
• D. INTRAORAL EXAMINATION
• E. DENTAL CASTS

Mandibular arch: Maxillary arch: Occlusion Sagittal: Occlusion Vertical: Occlusion Transversal:

WBLO 03

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

FRONTAL SMILING PROFILE

WBLO 04

FACIAL PHOTOGRAPHS BEFORE TREATMENT

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal

WBLO 05

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION BEFORE TREATMENT

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

WBLO 06

LATERAL SKULL RADIOGRAPH BEFORE TREATMENT

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

WBLO 07

TRACING OF LATERAL SKULL RADIOGRAPH BEFORE TREATMENT

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

THIS TRACING SHOULD BE IN THE COLOR BLACK. REMOVE THIS PART AND PLACE ONLY THE LOWER PART WITH THE TEXT BELOW THE CUT OFF LINE AT THE BOTTOM OF THE TRANSPARENT COVER; THEN PLACE THE TRACING IN THE TRANSPARENT

• COVER. IN THIS WAY THE TRACING CAN BE EASILY INSPECTED.

HAND TRACING SHOULD FACE TO THE RIGHT. COPIES ON TRANSPARENT MATERIAL ARE NECESSARY TO CONTROL RELIABILITY OF TRACINGS.

CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 1

WBLO 08

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Pretreatment Mean SD Sagittal Skeletal Relations Maxillary Position S-N-A 82º± 3.5º Mandibular Position S-N-Pg 80º± 3.5º Sagittal Jaw Relation A-N-Pg 2º± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS 8º± 3.0º Mandibular Inclination S-N / Go-Gn 33º± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 25º± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS 110º± 6.0º Mandibular Incisor Inclination 1 - Go-Gn 94º± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 2± 2.0 Dental Relations Overjet (mm) 3.5± 2.5 Overbite (mm) 2± 2.5 Interincisal Angle 1 / 1 132º± 6.0º

PERIAPICAL OR PANORAMIC RADIOGRAPHS BEFORE TREATMENT

WBLO 09

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

ANY OTHER RADIOGRAPHS BEFORE TREATMENT

WBLO 10

If needed

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

RADIOGRAPHIC ANALYSIS BEFORE TREATMENT

• A. INTRAORAL / PANORAMIC RADIOGRAPH
• B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

WBLO 11

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

TREATMENT PLAN AND THE REASON FOR IT

WBLO 12

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS UPPER ARCH

WBLO 12-1

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

WBLO 12-2

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

TREATMENT STEPS INTRA-ORAL OCCLUSAL VIEW COLOUR PHOTOGRAPHS LOWER ARCH

RÉSUMÉ OF THE TREATMENT CARRIED OUT INCLUDING ANY DIFFICULTIES ENCOUNTERED

WBLO 13

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

FRONTAL SMILING PROFILE

WBLO 14

FACIAL PHOTOGRAPHS AT COMPLETION OF TREATMENT

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal

INTRA-ORAL COLOUR PHOTOGRAPHS OF THE OCCLUSION AT COMPLETION OF TREATMENT

WBLO 15

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT

WBLO 16

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

TRACING OF LATERAL SKULL RADIOGRAPH AT COMPLETION OF TREATMENT

WBLO 17

THIS TRACING SHOULD BE IN THE COLOR RED. REMOVE THIS PART AND PLACE ONLY THE LOWER PART WITH THE TEXT BELOW THE CUT OFF LINE AT THE BOTTOM OF THE TRANSPARENT COVER; THEN PLACE THE TRACING IN THE TRANSPARENT

• COVER. IN THIS WAY THE TRACING CAN BE EASILY INSPECTED.

HAND TRACING SHOULD FACE TO THE RIGHT. COPIES ON TRANSPARENT MATERIAL ARE NECESSARY TO CONTROL RELIABILITY OF TRACINGS.

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 2

WBLO 18

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Pretreatment Posttreatment Mean SD Sagittal Skeletal Relations Maxillary Position S-N-A 82º± 3.5º Mandibular Position S-N-Pg 80º± 3.5º Sagittal Jaw Relation A-N-Pg 2º± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS 8º± 3.0º Mandibular Inclination S-N / Go-Gn 33º± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 25º± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS 110º± 6.0º Mandibular Incisor Inclination 1 - Go-Gn 94º± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 2± 2.0 Dental Relations Overjet (mm) 3.5± 2.5 Overbite (mm) 2± 2.5 Interincisal Angle 1 / 1 132º± 6.0º

PERIAPICAL OR PANORAMIC RADIOGRAPHS AT COMPLETION OF TREATMENT

WBLO 19

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

RADIOGRAPHIC ANALYSIS AT COMPLETION OF TREATMENT

• A. INTRAORAL / PANORAMIC RADIOGRAPH
• B. INTERPRETATION OF CEPHALOMETRIC ASSESSMENT

WBLO 20

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

DESCRIPTION OF THE TREATMENT RESULT

WBLO 21

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

DESCRIPTION OF THE POST-TREATMENT EVALUATION OF RETENTION

WBLO 21-1

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

FRONTAL SMILING PROFILE

WBLO 22

FACIAL PHOTOGRAPHS AT RETENTION / POST RETENTION

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Right Buccal Left Buccal Center Upper Occlusal Lower Occlusal

INTRA-ORAL COLOUR PHOTOGRAPHS AT RETENTION / POST-RETENTION

WBLO 23

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

LATERAL SKULL RADIOGRAPH AT RETENTION / POST-RETENTION

WBLO 24

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

TRACING OF LATERAL SKULL RADIOGRAPH AT RETENTION / POST-RETENTION

WBLO 25

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

THIS TRACING SHOULD BE IN THE COLOR GREEN. REMOVE THIS PART AND PLACE ONLY THE LOWER PART WITH THE TEXT BELOW THE CUT OFF LINE AT THE BOTTOM OF THE TRANSPARENT COVER; THEN PLACE THE TRACING IN THE TRANSPARENT

• COVER. IN THIS WAY THE TRACING CAN BE EASILY INSPECTED.

HAND TRACING SHOULD FACE TO THE RIGHT. COPIES ON TRANSPARENT MATERIAL ARE NECESSARY TO CONTROL RELIABILITY OF TRACINGS.

CEPHALOMETRIC MORPHOLOGICAL ASSESSMENT 3

WBLO 26

CANDIDATE NUMBER: DATE: AGE: CASE NUMBER:

Pretreatment Posttreatment Retention/ Postretention Mean SD Sagittal Skeletal Relations Maxillary Position S-N-A 82º± 3.5º Mandibular Position S-N-Pg 80º± 3.5º Sagittal Jaw Relation A-N-Pg 2º± 2.5º Vertical Skeletal Relations Maxillary Inclination S-N / ANS-PNS 8º± 3.0º Mandibular Inclination S-N / Go-Gn 33º± 2.5º Vertical Jaw Relation ANS-PNS / Go-Gn 25º± 6.0º Dento-Basal Relations Maxillary Incisor Inclination 1 - ANS-PNS 110º± 6.0º Mandibular Incisor Inclination 1 - Go-Gn 94º± 7.0º Mandibular Incisor Compensation 1 - A-Pg (mm) 2± 2.0 Dental Relations Overjet (mm) 3.5± 2.5 Overbite (mm) 2± 2.5 Interincisal Angle 1 / 1 132º± 6.0º

DESCRIPTION OF RETENTION / POST-RETENTION FINDINGS

CANDIDATE NUMBER: DATE: AGE:

WBLO 27

CASE NUMBER: