{
"Id": 3355,
"Name": "Alatsis, Patra HE 24-Jan-2018",
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"ReleaseDate": "2021-10-04T14:24:00",
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"Description": "Class 3, 2-jaw surgical case",
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"SORPatientDOB": "1993-09-25T00:00:00",
"SORAffiliateName": "Patra Alatsis",
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"COVClassification": "Cl III",
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"COVProposedTreatmentSummary": "Full upper and lower fixed appliances, in combination with orthognathic surgery to correct the Class III skeletal discrepancy.",
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"COVAppliance": "MX/MD MBT Empower .022 x .028 with bands on all terminal molars",
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"COVCaseDiagnonsisDental2": "• Flat profile \r\n• Obtuse nasolabial angle\r\n• Lips retrusive relative to E-plane\r\n• Non-consonant smile with 90% MX incisor display on smiling \r\n• MX midline 1mm right of facial\r\n• MD midline 1mm left of facial",
"COVCaseHistory": "Patient had history of previous orthodontic treatment in Nevada as a teen, with braces and a functional appliance to address Class III growth. Significant orthodontic relapse post treatment.\r\n\r\nPreviously extracted UR7. History of bruxing/clenching with significant anterior incisal wear facets U1-1, and generalized heavy posterior occlusal wear facets. Symptomatic right TMJ. \r\n\r\nOMFS diagnosis was congenital facial deformity with maxillary hypoplasia and mandibular hyperplasia. OMFS recommended a segmental LeFort osteotomy with minimal mandibular setback. ",
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"COVCaseDiagnosisSkeletal": "• Mild skeletal Class III\r\n• Deficient MX and MD\r\n• High mandibular plane angle \r\n• CVMS: 5",
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"COVCaseDiagnosisDental": "• Bilateral full cusp Class III molar\r\n• 100% right Class III canine, 30% left Class III canine\r\n• 0 to -1mm overjet\r\n• 0 to +1mm overbite \r\n• U2s in anterior crossbite with L2-3s\r\n• U1s edge-to-edge with L1s\r\n• 0 to 1mm overbite \r\n• Mild MX crowding, Moderate MD crowding\r\n• Upright MX and MD incisors\r\n• UL5 in posterior crossbite\r\n• Ovoid upper arch form, square shaped lower arch form\r\n• Lingually inclined LR4, LL4-5\r\n• CR-CO coincident, no functional shift",
"COVCaseTreatmentPlanAlternative": "Orthodontic/surgery case with a Maxillary advancement only ",
"COVCaseTreatmentPlan": "1. Refer for pre-ortho surgical consult. OMFS opted for 2-jaw surgery: 3-piece segmental MX advancement and limited MD setback\r\n2. Separate and band all terminal molars: UR6/UL7/L7s. Bond UR5-UL6 and L6-6\r\n3. Level and align with sequential ovoid NiTi archwires through .021\" x .025\" \r\n4. Progress pano to evaluate root parallelism, reposition brackets as needed\r\n5. Open coil springs between U 2-3s to create 1-2mm interradicular space for surgery prep\r\n6. Progress models, place detailed .019\" x .025\" SS wires \r\n7. Pre-surgical records and surgical hooks 1-3 days prior to surgery\r\n8. Continue to stabilize post surgery, elastics as needed\r\n9. Finish and detail in .019\" x .025\" TMA\r\n10. Retain with MX and MD Essix retainers",
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"FNLEvaluationofResultsAffiliate": "Despite several unforeseen setbacks during this case due to her softball-related dental trauma and infection post orthognathic surgery (see Memo above), the case finished well and the patient was very pleased with her results. The mandibular bone healed and remained clinically stable even after the mandibular surgical plates were removed. Good overall esthetic and functional results achieved.\r\n\r\nFacial balance and skeletal position were improved with surgery. Bilateral Class I molar and canine were established, with good overbite and overjet. Incisal angle improved and incisor control was maintained. Upper and lower archform were coordinated: lower intercanine width narrowed slightly as planned, lower premolars were uprighted over the bony ridge. Dental midlines were corrected. \r\n\r\n",
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