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1) Domain 4 – Critique the post-treatment records? What treatment effects do you observe?
1. Maxillary advancement
2. Maxillary incisor proclination
3. Maxillary arch expansion
4. Class 1 molar relation
5. Slight retroclination of mandibular incisors
6. Lateral open bite
7. Slight increase in lower face height
2) Domain 4 – What additional records are indicated at this time for this patient?
1. Lateral Cephalogram
2. Family history (to know a predilection for Class 3)
3. Height-weight chart
4. Hand-wrist radiograph
5. Panoramic radiograph
3) Domain 4 – How will future growth affect current treatment results?
1. Predilection towards skeletal Class 3 discrepancy, can result in late mandibular growth thereby outgrowing the skeletal correction achieved with the current treatment.
2. Pt. has a hyperdivergent tendency, which can worsen as the mandible grows in AP direction resulting in clockwise rotation of mandible and increase in vertical dimension
4) Domain 4 – What is appropriate retention for this patient?
1. Frankel 3 appliance
2. Maxillary Hawley with Adam’s clasp and Mandibular wraparound retainer
5) Domain 3 – What is the next phase of treatment for this patient?
1. Non-extraction comprehensive orthodontic treatment
2. Level and align maxillary arch
3. Align mandibular arch
4. Close residual spaces
5. Achieve bite settling
6. Monitor the pt. for growth completion, to plan forward with Orthoganthic surgery, based on unfavorable growth occurrence
6) 1Domain 2 – How will you assess the timing on the final phase of treatment for this patient?
1. Assess growth completion using following indicators –
Serial Lateral Ceph
Hand-wrist radiograph
Height-weight chart