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Case 1
Why is the maxilla considered normal in AP if the SNA is low (74.4 degrees)? When would you consider it normal vs low?
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6 Replies
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For the ideal treatment plan, maxillary orthopedic expansion was listed – isn’t the patient too skeletally mature for this as he is CVMS 5?
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Max Orthopedic expansion in late teens! Truly a hot topic in orthodontics!
It’s good to understand that the ABO recognizes debated/hot topic areas and they are a diverse group of practitioners themselves. The response in this question is focusing on some sort of expansion.
Personally, I’d look at the suture interdigitation on the CBCT and probably go for a MARPE (TAD expander). I have people I practice closely with that would go ahead and do normal expander and see what happened. Some people do orthopedic expansion on people in their 60’s.
Now what would be the risks or drawbacks or negative side effects on orthopedic expansion at this skeletal maturity?
Keep up the pace! Couple weeks to go.
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Brinda, good question about SNA.
This is an application of cranial base flexure (Adjusting SNA/SNB based on a steep / shallow cranial base measured between SN and FH). Dan has a nice video about this in Module 3. Have a look at his explanation and definitely let me know if that doesn’t clear it up.
Keep up the studying!
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I didn’t understand the math on that module.
What number am I looking at to determine if there is a steep cranial base?
What number determines a shallow base?
When it comes to adjusting the SNA, when do I need to adjust?
When do I add and when do I subtract…and to what measurements?
Thanks
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Amy, good thing to dive into! Cranial base flexure is unique but Dan does a nice job making it simple. I typed out some items in another discussion that I’m going to tag you in.
It is in the Module 3 Discussion Section: Topic – Sample Case and Cranial Base Flexure.
Donna asked similar questions and we went over it there.
Let me know if it doesn’t answer all your questions though! (We can look at it several different ways till it is all clear)
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Hello,
When adjusting for cranial base flexure, SNA=80 (which is within a standard deviation, AKA considered normal). However, when looking at NA-Perpendicular, I think this maxilla is retrusive.
Would it be wise to outline this during the exam? AKA saying what I just said above?Thank you!
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