Orthodontic Letter with Teeth Present

Orthodontist Note Teeth Present: Upper Right: 17, 16, 15, 14, 13, 12, 11 Upper Left: 21, 22, 23, 24, 25, 26, 27 Lower Right: 47, 46, 45, 44, 43, 42, 41 Lower Left: 31, 32, 33, 34, 35, 36, 37 Chief Concerns: Patient is concerned about the crowding in her upper and lower front teeth and wants to achieve a straighter smile. She also mentioned discomfort when biting due to her deep bite. Extraoral Examination Skeletal Base (AP Relationship): Class II skeletal base, mild retrognathic mandible. Vertical (FMPA): Average FMPA, no significant vertical discrepancy noted. Lip Competency: Competent lips at rest with no strain. Lip Trap: No lip trap observed. TMJ: No clicking, popping, or tenderness upon palpation of the temporomandibular joint bilaterally. Full range of motion. Facial Symmetry: Symmetrical facial appearance. Intraoral Examination Oral Hygiene: Good oral hygiene with minimal plaque and no signs of gingivitis. Soft Tissues: Healthy gingiva and oral mucosa, no pathological findings. Upper Arch: Crowding: Moderate crowding in the anterior segment, particularly involving the lateral incisors. Labial Segment Inclination: Proclined upper incisors. Over-eruption: No significant over-eruption of upper teeth. Lower Arch: Crowding: Moderate crowding in the anterior segment. Over-eruption: No significant over-eruption of lower teeth. Dentition: Full permanent dentition present. Incisal Relationship: Class II Division 1 incisal relationship. Right Molar Relationship: Class II molar relationship. Right Canine Relationship: Class II canine relationship. Left Molar Relationship: Class II molar relationship. Left Canine Relationship: Class II canine relationship. Overjet: 6 mm. Overbite: 70%, traumatic overbite with lower incisors contacting palatal gingiva. Crossbite: No posterior crossbite. Anterior crossbite involving tooth 12. Mandibular Displacement: No discernible mandibular displacement on closure. Summary and Plan Miss Jane Doe presents with a Class II Division 1 malocclusion, characterized by moderate upper and lower anterior crowding, a significant overjet of 6mm, and a traumatic deep overbite of 70%. Her skeletal base is mildly retrognathic, and her incisor inclination is proclined. She maintains good oral hygiene and has no TMJ issues. The primary concerns are aesthetic improvement due to crowding and functional improvement to address the deep bite and anterior crossbite. The proposed treatment plan involves fixed appliance therapy for comprehensive orthodontic correction. This will aim to align the dental arches, reduce the overjet and overbite, correct the anterior crossbite, and improve the overall incisal and molar relationships. Space creation for alignment will be achieved through interproximal reduction and potentially selective extractions if needed, to be discussed further. Patient education on maintaining excellent oral hygiene throughout treatment has been reinforced. A follow-up appointment is scheduled for 1 November 2024 to discuss appliance options and commence treatment.