Oral and Maxillofacial Surgery

Case of the Month


February 1998

Subjective:

The patient is a 17 y.o. white female referred to our office by her orthodontist for evaluation of her dentoskeletal malocclusion.

Objective:

Medical history revealed a well developed white 17 y.o. female. The patient is allergic to amoxicillin. Medications included Atenolol. There was a history of Wolff-Parkinson-White Syndrome.

Oral-Facial examination revealed maxillary and mandibular orthodontic appliances. Teeth numbers 1, 17, and 32 were impacted. Number 16 was congenitally missing. The maxillary dental midline was to the left 2 mm. Gingival recession was noted on the buccal of teeth number 22 and 27. Mild gingival edema and erythema was present. Vertical maxillary excess was noted with 7mm of incisial edge showing. 3mm of gingiva was observed when the patient smiled. An anterior openbite of 2mm was present as well as a 7 mm anterior-posterior discrepancy (Class III malocclusion). A Class III canine and molar relationship was present bilaterally. Flat nasolabial folds and infranasal region were associated with a concave facial profile.

Assessment:

Plan:

  1. Osteotomy evaluation
  2. Extraction of impacted teeth 1, 17, and 32 three to six months prior to orthognathic surgery
  3. Model Surgery with Orthognathic Relator
  4. Le Fort I Osteotomy
  5. Mandibular Intraoral Vertical Oblique Osteotomy

Results:


Before
After


Before
After
Before
After




Before
After		To enlarge, click on the cephalometric x-ray.




Before
After


Before
After


Before
After





Before
After		To enlarge, click on the panoramic x-ray.


Patient treated by:
  • Dr. Steven R. Tucker Oral and Maxillofacial Surgery
  • Dr. James A. Wells Orthodontist
  • Dr. Randy Travis Pediatric Dentistry 


 Steven R. Tucker DMD, PSC
 Oral and Maxillofacial Surgery
 909 Scherm Road
 Owensboro, KY 42301
 phone: 1-502-926-4107
 fax: 1-502-926-4166
 url: http://www.srt-psc.com

steven@occ-uky.campus.mci.net

Last Modified: January 31, 1998

Index Back