Case 2: Class I crowded, class III skeletal. Phase I+II non-extraction
Age 12.1
Start Phase I records (intra-oral photos are missing)
. Vertical
Frankfort to
mandibular plane
Palatal to
mandibular plane
Mean ± SD
24°
22° (18°- 28°)
25°
28° (24°- 33°)
-2,5°
-1 - +2 mm
SNA
76,5°
82° ± 3,5
SNB
75,5°
80° ± 3,5
ANB
1°
2°-4° ± 2,5
34,5°
33° ± 2,5
4,5 mm
21°
3 mm
4 mm
22°
4 mm
16,5°
25°
69,5°
67°
. Wits
. Steiner
Start phase I
GoGnSN
+ 1/NA
- 1/NB
. Y-axis
Summary ceph measurements:
- Class III tendency mesofacial, slightly open growth pattern
- Retroclined lower incisors
Phase I treatment summary
TPA and LLA were placed on the first molars.
1.5 years with 6 visits to “wait for eruption”
Phase II Start records:
. Vertical
Frankfort to
mandibular plane
Palatal to
mandibular plane
. Wits
. Steiner
Mean ± SD
23°
22° (18°- 28°)
22,5°
28° (24°- 33°)
-3,5 mm
-1 - +2 mm
SNA
76,5°
82° ± 3,5
SNB
76°
80° ± 3,5
ANB
+0,5°
2°-4° ± 2,5
35°
33° ± 2,5
3,5 mm
21°
+2,5 mm
4 mm
22°
4 mm
19°
25°
70°
67°
GoGnSN
+ 1/NA
- 1/NB
. Y-axis
Start phase II
Summary ceph measurements:
- Class III tendency mesofacial, slightly open growth
pattern
- Lower incisors are less retroclined
Summary of Phase II treatment mechanics
Alignment on 014N/016N for 4 months
Wire progression for 2 months
19x25ss KH loops upper and lower
Class III elastics for 1 month
Finishing 018ss for 4 months
Total 1 year with 13 visits
7 month Progress panoramic x-ray
Final Records
Only ceph numbers between start phase II and finish are taken under
consideration for final evaluation. Ceph made at start phase I has been made
on another ceph machine and cannot be used to compare.
. Vertical
Start phase II
Finish
Mean ± SD
23°
23,5°
22° (18°- 28°)
22,5°
23°
28° (24°- 33°)
-3,5 mm
-2 mm
SNA
76,5°
77°
82° ± 3,5
SNB
76°
76°
80° ± 3,5
ANB
+0,5°
1°
2°-4° ± 2,5
35°
35°
33° ± 2,5
3,5 mm
3 mm
4 mm
21°
22,5°
22°
+2,5 mm
2 mm
4 mm
19°
16,5°
25°
70°
71°
67°
Frankfort to
mandibular plane
Palatal to
mandibular plane
. Wits
. Steiner
GoGnSN
+ 1/NA
- 1/NB
. Y-axis
Summary ceph measurements:
Skelettal class III decreased slightly
Lower incisors retroclined slightly
-1 - +2 mm
Final Remarks:
This was an easy case, non-extraction. Phase I was worthwhile
Additional comments: not a part of the examination
Doctor time: No assistants are employed in the practice
Phase I = 5.5 hours
 2 consultations, take records, diagnosis and records processing = 3 hours
 Fit bands, send to lab LLA/TPA = 1 hour
 6 visits @ 15 minutes – 1.5 hour
Start phase II = 2.5 hours
 initial band and bond = 1.5 hour
 new records = 1 hour
Phase II = 6.5 hours
 2 visits @ 15 minutes = 0.5 hr
 6 visits @ 20 min = 2 hour
 4 visits @ 30 min (finishing) = 2 hour
 Deband and retainers (3x3) = 2 hours
Total Doctor Hours = 14.5 hours
Estimated efficiency with 1 assistant = 5.5 hours
 taking initial and final records = 1 hour
 record processing = 1 hour
 Phase I visits = 1 hour
 Band and bond = 0.5 hour
 Treatment visits = 2 hour
Adjusted possible time: Doctor 9 hours/Assistant 5.5 hours