E/O Symmeter and vertical proportions :
- noticable assymetry between left and right side of face
- frontal heigh is equally divided
Frontal facial profile:
- Facial fights,
- width of mouth is more than interpupillary
- width of nose is smaller than the interpupillary distance
- lhs las segment is smaller = uneven facial fifths
- lower face:
- tooth display:
- MI greater than usal at rest because of incompetance
- on smile is adequant
- absent buccal corridor
- smile arch is consonant
- dental midline is shifted to patients right
- tooth display:
- Lateral view
- convex profile
- equal proporitions
- Mandibular plane angle is normal
- Tooth/lip
- Protrusive lower lip
- Prominent and incompetent lips at rest
- IO frontal
- Anterior open bite
- central diastema
- IO occlusal
- mixed dentition: permanent 1st molars , permanent incisors : dental age: 8-9 years
- v shaped maxillary, u shaped mandibular
Problem list
- AOB
- increased overjet
- Class II relationship
- Lip incompetencne
- Midline discrepancy
- Diastema
- Malocclusion overall
Do nothing?
Tx:
- thumb sucking
- behavioral management
- appliance therapy