Dental And Oral Health - Case Study 45

Patient Profile: 

Patient is a Caucasian male, 5’ 10” and 155 lbs. Immediate post-orthodontic treatment age is 15 years; and pre-treatment age was 11.5 years. Patient has one younger sister.

Chief Complaint: 

Statement by Mother: “We are concerned about his bite. His upper front teeth appear too big, too long and too far forward.”

Medical History: 

No history of hospital admission. Patient may be allergic to penicillin as he experienced a skin rash when taking ampicillin for ear infection at age 7 yrs. Patient has an aortic valve heart murmur, discovered at birth, and is evaluated once a year by a pediatric cardiologist.

Dental History: 

Patient referred to orthodontist by pediatric dentist. History of regular dental care consisting of routine dental prophylaxis, dental sealants. Three small Class I amalgam restorations in teeth #3 and #19.

Health Behaviors: 

Patient brushes three times daily with a power toothbrush and a fluoride toothpaste.

Extraoral Examination: 

Palpation of submandibular, sublingual and cervical chain lymph nodes was within normal limits. No facial skin lesions. Frontal view of the face is bilaterally symmetrical. Eye movement is normal. No skin lesions in hair line.

Intraoral Examination: 

Visual examination and palpation of intraoral tissues was within normal limits. Teeth are in mixed dentition stage of eruption. Incisor and permanent 1st molar relationships indicate a Class II, Division I malocclusion.

Supplemental Information: 

A pre-treatment panelipse radiograph shows no periodontal bone loss; all permanent teeth are present; 3rd molars are developing; and no signs of bony pathology. A pre-treatment periodontal charting of probing depth, clinical attachment levels and bleeding on probing was not obtained.

A post-treatment plaque score and bleeding index were obtained at 7 days after removal of the orthodontic appliances. In addition, during a visual examination of the gingivae it was noted that several posterior teeth exhibited residual orthodontic resin cement. Subgingival exploration confirmed the presence of residual cement on several molar teeth.

Post-orthodontic Treatment Bleeding Index: 

66% (111/168 sites)

Post-orthodontic Treatment Plaque Score: 

25% (28/112 surfaces)