Scribd
Upload
392 views

Orthodontic Case Workup Form PDF

This orthodontic case workup form summarizes the clinical findings and analyses for a patient. It includes extraoral and intraoral examinations noting facial symmetry, profile, dentition and occlusion. Model analyses examine arch form and space conditions. Radiographic analyses review the panoramic x-ray and cephalometric tracings, noting skeletal relationships, dental angulation and airway morphology. The prioritized problem list categorizes treatment needs into anterior-posterior, vertical, transverse, dental alignment and facial esthetics issues.

Uploaded by

Joe M Renda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
392 views

Orthodontic Case Workup Form PDF

This orthodontic case workup form summarizes the clinical findings and analyses for a patient. It includes extraoral and intraoral examinations noting facial symmetry, profile, dentition and occlusion. Model analyses examine arch form and space conditions. Radiographic analyses review the panoramic x-ray and cephalometric tracings, noting skeletal relationships, dental angulation and airway morphology. The prioritized problem list categorizes treatment needs into anterior-posterior, vertical, transverse, dental alignment and facial esthetics issues.

Uploaded by

Joe M Renda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

Name: Case #: Date of Class:

Orthodontic Case Workup Form


Clinical Examinations:

Extraoral Examinations
Frontal:
Facial form: Mesofacial_____ Dolichofacial______ Brachyfacial_______
Facial symmetry: Symmetric_____ Asymmetric_____ (Specify_______________________________)
Lower facial height: Normal_____ Increased______ Decreased______
Facial midline compared with dental midlines:
Maxillary: On _____ or ___mm to R/L
Mandibular: On _____ or ___mm to R/L
Profile:
Facial form: Straight_____ Convex______ Concave______
Lower facial height: Normal_____ Increased______ Decreased______
Nasolabial angle: Average_____ Acute______ Obtuse______
Lip protrusion: Upper: Normal_____ Protrusive______ Retrusive______
Lower: Normal_____ Protrusive______ Retrusive______
Mentolabial fold: Average_____ Shallow______ Deep______
Chin Projection: Normal_____ Increased______ Decreased______
Neck/chin angle: Average_____ Acute______ Obtuse______
Throat length: Average_____ Increased______ Decreased______

Intraoral Examinations
Soft Tissue:
Pathology:
Hygiene:
Pocket depth > 3mm: BOP:
Reduced keratinized gingival tissue:
Abnormal frenum attachment:

Dentition:
Dentition: Primary_____ Early mixed_____ Late mixed_____ Permanent_____
Occlusion: Molar: Class I_____ (R/L) Class II_____ (R/L) Class III_____ (R/L)
Canine: Class I_____ (R/L) Class II_____ (R/L) Class III_____ (R/L)
(Primary molar): Flush terminal plane_____ (R/L) Distal step_____ (R/L) Mesial step_____ (R/L)
Overall: Class I_____
Class II Div 1 _____ (Sub Div R/L) Class II Div 1 _____ (Sub Div R/L)
Class III _____ (Sub Div R/L)
Overjet: _____mm
Overbite: _____%
Crossbite: Anterior_____ Posterior buccal_____ Posterior lingual_____
Name: Case #: Date of Class:

Model Analyses:

Arch form: Maxillary: Ovoid_____ Square_____ Tapered_____ Omega_____


Mandibular: Ovoid_____ Square_____ Tapered_____ Omega_____

Space analysis:
Maxillary: Space available: _____mm Space required: ______mm Spacing/Crowding: _____mm.
Mandibular: Space available: _____mm Space required: ______mm Spacing/Crowding: _____mm.

Bolton analysis: 3-3: _____mm Maxillary/Mandibular Excess/Deficiency


6-6: _____mm Maxillary/Mandibular Excess/Deficiency

Radiographic Analyses:

Panoramic:
Pathology:
Maxillary sinus:
Root morphology: Dilaceration #___________ Shortened #_____________ Other _________________
Medial condylar morphology: Normal _____ Abnormal _____ (Specify___________________________)

Cephalometric Analysis:
Skeletal A-P: SNA= , SNB= , ANB= . Class I _____ Class II _____ Class III _____
Mandibular plane angle: SN-GoGn= , Normal _____ Hyperdivergent ______ Hypodivergent ______
Dental: Maxillary incisors: U1-SN= , Normal angulation _____ Proclined_____ Retroclined _____
Mandibular incisors: L1-GoGn= __, Normal angulation ____ Proclined____ Retroclined _____
Name: Case #: Date of Class:

Prioritized Problem List:


Pathology:

Please summarize problems into the following five categories and put them in order (1 through 5) based
on treatment needs (1 being most prominent):

_____ Anterior-Posterior (A-P):

_____Vertical:

_____ Transverse:

_____ Dental alignment:

_____ Facial Proportions and Esthetics:

You might also like