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Orthodontic protocol Sagital relations Angle class: .................. Sagital relation right: ................... Sagital relation left: ................... Overjet (most protruded part): ........... .....mm Overjet (midpoint incisal edge 11): ......... mm. Overjet (midpoint incisal edge 21): ........ mm Overjet (mean 11, 21): ............. ................mm Transversal relations Unilateral crossbite: right: ........ (teeth: ........................), left: .......(teeth: ..........................) Bilateral crossbite: .....................(teeth: ........................) Crossbite single teeth: ........... ....(teeth: .......................) Scissors bite: ............ ..................(teeth: .......................) Transversal width 14/24 (buccal cusps): ................................ mm Transversal width 16/26 (mesiobuccal cusps): ...................... mm Palatal index (width/height): Premolar (14/24)............ Molar (16/26) ............... Vertical relations Deep bite: ................... Overbite: ................. mm Gingival contact: ............. Open bite: ................... Extention of open bite (teeth): .......................................................... Intra arch findings Spacing upper front: ................ Spacing lower front................... Spacing lateral left: .................. Spacing lateral right: ................ Crowding upper front: ............. Crowding lower front: .............. Crowding lateral left: ............... Crowding lateral right: ............. Congenitally missing teeth: .......................................................................................................... Impacted teeth: ............................................................................................................................. IOTN-AC: .................. PAR Displacement of contact points: 13/12........12/11..........11/21..........21/22...........22/23............ Sum: ............. 43/42........42/41..........41/31..........31/32...........32/33............ Sum: ............. Total: ............ Weighted (x1): ............................. Buccal occlusion right Buccal occlusion left Antero-posterior: ............ Antero-posterior: ............ Vertical: .......................... Vertical: .......................... Transversal: .................... Transversal: .................... Sum: ............................... Sum: ............................... Total: .............................. Weighted (x1): ............................... Overjet Horisontal overjet: ....................... Mandibular overjet: ....................... Total: ............................................ Weighted (x6): ............................... Overbite Open bite: .................................... Deep bite: ..................................... Total: ............................................ Weighted (x2): ............................... Midline ...................................................... Weighted (x4): ............................... Total sum: .................................... Total weighted sum: .......................
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