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Dr. Brad Fulton (General Dentist)
Dr. Jeff Shirck (Orthodontist)
Dr. Dave Smeltzer (OMFS)
May 7th, 2015
40 yo Male
 Chief Complaint:
“I keep breaking my teeth”

• Mandible 5mm left of MSP
• Decreased incisal display on smile
• Right gonion 7mm sub left gonion
• Missing #1/2/16
• Crown #7 with endo treatment
• Multiple anterior composite
restorations
• Discoloration #8
• Maxillary crowding
• Narrow maxillary arch
•
•
•
•
•
Crown #19
Fractured #25
Endo treated #26
Mandibular crowding
#17/#32 present
• Class III malocclusion right and left
• Crossbite #8-#15
• Mandibular midline 4mm left MSP
1.
2.
3.
4.
5.
Extract #17, 25, 32
Comprehensive orthodontics (Estimated
treatment time 18 months)
Orthognathic Surgery approximately 12 months
into treatment (Asymmetric BSSO to rotate
mandible back to the right to get chinpoint onto
face and a 2-piece Lefort with downgraft)Goal
will be to get middle of lower incisor on to the
midpoint of face
Post-surgical orthodontics
Restorative work on #7-10 (discussed whitening
and crowns/veneers)
6/12/13: Orthodontic treatment started
10/13/14: Surgical hooks placed for
orthognathic surgery
11/25/14: Three weeks post orthognathic
surgery
3/18/15: Day of debond