Download Case Studies

Case Studies
www.thebrace.com
The Brace Orthodontic Practice would like
to present to you a series of case studies.
This booklet is divided into NHS and
Privately treated patients and includes
information on the Index of Orthodontic
Treatment Need (IOTN) to help you
determine when to refer patients for
NHS treatment.
2
NHS patients
NHS treatments are available to children who are assessed and start
treatment before their 18th birthday and meet IOTN criteria.
Aesthetic Component
The IOTN comprises 2 components; Aesthetic Component and Dental
Health Component. The Aesthetic component (AC) consists of 10
photographs showing different levels of dental attractiveness on a
scale of 1-10; 1 being the most attractive and 10 the least attractive.
NHS treatment is only available to those children judged to be 6
and above on the scale.
Dental Health Component
The Dental Health Component (DHC) categorises the detrimental
effects of abnormal occlusal traits and categorises the severity of
malocclusion into 5 grades; 1 being very mild malocclusions and 5
being very severe malocclusions. As an example, an increased overjet
over 9mm, missing or impacted teeth would all classify as IOTN 5.
IOTN 1 would be a very mild deviation from normal.
3
Before
After
Mr C
4
Patient information:
12 year old Male
Diagnosis:
Class I malocclusion with severe upper
arch and mild lower arch crowding.
Anterior crossbites without displacements
were present.
IOTN:
4
Treatment plan:
Extraction of all first premolars and upper
and lower fixed appliances.
Treatment time:
19 months
Before
After
Mr H
Patient information:
12 year old Male
Diagnosis:
Class 2 division 1 malocclusion with an
increased overjet of 10mm, crowding in both
arches and a congenitally absent upper right
second premolar.
IOTN:
5
Treatment plan:
Twin block functional braces followed by
extraction of all UL5, URE, LL5 and LR5 and
upper and lower fixed appliances.
Treatment time:
34 months - this treatment time is reflective of
the severity of this case as 2 appliances were
required in addition to extractions.
5
Before
After
Mr A
6
Patient information:
12 year old Male
Diagnosis:
Class I malocclusion with severe crowding of
both arches and poor prognosis of LR6.
IOTN:
4
Treatment plan:
Extraction of all LR6, LL4, UL4 and UR4 and
upper and lower fixed appliances.
Treatment time:
15 months
Before
After
Mr R
Patient information:
17 year old Male
Diagnosis:
Class 3 malocclusion with severe crowding
of the upper arch and mild crowding of the
lower arch. Anterior and posterior crossbites
were present.
IOTN:
4
Treatment plan:
Extraction of all first premolars and upper and
lower fixed appliances.
Treatment time:
19 months
7
Private patients
There are no restrictions on private treatment, it is available to all.
Typically our private patients are people over the age of 18 and children
who do not meet IOTN requirements for NHS treatment. We offer some
discounts for private treatments delivered to those under the age of 18,
more information can be found on our website www.thebrace.com.
8
Before
After
Miss P
Patient information:
29 year old Female
Diagnosis:
Class I malocclusion with crowding of both
arches and anterior and posterior crossbites
with displacement.
Appliance type:
Ceramic (tooth coloured) upper and lower
fixed braces
Treatment plan:
Create space using expansion and
interproximal enamel reduction (IPR).
Treatment time:
20 months
9
Before
After
Miss G
10
Patient information:
26 year old Female
Diagnosis:
Class I malocclusion with mild crowding of
both arches and posterior crossbite
without displacement.
Appliance type:
Invisalign
Treatment plan:
Create space using expansion and
interproximal enamel reduction (IPR).
Treatment time:
13 months
Before
After
Mr L
Patient information:
34 year old Male
Diagnosis:
Class II division 1 malocclusion with spaced
arches and large midline diastema.
Appliance type:
Invisalign
Treatment plan:
Close space using and reduce overjet with
interproximal enamel reduction (IPR) as
required. Photos are presented at invisalign
refinement stage so this case is not quite
finished and we are now in the process of fully
closing the last millimetre of midline diastema.
Treatment time:
12 months
11
Before
After
Miss D
Patient information: 25 year old Female
12
Diagnosis:
Class II division 1 malocclusion with 8mm overjet
and mild crowding complicated by previous
orthodontic treatment involving extraction of
premolars and veneers to the upper front teeth.
Appliance type:
Lingual (Incognito) and miniscrew implants
Treatment plan:
Extract upper third molars and use miniscrew
implants to distalise the upper arch to create space
to reduce the overjet. The photos demonstrate
how temporary implants were placed into the
alveolar bone and used as anchors to allow the
upper back teeth to be pushed back against the
bone thereby preventing the upper front teeth from
coming forward and increasing the overjet.
Treatment time:
30 months
13
Before
After
Mr A
Patient information: 24 year old Male
Diagnosis:
Class 1 malocclusion with
spaced arches and retained
ULC and palatally placed UL3.
Appliance type:
Invisalign combined with
ceramic fixed braces
Treatment plan:
Extract ULC and moved UL3
into position with a localised
upper fixed appliance and
complete treatment with
invisalign and IPR as required.
Treatment time:
14
26 months
Before
After
15
The Brace, 15 Artillery Passage, London E1 7LJ
Tel: 020 7247 5768 Email: [email protected]
www.thebrace.com