2010 RWISO Journal - Roth Williams International Society of ...

Figure 9-e Left lateral intraoral photograph
showing end-on class II canine relationship.
Figure 9-f Panoramic x-ray.
Figure 9-g Lateral cephalogram.
Figure 9-h Superimposition of the cephalometric tracings
after orthodontic treatment (red line) and 4-year retention
(green line), showing that there was little change in the
soft-tissue and hard-tissue structures.
Upon clinical examination, wear on the maxillary canine
tips was noted as being quite severe for his age. Upon further
questioning, the patient complained of occasional headache
and pain in the area of the temporomandibular joint (TMJ).
His static occlusion showed 1.5 mm of overbite at the central
incisors and no overbite on the left lateral incisor. The lower
anterior teeth were tipped to the left side, resulting in a lower
midline shift to the left side. Dentin exposures were present
on the upper lateral incisal edges and the lower anterior
teeth. The upper and lower first molars also showed marked
wear on the cusp tips. Upon excursive movement of both
right and left sides of the madible, the posterior teeth on the
chewing side showed simultaneous contacts—that is, group
function—and teeth on the nonchewing side showed harmful
contacts (Figure 10).
RWISO Journal | September 2010
63