the tweed profile - The Charles H. Tweed International Foundation

The composite cephalometric tracings (Fig 8) illustrate the
upright mandibular incisors and the upward and backward
movement of the maxillary anterior teeth with good vertical
control of posterior teeth.
CASE 2
The second patient is a 23 year, 2 month old female. The
facial photographs (Fig 9) show a lack of facial balance because
of the retruded chin. The patient’s chief complaint was
the maxillary protrusion and crowding of anterior teeth. The
intraoral photographs (Fig 10) exhibit a class II molar relationship
with crowding of anterior teeth. The panoramic X-
ray (Fig 11) shows no pathology with the maxillary and the
mandibular third molars present.
The pretreatment cephalometric tracing (Fig 12) demonstrates
the class II skeletal and dental relationship. The FMA
of 42° indicates that this patient has a severe hyperdivergent
problem, therefore the control of the vertical dimension is
crucial. The FMIA of 41° and IMPA of 97° confirm the need
to upright the mandibular incisors. The ANB of 8° and the
AO-BO of 4mm illustrate the class II skeletal pattern. The
cranial facial difficulty was 222.5. The total space analysis
difficulty was 49.8. The total difficulty was 272.3.
To correct the crowding and the maxillary protrusion, four
first premolars were extracted. Even after first premolar removal,
a space deficit still existed as did the class II correction
requirement. After space closure and mandibular anchorage
preparation the malocclusion was re-evaluated. The
maxillary second molars were extracted to provide space for
maxillary posterior distal tooth movement. The total treatment
time was 27 months.
Fig 11
Fig 12
The posttreatment facial photographs (Fig 13) show a pleasing
facial change, a balanced facial profile and a nice smile.
The posttreatment oral photographs (Fig 14) exhibit a class
I intercuspation of the buccal segments, overbite and overjet
correction and no crowding. The posttreatment panoramic
X-ray (Fig 15) shows good root parallelism. The posttreatment
cephalometric tracing (Fig 16) shows the FMIA
increased from 41° to 50º. Reflecting vertical control, the
FMA remained at 42° and the occlusal plane also remained
at 16°.
Fig 9
Fig 13
Fig 10
Fig 14
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