the tweed profile - The Charles H. Tweed International Foundation

the final result. Communication with the parent and/or the
patient (if an adult) is paramount in order to impart an understanding
of the process of treatment. We must keep in mind
that some patients need extractions and some do not.
If we apply these principles in our daily practice, we should
be able to maintain and/or improve facials esthetics. The
following case studies illustrate the importance of accurate
diagnosis and treatment planning.
CASE #1
Patient SK’s chief complaint was her “crooked teeth” and
not being able to “get my front teeth together”. A review
of her records showed a total discrepancy of approximately
15mm, which included 5mm of crowding, and 10 mm of
cephalometric discrepancy. Skeletally she had an open bite
tendency as well (Figure 6). With a history of previous orthodontic
treatment and the obvious relapse due to the large
discrepancy, an extraction treatment plan was chosen. The
results (Figure 7) show nice soft tissue profile improvement
into the esthetic zone due to the alignment and retraction of
the anterior teeth.
CASE #2
An African-American female presented to Dr. John Bilodeau
as a transfer patient with partial appliances in place.
The diagnostic records revealed a dentoalveolar protrusion
with edentulous spaces in both arches (Figure 8). After discussing
the problem and her desires for soft tissue profile
improvement, she was retreated with the extraction of three
premolars. Mini-anchors were used for absolute anchorage.
The protrusion was reduced and all edentulous spaces were
closed. The facial change was evident due to the reduction
of the protrusion (Figure 9).
Figure 8. Mulu Pretreatment
Figure 6. SK Pretreatment
Figure 9. Mulu Posttreatment
Figure 7. SK Posttreatment
CASE # 3
Patient CW’s chief complaint was her “crooked teeth”. Her
diagnostic records revealed 6mm of TSAL and about 6mm
of protrusion (Figure 10). Due to the low mandibular plane
angle, the crowding and the protrusion and an already pleasing
profile, a non-extraction treatment plan utilizing interproximal
reduction was selected. The result reveals good
tooth and dental arch alignment, a slight reduction in the
dental protrusion and no change in the profile (Figure 11).
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