Patient | Olivia Needsortho | ||
Date of birth | November 14, 2008 | Sex | Female |
Contact info | Primary Home: 555 Home Street Fairfax, VA 22031, US Tel: +1(555)555-0001 |
Patient IDs | 111223333 2.16.840.1.113883.4.1 |
Document Id | 8ebd8c7d-97d6-4a78-8a23-945b62420531 |
Document Created: | August 1, 2018, 13:00, PST |
Healthcare service | Comprehensive orthodontic treatment of the adolescent dentition from February 15, 2017 to June 4, 2018 | ||
Performer (primary care physician) | Olga Orthodontist, DMD of Fairfax Orthodontic Care |
Author | Olga Orthodontist, DMD |
Contact info | Work Place: 12345 Main Street Fairfax, VA 22031, US Tel: +1(555)555-0002 |
Observation | Value |
---|---|
Orthodontic Narrative | 10 year old female presents with maxillary transverse and anteroposterior deficiency. Class III dental relationship with anterior and posterior crossbite. |
Orthodontic Habits | Tongue thrust. |
Traumatic Deviations | N/A |
Asymmetry of Lower Face | N/A |
Condylar Abnormality | N/A |
Craniofacial Anomalies | Cleidocranial dysplasia: retention of multiple non-resorbed primary teeth and multiple supernumerary teeth in maxilla and mandible. Midface hypoplasia induced class III skeletal relationship |
Orthognathic Surgery Possibility | Possible to align maxilla and mandible post growth cessation. |
Airway Problems | N/A |
Treatment Precondition | N/A |
Diagnostic Feature | Articulatory defect secondary to dental defect |
Craniofacial Anomaly | Cleidocranial dysostosis |
Dental Abnormality | Tooth #4s - Supernumerary |
Dental Abnormality | Tooth #11s - Supernumerary |
Dental Abnormality | Tooth #12s - Supernumerary |
Dental Abnormality | Tooth #20s - Supernumerary |
Dental Abnormality | Tooth #28s - Supernumerary |
Dental Abnormality | Tooth #29s - Supernumerary |
Benefits Requested | Comprehensive Treatment |
Dentition Stage | Mixed (transitional) |
Overjet | -4mm |
Openbite | 7mm |
Arch Crowding | Anterior Maxilla - 7mm |
Arch Crowding | Anterior Mandible - 8mm |
Labiolingual Deviation | 5mm |
Observation | Value |
---|---|
Salzmann Index | 63 |
Posterior Inter-Arch Deviation | Tooth 6 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 5 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 4 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 3 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 11 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 12 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 13 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 14 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 6 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 5 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 4 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 3 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 11 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 12 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 13 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 14 - Crossbite |
Posterior Inter-Arch Deviation | Tooth 6 - Openbite |
Posterior Inter-Arch Deviation | Tooth 11 - Openbite |
Overjet Teeth Count | 4 |
Crossbite Teeth Count | 10 |
Openbite Teeth Count | 6 |
Crowded Teeth Count | Anterior Maxilla - 4 |
Crowded Teeth Count | Anterior Mandible - 4 |
Rotated Teeth Count | Anterior Maxilla - 3 |
Closed Space Teeth Count | Anterior Maxilla - 1 |
Closed Space Teeth Count | Posterior Maxilla - 2 |
Closed Space Teeth Count | Posterior Mandible - 3 |
Document maintained by | Fairfax Orthodontic Care |
Contact info | Work Place: 12345 Main Street Fairfax, VA 22031, US Tel: +1(555)555-0002 |
Assigned entity | Tommy Toothman |
Contact info | Work Place: 12345 Main Street Fairfax, VA 22031, US Tel: +1(555)555-0002 |
Legal authenticator | Olga Orthodontist, DMD signed at June 4, 2018, 13:00, PST |
Contact info | Work Place: 12345 Main Street Fairfax, VA 22031, US Tel: +1(555)555-0002 |