Patient | Oscar Needsortho | ||
Date of birth | April 24, 1986 | Sex | Male |
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 | 6dfca1a2-4cdc-4e62-804d-61f3a6d90090 |
Document Created: | August 1, 2018, 13:00, PST |
Healthcare service | Comprehensive orthodontic treatment of the adult dentition from August 15, 2017 to July 25, 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 | 32 year old male with history of bicycle accident at age 6. Skeletal class I |
Orthodontic Habits | Tongue thrust |
Traumatic Deviations | (previous trauma) Right side Ramus notably longer than left side causing significant chin point deviation and lower |
Asymmetry of Lower Face | Chin point deviates 10mm to the left of midsagittal plane. |
Condylar Abnormality | Left side condyle displays evidence of previous (healed) fracture / short compared to right side |
Craniofacial Anomalies | N/A |
Orthognathic Surgery Possibility | Possible to improve lower face midline correction. |
Airway Problems | N/A |
Treatment Precondition | Temporomandibular Dysfunction |
Diagnostic Feature | Posterior crossbite limited to right side |
Craniofacial Anomaly | N/A |
Dental Abnormality | Tooth #4 - Absent |
Dental Abnormality | Tooth #17 - Absent |
Dental Abnormality | Tooth #32 - Absent |
Dental Abnormality | Tooth #A - Ankylosed |
Dental Abnormality | Tooth #1s - Supernumerary |
Benefits Requested | Comprehensive Treatment |
Dentition Stage | Permanent |
Overjet | 3mm |
Overbite | 2mm |
Openbite | 4mm |
Arch Crowding | Anterior Maxilla - 4mm |
Arch Crowding | Anterior Mandible - 7mm |
Labiolingual Deviation | 3mm |
Observation | Value |
---|---|
Salzmann Index | 26 |
Posterior Inter-Arch Deviation | Tooth 6 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 6 - Openbite |
Posterior Inter-Arch Deviation | Tooth 5 - Posterior Deviation |
Posterior Inter-Arch Deviation | Tooth 11 - Anterior Deviation |
Posterior Inter-Arch Deviation | Tooth 12 - Anterior Deviation |
Posterior Inter-Arch Deviation | Tooth 13 - Anterior Deviation |
Posterior Inter-Arch Deviation | Tooth 14 - Anterior Deviation |
Overjet Teeth Count | 2 |
Crossbite Teeth Count | 2 |
Openbite Teeth Count | 2 |
Missing Teeth Count | Posterior Maxilla - 1 |
Crowded Teeth Count | Anterior Mandible - 4 |
Rotated Teeth Count | Anterior Maxilla - 2 |
Rotated Teeth Count | Anterior Mandible - 4 |
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 July 25, 2018, 13:00, PST |
Contact info | Work Place: 12345 Main Street Fairfax, VA 22031, US Tel: +1(555)555-0002 |