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Example Case Submitted to the ABO Clinical Examination Disclaimer

This case presentation is an example of a case that fulfilled the Board's clinical examination requirements. There may be alternate methods, treatment plans and mechanics that could be used to achieve similar results.

This example is intended only as a guide, as presentation requirements are subject to change. Examinees should carefully follow the current exam year requirements when preparing case reports.

Original records for this case are of higher diagnostic quality than has been captured for this example presentation.

Notes to examinees

1. A printout of study model images is not part of the case presentation. Initial and/or interim study models will be submitted in plaster or in digital format as allowed in current exam year requirements. Final Study models will be submitted in plaster. Stereolithic or other reconstructed casts created from digital formats are unacceptable. All physical records, including plaster models, must be clearly marked with an informational label as described on the ABO website at "Record Identification." The example case includes images of the cephalogram with tracing overlay. This is not a submitted record, but serves to illustrate that your examiner will verify tracings against the cephalogram; therefore, ALL TRACINGS AND COMPOSITE TRACINGS MUST BE PRINTED ON TRANSPARENT MEDIA AT THE SAME SCALE AS THE UNTRACED LATERAL CEPHALOGRAMS.

2.

3.

4. Four reports per case and optional digital pretreatment models must be submitted to the ABO electronically prior to your exam date. Required case reports are: Written Case Report, Discrepancy Index, Cast-Radiograph Evaluation, and Case Management Form You may choose your method of submitting the case report data: Download the Case Report Work File, fill in and upload to the ABO electronic submission site Login and enter your reports directly to the ABO electronic submission site Use a combination of methods. The four case reports in this example case were completed using the optional Case Report Work File, then uploaded to the ABO electronic submission webpages.

ID# 12345 1-31-07

#2 13-08

Plaster Study Casts

ID# 12345 3-27-09

#2 15-10

The American Board of Orthodontics

Case Report Title Page

Case #2 DI ­ 44 Extraction Case

Patient's Name: Jane Doe ABO ID# 12345

ID# 12345 1-31-07

#2 13-08

ID# 12345 1-31-07

#2 13-08

ID# 12345 1-31-07

#2 13-08

EACH TRACING MUST BE SUBMITTED ON TRANSPARENT MEDIA AT THE SAME SCALE AS THE UNTRACED LATERAL CEPHALOGRAM

82 73 9

.

47

. .

114

.

39

. .

11 6 1

3

104

. .

ID# 12345 1-31-07

#2 13-08

ID# 12345 3-27-09

#2 15-10

ID# 12345 3-27-09

#2 15-10

ID# 12345 32709

#2 1510

EACH TRACING MUST BE SUBMITTED ON TRANSPARENT MEDIA AT THE SAME SCALE AS THE UNTRACED LATERAL CEPHALOGRAM

77 68 9

.

88 49

.

.

39

2

0

.

10 0

98

.

ID# 12345 3-27-09 #2 15-10

COMPOSITE TRACINGS MUST BE SUBMITTED ON TRANSPARENT MEDIA AT THE SAME SCALE AS THE UNTRACED LATERAL CEPHALOGRAM

ID# 12345 13-08 15-10

#2

ILLUSTRATION ONLY ­ EXAMINERS WILL OVERLAY TRACING ON CEPHALOGRAM

82 73 9

. .

47

. .

114

.

39

6

1

.

11 3

104

.

ILLUSTRATION ONLY ­ EXAMINERS WILL OVERLAY TRACING ON CEPHALOGRAM

88

77 68 9

49

39

2 10

0 0

98

The American Board of Orthodontics

Clinical Examination Case Report Work File

Version 2009-2010

Enter required case identification: ABO ID# Exam Year Case # Patient

12345 2010 2 Jane Doe

Instructions:

1. Adobe Reader, Version 8 or later, is required. Please select File...Save-As from the menu and save this Case Report Work File for each case that you will be submitting. 2. We recommend you Save-As with a descriptive filename, e.g. "ABOCase1.pdf". 3. Enter case report data to this work file at your convenience. 4. In the year prior to your intended clinical exam, register for the exam to activate your login to the ABO's electronic form website. 5. Using your ABO ID# and password, log into Form Submission. Online Services ­ Clinical Exam Electronic

6. Follow prompt to upload this Case Report Work File, or to enter case report data directly. 7. Your data will be verified against the current year's exam specifications.** 8. You may return to the electronic form webpages as many times as needed before the submission deadline. 9. When finished, you will mark the data for each case as Complete and select SUBMIT TO ABO. 10. You will be able to download a copy of your submitted case reports to Save and/or Print.

** Currently published ABO exam specifications apply to each year's exam, no matter when the examinee began gathering records. If you have uploaded a former year's Case Report Work File, you will be alerted if any data must be provided to meet current year specifications. You are encouraged to login early and verify your case report data.

6-3-2009

EXAM YEAR 2010 ABO ID # 12345

PATIENT'S NAME: RECORDS SET RECORDS DATE (mm-dd-yyyy) PT. AGE (yy-mm)

ABO WRITTEN CASE REPORT CASE# 2

Version 2009-2010

Page 2

Jane Doe

A

DOB (mm-dd-yyyy) A1

05-04-1993

B

01-31-2007 13-08

PHASE ONE OR

03-27-2009 15-10

PHASE TWO

SINGLE PHASE INITIATED TX DATE (mm-dd-yyyy) 04-02-2007 03-27-3009 COMPLETED TX DATE (mm-dd-yyyy) CASE CRITERIA IDENTIFIER Extraction Case DI VALUE 44

OR

CATEGORY NUMBER

HISTORY AND ETIOLOGY:

2,411

characters remaining

Patient is a 13y 8m Hispanic female who presented to the orthodontic clinic with a chief complaint of faulty speech. The speech therapist at school referred her to our clinic. School reports show slow learning abilities, low concentration and speech problems.

DIAGNOSIS Skeletal:

Class II skeletal due to a retrognathic mandible and excessive vertical growth. The growth evaluation is CVS 6.

Dental:

Tongue thrust, bilateral Class I molar and canine relationship, proclined upper and lower incisors, anterior openbite, overjet of 5 mm, anterior openbite of 2 mm, and there is mild upper and lower spacing.

Facial:

Lip incompetence at repose, obtuse nasolabial angle, protrusive upper and lower lips relative to the E-plane, everted lower lip, good upper incisor exposure at rest, and the interlabial gap at rest is 4 mm.

SPECIFIC OBJECTIVES OF TREATMENT Maxilla (all three planes):

Maxilla is well positioned and there are no skeletal objectives indicated.

Mandible (all three planes):

Accept retrognathia and perform an advancement genioplasty to improve the chin projection and increase face height.

Maxillary Dentition A-P:

Retract the maxillary and mandibular incisors and maintain the maxillary and mandibular molars with maximum anchorage until appropriate incisor position is obtained esthetically.

EXAM YEAR 2010 ABO ID # 12345 Vertical:

ABO WRITTEN CASE REPORT CASE# 2 Jane Doe

2,411

Version 2009-2010

Page 3

characters remaining

Extrude upper incisors to correct anterior openbite and provide speech therapy for tongue thrust. Maintain precise vertical molar control allowing no vertical change.

Intermolar Width:

Maintain transverse dimensions.

Mandibular Dentition A-P:

Maximum anchorage while needed.

Vertical:

Extrude lower incisors to correct anterior open bite. Absolute vertical control of molars.

Intermolar / Intercanine Width:

Maintain transverse dimensions.

Facial Esthetics:

Reduce U and L lip proclination and refer for genioplasty to improve chin projection.

TREATMENT PLAN:

1) Extraction of four first premolar teeth with advancement genioplasty. 2) Bands on the molars and bond remaining teeth using 0.022" x 0.028" slot standard edgewise brackets (no prescription). 3) .016" x 0.022" SS wires U and L with first, second and third order bends and start retracting canines with light power chains and J hook headgear for 12 hours a day, one night on the U3's, one on the L3's. 4) Proceed with arch wires: 0.018" x 0.025" SS until canines are fully retracted and dentition is leveled. 5) Use closing loops on 0.019" x 0.025" SS to retract incisors U and L. Continue with JH on the canines for anchorage. 6) Use Class II elastics if necessary and anterior elastics if needed for overcorrection of the open bite. 7) After retracting incisors, use coordinated 0.019" x 0.025" SS wires with no loops to finish and detail and coordinate arch forms. 8) Take progress x-rays and add gable bends and anterior artistic second order bends as needed for root parallelism. 9) Retention: Upper and lower circumferential Hawley. 10) Refer for extraction of third molars and for advancement genioplasty.

APPLIANCES AND TREATMENT PROGRESS:

Patient was very cooperative with J hook headgear, elastics, and oral hygiene. Nevertheless, gingival hypertrophy was an issue after incisor retraction which required the use of soft tissue dental laser from the U5-5 and L3-3. Procedure was uneventful and result was positive. Patient maintained good OH after procedure and no relapse of the hypertrophy was observed. Patient was debonded, delivered retainers and referred to OS for extraction of third molars and for advancement genioplasty. Full records will be taken afterwards.

RESULTS ACHIEVED If differing radiographic units preclude superimposition(s) ­ check here Maxilla (all three planes):

Maintained since no orthopedics and no surgery were performed.

EXAM YEAR 2010 12345 ABO ID # Mandible (all three planes):

ABO WRITTEN CASE REPORT Jane Doe CASE# 2

2,411

Version 2009-2010

Page 4

characters remaining

No growth was noted, maintained awaiting genioplasty.

Maxillary Dentition A-P:

Maxillary incisors retracted, some anchorage loss in the posterior, molars advanced 3 mm.

Vertical:

Fair vertical control, slight extrusions at the molars, relative incisor extrusion.

Intermolar Width:

Intermolar width was reduced 2 mm, but intercanine distance was maintained.

Mandibular Dentition A-P:

The lower incisors retracted with some anchorage loss in the posterior (molars advanced 3 mm).

Vertical:

Relative extrusion of the incisors, none at the molar, and open bite corrected.

Intermolar / Intercanine Width:

Intermolar width was reduced 2 mm, intercanine reduced 1 mm.

Facial Esthetics:

Reduced maxillary and mandibular lip proclination, refer for genioplasty to improve chin projection. Slight opening of the nasolabial angle but acceptable.

RETENTION:

Upper and lower circumferential Hawley removable retainers were placed. Will place bonded U1-1 if upper diastema recurs. Patient asked to continue her speech therapy to avoid relapse of the thrust.

FINAL EVALUATION OF TREATMENT:

Bimaxillary protrusion was corrected. Pt is very happy with result. She is scheduled in Oral Surgery for genioplasty and extraction of all four third molars. Soft tissue laser results are stable and patient smile is very pleasing. Given her vertical facial pattern, vertical control was very critical and was achieved by avoiding any molar extrusion.

EXAM YEAR 2010 12345 ABO ID #

ABO DISCREPANCY INDEX Version 2009-2010 CASE# 2 PATIENT NAME Jane Doe

TOTAL D.I. SCORE

OVERJET 0 ­ 0.9 mm. (edge-to-edge) 1 ­ 3 mm. 3.1 ­ 5 mm. 5.1 ­ 7 mm. 7.1 ­ 9 mm. > 9 mm. Negative Overjet (x-bite): 1 pt. per mm. per tooth Total OVERBITE 0 ­ 3 mm. 3.1 ­ 5 mm. 5.1 ­ 7 mm. Impinging (100%) Total

44

Examiners will verify measurements in each parameter.

= = = = = = =

1 0 2 3 4 5

pt. pts. pts. pts. pts. pts. pts

LINGUAL POSTERIOR X-BITE 1 pt. per tooth Total BUCCAL POSTERIOR X-BITE 2 pts. per tooth

Total

3

= = = =

0 2 3 5

pts. pts. pts. pts

CEPHALOMETRICS (See Instructions) ANB >6° or < -2° Each degree > 6° __ x 1 pt. Each degree < -2° __ x 1 pt. SN-MP > 38° Each degree > 38° __ x 2 pts. <26° Each degree < 26° 1 to MP > 99° Each degree > 99° __ x 1 pt. Total

= 4 pts. = __ 3 = __ = 2 pts. = __ 18 = 1 pt. = __ = 1 pt.

__ x 1 pt.

ANTERIOR OPEN BITE 0 mm. (edge-to-edge), 1 pt. per tooth = 4 pts. then 1 pt. per additional full mm. per tooth = 4 pts. 8 Total LATERAL OPEN BITE 2 pts. per mm. per tooth Total CROWDING (only one arch) 0 ­ 1 mm. 1.1 ­ 3 mm. 3.1 ­ 5 mm. 5.1 ­ 7 mm. > 7 mm. Total OCCLUSION Class I to end on =0 End-to-End Class II or III = 2 Full Class II or III =4 Beyond Class II or III =1 Total

5 = __

33

= = = = =

0 1 2 4 7

pts. pts. pts. pts. pts.

OTHER (See Instructions) Supernumerary teeth Ankylosis of perm. Teeth Anomalous morphology Impaction (except 3rd molars) Midline discrepancy (>3 mm) Missing teeth (except 3rd molars) Missing teeth, congenital Spacing (4 or more, per arch) Spacing(mx cent diastema > 2 mm) Tooth Transposition Skeletal asymmetry(nonsurgical tx) Addl. treatment complexities Identify:

__ x __ x __ x __ x @ __ x __ x __ x @ __ x @ __ x

1 2 2 2 2 1 2 2 2 2 3 2

pt.. pts. pts. pts. pts. pt.. pts. pts. pts. pts. pts. pts.

= = = = = = = = = = = =

__ __ __ __ __ __ __ __ __ __ __ __

pts. pts. per side pts per side pt. per mm additional

pts. pts. pts.

____________________________________________ ____________________________________________ ____________________________________________ Total Other 0

0

EXAM YEAR 2010 12345 ABO ID #

ABO Cast-Radiograph Evaluation CASE# 2 PATIENT NAME

Version 2009-2010

Jane Doe

Page 6

INSTRUCTIONS: Second molars should be in occlusion. Mark extracted teeth with a check in the bolded box. Place score beside each deficient tooth.

Total Score:

8

3

1 1

Alignment/Rotations

1

Marginal Ridges

2

1

1

Buccolingual Inclination 0

Overjet 0

EXAM YEAR 2010 12345 ABO ID # Occlusal Contacts

1

ABO Cast-Radiograph Evaluation CASE# 2 PATIENT NAME

Version 2009-2010

Jane Doe

Page 7

1

R

Buccal Surface

L

L

Lingual Surface

R

Occlusal Relationships

2

1

1

Interproximal Contacts

0

R

L

Root Angulation

0

R

L

Page 8

EXAM YEAR 2010 12345 ABO ID #

ABO CASE MANAGEMENT FORM Version 2009-2010 CASE# 2 PATIENT Jane Doe

Examiners will evaluate treatment objectives and results, in addition to doing a Records Analysis and Overall Analysis.

MEASUREMENTS

PRE TX A

SKELETAL ANALYSIS (S)

PROG A1 POST TX B DIFF. |A-B|

SCORING

0-Acceptable 1-Unacceptable

EXAMINEE TX OBJECTIVES

A-P MX A-P MN

Maintain/reduce maxillary position Maintain mandibular position

PRE TX OBJ

POST TX Score RESULT

SNA° SNB° ANB°

CEPHALOMETRIC

82

77 68

9

5.0 5.0

0.0

73

9

0 1 0 1 0 1 0 1 0 1 0 1

0 0 1 0 0 1 0 1 1 0 0 1 0 1 0 0 0 1

SN-MP** FMA°

47

49

2.0

39

39

0.0

VERT MX VERT MN

Prevent increase in vertical dimension

Prevent increase in vertical dimension

DENTAL ANALYSIS (D)

1 TO NA mm 1 TO SN° 1 TO NB mm 1 TO MP

6 2 4.0

114

11

104

88

10

98

26.0

1.0

6.0

A-P MX

Maintain upper incisors; achieve Class I molar and canine with normal overjet and overbite

A-P MN

Advance lower incisors; achieve Class I molar and canine with normal overjet and overbite

VERT

Prevent dental extrusion

0 1 0 1 0 1 0 1 0 1 0 1 0 1

0 1 0 0 1 0 1 0 1 0 1 0 1

6 TO 6 WIDTH 6 TO 6 WIDTH

32.5

30.5

2.0

TRANS MX TRANS MN TRANS ANT

CURVE OF SPEE ARCH FORM MN

Increase maxillary transverse dimension - resolve crossbite Maintain Maintain Level

0

30.0 25.5

28 24.5

2.0 1.0

0

0

ARCH

3 TO 3 WIDTH CURVE OF SPEE MANDIBULAR ARCH FORM

1

OV

0

OV

1.0

SAME

0

0

Maintain

FACIAL ANALYSIS (F)

Upper 1

0

0

1.0

3.0

E-LINE

Lower 3

FACIAL ESTHETICS

Maintain facial esthetics

0 1 0

Scoring sub-totals for S-D-F

Shaded areas for examiner only.

1

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