Each Affiliate Member shall be required to present the following records for each case presented:
Case Presentation Form
Use the enclosed standardized case Power Point template as a form for submitting each case. With this template, all radiographs and photos will be uploaded to the template and NOT submitted separately.
The Power Point template MUST be included in each binder and placed on your assigned table of the examining room. The Power Point case template for each case should be submitted to the Examining committee as well as your sponsors at least 30 days prior to annual meeting. The template can be sent as a PDF file to prevent any inadvertent changes.
The Power Point template includes all of the usual sections in a case workup, but provides a template for uploading photographs and radiographs within the same document. Please note that the number of slides/pages must NOT be increased. The only exception is in the case of additional alternate treatment plans which the guest or affiliate would like to include. In this instance, slide 19 may be duplicated and the additional plan(s) added.
The slides within the Power Point template have been organized to provide spaces for the initial case presentation, two progress presentations, and final case presentation. If the case is finished with only one progress presentation used, the slides for the additional progress presentation may be deleted.
Please pay close attention to the space given for each area. There is adequate space to complete each area with a font size of at least 18. DO NOT ADD any additional pages/slides.
If there are any questions regarding how to use the Power Point template, please contact your sponsor or any member of the Examining Committee.
A synopsis of case report MUST be include in each binder of case resume and 1 copy put on your assigned table of the examining room. The synopsis must be sent along with the case resume 30 days prior to annual meeting.
Synopsis of Case Report Sept 3 v1 Excel
A print out of case report MUST be include in each binder of case resume and 1 copy put on your assigned table of the examining room. Please print out the slides one to a page, double-sided.The synopsis must be sent along with the case resume 30 days prior to annual meeting.
Slides 1-24 are for the initial records,
Slides 25-37 for year 2 progress records,
Slides 38-49 for year 3 progress records
Slides 50-62 for final records.
Do NOT add slides UNLESS you have more than one viable treatment alternative (slide 19).
If that is the case, you may duplicate slide 19.
Clinical exam committee will evaluate your resume following these evaluation forms:
- Case presentation initial
- Case presentation progress
- Case presentation final
Complete Orthodontic Records
Complete records must be taken and presented annually representing the initial, progress, and completion (immediate post-treatment) stages.
Dental Casts
Casts must be taken at the Initial, progress, and completion phases of each case. All casts are to be made from excellent impressions.
Impressions which should extend far enough to allow accurate reproduction of all relevant soft and hard tissue anatomy in the dental casts.
Trimming or carving on the anatomical portion of the dental casts should be limited to the removal of bubbles and defects. After the casts are prepared, they should be smoothed and polished in such a manner that tooth and soft tissue detail are not destroyed.
The casts should be presented in an unmounted, dental articulated reference position. The backs must be trimmed flat with the teeth in maximum intercuspation.
It is not required to present cases on a semi-adjustable articulator, but if one wants to do so, please read the following instructions.
If the casts are to be presented in a joint dictated position (Centric Relation) a semi-adjustable articulator should be used. The casts should be mounted on the articulator using either an estimated or true hinge axis recording.
Documentation of a significant difference between the maximum intercuspation and centric relation positions should be noted and explained.
This documentation may be demonstrated as simply as an inter-occlusal registration bite for unmounted models or by the more complex use of an instrument that records a change in condylar axis of rotation such as a Condylar Axis Indicator (CPI), a Mandibular Position Indicator (MPI) or a Veri-Check instrument.
Cephalometric Records
1- Initial, progress, and completion lateral head radiographs are required with the nose facing to the right.
2- The head should be oriented in natural head position with the lips in repose.
3- Radiographs should be of good diagnostic quality with both hard and soft tissues visible.
4- Other radiographs, such as Posterior-Anterior head films and TMJ imaging, should be included as you feel appropriate to completely diagnose the case and assist in treatment planning. If any additional radiographs are needed, please insert them on new slides after the ceph analysis (slide 11).
5- If possible, all cephalometric radiographs should be taken with the same cephalostat so that magnification is consistent and superimposition can be performed. Ideally, a calibration scale attached to the mid-sagittal plane (nasion rest) should be visible.
6- Right and left ear rod concentricity should be tested in order to calibrate the cephalostat and minimize errors in head positioning.
7- All slides with radiographs are to be dated.
8- Identification labels for casts should include a minimum of patient initials, Angle Society case number and date of impression.
9- Radiographs should be labeled to distinguish right and left where appropriate.
Tracings
1- All tracings must be oriented with the nose facing to the right of the viewer.
2- Initial tracings should be drawn in black; first progress in blue; second progress in green; and completion in red. Computer tracings and superimpositions are permitted (Quickceph, Dolphin, Vistadent), as long as a consistent scale is used.
3- The tracings should record angle analysis in the Standardized Power Point template. A sample cephalometric analysis form is included on slides 9-11. You are encouraged to use this form.
4- Any analysis used must include at least the following:
4.1- ANB difference
4.2- Mandibular plane.
4.3- Molar relationship.
4.4- Incisor angulations.
4.5- Soft tissue contour.
5- A Visualized Treatment Objective (VTO) is required. The overall movements are entered on slide 24. This may be computer generated.
6- Three composite tracings are required (digital or manual).
8.1- Craniofacial Composite: Register on Sella with the best fit on the anterior cranial base bony structures (Planum Sphenoidum, Cribriform Plate, Greater Wing of the Sphenoid) to assess overall growth, soft tissue, and treatment changes.
8.2- Maxillary Composite: Register on the lingual curvature of the palate and the best fit on the maxillary bony structures to assess maxillary tooth movement.
8.3- Mandibular Composite: Register on the internal cortical outline of the symphysis with the best fit on the mandibular canals to assess mandibular tooth movement and incremental growth of the mandible.
Use the PDF template: Standardized Superimposition tracing Angle East June 2023
Note: If Frankfort Horizontal is drawn on the original tracing, it should be transferred to subsequent tracings. By not drawing Porion and Orbitale on the subsequent tracings, one will be reminded to superimpose on the cranial base and transfer the original Frankfort Horizontal. This will help reduce tracing and measurement error.
Panoramic and Intraoral Radiographs
1- Initial, progress, and completion panoramic or full mouth intra-oral radiographs shall be required, particularly in multidisciplinary cases.
2- All radiographs must be of good diagnostic quality
3- Radiographs should be labeled to distinguish right and left where appropriate.
4- Dental, periodontal and skeletal anatomy, including mandibular condyles, should be identifiable on panoramic films.
Photographs
1- Initial, progress, and completion photographs are required.
2- Facial photographs should be taken in natural head position with the lips in repose and smiling. (In addition, other views may be presented depending upon diagnostic value)
3- Frontal and profile views should be taken with lips in repose and smiling and the profile views should be oriented with the nose to the right.
4- Facial images should head and neck only and fit into the template on slides 4, 25, or 35
5- Intra-oral photographs shall include frontal, right and left lateral, and maxillary and mandibular occlusal views.
6- Intra-oral photographs should be approximately at 1:1 magnification.
General presentation instructions
Your written presentation should include a discussion of the patient’s diagnosis, a detailed problem list (including the patient’s and/or parents’ chief concern), your goals and objectives of treatment as well as the benefits and limitations of the treatment plan(s) proposed and finally selected. Your presentation should be supported with the documentation of your clinical examination and the patient’s diagnostic records. Angle’s Classification of the molar relationship should be used to select cases in the following categories. Cases are to be numbered according to the following guidelines:
Case I. Class II, division 1 with 6 mm or more of overjet, at least a side with 5 mm class II molar
Case II. Class II, division 1 with 6 mm or more of overjet, at least a side with 5 mm class II molar
Case III. Class II, division 1 with 6 mm or more overjet or class II division 2 or class II div 2, at least a side with 5 mm class II molar
Case IV. Four unit extraction
Case V. Adult treatment
Case VI. Adult treatment
Two [2] additional cases must be brought from one of the above categories, totaling eight [8], from which the Examining Committee and Affiliate will select six [6] cases to be completed. At least four (4) of the six (6) selected cases must be completed to the standards of excellence acceptable to the Examining Committee as partial fulfillment of the requirements for membership in Angle East. Treatment cannot be initiated more than 3 months prior to the annual meeting.
It is critical to carefully and properly select the necessary cases per the assigned category. Cases that do not fit the assigned category will not be accepted and the Affiliate will be required to present replacement cases at the next annual meeting.
An interdisciplinary case selection (perio, prostho, endo, TMJ, surgical) is permitted for the guest case. If an interdisciplinary case is to be selected for one of the prospectively treated case during the affiliates years of membership, only one such case is permitted and the candidate should keep in mind that the estimated treatment time should not exceed three years.
If a two- phase treatment case is to be used among the 8 prospective cases, the candidate must include full initial records of phase 1and full initial records (ceph, pan, photo, models) of phase 2 comprehensive treatment. Please note, if the patient was treated with two phases, ONLY the comprehensive phase can be presented.
Case that had previous comprehensive orthodontic treatment (retreatment) are not permitted.
Evaluation of the treatment results will be based on the attainment of the treatment goals and objectives that you have detailed in slides 14-16 as well as consideration of the following orthodontic treatment objectives:
1- Balance and harmony of facial features with proper proportions and symmetry, including the smile.
2- Maximum esthetics of the teeth and supporting soft tissues.
3- Treatment complementing facial growth, specifically demonstrating control of vertical skeletal and dental relationships.
4- Health of the teeth and the supporting tissues.
5- Coordinated arch form with all the teeth aligned within their supporting structures, including permanent second molars
6- Intercuspation of teeth supporting dental stability, free of interference and trauma.
7- Functional overjet and overbite relationships.
8- Proper axial inclinations and torque of all teeth, including 2nd molars.
9- Correction of all rotations. Complete space closure where appropriate
Specific areas to be evaluated by examining committee
Written Presentation
1- Diagnosis and Problem List (including the patient’s chief concern and contributory medical and dental histories)
2- Treatment Plan(s) indicating detailed goals and limitations of proposed treatment plan(s). Specific treatment goals or objectives should be established including assessment of tooth movement (incisors, molars and canines) and surgical movement when surgery is planned. Include a discussion of the biomechanics that will be needed to achieve the goals proposed in the selected treatment plan.
3- Documentation and analysis of the progress and final results will be compared to the original treatment goals that you forecasted at the start of treatment. Discuss any limitations of treatment and/or unanticipated results.
Diagnostic Records
1- Photographs
1.1- Diagnostic quality of images
1.2- Assessment of facial soft tissue balance and harmony
1.3- Changes forecast with treatment and/or growth
2- Panoramic Radiographs
2.1- Diagnostic quality of image
2.2- Visualization of hard tissue anatomy including mandibular rami and condyles
2.3- Integrity of dentition, periodontium and condyles
2.4- Alignment of dental units
2.5- Absence of root resorption
3- Cephalometric Radiographs & Tracings (Lateral and Posterior-Anterior views)
3.1- Diagnostic quality of images
3.2- Presence of initial, progress and completed radiographs, tracings and composite superimpositions
3.3- Discussion of cephalometric data that should support diagnosis, problem summary, the establishment of treatment goals and objectives and the proposed effects of treatment mechanics on treatment outcome
3.4- Attainment of “stated” treatment goals and objectives
3.4.1- Influence of growth on maxillo-mandibular relationship
3.4.2- Influence of treatment on maxillo-mandibular relationship
3.4.3- Changes in facial soft tissue
3.4.4- Changes in the occlusal plane
3.4.5- Changes in overjet and overbite
3.4.6- Torque and A-P position of anterior teeth
4- Dental Casts
4,1- Accurate replication of anatomical structures
4.2- Documentation of maxillo-mandibular relationship using upper and lower dental casts (models related in maximum intercuspation) or models related using a condylar reference position (CRP / CR)
4.3- If dental casts are related via a CRP / CR, please provide documentation of discrepancy between CRP / CR and MIC / CO and discuss significance of discrepancy
4.4- Occlusal plane changes
4.5- Overjet and overbite changes
4.6- Relationship of dental and skeletal midlines
4.7- Changes in dental arch symmetry
4.8- Changes of dental arch width at the canine and molar areas
4.9- General alignment
4.10- Correction of dental rotations
4.11- Angulation and torque of anterior and posterior teeth (including 2nd molars)
4.12- Marginal ridge relationships
4.13- Occlusal contacts of anterior and posterior teeth
Documentation of tooth size discrepancies and their management
Periodontal soft tissue changes
