Case Tc

Male patient, aged 11.4 years, with a Class 1 skeletal relationship (ANB 3°) and a slightly low-angle pattern (MM 23°). He was slightly Class 11 dentally. This type of malocclusion is frequently seen.

The incisor relationship was close to normal, although there was a midline discrepancy of 2 mm and a lack of space for erupting upper canines. The molar relationship was 3 mm Class II on the right and 2 mm Class II on the left. It was decided to treat to a square arch form.

Radiographs showed all permanent teeth developing normally.

At the start of treatment, the first molars were banded, and the patient was asked to wear a sleeping headgear. The lower arch was fully bracketed, and leveling and aligning was commenced with a .016 I lANTwire. An upper sectional multistrand wire was placed for the upper incisors.

T.C. Beginning 11.4 years 3/6/97

Fig. 7.87

SNA / 85 ° SNB / 82 • ANB£ 3° A-N J_ FH 0 mm Po-N _ FH 0 mm WITS 1 mm GoGnSN / 26 ° FM / 20 • MM/23" JL to A-Po 4 mm 1 »o A-Po 0 mm

T.C. Beginning 11.4 years 3/6/97

Fig. 7.97

Fig. 7.104

Fig. 7.101

Occlusal views at the start of treatment.

Sequential views after 2 months, 4 months, and 9 months of treatment. An upper sliding jig was placed on a .020 round archwire, and Class II elastics were worn during the daytime, with a headgear at night (Fig. 7.102). Upper molars and premolars moved distally to a Class I relationship, and space was created for upper canines (Fig. 7.103).

Occlusal views after 9 months of treatment. A lower lingual arch was maintained to support lower molars so that mesial movement did not occur in response to the Class II elastics. A lower steel rectangular wire was in place, with passive tiebacks.

After 18 months of treatment, the case is seen with upper and lower rectangular steel wires, passive lower tiebacks, and active upper tiebacks. Additional torque frequently needs to be placed in the anterior part of the upper archwire at this stage, to achieve palatal root torque of upper incisors and to correct the buccal occlusion (p. 284).

Fig. 7.101

Fig. 7.104

Fig. 7.103

Fig. 7.109

Fig. 7.106

Fig. 7.102

Fig. 7.105

Fig. 7.109

Fig. 7.103

Fig. 7.106

Fig. 7.113

Fig. 7.116

Fig. 7.110

The case after appliance removal.

Occlusal views of the case after treatment. Subsequent development of third molars was monitored.

Facial esthetics showed pleasing balance and harmony at the end of treatment, with upper and lower incisors well positioned in the facial complex.

Fig. 7.116

Fig. 7.110

Fig. 7.113

Fig. 7.112

Fig. 7.111

Fig. 7.112

Fig. 7.111

Was this article helpful?

0 0
Booze Basher

Booze Basher

Get All The Support And Guidance You Need To Permanently STOP The Battle With Alcohol Once And For All. This Book Is One Of The Most Valuable Resources In The World When It Comes To Transformational Tools For Battling Booze Binges And Staying Alcohol-Free.

Get My Free Ebook


Post a comment