Fig. 8: Before panoramic x-ray taken at a previous orthodontic consult. Fig. 9: Panoramic X-ray during treatment to evaluate distalization and eruption path of the upper canines and derotation of the lower canines. Treatment time of Figs.6-10 is three months. The patient is monitored during movement to make sure they are not abusing the appliance and causing unwanted movements which can happen easily. This patient bit her bands down under the tissue and that can cause supereruption of the posterior which in some cases is an unwanted side effect. Total treatment before retainers was just under 6 months. The parents had been on an orthodontic consult where the orthodontist had explained to them the research showed there was no long term benefit to phase one therapy. I believe that early expansion can solve airway problems which can effect the child their entire life, and is best done prior to the final bony development where it hardens and becomes more rigid. In addition stigma from bullying can become a cause for the child to not do well in school from the repeated distractions. I have heard discussions of the debate between the need for phase 1 treatment for orthodontic reasons, but I personally have found nonorthodontic reasons related to orthopedics and psychological devel-opment that make it a valuable tool in my office. Fig. 10 www.orthodontics.com Fall 2017 27
Journal of the American Orthodontic Society Fall 2017: Page 27
