CASE REPORT AB must be changed to a shorter size. C Fig. 14 A-C: Once the overjet is corrected the long Class III elastics Fig. 11: Cephalometric measures based on Ricketts, Jarabak and McNamara analysis. AB Fig. 15 A-B: Upper incisors at the beginning of treatment are distally tipped (A). After retraction they were now uprighted (B). Fig. 12: The anchorage bends effect on the position of the anterior part of the archwires before ligating them in the brackets’ slots. ABC Fig. 16 A-C: Torque phase with a pair of 0.019” x 0.025” stainless steel archwires. A B CD Fig. 13 A-D: The Class II elastics (2,5 ounces) are given to the patient at the first appointment. “Nevertheless, we have realized that when the canine self-ligating archwire slot is in a horizontal position, all those effects don't happen. This is because the self-ligating brackets are nothing but a tube, and the tube permits the tooth to make a bodily movement.” case, the girl’s upper incisor exposure was at the lip edge. Thus, the lower incisors would need to be more intruded then the upper (Fig. 12). Along with placing anchor bends into the 0.016” archwire a pair of 2.5-ounce Class II elastics are worn in order to correct the overjet and overbite. (Fig. 13). After finishing the overjet and overbite correction, the lower premolars were bonded and an 0.020” Premier Plus archwire was placed with a curve of Spee. The archwire, once engaged, then rested at the cervical incisors level in the upper arch. Also, a pair of short Class II elastics were given to the patient for full time wearing (Fig.14).By comparing the frontal views at the beginning and after the overbite correction, we can see in the initial photo-graph that the central incisors crowns were at this point tipped distally and at the end of the overjet correction their crowns were now uprighted (Fig.15). This is one of the advantages in using straight-wire brackets instead of Tip-Edge brackets on incisors as you would with the Her frontal view facial analysis showed a passive lip seal and a good smile arch when she is smiling. The upper incisors had poor exposure for a 12-year-old girl. The lateral view showed the upper lip and chin were both lightly retracted (Fig. 10). According to Rickets cephalometric measurements, she showed a skeletal Class II and her growth direction shown in the Jarabak cephalogram was diagnosed as hypodivergent (Fig.11). Since the patient did not present with incisor crowd-ing, we began the treatment by going straight to the 0.016” Premier Plus. Anchor bends were placed in both the upper and lower archwires. Usually in the upper and lower archwires, we make anchor bends with the same angle. Normally, we make the anchor bend angles so that the upper arch wire rests at the deepest part of the vestibule. But in this case, we placed a lighter anchor bend in the lower archwire to avoid the exces-sive protrusion of the lower incisors. In this clinical 22 Fall 2020 JAOS
Journal of the American Orthodontic Society Fall 2020: Page 22
