CASE REPORT Fig. 8 Fig. 12 Fig. 9 Fig. 13 maxilla that is not fused than it is to expand one that is. Is there a way to effec-tively treat a patient with the Big Daddy appliance Fig. 11 whose maxilla is already fused? Yes, if the Big Daddy appliance point of force application is placed at the level of the center of resistance of the maxillary first molar (Fig. 12), then the teeth will bodily translate. Case #3 The patient in Case #3 is an adult with a deep dental bite and constricted arches. The molars are Class I bilaterally. (Figs. 13-15) Treat-ment will entail utilizing Big Daddy appliances on both arches to widen. A piggyback intrusion arch 9 (Fig. 16) will be used to intrude the maxillary incisors to achieve proper overbite and overjet. Figs. 17-19 show the course of orthodontic treatment. Figs. 20-22 show the results of the orthodontic treatment. Both arches were widened and rounded out with Big Daddy appliances and proper overbite and overjet was achieved. How was proper axial inclina-tion of the maxillary posterior Fig. 10 Physics explains part of the dilemma. Biology explains the other part. Fusion of the maxillary sutures is completed at the age of 14-15 years in females and 15-16 years in males. 6 It is more effica-cious to bodily expand (Fig. 11) a 8 Fall 2022 JAOS
Journal of the American Orthodontic Society Fall 2022: Page 8
