Fig. 7 “This patient started out with another dentist as a serial extraction case. Is this a better option than the treatment plan that I am proposing?” plan that I am proposing? Let’s have the Sassouni + Archial Analy-sis answer that question (Fig. 21). b The skeletal vertical dimension is already deficient (Fig. 11-A). Extracting the 4 first bicuspids would deepen it further. Fig. 8 Simply placing brackets on a patient who possesses the above conditions will cause the bite to fly open rapidly and the skeletal vertical dimension to increase (Fig. 15). Assessing Cephalometric Bottom Line points 3 and 9 properly will allow a practitioner to predict what the treatment response will be to a proposal treatment. b Use a Nitanium Utility Arch (NUA) with tip-back bends to slightly intrude and torque 2, 1 1, 2 (Fig. 17) b Straight wire appliance Mandibular arch: b Use a lip bumper to distal rotate 6 6 and widen the arch (Fig. 17). b Straight wire appliance This patient started out with another dentist as a serial extrac-tion case (Figs. 19 and 20). Is this a better option than the treatment b The upper incisors are retru-sive and too vertical (Fig. 11-A). Extracting the 4 first bicus-pids would make them even more retrusive. b Constructed gonion is 13 mm behind the Posterior Arc (Fig. 11-B). At this age constructed gonion should be coincident with the Posterior Arc (Fig. 12). Extracting the 4 first bicuspids would entrap the mandible to the max virtually guaranteeing TMJ issues. b The upper lip angle is retruded (Fig. 6). Extracting the 4 first bicuspids would flatten the lip even more. Treatment Plan: What is the correct treatment plan in this case? Maxillary arch: b Use a Transpalatal bar 2 to widen and distal rotate 6 6 (Fig. 16). 14 Fall 2023 JAOS
Journal of the American Orthodontic Society Fall 2023: Page 14
