CLINICAL CASE REPORT Figure 14: Custom-made orthodontic form with a compilation of all data, diagnosis and orthodontic treatment plan. collected, where comprehensive diag-nosis and treatment plan were explained. Once all parties agreed to treatment, patient was scheduled to begin active treatment. Patient was thirteen years and 1 month of age at the onset of active treatment. Initial therapy consisted of impression for fabrication of custom made RPE appliance connecting to first molars and first bicuspids. The mandibular arch had tubes bonded on the first molars and brackets on all the remaining teeth present. Spac-ers were placed on mesial and distal of teeth K and T to accelerate their exfoliation thus allowing #20 and #29 to erupt. Two weeks later, the 14 Fall 2024 JAOS