ORTHOBITES Fig. 13 Fig. 14 “It is my belief that transverse correction during interceptive orthodontics is highly successful. However, due to the flat/block-like/ no anatomy/ primary molars, often sagittal correction issues relapse to various degrees (with repositioning appliance therapy).” Fig. 15 Fig. 19 Fig. 20 Fig. 21 Fig. 16 Fig. 17 Fig. 18 straight teeth affect and enhance self-esteem. De-rotating the molars gains arch length to make more room for the permanent erupting teeth. Prefabricated Utility Arch wires not only accomplish the cosmetic and rotation of the molar issues, but also can be employed to regain lost arch length, correct anterior cross bites, open closed bites, and advance or constrict the arch length. At the end of Phase I (normally 8-14 months), I look to see if I have satisfied the three points above. I will leave the patient with approxi-mately a 2 mm overbite, widened arches if needed, sagittal issues addressed, and enough room for the permanent canines, 1st premolars, and 2nd premolars to erupt without crowding. I simply employ a “pearl’ I learned from a prior mentor, Dr. Sim. I measure with a mm ruler from the mesial of the lower first molars to the distal of the lower laterals. I always attempt to leave around 22+ mm here. This will allow the permanent teeth room to erupt without crowding. When achieved, for retention, I place a lower lingual arch constructed from a laboratory or a Fixed Removable Lingual Arch – (OO2). I always want this to touch the lingual of the lower anterior teeth to hold the anteriors in place keeping the space for the perma-nent teeth to erupt (Figs. 19-20). And I finish with the upper four anterior teeth with the 2 mm over-bite as discussed. I do not employ upper retention in Phase I (other than bonding two or four upper anterior teeth together with a retainer wire to keep straight or prevent a relapse (if there were spac-ing issues between the two upper centrals) (Fig. 21). It is my belief that transverse correction during interceptive 12 January/February 2013 JAOS
Journal of the American Orthodontic Society January-February 2013: Page 12
