Fig. 9 Fig. 10 Fig. 11 Open coil spring was used to advance the anterior teeth. At this time, a nitanium palatal expander was also placed to correct the posterior crossbite (Fig. 9). Month 5. An .018 x .025 stainless steel wire was reached on the lower, so at this time, a “reverse” MDA® with CIII elastics was used to continue advanc- ing the anterior teeth. The Class III elastics, 2.25 heavy (6.4 oz.), are used to prevent distalizaton of upper molars. Distalization was also restricted by continued use of the expander (Fig. 10). Month 7. The patient broke his MDA®, so it was removed and the upper cuspids were bracketed and guided into place with a .012 NiTi wire (Fig. 11). Month 11. The patient was still in end-to-end occlu- sion in the ante- rior as well as still being Class III in the posterior after leveling the upper arch (Fig. 12). Fig. 12 www.orthodontics.com March/April 2010 39
Journal of the American Orthodontic Society March - April 2010: Page 39
