ORTHO BITES Fig. 8 Fig. 12 months during cleaning appointments to evaluate and ascertain if Phase II would be necessary. CASE TWO: Nine Year Old Caucasian Female This patient had an ectopic lower left lateral incisor (Fig. 8). She was Class II dental and Class I skeletal (ANB of 2 degrees and WITS of 1mm) and exhibited a mesocephalic growth pattern with a GoGn to SN of 31 degrees, Y-axis to SN of 66 degrees, and SL measure-ment of 49 mm. Several months into the treatment, it was necessary to extract the primary teeth on the lower left, place prefabricated utility arch wires, and bring the lower ectopic lateral into the proper position (Figs. 9-11). Treatment continued with the utility arch wires, light class II elastics, and it was decided to go on into Phase II as the premolars were beginning to erupt (Fig. 12). This is the “catch 22” stage. At this point Phase I is complete, but the permanent teeth are coming in. If all of the hardware is removed now and it is decided to begin Phase II within the year, then a full fee for Phase II would have to be charged. However, if the treatment Fig. 9 Fig. 13 Fig. 10 Fig. 14 Fig. 11 40 March/April 2011 JAOS
Journal of the American Orthodontic Society March-April 2011: Page 40
