ORTHOBITES Fig. 4 .014 nitinol the following month. This arch wire remained in the patient for six months. In month seven, I placed an .018 nitinol arch wire to round out the arches more. I placed an .020 stainless steel in month eight with accentuated curve in the upper arch wire and tie-back to open the bite without flaring the upper anterior teeth, and a reverse curve in the lower to allow flaring and intrusion. The bite opened nicely, and in month eleven, the second molars had erupted partially. I placed buccal tubes on the second molars and placed an .018 nitinol arch wire for a month. After the second molars were in alignments, I followed with a .016 x .022 nitinol and then a .016 x .022 stainless steel. The patient slipped a little class II; therefore, I opted to place an MDA for three months; distalized the upper molars, and retracted the premolars, canines, and anterior teeth with power chain. Fig. 5 Skeletal Fig. 6 SNA SNB ANB SND SN-GoGn Occ Plane to SN Y-Axis (SGn-SN) Interincisal Angle (U1-L1) Fig. 7 83.8 78.4 5.4 75.4 24.9 18.4 67.4 103.4 121.5 31.8 39.4 4.3 7.3 2.8 1.5 47.6 82.0 80.0 2.0 76.0 32.0 14.0 67.0 132.0 122.0 22.0 25.0 2.0 2.0 2.0 -1.0 51.0 4.0 4.0 2.0 4.0 5.0 3.0 3.0 2.0 4.0 2.0 2.0 2.0 2.0 2.0 1.0 2.0 0.4 -0.4 1.7* -0.1 -1.4* 1.5* 0.1 -14.3***** 4.9**** 1.9* 7.2***** 1.1* 2.6** 0.4 2.5** -1.7* check the lower bonded retainer Estimated Treatment Time: 18 -24 months PRE-ORTHODONTIC RECORDS: (Figs. 1-4) POST-ORTHODONTIC RECORDS: (Figs. 5 – 8) Gonial / Jaw Angle (Ar-Go-Me) U1-NA L1-NB U1-NA (mm) L1-NB (mm) Pog-NB (mm) Wits Appraisal (mm) Case Summary and Analysis In month one, complete records were taken, informa-tion and consent documents were reviewed with parents, and separators were placed between the interproximals of the first molars. The first molars were banded, the premo-lars and anterior teeth bracketed with .022 slotted brack-ets (Modified Roth Prescription), and an .012 Nitinol arch wire was initially placed. Composite pads were also placed on the occlusal of the first molars to open the bite to prevent bracket failure. As the second molars were not in full eruption, I delayed banding and progressed to an S-L (mm) Soft Tissue Upper Lip-S Line (mm) Lower Lip-S Line (mm) 2.2 6.3 0.0 0.0 2.0 2.0 1.1* 3.2*** www.orthodontics.com May/June 2012 13
Journal of the American Orthodontic Society May-June 2012: Page 13
