After finances were sorted out we developed a treat-ment plan for her Phase II treatment: • • • • • Keeping the UAW on until all permanent teeth are erupted. Driftodontics (extraction of remaining primary teeth). SWA series to finish the case. Monitoring the tongue habit and the molar rela-tionship throughout the treatment and retention. Estimated treatment time was 24-36 months. We initiated primary teeth removal to facilitate the eruption of permanent teeth into the desired spots, meanwhile maintaining arch length with our upper arch wire. 36 months after the start of treatment we were able to bracket the remaining permanent teeth and started with a 0.18 NiTi wire, then progressed to a thermal NiTi wire 0.16x0.22, and finally finished in a posted Stainless Steel wire 0.18x0.25. (Fig. 8) I removed the braces after 48 months in treatment (Fig. 9). I took final records, and sent impressions to the lab for removable retainers. The patient, parents, and I were all happy with appearance of teeth, the bite and her profile. The patient was kept on regular orthodontic and hygiene recall, (Fig. 10) final models were taken 15 months post treatment, and the patient as always was very good in maintaining her teeth and retainers. (Figs. 11 & 12) Having multiple phases rolled into one worked well for this patient because she was very responsible at maintaining great oral hygiene, and wearing elastics when she was instructed. The active orthodontic treat-ment was about a year for phase 1 and another year for phase 2, and two more years of holding what we had obtained in phase 1 and allowing the primary dentition to exfoliate and be replaced by the permanent succes-sors. Final cephlometric and panoramic x-rays as well as finished photos show a great result. (Figs. 13-18) Fig. 16 Fig. 14 Fig. 17 Fig. 15 Fig. 18 www.orthodontics.com www orthodontics com May/ May/June y / J une 2013 41
Journal of the American Orthodontic Society May-June 2013: Page 41
