ORTHOBITES “The GoGn remained relatively constant; the lips were no longer stained; the profile was spot-on; and I would doubt many clinicians would know that four premolars were removed.” Fig. 13 Fig. 14 Fig. 15 Fig. 11 Fig. 12 spaces, and reduce the fullness of the face. I presented both options, explained my reasoning to the parents, and the premolar extraction option was chosen. The four premolars were extracted in August 2007 and a light nitinol arch wire was placed (Fig. 4). A straight wire series was followed. Note in Figs. 5 and 6 that the spaces left by the removal of the first premolars literally closed on their own (without power chain or closing mechanics). This occurred due to the strain of the lip musculature attempting to gain a normal position. In March 2008, I placed .016 x .022 stainless steel with power chains (Fig. 7). In October 2008, I placed the patient in .018 x .025 with light class III elastics and power chain (Fig. 8). I continued to close space until March 2009, when I placed the patient in .018 x .025 sectional archwires and cross arch elastics (Fig. 9.) Figs. 10 – 18 show the final records taken in April 2009 and a series of side-by-side comparisons. The GoGn remained relatively constant; the lips were no longer stained; the profile was spot-on; and I would doubt many clinicians would know that four premolars were removed. Note the broad wide arch form still remains in both the upper and lower arches. And finally, there were not “dark triangles” that I have always heard about with extraction mechanics. Why? Because we are still using a broad arch form and form follows function…..remember? www.orthodontics.com September/October 2010 15
Journal of the American Orthodontic Society September-October 2010: Page 15
