ORTHOBITES Fig. 16 Fig. 19 Fig. 20 Fig. 21 Fig. 17 Fig. 22 Fig. 18 Lateral Coordinated Arch Development in Underdeveloped Arches Figs. 12 -17 are of a case which had inadequate space for eruption of the upper and lower anterior teeth. The Caucasian patient was 7.5 years of age at the time of treatment. He was missing his lower left cuspid and the space was completely lost. He was also space deficient in the upper anterior lateral incisor region. Employing the SIM analysis system, I found he needed 6mm of lateral expansion in the anterior to allow all of the permanent teeth to erupt. I placed an upper Nitanium Palatal Expander 2 in the upper arch and a lower Trans-verse TransForce appliance in the lower arch along with prefabricated utility arch wires (ORTHO ORGANIZERS-HENRY SCHEIN ORTHODONTICS) . The Phase I early treatment lasted for eleven months. I placed a lower Fixed Removable Lingual Arch (ORTHO ORGANIZERS-HENRY SCHEIN ORTHODONTICS) on the lower arch touching the lingual of the four lower incisors. I project from the post-operative pictures that Phase II orthodontics will most likely not be necessary. Fig. 23 in the mixed dentition. However I always inform the parents/responsible party that a Phase II may also be required in the future. The simple reason for this is that one can perform sagittal correction of arches, however since the permanent premolars have not erupted (which are the key to stability for all cases), many times the sagittal correction slips back into a class II. The primary molars are simply blocks and have no anatomy; therefore, the correction of the Class II dental cases often has a component of relapse. I have found that the relapse is not as bad as the original Class II and Phase II usually is shortened in duration. Figs. 18-26 show a Class II case which I treated employing utility arch wires and a Multi-Distalizing appliance (ORTHO ORGANIZERS-HENRY SCHEIN ORTHODONTICS) . The patient was 9.3 years of age when I began treatment. I leveled and aligned with pre-fabri-cated utility arch wires and placed a NPE2 to correct the cross bite. I then constructed a lower 18 x 15 SS utility arch wire and placed the MDA on the upper arch. I had the patient wear three ¼” elastics per side for one week Address Sagittal Issues in Early Treatment There are many appliances to address sagittal issues 12 Spring 2014 JAOS
Journal of the American Orthodontic Society Spring 2014: Page 12
