CASE STUDY panoramic image did not show any evidence of root resorption (Fig. 19). Total treatment from records to retainers was 22.5 months. This extraordinary case was challenging due to multiple situations that needed to be managed as a team effort. Our patient presented with a constellation of problems including skeletal Class III combined with anterior open bite, anterior and posterior crossbite, maxillary canines in ectopic position and severe maxillary incisor crowding. His medical history included spina bifida, generalized muscle weakness, compromised mobility, hydrocephaly shunt and episodes of breathing apnea combined with lung issues. The treatment results revealed the value of using strategic tooth extractions. The mandible was primarily treated with skeletal anchorage to allow preservation of the Class I molar relationship and intrusion of the molars, thus combining molar intru-sion and anterior maxillary retrusion to correct the crossbite, overbite and overjet. As stated in previous articles, we continue to expand our knowledge of options in orthodontic treatment, opening the door to a more creative and customized treatment for our patients’ needs. References 1. Echeverri JC, Echeverri EA:, :Balance and Equilibrium: Orthodon-tic treatment with tooth mass balance and Skeletal Anchorage 2. Assisted Protraction to Create Balance, Journal of the American Orthodontic Society 13, issue 5: 26 -32, 2013 Boulet, SL; Yang Q, Mai C, Kirby RS, Collins JS, Robbins JM, Mulinare J (2008). "Trends in post-fortification prevalence of spina bifida and anencephaly in the United States". Birth Defects Research (Part A) 82 (7): 572-82 Protect Yourself From Latex Allergies: Plant Biologists and Immunochemists Develop Hypoallergenic Alternative To Latex. Science Daily. 1 December 2008. Anderson K, Anderson LE, Glaze WD. Hydrocephalus. In: Mosby’s Medical, Nursing & Allied Health Dictionary. 5th ed. St. Louis, MO: Mosby 1998 Arthur J Nowak and Paul S Casamassimo, The Handbook of Pedi-atric Dentistry: fourth edition, American Academy of Pediatric Dentistry 2011 H. Stephen Kaye, Taewoon Kang, Mitchell P. LaPlante. Wheelchair Use in the United States. Disability Statistics Center. [Online] May 2002. [Cited: 10 30, 2010.] http://dsc.ucsf.edu/publication.php. Wilmes, B: Fields of Application of Mini-Implants In: Ludwig B, Baumgaertel S, Bowman J: Mini-Implants in Orthodontics: Inno-vative Anchorage Concepts. 2008, Quintessence Publishing Co, Ltd. pp 91-96 3. 4. 5. 6. 7. Reference material suggested: 8. Echarri P, Tae-Weon K, Favero L, Hee-Jin K: Orthodontics and Microimplants. 2007 Editorial Ripano, S.A. 9. Cope, J: OrthoTADs: The Clinical Guide and Atlas. 2007 Under Dog Media, LP. 10. Jin-Jong Lin J: Creative Orthodontics Blending the Damon System & TADs to Manage Difficult Malocclusions. 2010 Yong Chieh Enterprise Co., Ltd. 11. Ludwig B, Baumgaertel S, Bowman J: Mini-Implants in Orthodon-tics: Innovative Anchorage Concepts. 2008, Quintessence Publish-ing Co, LTD, 12. JAOS journals: All! www.orthodontics.com Spring 2014 23
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