Fig. 4 Fig. 3 Clinical Analysis Patient is 7 yr. 3 mo. old Caucasian male who presented with a mesencephalic, symmetrical face. Patient is in a tran-sitional dentition, upper permanent first molars are present with mesio-lingual rotation in a dentally half Class II rela-tionship. The lower midline deviation is to the right by 3 mm with an over jet of 3 mm. The patient has an overbite of 50% to 90% due to the uneven eruption of teeth #8 and #9 and the mesial alignment of the lower incisors. There is moderate crowding on the mandibular and maxillary arches. A low attachment of the upper labial frenum is present. (Figs. 1 & 2) teeth to be present. The patient is in the early mixed dentition stage. Deficiency of space for upper lateral incisors can lead to ectopic or delayed eruption of these teeth if the situation is not resolved soon. (Fig. 3) A cephalometric radiograph was taken and traced. According Dr. Carapezza’s analysis, the patient has a Skele-tal Class II tendency with a clockwise growth pattern. Skeletally open case (Y axis over 70 degrees) is present. (Fig. 4) Cephalometric space is available on the upper arch, as the teeth can afford to move forward. The lower incisors should only be moved slightly forward in order to stay within the biological borders. TMJ Examination The TMJ examination is normal, no prior history of joint dysfunction or pain is present. Clinical examination reveals no popping or clicking. Normal limits of opening to 40 mm are present with no right and left deviations. The panoramic radiograph showed all permanent Model Analysis (Fig. 5) Upper Arch: U-shaped arch, 2 mm of transverse defi-ciency is present in the molar area, 5 mm in the bicuspid Fig. 5 www.orthodontics.com Spring 2018 9
Journal of the American Orthodontic Society Spring 2018: Page 9
