CASE REPORT “Logan’s case involved complex orthodontic, dental, functional and airway factors. There are many pathways to correct these problems, but the treatment chosen for Logan was based on the fact that both the maxilla and mandible were posterior in relation to the cranial base, and the rationale that the mandible was postured and developing in a posterior position from the maxilla.” pathways to correct these prob-lems, but the treatment chosen for Logan was based on the fact that both the maxilla and mandible were posterior in relation to the cranial base, and the rationale that the mandible was postured and developing in a posterior position from the maxilla. Upper airway compromise and restricted tongue movement led to the narrow upper and lower dental arches. The severe retroclination of #7 caused the mandible to take a posterior trajec-tory on opening and closing. Therefore, correction of the constricted upper and lower arches while simultaneously allowing a corrected mandibular trajectory and protraction of the maxilla to normal position in relationship to the cranial base was chosen, in hopes that the mandible would come forward and resolve the Class II dental occlusion. However, after upper and lower arch expansion, reverse pull face gear and correction of #7, the Class II did not improve. At this point, a functional appliance could have been utilized but with the appli-ances already in place, the Twin Fig. 16 Fig. 17 Fig. 18 www.orthodontics.com Spring 2022 17
Journal of the American Orthodontic Society Spring 2022: Page 17
