Fig. 2 Fig. 3 b Upper right and left first perma-nent molars were ectopic and were causing premature exfolia-tion of the upper right and left primary second molars. b The cephalometric radiograph was traced digitally. It exhib-ited a clockwise growth pattern with a GoGn to SN of 42 -clockwise grower, Y-Axis of 74 degrees –high angle, Skeletal Class II with ANB of 7 degrees and a WITS of 3. (Figs. 2, 3 & 4) The treatment objectives were to close anterior space, serial guidance, level and align the arches, open the bite, and correct the crossbite by expanding the upper arch. Treatment Plan b Nitanium Palatal Expander for arch development and to control the vertical b Use UAW (Utility Arch Wire) to level, align and rotate b Tip back bend to intrude upper incisors with UAW Patient I: Pre-Treatment Montage TMJ Examination b TMJ examination revealed that his vertical opening was 45 mm b Right and left laterotrusive movements measured 7 mm’s on both sides b Patient I stated that he was not experiencing any pain b There was no popping or clicking or deviations b Advance the upper incisors using stopped arch wires b Extraction of upper right and left primary second molars b Straight wire series to level align and rotate teeth. Begin advancing slowly upper incisors with stopped archwires b Continue to bracket and bond as permanent teeth erupt Radiographic Analysis b The panoramic x-ray showed a full complement mixed dentition teeth. b As patient was seven years old, the third molars were not yet formed. b His bone density appeared to be normal. 22 Spring 2022 JAOS
Journal of the American Orthodontic Society Spring 2022: Page 22
