CASE STUDY Fig. 9: Shown are the patient’s anterior intraoral photographs at different stages of treatment with a Frankel III appliance (from insertion to eight months later). Fig. 10: The patient’s actual Frankel III appliance with side screws is shown. Fig. 11: The figure shows the patient’s post-treatment intraoral photographs and ceph tracing. Fig. 12: Shown are post-treatment intraoral photographs. screws were turned to advance the maxillary pads approximately 2 mm away from the maxillary tissue. Although treatment was essentially completed in 10 months, the author advised the father to have his son wear the appliance longer. Mean-while, the appliance broke several more times and had to be repaired. On July 16, 2013, the maxillary pad had to be advanced again. Had the appliance not broken and been repaired, the only adjustments required would have been turning the screws to advance the maxillary pads twice during treatment. On March 11, 2014, post-treat-ment records were taken. Fig. 11 shows a post-treatment facial photo-graph and Jefferson Ceph analysis. The post-treatment ceph tracing shows significant improvement in developing the maxilla forward to nearly ideal A-P positing. Concur-rently, the patient’s mandible is in ideal A-P position, and his mandibu-lar vertical position is also ideal. Post-treatment, his maxilla and mandible were nearly in perfect position. His Jefferson Skeletal Clas-sification post-treatment was skele-tal Type I, normal vertical. Fig. 12 shows the post-treatment intraoral photographs. The patient and his parents were pleased with the treatment results. During Phase II, no fixed appliance therapy was necessary, and the parents did not want it. After treatment, no retain-ers were inserted. Fig. 13 shows pretreatment and post-treatment cephalometric radio-graphs. Note the pretreatment and post-treatment cephalometric radio-graph. Both the maxillary sinus and pharyngeal airway appear to be significantly larger after treatment than they were before—thus www.orthodontics.com Spring 2025 17
Journal of the American Orthodontic Society Spring 2025: Page 17
