Fig. 4 Andrews Fully-Programmed Straight-Wire Appliance (SWA) Concept and Mechanics “The current Class III protocols for skeletal-based Class III was not part of conventional treatment up until the last part of the 20th century. Some orthodontic departments considered it “a waste of money and time” and Medicaid service administrators refused the early treatment of Class III and allocated these cases for orthognathic surgery.” í Fully-Programmed Appliance – Andrews Extraction SWA Systems 6 (Fig. 4) Fig. 5a Phase 4 – Adult Dentition Goals í Acceptable “Wits” range for Class III í Desirable Oro-Facial Harmony 7 (Figs. 5a, 5b & 5c) Desirable Oro-facial Harmony, Patient Post-Treatment E.P., Age 18y 3m 2nd upper bicuspid/1st lower bicuspid extraction, Wits -1 í Camouflage post retainer extraction treatment (Figs. 6a, 6b and 6c) Fig. 5b Discussion The current Class III protocols for skeletal-based Class III was not part of conventional treat-ment up until the last part of the 20th century. Some orthodontic departments considered it “a waste of money and time” 8 and Medicaid service administrators refused the early treatment of Class III and allocated these cases for orthognathic surgery. 9 The 21st century acceptance of Class III cases mandate several phases of treatment through completed growth and develop-ment. This requires a commit-ment from patient, parent and clinician without a promise of 100% success. 10 Patient Post-Treatment C.P., Age 19y 2m, 2nd upper bicuspid/ 1st lower bicuspid extraction, Wits -6 í Continue to modify the growth pattern with RPE/RPFM (if necessary). í UAW mechanics: Goals –Proper overbite/overjet/molar relationship/lip seal/serial guidance and NPE to control neuromuscular problems Phase 3 – Late Mixed/ Early Adult Dentition Camouflage Protocols 20 Summer 2019 JAOS
Journal of the American Orthodontic Society Summer 2019: Page 20
