Fig. 36 Fig. 34 Fig. 35 The maxillary incisors were intruded with UAW therapy to reduce the dental deep bite and the gummy excess (Fig. 31-B). The mandibular arch was developed with lip bumper therapy. The width of the mandibular first molars increased 9 mm and space was created for cuspid eruption (Fig. 32). In many cases during lip bumper therapy as space is being created, the mandibular incisors self-align to a more favorable position. That was not the case here as this patient’s mandibular incisors were grossly misaligned. The straight wire appli-ance straightened the incisors with-out flaring (Figs. 33 and 34). The panoramic taken near the end of treatment shows that the mandibu-lar second molars were not impacted (Fig. 35). conjunction with the initial leveling wires (Fig. 36). 3 The 2 mm of expansion programmed into the lip bumper widens the molars leaving the incisors where they are or retracting them slightly if that is the objective. Lip bumpers may be used in the maxillary arch in Class III cases (Fig. 37) to run interference for the maxillary incisors and allow for premaxilla development. The lip bumper is an effective treat-ment modality to correct crowding in the mandibular arch. By correcting the sagittal and transverse dimensions simultaneously, the mandibular first molars move distal-buccally, allowing the incisors to maintain their axial position or even move to the lingual if the case warrants this. Fig. 37 References 1. Carapezza, Leonard J., DMD. Six Keys to Early Mixed Dentition Class II Correc-tion: A Quantified Approach to Diagnosis and Treatment. Journal of American Orthodontic Society; Spring 2014. 2. Gerber, Jay W., D.D.S, Beistle, Richard T., D.D.S., Magill, Thomas S. Orthodontic Diagnostics: a Modified Sassouni + Cephalometric Analysis. 3. Greenfield, Raphael L. DDS, MSCD. Non Ex Factors. 98.5% Nonextraction Therapy using Coordinated Arch Development. DaehancNarae Publishing, Inc. Seoul, South Korea; 2010. 4. https://andersonorthodonticslab.com/ 5. https://www.orthazone.com/ 6. Mulligan, Thomas F. Common Sense Mechanics in Everyday Orthodontics II, CSM 2012 Additional Uses of the Lip Bumper In cases where the teeth are brack-eted, the lip bumper may be used in 14 Summer 2022 JAOS
Journal of the American Orthodontic Society Summer 2022: Page 14
