CLINICAL CASE REPORT Fig. 27: Dental crowding has been eliminated. Transverse constriction has been relieved and improvement on dental occlusion is evident. Facial features have improved with a better balance between chin and face. Fig. 31: Post treatment airway CBCT. Images show improvement in his airflow. Fig. 32: Materials and tools to fabricate RPE’s at author’s office. A Fig. 28-30: CBCT final showing development of the arches through expansion and straight arch wire appliances. surveying adjustable table to hold model and adjust inclinations as needed. A 139 orthodontic bending plier, marking ink pen, soldering flux, silver solder, a 12 mm RPE four leg screw, 036 SS straight wire, heavy duty cutting plyers and a soldering torch. dental crowding and believed the patient had enough maturation and self-control to cooperate during orthodontic treatment. Clinical Analysis The oral exam revealed a Class II dental malocclusion with severe crowding of incisors and canines in both arches. Maxillary incisors #7 and #8 were bucalized and flared. The maxillary and mandibular lips were behind the smile lip line and the mandibular lip and chin were retruded giving a very strong Class II appearance to the lateral profile. Facial features included a thin face with transverse constriction and a retruded mandible. The dental occlusion was a Class II canine and molar occlusion with protrusive maxillary incisors and maxillary transverse constriction. His mandible showed lingualized bicuspids and molars, with ectopic positioning of the canines, and straight mandibular incisors. Clinical facial appearance was of a short face with cephalometric values being in mesocephalic range. His maxillary midline was centered with the face and mandibular midline deviated towards the left side by 2 mm, and a deep overbite of 6 mm and overjet of 3 mm were present. A frontal image showed the positioning of anterior teeth as being crowded, protruded and in ectopic position. Buccal corridors of the smile were dark and constricted (Fig. 14). TMJ Examination TMJ examination was within normal parameters and there was no 22 Summer 2022 JAOS
Journal of the American Orthodontic Society Summer 2022: Page 22
