realigned the upper teeth with 0.018 NiTi wire and correct the dental midline (Fig. 8). µ Use Mushroom Arch 0.019X0.025 NiTi with cinch back to close the anterior space (Fig. 9). ¸ Finish with 0.018 x 0.025 SS to engage the 0.022 bracket slot. ¹ Deband and deliver both upper and lower Hawley Spring Retainers (Five Star Orthodon-tics Laboratory). See Figs. 10 and 11. The upper right canine (UR3) root tip was distally tipped after using the Carriere 3-D Motion Appliance (Fig. 12). At the completion of the case, a nice overbite, overjet, and interincisal angle resulted. See Figs. 13–16 for more. The patient’s posterior occlusal plane was reduced and flattened. The patient’s lower facial height was slightly increased. The mandibular plane angle was also increased due to the mandible repositioning forward from the use of Class II elastics. The upper and lower lips moved back slightly but not significantly (Fig. 17). The patient followed up after six months, as shown in Fig. 18. Figure 9: For two months, a Mushroom Loop 0.019X0.025 NITI wire was activated and cinched back to close anterior spaces. . Figure 10: Final photos of completed case Case Discussion Using an articulator for mounting the patient’s models helped us collect addi-tional data to be used to diagnosis the case: Curve of Wilson, Curve of Spee, dental relationship, midline symmetry, occlusal plane, crowding, spacing, front teeth inclination, and so on. Extraction of all third molars helps to remove posterior interferences that contribute to many problems for Class II high angle cases, especially a steep upper posterior occlusal plane, where the mandible rotates backward and up, compressing the joints. As a result, Class II high angle cases tend to have more TMJ problems, as indi-cated in Sato’s research. Removing all wisdom teeth makes it easy for the Carriere 3-D Motion Appliance to distalize the upper right molar and canine into Class I occlu-sion. Also, an upper arch with a Class II, Division I relationship is narrow, preventing the mandible from moving Figure 11: Final case completed. Models were mounted on SAM II Articulator. orthodontics.com Summer 2026 17
Journal of the American Orthodontic Society Summer 2026: Page 17
