Fig. 28 Fig. 30 Fig. 31 Fig. 29 mandibular cuspids and bicuspids are occurring (Fig. 28). Full appliances will not be placed until the cuspids, bicus-pids and second molars have fully erupted. Toe-In-Bend Figures 29 and 30 show a clinical case I treated demon-strating the use of the toe-in bends to distal rotate and buccalize the maxillary first molars. The patient presented with a bilateral ½ Class II molar relationship with excess overjet and a deep dental bite. The maxillary molars were mesially rotated (Fig. 29). The incisors and cuspids were bracketed and the molars banded and an .020 SS archwire was placed. Toe-in bends were placed mesial to the maxil-lary first molar brackets. Tip-back bends were also placed mesial to the maxillary first molar brackets to extrude the molars and intrude the incisors. Buttons were bonded on the cuspids just gingival to the archwire to maintain vertical control of the cuspids. The molars rotated to the distal and moved slightly to the buccal. The anterior overbite and overjet condition was greatly improved. Spontaneous eruption of the un-bracketed maxillary and mandibular bicuspids is occurring (Fig. 30). Full appli-ances will not be placed until the bicuspids and second molars have fully erupted. Fig. 32 Toe-Out-Bend The toe-out bend is used to lingualize maxillary first molars and mesial rotate them. As mentioned earlier in most Class II cases the maxillary first molars are mesially, not distally, rotated. Therefore I rarely use the toe-out bend in the horizontal plane (Fig. 24). www.orthodontics.com Winter 2015 29
Journal of the American Orthodontic Society Winter 2015: Page 29
