Fig. 13 Fig. 14 Fig. 16 Fig. 17 Fig. 15 lary arch, the goal was to vertically impact the maxilla to reduce the skeletal vertical dimension, intrude the incisors and lessen the gummy smile. The patient’s palatal plane is parallel to the cranial base (Fig.9). The objective here is not to change the inclination of the palate laterally. In the mandibular arch, the goal was to intrude the first and second molars to further reduce the skeletal vertical dimension. A transpalatal arch with extended auxiliaries was fabricated and inserted (Fig. 12). Two 8 mm TADs 1,3 were placed on the palate just off the midline and in line with the eyelets of the auxil-iaries. Activated power chain was extended from the TADs to the auxiliaries. This produced a bilateral intru-sive force on the posterior maxilla. Anteriorly, a single 6 mm TAD was placed labially Fig. 18 between the central incisors (Fig. 13-A). Activated clear power chain was placed as follows: one end of the power chain was placed over the TAD head, brought incisal to both central incisor brackets and the other end of the power chain finished at the TAD. The O-ball cap was placed on the TAD ball to secure the power chain ends. This produced an anterior intrusive force on the maxilla. Just a piece of advice: do not place a TAD through a frenum (Fig. 13-A). Use two TADs between the central and lateral incisors if possible. The www.orthodontics.com Winter 2020 11
Journal of the American Orthodontic Society Winter 2020: Page 11
