CASE STUDY Fig. 5: Progress 3 months 10/21/2014. Fig. 7: Progress Twin Force appliance. Fig. 6: Progress 10 months 3/19/2015. Fig. 8: Final composite pictures. Radiographic Analysis A Cephalometric radiograph was taken (Fig. 2) and traced using the Ron Austin Analysis (Fig. 3). The tracing revealed normal growth, a skeletal Class II, retruded soft tissue and a cephalometric reading of a dental Lower 1 to Apo of +2. b Retract flared upper incisors b Retain positive results over time b Finish in 0.022ss wires b Total treatment time with Phase II is 24 months. Treatment Plan b Phase I: Utilize Herbst Class II appliances b Tip-Edge orthodontic brackets and archwires b Treatment time of 12 months. b Optional Phase II with Tip-Edge brackets b Elastic wear, Class II with 2 oz of force b Retainers: Upper Essix and b Lower permanent lingual wire Treatment Initial records were obtained on May 20, 2014. Initial models were duplicated and then sent to Johns Dental Lab for fabrication of the Herbst appliance. On July 31, 2014, the Herbst appliance was delivered. Upper and lower SSC crowns were cemented using Ketac cement. Upper 3x3 brackets were placed with .014 Niti wire to the upper 6's so retraction of the upper incisors could begin. Shims were added incrementally to further advance the lower jaw. Several times the screws came loose Diagnosis b Class II skeletal b Overjet 12mm b Flared upper incisors Treatment Objectives b Advance lower jaw to improve profile b Achieve a Class I molar and canine classification 34 Winter 2020 JAOS
Journal of the American Orthodontic Society Winter 2020: Page 34
