Video
So this case’s layout is a little different, we didn’t have the same charting software when we did this case and couldn’t get as many notes as usual. Let me know if you have any questions!
Inital Exam
Diagnosis
- The upper cuspids are blocked out due to severe crowding.
- The lower anteriors are also pretty crowded.
Treatment Options
- Traditionally, most orthodontists would extract 4 bicuspids to create space for cuspids. With PSL we can avoid extraction so this wasn’t a good option.
- Use open coil spring to create space for blocked out cuspids. By creating more posterior width we can open up space for crowded anteriors.
Initial Setup
Torque Selection
Upper
- Because we are using coil springs to open up space for the cuspids, the teeth are going to want to flare forward. Anticipating this, I chose:
- Upper 2-2 Low Torque
Lower
- Lower 2-2 Low Torque
- Lower right 3-High Torque
- Notice how you can see more of the facial surface of the tooth. It looks like it’s dumped in requiring a little more buccal crown torque to upright.
- Lower left 3- Regular Torque
Wires
.014 CuNiTi
Upper
.014 CuNiTi
Upper Wire Progression
2 Months – .018
5 Month – 14×25 CuNiTi
9 Months – .014 CuNiTi
We dropped back down to a light wire when we bonded the upper 3’s
13 Months – 14×25 CuNiTi
16 Months – 18×25 CuNiTi
24 Months – 19×25 SS
28 Months – Debond
Lower Wire Progression
11 Months – 14×25 CuNiTi
24 Months – 16×25 SS
Month 9
Tx Update
The upper 3s naturally erupted and were ready to bring down in to place. We bonded high torque brackets because they were looking pretty flared. (Sorry about not having pictures!)
Before & After
