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!
- The upper cuspids are blocked out due to severe crowding.
- The lower anteriors are also pretty crowded.
- 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.
- 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 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
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
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!)