Video
- Initial Exam
- Initial Setup
- Month 3
- Month 5
- Month 7
- Month 9
- Month 10
- Month 12
- Month 14 - Pano
- Month 18
- Month 20
- Month 22
- Month 24 - Finish
Inital Exam
Chief Complaints
- Severe crowding
- Blocked out cuspids
Diagnosis
- Nice balanced face.
- Decreased vermillion display
- Needs mid face support
- Great shape to her teeth.
Treatment Plan
- Create better vermillion display and mid face support
- Precise bracket placement for beautiful smile arc
- Keep upper incisors in place and create a beautiful smile around them
- Variable torque selection
- Non-extraction
- Goal of 18 Months
Initial Setup
Inital Bonding
Torque Selection
Upper
- High Torque Upper 3’s
- They look pretty dumped in.
- Low Torque upper 2-2
- Because we are using class III mechanics, we want to avoid causing the upper teeth to flare forward
Lower
As we retract the lower arch, the lower anteriors are going to want to dump in lingually.
- Lower 2-2- Low Torque bracket reversed
- This will keep the roots upright and the crowns upright and not just dump the crowns back or stick the roots out through the bone.
- Lower 3s-High Torque

Coil Springs
- I placed coil spring to make room for the upper cuspids. I only activate the spring by 1/2 a bracket length to keep the forces light.
- I also placed coil spring to make room for the LL2.
Wires
Upper
.014 CuNiTi
Lower
.013 CuNiTi
Month 3
Wire Progression
Upper: .018 CuNiTi
Lower: .018 CuNiTi
Comments
Every visit I activate the coil spring by another 1/2 a bracket to continue to open up space.
Month 5
Wire Progression
Upper: .014 CuNiTi
Lower: .018 CuNiTi
Comments
We’ve dropped a wire on the upper arch to pick up the cuspids (now that we have room for them to come in.)
Month 7
Wire Progression
Upper: .016 CuNiTi
Lower: .018 CuNiTi
Month 9
Wire Progression
Upper: .018 CuNiTi
Lower: .018 CuNiTi
More Activation of coil spring
Month 10
Wire Progression
Upper: 14×25 CuNi
Lower: .014 CuNiTi
Engaged lower left 2
Month 12
Wire Progression
Upper: 19×25 PT NiTi
Lower: 14×25 CuNi
Month 14 – Pano Repo Visit
Wire Progression
Upper: 19×25 PT CuNi
Lower: 18×25 CuNiTi
Bracket Repo:
UR1,2,3 LR3
Replaced UR 2 with High Torque Bracket
Month 18
Wire Progression
Upper: 19×25 TMA
Lower: 17×25 TMA
Comments
I placed a sling under the upper anteriors to keep them from dumping in.
Month 20
Wire Progression
Upper: 19×25 TMA
Lower: 17×25 TMA
Comments
Started the final hard tissue contouring at this visit
Month 22
Wire Progression
Upper: 19×25 TMA
Lower: 17×25 TMA
Bracket Repo:
I adjusted the UL1, and stepped the LL2/3 up