Jennifer’s Case

Video

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

BeforeĀ  & After

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