Diagnosis

• Lack of upper lip support due to 4 bi extraction from prior orthodontic treatment (25 years ago)
• Collapsed posterior arches
• Root resorption & bone loss from prior treatment

Treatment Options

• Surgical option- 2 jaw surgery to restore upper/mid face support
• Open extracted bicuspid space and place implants
• Open extracted bicuspid space and use TADs to close molars forward, protecting the upper lip. (Mindy chose this option.)

Upper

• Upper 2-2 Low Torque
• Upper 7-7 Regular Torque
  • No bracket on Upper 3’s

Lower

• Lower 2-2, 6-7 Regular Torque
• Lower 3-5 High Torque

Auxiliary

Teeth: Remove Tooth at UR8, UL8, LL8, LR8 (Adult)

Brackets: Add Metal LT 7-7; Update Regular Torque Metal Bracket at L L/R 2-2

Comments

Pt had RPE

Auxiliary

Teeth: Add Tooth at UR5, UL5 (Primary)

Brackets: Remove MolarTube Bracket at UR7, UL7, LL7, LR7

Comments

• Bonded UL4 for first time
• Pt has cavities on L 7’s. did not bond today we will bond next visit once cavities are filled. placed wire gingival of URe, it is ready to come out

Auxiliary

Teeth: Add Tooth at UR5 (Adult)

Brackets: Add MolarTube Bracket at LL7, LR7

Comments

Auxiliary

Teeth: Add Tooth at UL5 (Adult)

Brackets: Add SnapLink Bracket at UR7, UL7

Comments

Bonded U7’s and UL5. Placed new UAW

Auxiliary

Comments

Auxiliary

Comments

Auxiliary

Brackets: Reposition Regular Torque Metal Bracket at UR4, UR5; Reposition High Torque Metal Bracket at LR5, LR4

Bracket Hooks: Add Bracket Hook at UL3, LL3, LL4, UR3, LR3, LR4, UR4, LR5, UL4, LL5

Elastic Bands: Add Moose at UR4-LR5-LR4,UL4-LL4-LL5 (Fulltime); Add Triangle Moose (Fulltime, Both)

Steel Ties: Add Steel Tie at LL3-LR3, UL3-UR3 (Figureeight, Under)

Comments

Auxiliary

Elastic Bands: Remove Moose at UR4-LR5-LR4, UL4-LL4-LL5; Add Moose at UR6-LR3, UL3-LL6 (Fulltime); Remove Triangle Moose (Both)

Comments

Auxiliary

Bends: Add Bend at UL2 (Upper, MesialOut); Add Bend at UR2 (Upper, BuccalStep)

Elastic Bands: Remove All Elastic Band; Add 6-4-3 (Moose) (Fulltime, Both)

Comments

Auxiliary

Brackets: Reposition High Torque Metal Bracket at UR3; Rebond Low Torque Metal Bracket at UR2; Reposition Low Torque Metal Bracket at UR1, UL1-UL2

Comments

Auxiliary

Comments

Auxiliary

Bends; Add Bend at UL1 (Upper, ExtrusionStep)

Elastic Bands: Remove All Elastic Band; Add Class II (Moose) (Fulltime, Left); Add Class III (Moose) (Fulltime, Right)

Comments

Auxiliary

Bends: Add Bend at UR1 (Upper, LingualCrownTorque)

Elastic Bands: Remove Class III (Fulltime, Right); Add Box (Moose) (Fulltime, Left); Add Class II (Moose) (Fulltime, Both)

Comments

Auxiliary

Elastic Bands: Remove All Elastic Band; Add 6-4-3 (Moose) (Fulltime, Both)

Comments

Auxiliary

Bends: Add Bend at UR5, UL5 (Upper, IntrusionStep); Add Bend at UR4 (Upper, BuccalCrownTorque); Add Bend at UL3 (Upper, LingualCrownTorque); Add Bend at LL5 (Lower, BuccalCrownTorque)

Comments

BCT UR1

Auxiliary

Bends: Add Bend at LL3, LR3 (Lower, ExtrusionStep); Add Bend at UR1 (Upper, ExtrusionStep); Add Bend at UR2 (Upper, MesialOut)

Comments

Took L perm imp

Auxiliary

Brackets: Rebond High Torque Metal Bracket at LR3

Bends: Add Bend at UR1 (Upper, MesialOut)

Elastic Bands: Remove 6-4-3 (Fulltime, Right); Add Moose at UR3-LR3-LR4 (Fulltime)

Comments

We did not DB today due to LR3 off and it dropped down to far — we also Adj UR1 and changed RB

Auxiliary

Bends: Add Bend at UR3 (Upper, LingualCrownTorque)

Comments

• SLING FOR UR3
• Took L perm impression

Auxiliary

Debracket

Comments

Bonded U/L perms – 3-3