Video
Inital Exam
Background
- 25 years old-has wanted braces for many years but her parents couldn’t afford to put her into treatment.
- Mid-face deficiency
- Incisors going every which direction
Treatment Plan
- Treat the case to the upper incisors
- Correct Deep Bite while protecting smile arc
- We don’t want to lose the smile arc by intruding the upper incisors
- Enhance the upper lip and mid face
- Use variable torques on upper incisors
- Fix crowding by widening upper/lower arches
Treatment Plan
- Started with anterior bite turbos
- This will open up the vertical height of her face and preserve where the upper incisor is
- then we can extrude the posterior teeth together with class 2 elastics (from day 1)
- We can stop extruding the posterior teeth once we have over leveled the deep bite
Torque Selection
Upper
- Because we are using coil springs to open up space and push anteriors forward, the teeth are going to want to flare forward. Anticipating this, I chose:
- Upper 2-2 Low Torque
- Upper 3s Regular Torque
Lower
- Lower 2-2 Low Torque
- Lower 3s High Torque
- Lower cuspids are very dumped in.
Bracket Placement
- I wish I pictures to show this, but I placed brackets for good occlusion and a beautiful smile arc.
- Upper Central’s and laterals need to be placed slightly more gingival than the cuspids.
- The lower centrals and laterals need to be placed more incisal than the cuspids
Month 2
Wire Progression
Upper: 14X25 CUTI
Lower: 14X25 CUTI
Elastics
cl2 right box left with fox
Month 4
Wire Progression
Upper: 14×25 CuTi
Lower: 14×25 CuTi
Bracket Repo
Repo’s UL2
Month 6
Wire Progression
Upper: 14×25 CuTi
Lower: 14×25 CuTi
Month 11
Wire Progression
Upper: 18×25 CuTi
Lower: 18×25 CuTi
Bracket Repo
Repo’d UL1 & UR2
Month 18 – Before & After
