Ondalynn’s Case Study

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

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