Pacific Coast Society of Orthodontists Bulletin Fall 2016 - 34

Case Report Initial cephalograms and handwrist radiograph Initial Lateral Cephalometric Measurements Variable Norm Pre-Treatment SNA (º) 82.0 81.3 SNB (º) 80.9 76.8 ANB (º) 1.6 4.5 FMA (FH-MP) (º) 23.9 26.5 SN-MP (º) 32.9 39.3 4.3 -1.1 102.8 99.9 4.0 10.0 IMPA (L1-MP) (º) 95.0 81.5 Upper Lip-E Line (mm) -5.9 -7.7 Lower Lip-E Line (mm) -2.0 -0.3 U1-NA (mm) U1-SN (º) L1-NB (mm) Treatment Options 1. Surgically assisted rapid palatal expansion (SARPE) for correction of maxillary constriction, and counterclockwise rotation of the mandible with orthognathic surgery. Extraction of the maxillary primary laterals, and creation of implant spaces for the implant replacement of the maxillary lateral incisors. Arch development will be used for the alignment of the teeth without further extractions. 2. Microimplant-assisted rapid palatal expansion (MARPE) to correct the maxillary constriction. Extraction of the maxillary primary lateral incisors and mandibular first premolars. Protraction of the maxillary posterior dentition to close the anterior space; retraction of the mandibular anterior teeth to improve the overjet. Orthodontic extrusion of the teeth will be required in order to achieve proper overbite, while the bite opening is prevented by the intrusive force of the mandibular molars. Post-treatment description of Case E.B. begins on the next page. 34 PCSO Bulletin  Fall 2016

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