Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 40
Case Report
How would you treat this malocclusion?
Post-Treatment
Case H.M. 50 years, 10 months
Treatment Plan
Treatment options were discussed with the
patient, including the different facial and occlusal
outcomes. The patient was evaluated by a periodontist and given clearance for orthodontic
treatment with hygiene recall visits every four
months. The patient wanted minimal IPR and
said that she wanted to have minimal compliance during treatment. While she was willing to
remove her lower third molars, she wanted no
other extractions. Using the Tetragon Analysis, a
cephalometric goal close to U1-SN/IMPA of
120/80 was chosen, as this is a guide for an
acceptable dental camouflage in a Class III skeletal non-surgical treatment. From this, we chose
the last option: lingual appliances with TADs to
distalize the mandibular dentition.
A digital scan was sent to 3M for Incognito setup.
Lateral cephalometric planning showed the need
for mandibular arch retraction, while the setup
showed the anterior teeth coming forward.
Mandibular anchorage control was already identified and addressed with TADs in the cephalometric planning. It is unfortunate that as of yet
there is no true avenue for cephalometric inclusion in most commercial digital setups. The
mandibular wires were chosen with an increased
canine offset to allow for less mandibular IPR
than outlined in the setup.
Treatment Progress
The appliances were placed and progressed
through the normal wire sequence: 0.014" round
nickel-titanium (NiTi), 0.016"ú0.022" NiTi,
0.018"ú0.025" superelastic NiTi, 0.016"ú0.024"
stainless steel. TADs were placed between the
mandibular first molars and second premolars
once the 0.014" NiTi wire was fully engaged in
the mandibular anterior area with a passive
power chain. Retraction with 150 grams of force
to the TADs allowed for routine alignment of the
mandibular teeth.
Progress photos
40
PCSO Bulletin Spring 2018
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2018
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 1
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 2
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 3
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 4
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 5
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 6
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 7
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 8
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 9
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 10
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 11
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 12
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 13
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 14
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 15
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 16
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 17
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 18
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 19
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 20
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 21
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 22
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 23
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 24
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 25
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 26
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 27
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 28
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 29
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 30
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 31
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 32
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 33
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 34
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 35
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 36
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 37
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 38
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 39
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 40
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 41
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 42
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 43
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 44
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 45
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 46
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 47
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 48
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 49
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 50
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 51
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 52
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 53
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 54
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 55
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 56
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 57
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 58
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 59
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 60
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 61
Pacific Coast Society of Orthodontists Bulletin Spring 2018 - 62
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