acific Coast Society of Orthodontists Bulletin Summer 2018 - 36
Special Section
Case Report
RETENTION
How would you treat this malocclusion?
Post-Treatment
Case J.K. 10 years, 7 months
Treatment Plan
Treatment options were discussed with the
patient's family, including the differences in the
facial balance results. The family rejected the
future mandibular advancement surgery option,
but agreed to treat the patient with Phase 1
(option 2); they preferred the splint headgear
option, as it meant brackets would be on the
teeth for a shorter period of time.
Fixed appliances: band 6|6; bond 0.018" slot
brackets on C21|12C; use 0.014" nickel titanium
(NiTi), and 0.016"* 0.016" stainless steel (SS) for
alignment.
Split headgear appliance
Fabricate splint headgear: add headgear inner
bow to a 3 mm pressure-formed splint with
acrylic resin. The patient is to use a splint headgear device with an occipital headgear strap
applying 1 lb. of force for 14 hours per day in order
to restrain maxillary growth for one year. When
overjet and overbite is normalized, reduce use to
overnight hours only for an additional four
months.
Place interim Phase 1 to Phase 2 retainer with
bite ramp, to be worn at night only through the
transition to permanent dentition. Evaluate in
permanent dentition for Phase 2 orthodontic
treatment. Consider discussing mandibular
advancement surgery with the family when the
patient's growth is finished.
Treatment Progress
The maxillary first molars were banded and
brackets were placed on the six maxillary anterior teeth, and aligned with 0.017"* 0.017" NiTi.
After four months, a maxillary impression was
taken in order to fabricate the splint headgear.
The splint used a Biocryl 3 mm material formed
Phase 1
Final photos
10 years, 7 months
36
PCSO Bulletin Summer 2018
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