Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 43

Case Report
Case Report
How would you treat this malocclusion?
Pretreatment
Case B.L. 13 years, 2 months
A video of this case can be found at www.
pcsortho.org/case-reports/
Diagnosis and Etiology
B.L. is a 13-year-, 2-month-old Asian boy presenting
to my office for a phase II consult with
a chief complaint of " lower teeth crowding. "
B.L. previously came to my office for a 9-month
phase I treatment beginning when he was
8 years, 0 months. In phase I, a rapid palatal
expander and reverse-pull headgear were used
to correct a maxillary transverse deficiency and
a skeletal Class III relationship with an overjet of
−1 mm (Figure 1). His U4s were also extracted at
the end of phase I because of severe upper arch
crowding with inadequate spaces for normal
eruption of the U5s. B.L. is in good general
health with no contributing medical history and
denies any oral habits.
Extraoral and Intraoral Findings
B.L. presents with a straight profile and an
obtuse nasolabial angle. He has a dolicocephalic
face with normal chin projection and lip protrusion.
He has a flat smile arc with 50% maxillary
incisal display at animation. His temporomandibular
joints are within normal limits with no
signs of clicking or pain on clinical examination.
Intraorally, he presents with bilateral Class I
molar relationships and 1-mm Class III canine
relationships. He has a moderate curve of Spee
with an edge-to-edge anterior relationship in
which UL2 is in anterior crossbite. His maxillary
dental midline is coincident with the facial
midline, and the mandibular dental midline is
slightly off to the left. He has severe crowding
on the ovoid mandibular arch with the L4s
blocked out buccally. He has mild crowding in
a tapered maxillary arch where the U4s were
extracted previously in phase I. He has good
oral hygiene with no signs of gingival recession
(Figures 2 and 3).
Figure 2. Pretreatment facial and intraoral photographs (B.L., 13 years, 2 months)
Figure 1. Facial and intraoral photographs before phase I treatment (B.L., 8 years, 0
months)
Figure 3. Pretreatment digital dental models (B.L., 13 years, 2 months)
Spring 2022 PCSO Bulletin
43

http://www.pcsortho.org/case-reports/ http://www.pcsortho.org/case-reports/

Pacific Coast Society of Orthodontists Bulletin Spring 2022

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2022

Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 1
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 2
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 3
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 4
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 5
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 6
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 7
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 8
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 9
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 10
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 11
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 12
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 13
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 14
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 15
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 16
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 17
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 18
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 19
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 20
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 21
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 22
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 23
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 24
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 25
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 26
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 27
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 28
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 29
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 30
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 31
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Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 33
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 34
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 35
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 36
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 37
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 38
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 39
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 40
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 41
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 42
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 43
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 44
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 45
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 46
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 47
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 48
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 49
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 50
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Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 53
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Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 55
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 56
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