12/19/2016

1

Class II Skeletal, Class II(I) Dental, Long Anterior Lower Face Height, Maxillo

dib l d t l

KEVIN HAINESAGE: 12.6

– mandibular dental protrusion, Crowding

Adrian J Palencar, MUDr, MAGD, IBO, FADI, FPFA, FICD

Active Treatment – 4 years2

3

MACRO-ESTHETIC APPRAISAL

5 6

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2

7 8

9

MINI-ESTHETIC APPRAISAL

11 12

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3

13

MICRO-ESTHETICAPPRAISAL

15 16

17

APPRAISAL OF THE AIRWAY

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4

19

3

20

33

APPRAISAL OF THE POSTURE

22

23 24

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5

25 26

27 28

SNA 84SNB 78ANB 6Wits 3NS/GoM 42ALFH 76U1/SN 110L1/GoM 98U1/L1 110

29

U1/L1 110Growth X 78Harvold 28

30

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6

31 32

33

Bonded Hyrax

34

Bowbeer Appliance

35

014 NiTi

36

016 SS

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7

Hyrax has been removed after 12 months

37

014 NiTi

38

016 NiTi

39

019x025 V-Force 3

Good inter-digitation, however the MX incisors are too proclined

40

MN transverse development crystalized

41

MX 019x025 NiTi, MN 014 NiTi

42

By-pass

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8

43

AFTER 18 MONTH OF TREATMENT, THE

PARENTS, PATIENT AND THE CLINICIAN AGREED THE CLINICIAN AGREED THAT FOUR BICUSPIDS HAVE TO BE EXTRACTED

45

MX 018x025 SS, MN 018 SS, Step Down, ¼” – 4.5 oz. Elastics

46

MN 1st bicuspids were excised

MX & MN 018 SS, Step up and Step down, ¼” – 4.5 oz. Elastics

47

MN 1st bicuspids and left 2nd molar were excised

Titration of force level with the

48

CORREX gram gage

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9

MX 018 SS, MN 016 NiTi Stopped Retraction of MX Right Cuspid and

MN left Cuspid

49

Slenderized 2.2 mm (Bolton

discrepancy) on the right side, to shift the midline

50

MX & MN 018 SS, Midlines are Approximating

51

Oral Hygiene Appraisal

52

Appraisal of Maxillary and Mandibular Dental

Protrusion

53

Off-center bend

Patient and parents found the lips

competent and the convexity pleasing

54

12/19/2016

10

Following Retraction of Anterior Teeth the Position is Crystalized with Mandibular Lingual Arch

55

Ligature (Anchor) Tie of Six Anterior Teeth

56

Buccal Intra and Off-center bends

57

018 SS Arch Wires

58

59

Lingual Intras

Mandibular Lingual Arch to Crystalize the Position of the Anterior Teeth

60

12/19/2016

11

61

TAD Placement Guide

62

Ancor Pro® – 1.6 x 8.0 mm (OrthoOrganizers)

63

018 SS, Off-center Bends. Incorrect Protraction of

Mandibular Molars

64

Tissue Overgrowth over the TADs

65

Power arms were Soldered to the Mandibular First molar Bands

66

12/19/2016

12

Countering Mesio-lingual Moments

67

Countering Mesio-lingual Moments

68

The TAD in MN Right Side Failed

69

Almost There, 018 SS

70

TAD has been Removed on the Left Side

71

PRE-DEBRACKETING APPRAISALAPPRAISAL

12/19/2016

13

Appraisal of h fil

73

the profile

Appraisal of the Incisal Line Congruency

74

Appraisal of the Smile Line and Buccal Corridors

75 76

Appraisal of Bracket Position

77 78

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14

Post – re-bracketing, 016 NiTi

79

019x025 V-Force 3

80

“W” with Tail, 2x 3/8” - 2 oz. Elastics, 018x025 SS

81 82

83 84

12/19/2016

15

2006 2011SNA 84 81SNB 78 77ANB 6 4Wits 3 2NS/GoM 42 35ALFH 76 75U1/SN 110 118L1/GoM 98 93U1/L1 110 117 G th X 78 81

85

Growth X 78 81Harvold 28 35

86

87 88

89 90

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16

91 92

93 94

95 96

12/19/2016

17

97

2007

2011

98

2011

2012

2007

99

2011

2012

2007

2011

100

2012

“GOD DOESN‘T ASK YOU TO SUCCEED,

JUST TO TRY”JUST TO TRY”

Mother Theresa of Calcutta

102 Dr. Adrian J. PalencarAdrian J. Palencar, MUDr, MAGD, IBO, FADI, FPFA, FICD