Pacific Coast Society of Orthodontists Bulletin Summer 2014 - (Page 39)
How would you treat this malocclusion?
fter consideration of the two treatment options,
the patient chose Option 1: comprehensive orthodontic treatment with extraction of maxillary
first premolars, and space closure with TADs. The patient
selected this option because it addressed her chief concerns of straightening her front upper teeth and closing
the spaces in the back. Additionally, mandibular molar
protraction is a cost-effective treatment alternative, as it
obviates the need for dental implants.
The patient was referred to her general dentist for
extraction of her maxillary first premolars. The maxillary
teeth were bonded with a 0.022" self-ligating preadjusted
edgewise appliance; the mandibular teeth were bonded
with a 0.022" preadjusted edgewise appliance; and 0.016"
NiTi archwires were placed. Eight months later, when the
initial aligning and leveling procedures were completed,
two TADs (1.8 mm x 8 mm) (Imtec, 3M Unitek, Monrovia,
CA) were placed interdentally between the maxillary first
molar and second premolar bilaterally. Retraction and
intrusion of maxillary anterior teeth was initiated with NiTi
open coil springs delivering 150g of force on each side.
The open coil springs were engaged from the TADs to the
hooks soldered between the lateral incisors and canines on
the 0.019" x 0.025" stainless steel archwire.
1) Retraction of the maxillary incisors was delayed for
four months in order to allow for restoration of a decayed
maxillary left first molar.
PROGRESS PHOTOS: 8 MONTHS OF TREATMENT
2014 * PCSO BULLETIN
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Summer 2014