Orthotown March 2018 - 22
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huge interproximal spaces. The lower #23 has the poorest prognosis so it gets extracted. I would
use your favorite appliance. If the lower needs an implant or Maryland type bridge splint due to
further loss, so be it. Of course, this is planned via 3-D simulation nowadays. ■
12/18/2017
charlestonbraces
Intraoral Scan:
Member Since: 06/05/09
Posts: 10 and 11 of 26
Do you not think #24 has the worse prognosis since #23 appears to have higher bone levels
than #24 (with the exception of the facial bone on #23)? ■
12/18/2017
davidharnick
Member Since: 08/28/02
Post: 12 of 26
I don't know. The perio letter said that #23 was not treated so I assumed it was the worst.
Between you and the periodontist I think. ■
12/18/2017
charlestonbraces
I sent another letter to the periodontist inquiring on the long-term prognosis of #25, 24, and 23. ■
Member Since: 06/05/09
Post: 13 of 26
danbraces
Member Since: 11/09/08
Post: 14 of 26
12/18/2017
It's amazing how much I think like David Harnick! Maybe because we're a couple of old
guys! Non-ext on upper and one lower incisor. You want even contact in CR and a good attempt
at coupling. She will be happy with straight teeth and even bite! ■
12/18/2017
charlestonbraces
Which incisor would you extract, Dan? ■
Member Since: 06/05/09
Post: 15 of 26
JohnnySS
Member Since: 10/18/13
Post: 16 of 26
12/18/2017
In my office, non-ex passive self-ligation, flipping the upper cuspid to cuspid for negative
torque. Ortho Classic brackets, Pitts 21. And no, I have no interest in the company. Go slow
starting with super-cable (Speed product-amazing wire to start) and eyelet on upper right lateral.
Lower arch same or leave lower incisors off and gentle expansion coil from cuspid to cuspid
with eyelet on one of the lower incisors to control that long span of wire.
For me, closing spaces is more traumatic to tissues than slow and gentle expansion with
close monitoring by perio. And patient must be aware of risks regardless of ortho tx plan, or no
ortho. My goal would be 18 months of treatment, keeping arch coordination and torques under
control with light elastics.
I am in no hurry to line up teeth like these. Light (2oz) elastics to start. Ask me for more info
if you're at all interested in the wacky outlier's treatment plan. ■
12/19/2017
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MARCH 2018 // orthotown.com
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