Pacific Coast Society of Orthodontists Bulletin Fall 2013 - (Page 28)

Case Report Progress and Post-Treatment How would you treat this malocclusion? Case J. M. treatment plan used treatment progress ros and cons of all treatment options, except the two-stage surgery approach, were initially discussed with the patient. The surgical plan with extractions was decided upon, but following surgical consultation this plan was changed to the two-stage non-extraction plan. It was decided that the amount of transverse discrepancy in the maxilla indicated that expansion to relieve crowding was not only possible, but also ideal, and the increased stability of expansion produced from SARPE procedures over two-piece Lefort-1 osteotomy validated the aggressive approach. TADfacilitated posterior intrusion could have produced an acceptable occlusion, but it would entail increased treatment time, and would not have addressed the patient’s insufficient incisor display when smiling. Following the patient’s records appointment, active treatment was delayed for 10 months due to problems with insurance and scheduling surgery. P An 0.022 appliance (Roth prescription brackets) was placed on the patient's lower teeth, with the first and second molars banded, brackets bonded 5-5, and an initial 0.014 NiTi wire. Bonding of the lower left lateral incisor was delayed for two months, until space was created for it using a push-coil spring between the central incisor and canine. After three months of treatment in the mandible, a maxillary Hyrax appliance with a 12mm screw was banded to the patient’s first molars and pre-molars, and he underwent the SARPE procedure. Expansion protocol POST-SARPE INTRAORAL mAxILLARY OCCLUSAL RELAxED SmILINg POST-SARPE PANOREx BEFORE FIxED APPLIANCES 28 PCSO Bulletin • FALL 2013

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Fall 2013

An Editor's Journey
A Sense of Belonging
To Meet Member Needs, You Have to Know Members
Stronger, More Efficient, More Focused
Service Behavior
Class II, Division 2 Malocclusions, Part II
Dr. Terry McDonald Interviews Dr. Douglas Klein
Mark Douglas, DDS
Vincent G. Kokich, Sr., DDS, MSD
Elastic Wear Tips
PCSO Business
PCSO at a Glance
Case Report Pre-Treatment
Case Report Post-Treatment

Pacific Coast Society of Orthodontists Bulletin Fall 2013