Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 46

Case Report
tion. Power arms were used for space closure,
as these arms made it possible to apply forces
more apically, closer to the center of resistance,
to prevent bowing effects. A " duplex " power arm
was placed to connect the L5s and L6s to increase
the anchorage. At 6 months, the premolar
extraction spaces were closed, and a continuous
mandibular Smartwire 2 was engaged (Figures
7C and 8C). Power chains were continued from
the power arms after space closure to continue
uprighting the roots of the L3s and L56s. At 8
months, these roots were sufficiently uprighted,
the power arms on the L3s were removed, labial
buttons were bonded on the U5s, and a vertical
elastic (3/16 in., 4.5 oz) from the U5s to the L5,6
duplex power arms were used to settle the
occlusion (Figures 7D and 8D).
At 13 months, the treatment objectives were
completed, and the patient and his parents
were satisfied with the overall treatment (Figure
7E and 8E). However, the patient and parents
agreed to continue treatment for additional
finishing improvements at my request, and the
patient's updated intraoral scan and photos
were submitted to the InBrace Smile Design
Studio to generate a digital enhancement (DE)
Smile Design, which was used to fabricate
new Smartwires to address minor details in
alignment and occlusion. At 14 months, DE
Smartwires were engaged for final detailing.
At 16 months, the duplex power arms were
removed; clear buttons were added at the same
appointment on LR5, 6, UL3, and LL3,5; and
settling elastics (3/16 in., 4.5 oz) were given to
UR5-LR56 and U35-LL35. These settling elastics
continued until his appliance was debonded.
Upon completion of treatment, upper and lower
Essix retainers were delivered for retention. The
patient was instructed to wear these retainers
full time for 6 months and only at nighttime
thereafter.
Treatment Results
The total treatment time for the mandibular arch
was 19 months and for the maxillary arch was
14 months, including the waiting time for the
DE Smartwires to arrive. All treatment objectives
were accomplished predictably and efficiently
in 11 total appointments at 6- to 8-week
appointment intervals, which made this a very
Figure 7. Progress mandibular arch occlusal view intraoral photographs from initial to 13 months in
treatment: (A) initial; (B-E) 2, 6, 8, and 13 months, respectively
Figure 8. Intraoral photographs of the progress of the right buccal from initial to 13 months: (A)
initial; (B-E), 2, 6, 8, and 13 months, respectively
Figure 9. Posttreatment facial and intraoral photographs (B.L., 14 years, 9 months)
46
PCSO Bulletin Spring 2022

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
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Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 27
Pacific Coast Society of Orthodontists Bulletin Spring 2022 - 28
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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
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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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