Orthotown Jan/Feb 2016 - (Page 10)

clinical orthodontics // message board Transfer Case: Can I Finish Without Surgery? A Townie wants to know if she can finish a difficult transfer case without surgery. Orthotown.com > Message Boards > Clinical Topic > Clinical Orthodontics > Transfer Case: Can I Finish Without Surgery? alicia85 Member Since: 10/19/15 Post: 1 of 40 Related Message Boards Surgery Only? Surgery Only Class II Adult Does Not Want Surgery. How to Camouflage? Class II Adult Hello all! Needing your expert opinion once again (love this forum, by the way). This patient is 11 years old and is currently in braces. I have attached the initial records and progress records. She had all 4's extracted and all the spaces closed by the previous doctor. Her bite is still very deep and overjet is huge. I've talked to the parents over the last couple visits about surgery and of course they ask if there is anything else we could do. Do you think a Class II corrector could help? I currently have her in reverse curve wires to try to open the bite but even that seems like it hasn't been working out as I hoped. Any advice is appreciated. Thanks in advance. Side note: I just finished residency last year, but feel like I wasn't prepared enough for the real world-is this just me? If not, how long did it take for you to feel like you knew what you were doing? (I could go on and on about my woes including staff, overhead, how some of my cases are finishing...) ■ DEC 3 2015 Fenrisúlfr Member Since: 02/25/09 Post: 2 of 40 What is the wire and slot size? The wires seem too flimsy for the mechanics and the canine angulation is definitely not helping the deep bite. I'd repo all brackets, invert the lower 2-2 (if MBT, in order to establish lingual root torque on the lower incisors), fill the slot ASAP (21x25 SS for me), and get the 3rds out. Once the tooth angulations improve and the rectangular SS wire is in place, the bite will open up. At that stage, I'd pick up the 7's with sectional wires (with aux. slot on the upper and bondable double tubes on the lower) and then work on AP correction. The arches need to be fully leveled, aligned and torqued before you can evaluate the degree of AP correction required. Not a surgical case in my opinion. Once things level out, and with some growth, Class II ELS or a Forsus ought to do the trick. ■ DEC 3 2015 alicia85 Member Since: 10/19/15 Post: 3 of 40 .018 slot Roth. Just realized that I didn't post the original pano (both were progress). I'll post once I get back to the office. ■ DEC 3 2015 4OnTheFloor Member Since: 10/26/03 Post: 4 of 40 Hard to tell how Class II the molars are in the photos, but she looks pretty young still. Have you thought about a Herbst appliance? ■ DEC 3 2015 Continued on p. 12 10 JANUARY/FEBRUARY 2016 // orthotown.com http://www.Orthotown.com http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=244281&g=1 http://www.orthotown.com/MessageBoard/thread.aspx?a=11&s=6&f=693&t=156991 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown Jan/Feb 2016

Orthotown.com Highlights
Embrace Progress: You Can’t Fight Mother Nature
Transfer Case: Can I Finish Without Surgery?
Best Direct Bonding Protocol
Class III Treatment in 15 Months
Go Beyond Accommodating: Working with Extra-Needs Patients
Treatment of Open-Bite with Mini-Screws and Segmental Mechanics
Cali Orthodontist an Engineer of New Smiles
Poll
Serendipity and the Right Technology: One Orthodontist’s Story
Townie Choice Awards 2015: Townies Have Spoken!
12 Marketing Tips for Orthodontists in 2016
Ad Index

Orthotown Jan/Feb 2016