The AP position of your upper incisors is the key to your anchorage requirements. If you are happy with where they are, then you need to plan posterior protraction. I am Begg trained and use Tip Edge routinely, so bringing the premolars forward is easy. Get into a rectangular wire. I use 19/25 steel, then use push coilspring between the first molars and second premolars to create a " 5 to 5 anchorage unit. " Lock this up by your preferred means, then protract the molars. Personally I then move to 22/28 combo wire with 8 degrees labial crown torque. The rounded distal part of the wire makes molar protraction simple and can also help with protracting the lower molars without taxing lower anterior anchorage. You need to have a look at the lower right 1st premolar. What is going on with the apical bone? Good luck. ■ samwhittle Member Since: 08/08/19 Post: 5 of 10 11/19/2020 I have treated several cases very similar to this one. I also recommend ext U3s and L4s. ■ 11/22/2020 I think that the bony concern including the LR4 is idiopathic osteosclerosis. It should not be considered concerning to the treatment of this case. However, while I agree with the removal of the LL4, might the removal of the LR4 be a challenge since it is trapped beneath the mesial convexity of the LR5? ■ drjrporter Member Since: 05/05/08 Post: 6 of 10 DrHowardSpector Member Since: 06/14/09 Post: 7 of 10 11/22/2020 Be careful to watch for excessive root resorption in this case. ■ Cooper121 11/23/2020 Member Since: 10/23/20 Post: 8 of 10 Share your extraction cases! The Orthotown message boards are a great place to share your favorite cases or get advice on cases you haven't yet completed. Want to join in on the fun? Head to orthotown.com/messageboard to share your most complicated cases or weigh in on your peers' cases. FREE FACTS, circle 37 on card orthotown.com \\ JANUARY/FEBRUARY 2021 OT0121_MB1_ImpactedCanines.indd 19 19 1/15/21 11:27 AMhttp://easyrxcloud.com http://www.orthotown.com/messageboard http://www.orthotown.com