Orthotown December 2020 - 34
Within three weeks, a midline split was
achieved (Figs. 19 and 20) and within two
months, 10mm of skeletal expansion was
achieved (Fig. 21).
During the expansion process, the
patient developed an anterior open bite,
mostly due to posterior interferences, so a
multiloop edgewise arch wire (MEAW) was
delivered (Fig. 22), and vertical elastics were
worn from the maxillary canine hooks to
the most anterior mandibular MEAW hook.
Within 9 weeks, the open bite had been
closed and the 12-week retention period
of the MARPE was complete (Fig. 23), so
the MARPE was removed and the patient
was scheduled for removal of her braces.
Treatment time was 18 months.
Comparing the arch forms from start
to finish (Figs. 24a and 24b), one can
appreciate the combination of MARPE
and Norris Extra Broad wires in developing
broad, airway-friendly arches. Note that
in the mandibular arch, no expander was
used-only Norris Extra Broad wires and
one MEAW wire.
Final records (Fig. 25-27), taken when
the patient received updated provisional
restorations, reveal a fuller smile and elimination of dark buccal corridors. Tooth #3
(UR6) was extracted as planned, and the
patient was undergoing grafting procedures
in preparation for her dental implants.
CBCT imaging taken at the time of
MARPE insertion (Fig. 28a) demonstrates
the critical bicortical engagement of the
microimplants through the palate as well
as the nasal floor. CBCT imaging taken
upon MARPE removal (Fig. 28b) reveals
new bone forming in the maxillary midline,
as well as dramatically improved airway
spaces surrounding the inferior and middle
turbinates.
A comparison of initial and final facial
photographs (Fig. 29) demonstrates a wider
alar base, fuller cheeks, broader smile, and
a dramatic improvement in her dark buccal
corridors and overall facial aesthetics. n
Fig. 19
Fig. 20
Fig. 21
Fig. 22
Fig. 23
Reference
1. Dolt, AH 3rd, and Robbins, JW. " Altered passive eruption: an
etiology of short clinical crowns. " Quintessence Int. 1997
Jun; 28(6): 363-72.
34
DECEMBER 2020 // orthotown.com
OT1220_Norris_Case-Study_MM.indd 34
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Orthotown December 2020
Table of Contents for the Digital Edition of Orthotown December 2020
Embrace Progress
Poll: Small Equipment and Supplies
Message Board: Class II Div 1 Deep Bite Teen Aligner Case
Message Board: Extraction Mx 6
Office Visit: Dr. Jason Battle
As Easy As 4, 5, 6
5 To Grow On
Ad Index
Continuing Education: Slop-py Work
Orthotown December 2020 - Cover1
Orthotown December 2020 - Cover2
Orthotown December 2020 - 1
Orthotown December 2020 - 2
Orthotown December 2020 - 3
Orthotown December 2020 - 4
Orthotown December 2020 - 5
Orthotown December 2020 - 6
Orthotown December 2020 - 7
Orthotown December 2020 - Embrace Progress
Orthotown December 2020 - 9
Orthotown December 2020 - 10
Orthotown December 2020 - 11
Orthotown December 2020 - Poll: Small Equipment and Supplies
Orthotown December 2020 - 13
Orthotown December 2020 - Message Board: Class II Div 1 Deep Bite Teen Aligner Case
Orthotown December 2020 - 15
Orthotown December 2020 - 16
Orthotown December 2020 - Message Board: Extraction Mx 6
Orthotown December 2020 - Office Visit: Dr. Jason Battle
Orthotown December 2020 - 19
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Orthotown December 2020 - 21
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Orthotown December 2020 - As Easy As 4, 5, 6
Orthotown December 2020 - 27
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Orthotown December 2020 - 5 To Grow On
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Orthotown December 2020 - Ad Index
Orthotown December 2020 - Continuing Education: Slop-py Work
Orthotown December 2020 - 43
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