Orthotown March 2022 - 24
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Dr-T
Member Since: 05/19/09
Post: 2 of 10
You may have to forgo ideal orthodontic results for patient satisfaction at this point. Judging by
the hygiene, the patient may have hit " orthodontic burnout, " and hoping for patient cooperation
may be unrealistic. I would recommend coming up with your three best treatment plans and
having a meeting with the parents. Your plans should discuss extraction versus nonextraction;
canine substitution versus opening the space and replacing the missing lateral; bite discrepancy,
retention and the impacted third molars. Give estimates on treatment times and what cooperation
will be needed with each plan. My feeling is that they will want the quickest plan, which will be
nonextraction with lifetime retainers. ■
11/15/2019
ucla98
Member Since: 09/28/07
Post: 3 of 10
I don't think the UL3 is in the UL2 position, but the UL1 is in the UL2 position, and this
is why the upper midline is way off. For you to do canine substitution in this case, the buccal
segment has to be in a Class II relationship; it is Class I right now. So I'd give this patient two
treatment options:
1. Canine substitution and correct the upper midline shift by creating space between UL5
and UL6 for an extra premolar implant. For the right side, extract UR4 (or UR5) to
correct the Class II problem on that side.
2. Open up space between UL1 and UL3 for an implant for the missing UL2. And extract
UR4 (or UR5) for correction of Class II problem on that side.
I think the other ortho's treatment plan (extraction of UR4 and both lower 5s) is also a
ortho09345
Member Since: 11/18/18
Post: 4 of 10
reasonable treatment option if the lower incisors fl are out too much. Need to see the ceph. ■
11/15/2019
■
11/15/2019
Fenrisúlfr
Member Since: 02/25/09
Post: 5 of 10
zxzxzx
Member Since: 02/28/03
Post: 6 of 10
Fenrisúlfr
Member Since: 02/25/09
Post: 7 of 10
About a year or so. I recently inherited about 15 transfers all needing extractions, so that's
the basis for the estimated time. ■
11/17/2019
Let's say the patient opts for the extractions you are suggesting. How much more time will
be in treatment? ■
11/17/2019
I would offer two options. Extraction of UR4 and L5 or debond. And I'd remove and replace
all the brackets, band the 7s and refer for extractions once the arches are in 19x25 SS. ■
11/17/2019
24 MARCH 2022 // orthotown.com
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Orthotown March 2022
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