Case Report Category #: 3
Date of Birth: 03/18/88
Age (years and months): 11 years 10 months

1. PRETREATMENT RECORDS
   Date of Records: 01-05-00
   Diagnosis:
   • Skeletal: Class I. Lower mandibular plane angle, palate is slightly narrow.
   • Dental: Class I, Arch length discrepancy with the maxillary lateral incisors, right second premolar and right first molar in crossbite.
   • Facial: Profile straight with good mesiolabial angle and soft tissue.
   
   

   Treatment Plan:

   1. Extract four second premolars to correct the arch length discrepancy and maintain the facial balance.
   2. Move the incisor mandibular plan angle to accommodate the maxillary incisors.
   3. Retain with a maxillary Hawley and mandibular mini spring retainer.

   Treatment:

   1. Extract all second premolars.
   2. .022X.028 / Appliances placed. No torque and no angulation.
   3. Class III Elastics were used for two months.
   4. Anterior Vertical elastics were used for six weeks.

   
   

   Initiated Treatment

   Date: 7-19-00

   Appliance Removal

   Date: 4-8-02

   Active Treatment Time

   Duration: 20.5 Months

2. POSTTREATMENT RECORDS
   Date of Records: 1-29-03
   Retention: Maxillary Hawley, Mandibular Mini Spring Retainer.
   
   Retainers were worn full time for seven months, then p.m. for eighteen months and as needed after two years.
   
   

   Retention Completed

   Date: N/A

   Retention

   Duration: As Needed

HISTORY AND ETIOLOGY: Healthy Caucasian female, had adenoids removed at the age of nine years. Reported no allergies. Primary complaint was crowding and the posterior crossbite.

DIAGNOSIS:
Skeletal: Class I, slightly narrow intermolar width in the maxillary arch.
Dental: Class I, arch length discrepancy, posterior unilateral crossbite, maxillary lateral incisors in crossbite.

TREATMENT PLAN: Extract four second premolars.

SPECIFIC OBJECTIVES OF TREATMENT:
Maxilla:

• A-P: Maintain

Mandible

• A-P: Maintain
• Vertical: Maintain

Maxillary Dentition

• A-P: Correct crossbite
• Vertical: Maintain smile line
• Intermolar Width: Maintain

Mandibular Dentition

• A-P: Move incisor mandibular plane angle lingually to accommodate maxillary incisors.
• Vertical: Maintain
• Intermolar / Intercanine Width: Constrict lower molar width, maintain intercanine width

Facial Esthetics: Maintain

APPLIANCES: .022X.028 edgewise appliances with no torque and no angulation.

TREATMENT PROGRESS:

RESULTS ACHIEVED:
Maxilla:

• A-P: The SNA measurement decreased one degree.

Mandible

• A-P: The SNB measurement stayed the same.
• Vertical: The posterior facial height increased 2 mm. The anterior facial height increased 3 mm and the SN Go Gn measurement increased approximately .5 degrees.

Maxillary Dentition

• A-P: The central incisors moved palatally slightly, while the maxillary molars moved anteriorly approximately 3.5mm.
• Vertical: The maxillary molars moved downward 2mm and the incisors maintained their relative vertical position.
• Intermolar Width: The width was maintained.

Mandibular Dentition

• A-P: The IMPA decreased 6º and the mandibular molars moved forward approximately 2mm.
• Vertical: The mandibular incisors to the mandibular plane increased 4mm and the mandibular molar to the mandibular plane increased 3mm.
• Intermolar / Intercanine Width: Intermolar width decreased 3mm and intercanine width increased 1mm.

Facial Esthetics: Good lip curl maintained.

RETENTION: Maxillary Hawley retainer and mandibular mini spring retainer.

FINAL EVALUATION OF TREATMENT: Facial esthetics good. Function good. Prognosis good.