Case 62      Diagnostic Summary:

 

O.B. 11Y 10M                    Hyperdivergent growth pattern

Class II/I                             Skeletal Class I

LMD                                   Dentoalveolar Class II

                                               Bilateral crossbite

                                                Both arches constricted

                                                Lower midline deviated 2 mm. to the left

                                                Frequent bronchitis

                                            Blocked mandibular right 2nd molar

 

Treatment:

 

Expand maxillary posterior segments with Hyrax 6446

Use combi gear 1:1 ratio during expansion (Textbook, pg. 208),

     to prevent extrusion of the maxillary arch during distalization

Correct mandibular midline to right

Develop (upright) mandibular arch transversely
 & sagittaly

Direct the forces of occlusion through the long axes of the teeth

Utilize level 2 lip bumper when unblocking lower right 2nd molar

Circumferential supracrestal fiberotomies on upper central

     incisors during active treatment, followed by fixed retention.