Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 51

Case Report
forward growth of the mandible. The maxillary
and mandibular superimposition showed
slight proclination and relative extrusion of
the maxillary and mandibular incisors.
Heavy Class II elastics were used, especially
on the right side. However, the aligners did
an adequate job of preventing proclination of
the mandibular incisors and retroclination of
the maxillary incisors. The maxillary molars did
not appear to have been distalized as much
as anticipated since sequential distalization
was used. However, this was only unilateral
and thus difficult to trace on a cephalometric
radiograph.
Following treatment, the patient had fillings
replaced on the maxillary central incisors,
which had discolored over time, as well as a
buildup of the mesial-incisal edge of the maxillary
left lateral incisor to improve esthetics.
This report showcases the use of clear aligners,
Class II elastics, and sequential distalization to
correct a unilateral full cusp Class II malocclusion
while simultaneously uprighting and
mesializing a mandibular right second molar
into the position of a missing mandibular
right first molar. Our patient had excellent
compliance with both his aligners and elastics.
Without his compliance, the success of this
case would not have been achieved. He was
retained with maxillary and mandibular clear
retainers that were worn full-time for the first
three months followed by nighttime wear
indefinitely. Excellent retainer wear was emphasized
to maintain the vertical position of
the maxillary right second molar while waiting
for the eruption of the mandibular right third
molar into the mandibular right second molar
space. The ABO Case Radiograph Evaluation
Score was 17 (Figure 12).
Editor's Comments
The editor would like to compliment the
authors' excellence in managing the root position
of the mandibular second molar while
protracting and uprighting without involving
partial fixed appliances and hope our readers
can benefit from this case report when treating
similar cases.
Figure 11. Cephalometric superimposition: black, pretreatment; green, posttreatment
Spring 2023 PCSO Bulletin
51
Table 2. Comparison of Pretreatment and Posttreatment Cephalometric Measurements
Pretreatment
Cephalometric
Measurement
SNA (°)
SNB (°)
ANB (°)
FMA (FH-MP) (°)
SN-MP (°)
U1-NA (mm)
U1-SN (°)
L1-NB (mm)
IMPA (L1-MP) (°)
Upper lip to
E-line (mm)
Lower lip to
E-line (mm)
Norm
82.0
80.0
2.0
25.0
32.0
4.0
104.0
4.0
90.0
−4.0
−2.0
83.5
79.0
4.5
32.1
34.5
3.2
102.9
6.2
90.0
1.9
−0.9
Posttreatment
81.0
79.1
1.9
33.4
32.8
5.5
105.4
5.5
88.6
0.5
-5.7
Figure 10. Posttreatment panoramic radiograph (left) and lateral cephalogram (right)

Pacific Coast Society of Orthodontists Bulletin Spring 2023

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2023

Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 1
Pacific Coast Society of Orthodontists Bulletin Spring 2023 - 2
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