Orthotown April 2016 - (Page 18)
clinical orthodontics // message board
Never Promise Non-Extraction
Treatment to Phase I Patients
Patient doesn't want extractions, but is there any other option?
Orthotown.com > Message Boards > Clinical Topic > Clinical Orthodontics > Never Promise Non-Extraction Treatment to Phase I Patients
Billy Wonka
Member Since: 08/31/08
Post: 1 of 17
Related Message Boards
How Would You Treat?
You Treat
Severe Crowding Treated
Non-Extraction
Crowding Treated
Introduction
This 11-year-old boy presented to
my office last week with the chief concern of crowding. I learned that the
patient had previous Phase I treatment
by another orthodontist, consisting of
an upper expander and some upper
and lower partial braces. "My teeth
are crowded and my upper cuspids
don't have room to come in."
The previous orthodontist had
left in the TPA. Of course mom and
patient prefer non-extraction treatment, but I just don't see how I can do
so in a mild Class II, especially since
this is a high-angle case with blockedout U3s, particularly UR3.
There's at least 10-11mm of
crowding in the upper arch, and
5-6mm in the lower arch. The upper
dental midline is 1-2mm, and shifted
to the right of the facial midline. Oral
hygiene is certainly suspect. PANO
reveals radiographic impaction of LR7 (please
excuse the white shadow near LR3 area).
Ceph findings: SNA 77, SNB 74, ANB 3,
U1-SN 100, U1-NA 23/4, L1-NB 22/5, FMA
32, FMIA 64, IMPA 84 (probably should be a
bit higher), interincisal angle 132.
These are my options: 1. Extract all 4s; 2.
Extract upper 4s and lower 5s; 3. Extract UR4,
LR5, UL4 and LR4.
I don't think I can treat this case nonextraction and I'm not good enough with my
mechanics to treat with extractions of all 5s.
What would you do? Thanks for your input
and cheers. ■
JAN 12 2016
Continued on p. 20
18
APRIL 2016 // orthotown.com
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Table of Contents for the Digital Edition of Orthotown April 2016
Orthotown.com Highlights
Embrace Progress: Decisions, Decisions
Industry News
Crossbite with Impacted Canines
Never Promise Non-Extraction Treatment to Phase I Patients
Netherland Doc Combines European, American Treatments
Your More Digital Future
Change the Words, Change Your Results
Protect Your Position in the Mouthguard World
Practice Solutions: American Orthodontics
Poll
Corporate Profi le The One to Watch: Henry Schein Orthodontics leads the field in innovation, ethics and business acumen
American Association of Orthodontics
Ad Index
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