Orthotown August 2018 - 37

by Dr. Saritha Chary-Reddy and Karthik Reddy
Dr. Saritha Chary-Reddy received her DDS with honors
from the University of Oklahoma Health Sciences
Center, and also has earned a PhD in the field of
genetics. During her specialty training in orthodontics
and dentofacial orthopedics at the University of Texas
Health Science Center in San Antonio, she received a
Best Scientific Presentation award for her research in
genetic disorders that relate to tooth and facial disorders.
Chary-Reddy is a diplomate of the American Board of Orthodontics,
receiving board certification in 2006. Her professional affiliations include
the American Association of Orthodontists, the Southwestern Society of
Orthodontics, the American Dental Association, the Texas Dental Association
and San Antonio District Dental Society.

Aspiring dentist Karthik Reddy currently
is an undergraduate student at Trinity
University in San Antonio, Texas. He works
as an intern with Chary-Reddy at VK
Orthodontics during the summer.

Treatment plan
Several treatment options were offered to the patient:
* Distalizing maxillary molars using microscrews.
* Extraction of mandibular first premolars and surgical
mandibular advancement.
*
Extraction of maxillary and mandibular first premolars.
* Extraction of only maxillary first premolars, with interproximal
reduction in the mandibular arch to relieve crowding.
Patient did not want either surgery or extraction option. She said that her
brother had the same bite as hers and had undergone an extraction treatment
plan with another orthodontist, but she did not like the aesthetics of his
final smile result. Therefore, the patient chose the first option.

Treatment progress
Radiance brackets from American Orthodontics with 0.022 MBT
prescription were bonded on maxillary and mandibular arches. Sectional
wires were placed in the maxillary arch from upper canine to canine, and
bilaterally from first premolar to second molars. Sectional archwires were used
to prevent the resistance from sliding mechanics. For efficient leveling of the
Curve of Spee, mandibular second molars were also banded. A continuous
archwire was placed in the mandibular arch.
Initial archwires were 0.014 nickel titanium (NiTi), followed by 0.016
NiTi and then 0.018 stainless steel (SS). The maxillary 0.018 SS archwire
was left 3-4 mm longer distal to the second molars to keep the molars in
archwire during the distalization process. Passive NiTi coil springs were
added bilaterally between maxillary second premolars and first molars, and
between first and second molars.
When patient was in 0.018 SS wires, she was referred to an oral surgeon
for placement of microscrews and extraction of maxillary and mandibular
third molars. Microscrews were placed bilaterally at the buccal/mucogingival
junction between maxillary first molar and second premolar (Fig. 2). An
elastic chain was attached from the microscrew to the first premolar. The
microscrews were used as indirect anchorage to prevent mesial movement

Fig. 1. Pretreatment pictures and X-rays.

orthotown.com \\ JULY/AUGUST 2018

37
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Table of Contents for the Digital Edition of Orthotown August 2018
