Orthotown January/February 2021 - 19

The AP position of your upper incisors is the key to your anchorage requirements. If you are
happy with where they are, then you need to plan posterior protraction. I am Begg trained and use
Tip Edge routinely, so bringing the premolars forward is easy. Get into a rectangular wire. I use
19/25 steel, then use push coilspring between the first molars and second premolars to create a " 5
to 5 anchorage unit. " Lock this up by your preferred means, then protract the molars. Personally
I then move to 22/28 combo wire with 8 degrees labial crown torque. The rounded distal part
of the wire makes molar protraction simple and can also help with protracting the lower molars
without taxing lower anterior anchorage.
You need to have a look at the lower right 1st premolar. What is going on with the apical bone?
Good luck. ■

samwhittle
Member Since: 08/08/19
Post: 5 of 10

11/19/2020

I have treated several cases very similar to this one. I also recommend ext U3s and L4s. ■
11/22/2020

I think that the bony concern including the LR4 is idiopathic osteosclerosis. It should not
be considered concerning to the treatment of this case. However, while I agree with the removal
of the LL4, might the removal of the LR4 be a challenge since it is trapped beneath the mesial
convexity of the LR5? ■

drjrporter
Member Since: 05/05/08
Post: 6 of 10

DrHowardSpector
Member Since: 06/14/09
Post: 7 of 10

11/22/2020

Be careful to watch for excessive root resorption in this case. ■

Cooper121
11/23/2020

Member Since: 10/23/20
Post: 8 of 10

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Orthotown January/February 2021

Table of Contents for the Digital Edition of Orthotown January/February 2021

Orthotown January/February 2021 - Intro
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Orthotown January/February 2021 - 1
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