Orthotown October 2023 - 27
Fig. 2: The design also incorporates a center slot lineup that allows for predictable
vertical expressed position when using selective variable torque brackets.
Fig. 3a
Fig. 3b
Fig. 3c
Fig. 3d
open incisal embrasures, resulted
in poor smile aesthetics.
Objectives/plan
The objectives for the maxillary
arch were to develop the arch,
create space for the maxillary anterior
teeth, and maintain the vertical
and A-P position and angulation
of the incisors. The mandibular
objectives were posterior buccal
uprighting, leveling the curve
of Spee, and advancing lower
incisors while controlling facial angulation
for an ideal result. A nonextraction
plan was chosen using
the Damon Ultima System, along
with the use of light Class 2 elastics
overbite correction.
Case setup
The brackets chosen were Damon
Ultima PSL variable torque
brackets. Because of the need for
maxillary arch development and
the plan to use Class 2 elastics,
proclined torques were used on
the maxillary anterior to protect the
facial angulations from the unwanted
lingual tipping predicted with
both arch development and Class 2
elastics. In the mandibular arch, the
lower canines required uprighting;
therefore, proclined brackets were
used and retroclined were used on
the L2-2 to protect lower incisor
angulation against the proclining
forces of arch leveling and resultant
forces of Class 2 elastics (Fig. 4,
p. 28).
All permanent teeth were bonded
except for the UR3, where a nickel
titanium (NiTi) coil spring activated
2 mm was placed to create space
for eruption. Initial wires, 0.014-inch
copper nickel titanium (CuNiTi),
OCTOBER 2023 | 27 | ORTHOTOWN.COM
were placed in both arches; the bite
was disarticulated, and 2-ounce,
3/16-inch elastics started from the
U4s to the L6s full-time, and a referral
was provided to have Tooth C
removed.
Case progression
Phase 1 (0-7 months)
Bracket placement was positioned
in a normal bonding protocol
around FA point with the U1s at
5.5 mm from the incisal edge to
the bracket slot. Initial 0.014 CuNiTi
U/L and an early elastic were
started using 2-ounce, 3/16-inch
Class 2 elastics from the U4s to
the L6s to support the open coil
spring, as well as the correction of
the Class 2. It is important to note
that if the lower arch had moderate
crowding, elastics would have
been delayed until the crowding
http://www.ORTHOTOWN.COM
Orthotown October 2023
Table of Contents for the Digital Edition of Orthotown October 2023
Orthotown October 2023 - Cover1
Orthotown October 2023 - Cover2
Orthotown October 2023 - 1
Orthotown October 2023 - 2
Orthotown October 2023 - 3
Orthotown October 2023 - 4
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Orthotown October 2023 - 15
Orthotown October 2023 - 16
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Orthotown October 2023 - 18
Orthotown October 2023 - 19
Orthotown October 2023 - 20
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Orthotown October 2023 - 22
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Orthotown October 2023 - 27
Orthotown October 2023 - 28
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Orthotown October 2023 - Cover3
Orthotown October 2023 - Cover4
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