Orthotown September 2021 - 35
Elastic chains constrict, whereas
open-coil springs expand.
and change. Eventually the provisional composite restorations can be replaced with more
definitive porcelain restorations, enhancing the long-term aesthetic prognosis.
Case study
A 10-year-old patient presented with a chief complaint of maxillary spacing and missing
maxillary lateral incisors #7 and #10 (Fig. 3a, p. 32). She had a deep bite and an Angle's Class
II molar and canine relationship. Clinical examination of her short clinical crowns hinted at
early signs of altered passive eruption, but because of her young age and growth potential,
a definitive diagnosis could not be made at that time. The cephalometric radiograph (Fig.
3b, p. 32) revealed that she was brachycephalic and slightly bimaxillary retrusive. However,
her maxillary incisal angulation was ideal. The panoramic radiograph (Fig. 3c, p. 32) was
unremarkable, with the exception of the missing teeth #7 and #10.
The patient was treatment-planned for cuspid substitution, converting the maxillary
cuspids to lateral incisors and the maxillary premolars into cuspids. The molars would remain
Angle's Class II.
The cuspid conversion procedure described earlier was followed as tooth #6 was reshaped
to resemble missing tooth #7 and tooth #11 was reshaped to resemble #10. Brackets with an
0.020-by-0.026-inch slot (Norris 20/26) were placed, paying particular attention to move
the maxillary first premolar brackets 3 mm to the occlusal to begin intruding those teeth that
would eventually serve as maxillary cuspid teeth. Mandibular molar brackets with 0 degrees of
rotation and 20 degrees of torque were placed on the maxillary molars to enhance the fit of the
molars in an Angle's Class II relationship. Bite turbos were placed to disclude her occlusion.
A 0.014-inch Norris Extra Broad NiTi archwire was placed at the initial visit (Figs. 4a-4c).
The normal Norris 20/26 system archwire progression was followed, and an 0.018-by0.018-inch
Norris Extra Broad NiTi wire was placed at her next appointment (Figs. 5a-5c).
Subsequently, a 0.019-by-0.025-inch NiTi wire was placed, which completed the intrusion
of the maxillary first premolars, continued arch development and provided a strong enough
wire on which excess spaces could begin to close using elastic chains and Class III elastics
(Figs. 6a-6c).
Once the maxillary first premolars reach an ideal Class I relationship with the lower
canines, then the orthodontic brackets are removed from them and composite resin
is added to convert them to canines. Note that when the brackets are replaced after the
bonding procedure, they are sometimes placed in an even further incisal position to further
orthotown.com \\ SEPTEMBER 2021 35
http://www.orthotown.com
Orthotown September 2021
Table of Contents for the Digital Edition of Orthotown September 2021
Table of contents
A Voice in the Arena: Champion What Your Patients Want
Industry News
New Products
Poll: Digital Imaging
Message Board: Cinch Back Vs. Tying Back of the Stainless Steel Wire
Message Board: Placement of Orthodontic Elastic Modules, O-Rings, Donuts
Message Board: Sterilization for Startup
Product Profile: Memotain
Product Profile: 3M Clarity Aligners Flex + Force
Product Profile: GT-Flex Pro Thermoforming Plastic
Cuspid Substitutions by Dr. Robert “Tito” Norris
Special Section: Startup Showcase
Keep Your Story Straight by Paul Edwards
How’s Your (Financial) Health? by Jay Geier
Cover Your Assets by Tom Jewkes and Dan Gavin
Ad Index
Orthotown September 2021 - Intro
Orthotown September 2021 - Cover1
Orthotown September 2021 - Cover2
Orthotown September 2021 - 1
Orthotown September 2021 - 2
Orthotown September 2021 - 3
Orthotown September 2021 - Table of contents
Orthotown September 2021 - 5
Orthotown September 2021 - 6
Orthotown September 2021 - 7
Orthotown September 2021 - A Voice in the Arena: Champion What Your Patients Want
Orthotown September 2021 - 9
Orthotown September 2021 - 10
Orthotown September 2021 - 11
Orthotown September 2021 - Industry News
Orthotown September 2021 - 13
Orthotown September 2021 - New Products
Orthotown September 2021 - 15
Orthotown September 2021 - Poll: Digital Imaging
Orthotown September 2021 - 17
Orthotown September 2021 - 18
Orthotown September 2021 - 19
Orthotown September 2021 - Message Board: Cinch Back Vs. Tying Back of the Stainless Steel Wire
Orthotown September 2021 - 21
Orthotown September 2021 - Message Board: Placement of Orthodontic Elastic Modules, O-Rings, Donuts
Orthotown September 2021 - 23
Orthotown September 2021 - Message Board: Sterilization for Startup
Orthotown September 2021 - 25
Orthotown September 2021 - Product Profile: Memotain
Orthotown September 2021 - 27
Orthotown September 2021 - Product Profile: 3M Clarity Aligners Flex + Force
Orthotown September 2021 - Product Profile: GT-Flex Pro Thermoforming Plastic
Orthotown September 2021 - Cuspid Substitutions by Dr. Robert “Tito” Norris
Orthotown September 2021 - 31
Orthotown September 2021 - 32
Orthotown September 2021 - 33
Orthotown September 2021 - 34
Orthotown September 2021 - 35
Orthotown September 2021 - 36
Orthotown September 2021 - 37
Orthotown September 2021 - Special Section: Startup Showcase
Orthotown September 2021 - 39
Orthotown September 2021 - 40
Orthotown September 2021 - 41
Orthotown September 2021 - 42
Orthotown September 2021 - 43
Orthotown September 2021 - 44
Orthotown September 2021 - 45
Orthotown September 2021 - Keep Your Story Straight by Paul Edwards
Orthotown September 2021 - 47
Orthotown September 2021 - 48
Orthotown September 2021 - 49
Orthotown September 2021 - 50
Orthotown September 2021 - 51
Orthotown September 2021 - 52
Orthotown September 2021 - 53
Orthotown September 2021 - How’s Your (Financial) Health? by Jay Geier
Orthotown September 2021 - 55
Orthotown September 2021 - 56
Orthotown September 2021 - 57
Orthotown September 2021 - 58
Orthotown September 2021 - 59
Orthotown September 2021 - Cover Your Assets by Tom Jewkes and Dan Gavin
Orthotown September 2021 - 61
Orthotown September 2021 - 62
Orthotown September 2021 - 63
Orthotown September 2021 - Ad Index
Orthotown September 2021 - Cover3
Orthotown September 2021 - Cover4
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