CASE 2 - Patient R. S. H. 7766 AAO 2011

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8/15/2011 1 RG Wick Alexander, DDS, MSD Diplomate of the American Board of Orthodontics 840 West Mitchell Street Arlington, Texas 76013 www.drsalexander.com www.alexanderdiscipline.com TM

A.A.O. Chicago May 15th 9:35 am:

8/15/2011 2 A.A.O. Chicago May 15 th 9:35 am It’s Time to . . . Stand up for Stability !

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Long -Term Case 2 From the “Room of Truth” …

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8/15/2011 4 Is Cuspid Protected Occlusion . . . Critical ?

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8/15/2011 5 Patient : R. S. H. #7766 Age : 13 yrs. 0 mo. 1986

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82 79 3 33 102 133 92 Pre – TX

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8/15/2011 7 Pre - TX Maxillary right central incisor chipped

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8/15/2011 8 DIAGNOSIS : A normal Class I skeletal pattern MISSING maxillary right lateral incisor Peg – shaped maxillary left lateral incisor

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8/15/2011 11 Discussed with parents . . . Open or close Lateral spaces

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8/15/2011 12 TREATMENT PLAN : Cuspid substitution Extract maxillary left lateral incisor Class 3 elastics to “burn maxillary anchorage.” 1986

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8/15/2011 13 16 MONTHS: Maxillary & Mandibular 17 X 25 SS LB3’s elastics

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8/15/2011 15 Treatment Time: 23 Months

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8/15/2011 16 FINAL OCCLUSION : Maxillary Cuspid substitution Class II molar relationship No TMJ problems

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Maxillary Archwire Sequence :

8/15/2011 19 Maxillary Archwire Sequence .0175 Multistrand SS 5 mos. .016 S.S. 3 mos. 17 X 25 SS 15 mos. TREATMENT TIME: 23 mos.

Mandibular Archwire Sequence :

8/15/2011 20 Mandibular Archwire Sequence None 4 mos. 17 X 25 Multistrand SS 2 mos. 16 X 22 TMA 5 mos. 17 X 25 S.S. 12 mos. TREATMENT TIME: 19 mos.

Individualized Forces::

8/15/2011 21 Individualized Forces: Elastics: Class 3 4 mos. Buccal Box Class 3 6 mos. Finishing elastics 2 mos.

Case Comparison ::

8/15/2011 22 Case Comparison : Treatment Time : 23 months

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8/15/2011 23 Treatment Time: 23 Months

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8/15/2011 27 36.8 36.8 25.7 25.7

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8/15/2011 82 79 3 33 102 133 92 Pre – TX 83 80 3 36 105 141 78 Post – TX

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8/15/2011 31 February 2011 23 Years Post - Treatment

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8/15/2011 32 Age : 38 years

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36.8 36.8 25.7 25.7 36.4 25.4

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T1 T2 T3 IMPA 92 90 92 8/15/2011 36

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8/15/2011 37 Full crown maxillary right central incisor

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8/15/2011 38 TM

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