Case Report How Would You Treat This Malocclusion? Posttreatment Case C.H. 18 years, 2 months Treatment Plan All treatment options were discussed with the patient and his parents. They preferred to have neither prosthodontic restorations nor extractions in the mandibular arch. Therefore, it was agreed that option 1 would be the most appropriate choice: nonsurgical comprehensive orthodontic treatment with extraction of UR5, closing spaces of the max- illary second premolars. No further CBCT was needed because UR5 was to be extracted. Treatment Progress Treatment was started with the extraction of UR5. Prior to bonding, 0.022-inch slot INSIGNIA brackets with an individualized prescription were bonded U6-6 and L7-7. Leveling and alignment were performed using the wire sequence listed in Table 2. After two months in treatment, the patient noticed the development of an anterior open bite, which was an expected possible issue given his hyperdivergent growth pattern (Figure 5). Hooks were added to U1s and L2s to allow the use of anterior "rainbow" vertical elastics (5/16-inch, 2 oz, U1s to L2s single or double) at night. There was an Table 2. Archwire Sequence Used for This Case Upper Arch Lower Arch Damon Cu NiTi 0.016-in Damon Cu NiTi 0.016-in Damon Cu NiTi 0.018-in Damon Cu NiTi 0.018-in Damon Cu NiTi 0.014 × 0.025-in Damon Cu NiTi 0.014 × 0.025-in Damon Cu NiTi 0.018 × 0.025-in INSIGNIA Cu NiTi 0.014 × 0.025-in Damon stainless steel 0.016 × 0.025-in (sliding mechanics) Damon Cu NiTi 0.018 × 0.025-in Damon Cu NiTi 0.014 × 0.025-in (U7s engaged) Damon stainless steel 0.016 × 0.025-in INSIGNIA TMA 0.019 × 0.025-in (finishing wire) INSIGNIA TMA 0.017 × 0.025-in (finishing wire) Figure 5. Progress photos showing the development of open bite after 2 months in treatment 44 PCSO Bulletin Spring 2020