Pacific Coast Society of Orthodontists Bulletin Spring 2020 - 47
Case Report
Figure 10. Superimpositions
Table 3. Comparison of Initial and Final Lateral Cephalometric Measurements
Variable
Norm
Pretreatment
Posttreatment
SNA (°)
82.0
75.4
76.0
SNB (°)
80.0
72.6
72.1
ANB (°)
2.0
2.8
3.9
FMA (FH-MP) (°)
25.0
34.7
36.0
SN-MP (°)
32.0
46.6
47.5
4.0
8.9
5.6
104.0
104.4
96.2
4.0
11.1
8.9
IMPA (L1-MP) (°)
90.0
96.6
86.6
Upper lip E-line (mm)
−4.0
2.6
2.2
Lower lip E-line (mm)
−2.0
6.4
4.9
U1-NA (mm)
U1-SN (°)
L1-NB (mm)
A posttreatment panoramic radiograph
showed acceptable root parallelism and the
possible future impaction of mandibular
third molars (L8s); there were no significant
signs of root resorption or alveolar bone
resorption. The patient's ABO Cast-Radiograph Evaluation score was 18, as assessed
from the printed digital models. One of the
keys to the success of this treatment was
the patient's cooperation in not missing
any appointments, wearing the elastics as
Spring 2020 PCSO Bulletin
indicated, and maintaining excellent oral
hygiene (Figure 11).
Editor's Comments
The editor appreciates Dr. Morell and his
supervising instructors, Drs. Hoffman and
Grykyliak, for submitting this interesting
case to the PCSO Bulletin to share with our
PCSO members. This patient's treatment
became challenging when the possibly
most straightforward option, extraction of
all three existing second premolars, was
declined by the patient and his parents, who
were the ultimate decision makers. With
the aid of TSADs, the authors were able to
protract the maxillary posterior teeth to
close the spaces without compromising the
final functional occlusion or esthetics. It is
applaudable that the authors were able to
upright the lower anterior teeth slightly,
given the mild crowding on the mandibular
arch.
47
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