Weekly Question and Answer session. Jan 16, 2019

Welcome to 2019 and I hope that you had a wonderful holiday and restful festive season. We are all looking forward to a very big year in 2019 and OrthoEd have some very exciting developments planned for this year.

We had our first question and answer session for 2019, which involved a discussion of two cases.

The first case was a 13-year-old who presented in the late mixed dentition with the 85 still present and a unilateral class II buccal relationship on the right-hand side. In addition there were some risk factors with regards to the measly inclined and a high canine's and how traditional full banding would have potential side-effects, including canting of the occlusal plane and significant flaring of the upper teeth, in conjunction with some constriction of the upper arch. Hence discussion revolved around how to manage this risk in the early stages of treatment and also to address the correction of the class II buccal relationship on the right-hand side

The second case was a fully treated case, that commenced with a early phase of therapy as patient had significant crowding in both the upper and lower anterior segments, but a good class I molar relationship bilaterally – and treatment involved the use of an upper quad helix appliance and lower bi helix appliance to expand the arches, provide significant rotation of the molars and partial braces were also placed to improve the anterior alignment. A second phase was carried out later involving upper and lower fixed braces – and a great result was achieved with some over correction of the buccal relationship – but interesting questions were raised with regards to torque  issues and improving those to improve long-term stability, as well as the inaccuracy of OPG radiographs to assess root proximity and also demonstrating a wonderful final profile, yet the final lateral cephalometric radiograph would indicate a Bi maxillary dental protrusion and would demonstrate once again that the clinical findings and diagnosis should always override the cephalometric analysis – and the settlement you analysis should only be used to confirm a clinical diagnosis and treatment plan

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