A Compromised Plan – See How It Worked Out

Case Summary

Not every case is treated to ideal for a variety of factors. In this case, the patient was presented with the ideal extraction pattern of UR5, LR5, UL4, LL5. 

Since UL5 was root-treated, this tooth was the preferred tooth to extract in the upper left quadrant.

However, the patient decided she only wished to have one tooth removed, Ul5.  

This meant that the occlusion on the left side would not be ideal. In addition, the centreline would be expected to drift to the left, which would be exacerbated by uprighting the distoangular UR3. 

Control of the centreline would be a challenge. This was relayed to the patient, but it didn’t alter her decision. IPR on the upper right side helped to maintain the centreline.

An upper Nance appliance helped to hold the space once UL5 was extracted.

Problem List

Skeletal 2

Crowding especially high canine UL3

Class 2 canines and molars left

Lower centreline

Ideal Plan

Xla  UR5, LR5, UL4, LL5  but due to root filled tooth, UL5 was to be extracted.

Compromised plan

Xla UL5, Nance appliance, UFA / LFA

Fixed and Essix retainers.

Wires Used

012 Niti

016 Niti

20 x 20 Niti

19x 25 Niti

MID-TREATMENT PHOTOGRAPHS:

The knowledge and experience I gained from IAS Academy’s Advanced Course proved invaluable when treating this case and also gave me the confidence to treat other advanced cases that I previously would have referred.

I’d encourage anyone with a basic knowledge of orthodontics to take their skills to the next level with the academy’s advanced training. The mentoring is first-class, the is support excellent, and the course syllabus is absolutely comprehensive—plus, I met many new friends while training!