I planned to use upper and lower fixed appliances following the extraction of all the first premolars. I planned to use upper Nance and lower lingual arch appliances as I knew the inclination of the canines would create high anchorage demands. I felt the patient would need upper and lower retainers and planned to review her retention progress regularly after treatment.
Once the canines were sufficiently retracted, I ligated the upper and lower incisors into the bracket slots. The upper Nance and lower lingual Arch were removed once I had run through the complete wire sequence and into 0.019” x 0.025” NiTi wire, and the lower centreline had been established.
At bond-up, the upper and lower incisors were only minimally engaged to prevent them proclining. Lace-backs were applied at each quadrant between the first molars and second premolars. A power chain was used to retract the canines from the laced back second premolars. Upper Nance and lower Lingual Arch appliances were used to provide additional anchorage.