Fixed Anterior Alignment – Case Study: SS

Fixed Anterior Alignment by Dr Nick Simon

Dr Nick Simon is a former IAS teacher and Mentor. He was a delegate on the first cohort of the Advanced Fixed Course taught by Prof Ross Hobson, and this case was mentored by Zaid Esmail, an orthodontic specialist and IAS Advanced Course mentor, on IAS Academy’s Advanced Post-Training Forum.


Straight White Teeth London
6 Drayton Green Road,
West Ealing,
W13 8RY

Website: Click Here


The patient presented with class I, division 2 incisors, increased overjet, increased overbite and other issues.

Pre Treatment
Pre Treatment
Measurement Result
Skeletal Pattern Class II Mild
Lower Face Height Average
Facial Asymmetry No
Soft Tissues Competent lips, acute NLA, low smile line
Teeth Present 8 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7 8, 7 6 5 4 3 2 1 | 1 2 3 4 5 6 7
Incisor Classification Class II Div 1
Overjet 12mm
Overbite 70% overlap and complete
Centerlines Coincident Upper, Deviated Lower, Right by 1mm
Displacement on closure No
Molar Relationship Right Class II Full, Left Class II Full
Canine Relationship Right Class II Full unit, Left Class II Full unit
Crossbite No
Spacing/Crowding Upper Arch 1mm, Lower Arch 1mm


I planned extraction of both upper first premolars, followed by treatment with an upper Nance appliance and fixed braces with teeth whitening and composite bonding to upper anterior teeth to complete.


I extracted the upper first premolars and first fitted a Nance appliance (for increased anchorage) before fitting a 3M upper fixed appliance with Unitek Gemini brackets. Here, you can see the laceback on the upper first molar and second premolars and a power chain running from the upper second premolars to the upper canines.

Mid Treatment - Here you can see the canines are now retracted and the full power chain applied.
Mid Treatment
Mid Treatment
Mid Treatment
Mid Treatment
Pre Treatment
Post Treatment
Pre Treatment
Post Treatment
Pre Treatment
Post Treatment
Pre Treatment
Post Treatment