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.
CONTACT INFORMATION
The Ealing Dental Practice
6 Drayton Green Road,
West Ealing,
London,
W13 8RY
Website: Click Here
Class 2 div 1 Case treated with extraction of both upper 1st premolars, upper Nance appliance, Fixed braces , teeth whitening and composite bonding to upper anterior teeth.
Case Mentored by Zaid Esmail in the Advanced Post Training Forum.
PRE-TREATMENT PHOTOGRAPHS: EXTRA-ORAL 
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PRE-TREATMENT PHOTOGRAPHS: INTRA-ORAL 
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PRE-TREATMENT PHOTOGRAPHS: INTRA-ORAL | Measurement | Result |
|---|---|
| Skeletal Pattern | Class II Moderate |
| FMPA | Low |
| 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 |
| Crowding | Upper Arch 1mm, Lower Arch 1mm |
Skeletal 2
Class 2 div 1 incisors
Increased overjet
Increased overbite
Mild crowding
Class 2 molars and canines – Full units
Lower centreline displacement 1mm to right
Bond Up
Upper first Premolars are extracted and upper Nance appliance fitted. The Nance appliance increased anchorage and helped prevent the upper posterior teeth coming forward, leaving sufficient space for retraction of the upper canines. Two weeks later upper and lower fixed appliances were placed using 3M Unitek Gemini brackets. Laceback of upper 1st molar and 2nd premolar.
Powerchain runs from upper 2nd premolars to upper canines to start retraction of canines into Class 1.
MID-TREATMENT PHOTOGRAPHS: INTRA-ORAL 
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POST-TREATMENT PHOTOGRAPHS: EXTRA-ORAL 
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POST-TREATMENT PHOTOGRAPHS: INTRA-ORAL The main problem was the patient made frequent visits abroad for 3-4 months at a time and this made treatment protracted. However, the aims of treatment were met and the patient was thrilled with the result.
The IAS advanced course was the best course I have completed. It gave me the ability to treat a whole range of orthodontic cases that previously I would have referred. This case is just one example of that. I would encourage anyone who has had some experience with fixed braces to join this pathway, you will not regret it. The mentoring is excellent and you will feel confident that you have the support and advice both during and after the course. That is so important to us GDP’s..to make us feel safe, plus you’ll make great friends along the way.
