Orthopedic and Dental Expansion

The second case is a 13 year old male. I think exractions would have worked out well in this case, I thought that I might go that route as well but I wanted to use an RPE first to address transverse and then re-evaluate before braces. Sometimes when I do this I still decide to take out teeth anyway, an RPE is never presented to a patient as a solution to avoid extractions, it is a tool used to address transverse when needed. I often (especially in mixed dentition) will use caplin hooks lingual of L6s with night time only heavy cross elastics up to the U6s when expanding the maxilla to allow the lower molars to upright with the upper molars when this is appropriate. RPE was in for 6 months prior to placing braces (I left it on for the first 6 months of braces as well). A diastema formed early on in the RPE but then closed. Total time in braces was just under 19 months. The final photos shown are 6 months after debond. Inverted lateral incisor brackets were placed on all 4 upper incisors. Extra broad niti wires used and then finish in 16X25SS UL with customized arch shape. In an inverted setup I typically do not advance past 16X25SS in the upper arch. At bottom of this text I attached an article where I discuss in detail my rationale when using an inverted setup. Back when this patient was started I was not bonding for smile arc (ala Tom Pitts) so I had to repo all anteriors after about 8 months in tx to address that. Total IPR was 0.4mm between each contact UL2-2 and 0.2mm UL 2-3s. I did not engage UR3 until open coil had made full space for the tooth

Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion
Orthopedic and Dental Expansion