how to treat this case ?

patient age 12 years girl

with severe crowding maxillary and mandibular

i begin my treatment

with arch wire 12 NITI TA autoligating braccket only to develop the maxillary arch

but in 2 months i got open bite occlusion 

how to correct this thanks

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Replies

  • i forget i used inversed spee curbe arch 16X16 to correct the open bite

    Franco Bruno said:

    I think that after 8 months you don't have a good control of the occlusal plane. In a bi-protrusion with openbite this is mandatory. I sugget you to add a palatal bar, or better, a Quad-helix. But you have to start working in the lower, instead you'll see a nice surgical case soon

    Dr bruno

    tarik aouad said:

    hello all

    after 8 months of treatment without extraction 

    that's the results

  • thanks DR

    yes i added quadhelix

    i started the lower arch

    later i will put photos 

    the results are not good 

  • I think that after 8 months you don't have a good control of the occlusal plane. In a bi-protrusion with openbite this is mandatory. I sugget you to add a palatal bar, or better, a Quad-helix. But you have to start working in the lower, instead you'll see a nice surgical case soon

    Dr bruno

    tarik aouad said:

    hello all

    after 8 months of treatment without extraction 

    that's the results

  • hello all

    after 8 months of treatment without extraction 

    that's the results

    el khanza fatima zahra apres 8mois 001.jpg

    el khanza fatima zahra apres 8mois 004.jpg

    el khanza fatima zahra apres 8mois 003.jpg

  • CVM from your ceph indicate indicate itis in stage 6 and there is no growth spru itis also open bite , cramped tongue , may be tongue thrust  dont be angery from me we are here for help each other i have a case like this TREATMENT PLAN

    1. Maxillary Anterior Sagittal 3 screw
    1 midline screw
    2 side screws
    Cut distal lateral incisors
    Adam’s Clasps First bicuspids
    First molars

    2. Mandibular Bowbeer Appliance
    1 midline screw
    Occlusal rests lower first molars

    After the maxillary arch has been properly developed to normal (intermolar width 36-39 mm.) and the lower posterior teeth have been uprighted over basal bone, re-evaluate the case.

     distalized with a DMJ 2000. If you need more expansion, add a midline screw.

  • don't forget i'm using something like damon system thecnic and patient is still growing up we should only use quadhelix or disjoncteur .........or 

    i don't agree for extractions dr ahmed fawzy kassem

  • dear dr tarek treatment of childern depend on the patient profile  i send you pictures of some distalizer that i do with my cases but their profile ( z angle) tweed reading my opinon your case z angle or E LINE PASS outside the nose tip& all permanant teeth erupted  try without extrac, and look for stability of case and the final esthetic  good luck  

    New Microsoft Word Document (3).doc

  • for children we don't extrate
  • dear dr tarek you didnot mention your cast analysis for space required  this profile is an extraction profile itis a vertical growing sever crowding ,my opinion is to extract 4 bicuspid retract cuspid and flare the incisor since itis vertical i analyse your ceph can you send cast analysis to complete diagnosis and photo for cast

    Presentation3.ppt

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