This 36 year old male presented with a bilateral skeletal cross bite with the mandible deviated ippsi latera to the cross bite. Evaluation of the TMJs revealed the right joint was a SR Type II. Full records were made at the initial examination appointment.
The Bimler analysis showed the patient to be a skeletal Class I, dental division Two. The length of the maxilla was short, and the position of the maxilla was normal. Upper bicuspids were missing. The patient made the decision to replace the missing bicuspids with bridges as opposed to with implants.
The initial appliance was an upper 3D-Schwarz modified with occlusal coverage of acrylic followed with a Fan Schwarz to complete the maxillary development.
After the correction of the posterior skeletal cross bite the lower arch was placed into full Delta Force. The upper Fan Schwarz appliance was followed with full Delta Force. A composite table was bonded to the lower right second to support the right mandibular condyle on the disk. The occlusion was finalized with vertical elastics in the patient’s Functional Centric Relation.
The missing upper bicuspids were replaced with bridges. The treatment time waw 26 months.
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