No Quiz, but Questions (Part IV)

A 13-year-old boy has severe crowding (Fig.1-5).  Four of the first bicuspids were extracted on 02/17/2014.  Full mouth brackets or bands (except #18) were placed on 03/27/2014.  Alignment improved 2 months later (Fig.11, 05/24/2014).  The upper 18 ss wire was modified (Fig.12), and fixed with alastiks (Fig.13,14).  One month later (07/01/2014), local alignment also improved (Fig.15); the upper modification is confined to one tooth.

Four and a half months post bracketing (Fig.21-25), what do you find and what should be done next?

Prior to bracketing, the mesiodistal space for #18 is planned to be obtained by moving #20 and then #19 mesially (Fig.31-35, 16x16 ss).  The six anterior lower teeth are tied together in a figure 8 fashion.  Power chains are placed between the lower canine and the 2nd bicuspids.  The upper diastemata are to be closed by power chains between the 1st molars.

The kid returns 1 month 10 days after last visit.  Wires change to 16x22 ss with figure-8 wires placed between UR3 and UL4 and between LL3 and LR 4 (Fig.41-45). A separator is placed between LL6 and 7.

Two months later, LL7 (#18 in Fig.53,54) appears to be uprighted by itself (probably due to mesialization of the teeth mesial to it); a bracket is placed with .012 niti wire.  No power chains are used to close the diastemata among the upper teeth, since the anterior overjet is minimal.  A rotation wedge is placed in the distal wings of #27 to fix rotation.  Is it right?

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Xin Wei, DDS, PhD, MS 1st edition 08/14/2014, last revision 11/30/2014