Prior to Upper Anterior Distalization

When upper anterior alignment is near normal 10 months post banding, the patient feels that the upper anterior teeth are slightly protrusive (Fig.1,2).  It appears that the lower anterior teeth present an obstacle to the upper tooth distalization (Fig.3).  After presentation of treatment options (mini implant to intrude the lower anteriors and proximal reduction of the lower teeth), she accepts the latter.  Following proximal reduction from LL5 mesial to LR5 mesial, the 1st step is to distalize L4s using L5,6s as anchorage (Fig.4,5; 16x16).  If the latter has been achieved when the patient returns, splint L4-6s and retract L3s.  When the lower arch diastemata close, the upper dental midline has been moving to the left in the last 13 months (Fig.6-9).  Finally crowding and facial profile improve (Fig.10-14).  Return to Ortho Cases Xin Wei, DDS, PhD, MS 1st edition 10/12/2017, last revision 07/21/2019