An 8-year-old boy with both permanent upper central incisors in crossbite; there is an anterior mandibular displacement on closure on 1̲/1̲ and a 5mm overbite on these incisors. 6edc21 are present in each quadrant.

1. Adams’ clasps 6̲/6̲.
2. Adams’ clasps d̲/d̲.
3. Posterior capping.
4. Z-spring(s).

An upper removable appliance incorporating these components is required to correct the anterior crossbite.

1. IDENTIFY = DISTAL END CUTTER
   
2. IDENTIFY = ADAMS PLIER
   
3. IDENTIFY THE MALOCCLUSION =
   1. ANTERIOR CROSSBITE
      
   2. SCISSOR BITE
      
4. IDENTIFY THE FIGURE = CBCT SCAN FIGURE
   
5. IDENTIFY THE ANGLE MARKED BY THE ARROW IN THE
   1. MAXILLARY STUDY MODEL = 70 DEGREES
      
   2. MANDIBULAR STUDY MODEL = 65 DEGREES
      
6. WHAT DO THE POINTS ON THE FIGURE DEPICT?
   1. GINGIVAL ZENITH
      
   2. GOLDEN PROPORTIONS
      
   3. CONNECTORS
      
7. IDENTIFY THE GREEN LINE = HARMONY LINE
   
8. IDENTIFY THE MALOCCLUSION AND HABIT = CLASS 3 MALOCCLUSION AND TONGUE THRUSTING HABIT
   
9. IDENTIFY THE APPLIANCE = FOX PLANE
   
10. WHAT IS RATIO BETWEEN MIDDLE AND LOWER FACE = 45:55
    
11. IDENTIFY THE TYPE OF MOYERS MALOCCLUSION =
    1. TYPE C = MANDIBULAR ANTERIORS ARE PROCLINED + MAXILLARY IS RETROGNATHIC
       
    2. TYPE D = MANDIBULAR ANTERIORS ARE UPRIGHT + MAXILLARY IS RETROGNATHIC
       
    3. TYPE B = MAXILLA IS PROGNATHIC
12. 

1. IDENTIFY THE SPACE MAINTAINER = BAND AND LOOP
   

2. IDENTIFY THE APPLIANCE = DISTAL SHOE SPACE APPLIANCE
   
3. IDENTIFY = ACTIVE TIE BACKS ***
   
4. IDENTIFY = E- CHAIN
   
5. IDENTIFY = GOLD CHAIN
   
6. IDENTIFY = MONOCRYSTALLINE AND POLYCRYSTALLINE CERAMIC BRACKETS
   
7. IDENTIFY THE TYPE OF ELASTICS = SETTLING ELASTIC
   
8. IDENTIFY THE BRACKET = DAMON BRACKET
   
9. IN WHICH SECTOR IS THIS CANINE IMPACTED = SECTOR 4
   
10. IDENTIFY THE INSTRUMENT = SEPARATOR PLACING PLIER
    
11. IDENTIFY = SPOT WELDER
    
12. IDENTIFY = SAND BLASTER AND MICROETCHER
    
13. IDENTIFY = WEINGART
    
14. IDENTIFY = DELA ROSA
    

IDENTIFY = TWEED RIBBON ARCH PLIER**

1. IDENTIFY THE APPLIANCE = K LOOP DISTALIZING APPLIANCE
   
   

2. IDENTIFY THE APPLIANCE = MANDIBULAR ANTERIOR REPOSITIONING APPLIANCE
   
   
3. IDENTIFY THE APPLIANCE = KLAPPER SUPER SPRING
   
   
   

4. IDENTIFY THE APPLIANCE = RIBBON ARCH APPLIANCE
   
   
   
5. IDENTIFY THE APPLIANCE = PIN AND TUBE APPLIANCE
   
   
   

6. IDENTIFY THE FIGURE = NOLA DRY FIELD SYSTEM
   
   
   
7. WHO GAVE THE FOLLOWING STAGES = MCNAMARA AND BACETI
   
   
   
8. IDENTIFY THE BONE = TRAPEZIUM, TRAPEZOID, CAPITATE AND HAMATE
   
   
   
9. IDENTIFY THE APPLIANCE = LINGUAL CLEAT
   
10. IDENTIFY THE AUXILIARY = UPRIGHTING SPRING
    
    
    
11. IDENTIFY = MECKEL’S CARTILAGE
    
    
    
12. IDENTIFY THE STRESS LINE = RED, BLUE, ORANGE  AND PURPLE
    
    
    
13. IDENTIFY THE FUNCTIONAL APPLIANCE = BIONATOR
    
    
14. IDENTIFY THE FUNCTIONAL APPLIANCE = FUNCTIONAL REGULATOR
    
    
    
15. IDENTIFY THE FUNCTIONAL APPLIANCE = TOOTH POSITIONER
    

An 11-year-old female presented with a class II division 1 malocclusion on a moderate skeletal class II pattern with reduced vertical dimensions complicated by an increased overjet (11mm), increased overbite, generalized spacing and bi-maxillary proclination.

The aetiology of this malocclusion is multi-factorial.

The moderate skeletal class II discrepancy resulted in an increased overjet and class II molar relationship. The overjet was exacerbated by the presence of a lower lip trap. The generalized spacing was a result of an underlying dento-alveolar disproportion. This was compounded by bi-maxillary proclination, which arose due to resting soft tissue pressures and dento-alveolar compensation.

TREATMENT PLAN

• Integration of twin block functional and sectional lower fixed Herbst appliancee
• Continuation of functional appliance wear at night
only
• Use of headgear
• Inter-arch class II elastic traction following fixed
appliance placement

The prognosis for long-term stability of class II correction is good in this case, as the new maxillary incisor position will be controlled by the lower lip following the achievement of lip competence.

1. Head is tilted backwards
2. Anterior open bite
3. Increased overjet/ Proclined anterior teeth
4. Crowding seen in anterior segment 
5. Supra erupted posterior 
6. Posterior crossbite
7. Narrow maxilla and deep palatal vault
8. Xerostomia = prone to caries
9. Gingival recession
10. Bleeding from gums
11. Narrow nasal passages