2010 RWISO Journal - Roth Williams International Society of ...

Figure 6-e Left lateral intraoral photograph in MIP showing
class II molar relationship and retained deciduous canine.
Figure 6-f Panoramic x-ray. The upper left canine showing
root apex almost formed, but not erupted, due to lack of space.
Figure 6-g Lateral cephalogram showing slightly
retrusive mandible and protrusive upper incisors.
Jarabak’s cephalometric analysis showed a strong counterclockwise
growth tendency expressed in such measurements
as a posterior facial height-anterior facial height ratio
of 70%, a long ramus height in comparison to the posterior
cranial base length, and a small Y-axis-to-SN angle (Table 1).
60 Linton, Jung | The Effect of Tooth Wear on Postorthodontic Pain Patients: Part 2
Table 1 Jarabak’s analysis of case 6 in January 2000.
The maxillary arch was rapidly expanded with a fixed-
type expander, which was retained for 6 months. Growth
modification of the maxillary protrusion was accomplished
simultaneously with a high-pull headgear for 10 months. The
diagnostic study models mounted before and after headgear
therapy clearly showed the effect of the growth modification
treatment (Figure 7).
Figure 7 Mounted models of the case before and after the
first phase of growth modification treatment. The models were
mounted on a semiadjustable articulator with estimated
face-bow transfer and with centric relation bite registration
records. The class II relationship of the first molars (blue lines)
in January 2001, was improved compared to the molar
relationship of the case in January 2000.
Subsequent to headgear therapy, the four first premolars
were extracted, and the patient received fixed-appliance
therapy for the following 20 months. Class I canine and
molar relationships were achieved with maximum anchorage
in the upper arch and moderate anchorage in the lower
arch in December 2002. The patient’s facial appearance was