The 20 Principles of the Alexander Discipline, Volume 3. R.G. "Wick" Alexander
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Название: The 20 Principles of the Alexander Discipline, Volume 3
Автор: R.G. "Wick" Alexander
Издательство: Bookwire
Жанр: Медицина
Серия: Volume
isbn: 9780867157086
isbn:
Figs 1-7cc and 1-7dd Occlusal views 21 months into treatment.
Figs 1-7ee to 1-7gg Final facial views.
Figs 1-7hh to 1-7jj Final intraoral views.
Figs 1-7kk and 1-7ll Final occlusal views.
Fig 1-7mm Posttreatment cephalometric tracing.
Fig 1-7nn Posttreatment panoramic radiograph.
Figs 1-7oo to 1-7qq Facial views 7 years posttreatment.
Figs 1-7rr to 1-7tt Intraoral views 7 years posttreatment.
Figs 1-7uu and 1-7vv Occlusal views 7 years posttreatment.
Fig 1-7ww Composite cephalometric tracing 7 years posttreatment.
Case 1-3
Overview
A 17-year-old girl presented with a high-angle, bilateral posterior crossbite skeletal pattern (Figs 1-8a to 1-8h). She had a severe open bite (5 mm). Treated in 1974, this case took place in the early years of rapid palatal expansion use, especially on adult patients.
Examination and diagnosis
Posterior bilateral crossbites resulted from the V-shaped maxillary arch form. A skeletal Class III and high-angle pattern, open bite, and tongue thrust made this problem very difficult to correct. The minor arch length discrepancy and facial soft tissue profile must be considered in the diagnosis.
Treatment plan
Nonextraction treatment would commence with rapid palatal expansion and then full appliances. Speech therapy was recommended to improve the tongue posture. Final results are shown in Figs 1-8i to 1-8q.
Evaluation
The patient’s treatment chart did not mention up-anddown elastics or reverse curves of Spee in the archwires to close the open bite; however, it is assumed that these mechanics were used.
Discussion
Long-term observation showed remarkable anterior overbite stability (Figs 1-8r to 1-8z). Also, the mandibular anterior teeth were stable; only minor rotations recurred in the maxillary lateral incisors.
| Table 1-7 | Archwire sequence |
| Archwire | Duration (months) |
|---|---|
| Maxillary | |
| 0.016 multistrand | 2 |
| 0.016 SS | 14 |
| 17 × 25 SS | 7 |
| Active treatment time: | 23 months |
| Mandibular | |
| 0.0176 multistrand | 2 |
| 0.016 SS | 7 |
| 17 × 25 SS | 5 |
| Active treatment time: | 14 months |
| Table 1-8 | Individualized forces |
| Force | Duration (months) |
|---|---|
| RPE | 6 |
| Elastics | |
| Class III | 1 |
| Midline | 1 |
| Box | 4 |
Case 1-3
Figs 1-8a to 1-8c Pretreatment facial views. The profile is Class III retrognathic.
Figs 1-8d to 1-8f Pretreatment intraoral views. The patient has a 5-mm open bite.
Fig 1-8g Pretreatment periapical radiographs.
Fig 1-8h Pretreatment cephalometric tracing.
Figs 1-8i to 1-8k Final facial views after 23 months of treatment.
Figs 1-8l to 1-8n Final intraoral views.
Fig 1-8o Posttreatment panoramic radiograph.