1. M. BAXTER PRETREATMENT RECORDS

2. This thirteen year old female patient has “reasonable” facial esthetics, but a significant Class II occlusion and an anterior open bite. A tongue habit contributed to the malocclusion.

3. M. Baxter

8. FMIA66 FMA24 IMPA90 SNA80 SNB76 ANB4 AO BO3mm OCC2 Z82 UL17mm TC22mm PFH45mm AFH66mm INDEX.68 M. Baxter M. Baxter Pretreatment

9. CRANIAL FACIAL ANALYSIS CEPH.DIFFICULTY NORMAL RANGEVALUEFACTORDIFF FMA 22°- 28°2450 ANB 1°- 5°4150 Z ANGLE 70°- 80°8224 OCC PLANE 8°-12°2318 SNB 78°-82°76510 PFH-AFH.65-.75.6833 M. Baxter C.F. DIFFICULTY TOTAL35

10. TOTAL SPACE ANALYSIS WEIGHTED ANTERIORVALUEDIFF TOOTH ARCH DISC.01.50 HEADFILM DISC.010 TOTAL 00 MID ARCH TOOTH ARCH DISC.0 CURVE OF SPEE2 TOTAL 212 OCCLUSAL DISHARMONY (CLASS II OR CLASS III) 6212 M. Baxter

11. TOTAL SPACE ANALYSIS DIFFICULTY POSTERIORFACTORDIFF TOOTH ARCH DISC.16 (-) EXPECTED INC.0 TOTAL16.58 TOTAL S.A. S.A. DIFF ANTERIOR00 MID ARCH22 POSTERIOR168 TOTAL 1810 M. Baxter

12. C.F. DIFFICULTY35 S.A. DIFFICULTY10 TOTAL DIFFICULTY45 M. Baxter DIFFERENTIAL DIAGNOSIS AND CLINICAL ANALYSIS INDEX DIFFICULTY: MILD 0-60 MODERATE 60-120 SEVERE 120+

13. TREATMENT PLAN: 1. Extract maxillary and mandibular third molars. 2. Prepare the mandibular arch. 3. “Distalize” the maxillary arch. 4. Control the tongue

15. M. Baxter

24. FMIA68 FMA24 IMPA88 SNA79 SNB76 ANB3 AO BO2mm OCC1 Z82 UL12mm TC18mm PFH46mm AFH68mm INDEX.67 M. Baxter Posttreatment FMIA66 FMA24 IMPA90 SNA80 SNB76 ANB4 AO BO3mm OCC2 Z82 UL17mm TC22mm PFH45mm AFH66mm INDEX.68 M. Baxter Pretreatment

25. M. Baxter Pretreatment Posttreatment

26. M. Baxter

33. POSTTREATMENT: After the extraction of the third molars headgear was worn to both the mandibular and maxillary arches. The tongue problem was addressed with a tongue crib.

34. Following mandibular anchorage preparation the maxillary arch was distalized with Class II elastics and headgear. The tongue crib was incorporated into the maxillary Hawley retainer.