case_images: PMC8564172_01
case_images: a-k. Pre-treatment records
case_images: JOS-10-24-g001.jpg
case_images: PMC8564172_01_JOS-10-24-g001.jpg
case_images: F1
case_images: No sign or symptoms of TMJ problems and no limitations in mandibular movements were detected [Figure 1].
case_images: a-c. Phase 2, maximum anchorage bidimensional system in place; with hooks crimped distal to canines, uprighting springs on canines and full engaged 0.018 x 0.022 SS wired with elastic module from premolars and molars to crimped arch hooks
case_images: JOS-10-24-g002.jpg
case_images: PMC8564172_01_JOS-10-24-g002.jpg
case_images: F2
case_images: a-c. Phase 3 finishing phase with 0.016 x 0.022 SS archwire and intermaxillary vertical elastics
case_images: JOS-10-24-g003.jpg
case_images: PMC8564172_01_JOS-10-24-g003.jpg
case_images: F3
case_images: a-k. Post-treatment records
case_images: JOS-10-24-g004.jpg
case_images: PMC8564172_01_JOS-10-24-g004.jpg
case_images: F4
case_images: When full space closure has been achieved a finishing wire (.016 x 0.022 SS) has been used to finalize upper canines and first premolars torque and gingival margins leveling [Figure 4]. Full Class II molar relationship and Class I "canines" relationship with proper OVB and OVJ and in particular with regular smile arc exposure has been reached in around 24 months [Figure 4].
case_images: a and b. General and maxillary superimposition showing slight anterior retraction and molar mesialization
case_images: JOS-10-24-g005.jpg
case_images: PMC8564172_01_JOS-10-24-g005.jpg
case_images: F5
case_images: The lateral X-ray general superimposition showed the amount of upper and lower incisors retraction (6  in the upper and 8  in the lower) due to upper space closure and IPR in the lower and a favorable counterclockwise rotation of the mandible (1  reduction of SN-GoGn) [Table 1] due to space closure with posterior maxillary molars mesial movement [Figure 5].
case_images: a-i. Two years follow up out of retention
case_images: JOS-10-24-g006.jpg
case_images: PMC8564172_01_JOS-10-24-g006.jpg
case_images: F6
case_images: Natural settling of the posterior occlusion can be noticed while third molars were extracted at this time [Figure 6].
case_images: a-h. Ten years follow up out of retention
case_images: JOS-10-24-g007.jpg
case_images: PMC8564172_01_JOS-10-24-g007.jpg
case_images: F7
case_images: The facial analysis showed normal aging processes with stable torque and lip support and proper smile exposure [Figure 7].
case_images: PMC8564172_02
case_images: a-j Pre-treatment records
case_images: JOS-10-24-g008.jpg
case_images: PMC8564172_02_JOS-10-24-g008.jpg
case_images: F8
case_images: No signs or symptoms of TMJ problems and no limitations in mandibular movements were detected [Figure 8].
case_images: a-d. Asymmetric maximum anchorage bidimensional system in place; with hooks crimped distal to premolars, uprighting springs on premolars and full engaged 0.018 x 0.022 SS wire with elastic module from molars to arch crimped hook
case_images: JOS-10-24-g009.jpg
case_images: PMC8564172_02_JOS-10-24-g009.jpg
case_images: F9
case_images: The project aimed, only after centering the midlines, to close all the remaining gaps in the upper by asymmetric mesial space closure applying the same Bidimensional Biomechanical System and the same bonding procedure [Figure 9].
case_images: a-d. Finishing phase with 0.016 x 0.022 SS archwire and intermaxillary vertical elastics
case_images: JOS-10-24-g010.jpg
case_images: PMC8564172_02_JOS-10-24-g010.jpg
case_images: F10
case_images: After reaching complete space closure a finishing wire (.016 x 0.022 SS) has been used to finalize upper canines and first premolars torque and gingival margins leveling [Figure 10].
case_images: a-k Post-treatment records
case_images: JOS-10-24-g011.jpg
case_images: PMC8564172_02_JOS-10-24-g011.jpg
case_images: F11
case_images: Facial analysis revealed a slight improvement in nasolabial angle due to upper proclination with a more balanced smile [Figure 11].
case_images: a and b. General superimposition showing asymmetric molar mesial movement and anterior torque maintenance
case_images: JOS-10-24-g012.jpg
case_images: PMC8564172_02_JOS-10-24-g012.jpg
case_images: F12
case_images: A favorable clockwise control of the mandible (1  increase of SN-GoGn) [Table 2] occurred during treatment due to extrusion of the posterior sectors [Figure 12].
case_images: a-i. Two years follow up out of retention
case_images: JOS-10-24-g013.jpg
case_images: PMC8564172_02_JOS-10-24-g013.jpg
case_images: F13
case_images: At 2 years out of the retention stage, the occlusion was still stable with natural periodontal conditions and stable alignment, third molars have been extracted at this time [Figure 13].
case_images: a-h. Ten years follow out of retention
case_images: JOS-10-24-g014.jpg
case_images: PMC8564172_02_JOS-10-24-g014.jpg
case_images: F14
case_images: The 10 years control out of retention showed a still stable full Class II molar relationship and Class I "canines" relationship with some criticism only related to wearing of premolars restoration that needed to be renewed and some relapse of lower incisors position [Figure 14].