LB Case Class 3

Hi Josh,
looking at the photos I d try non extraction
The lower laterals look like a little IPR would help them and the upper canines look wide so some IPR there as well

but warn upper may need extraction in consent - a therapeutic diagnosis

upper and lower fixed
UPR U3's and L2's, clay be some class 3 elastics
14 months
Hawley retainer for upper as the upper will expand a little in premoalr region

Ian]

Ian

Another teen who doesn't want to wait for NHS ortho - it's happening as you predicted!

Anyway:
Skeletal 3, increased FMPA and LAFH, increase NLA
Pt has had a growth spurt in last year or so.
Buccal class 3 1/2 unit
Incisors slight class 3 with reduced OJ and OB. Some posturing present and tends toward edge to edge but can get lowers back behind uppers when advised to try so I think he was just biting a little all over the place at times on exam.
Severe upper and mod lower crowding
Incisors retroclined and upper arch is narrow with some room for expansion by buccal tip

My main question is whether we should delay treatment to allow his growth to finish off - he's 14yr 4m. If I treat with XLA Lower 4s Upper 5s as I think he needs then are we risking him 'growing away from us' and subsequently needing surgery but getting spaces. Should I wait till he's older? Obviously he didn't want to wait for his NHS ortho but I've warned him we may also delay due to growth anyway.

What do you think?

Thanks

https://www.dropbox.com/sh/81m7rwejg2mmpox/AABWiWnyKjnLPAx6OHvH-TfOa?dl=0