T shell - new pt

Hmmm...
the buccal segments look quite good... and there is some crowding in the lower - may be more than you think... as the lower canine is distally tipped.... so they will come forward quite a bit which would reduce the overjet.....that LR3 especially so

so its either lower 5's and upper 4's....
or
non extraction BUT careful with placement of lower canines - do not place them down the long axis of the tooth as it will flare them forward too much...but place them vertically.... and some IPR upper and lower...

could do a therapeutic diagnosis to see where they end up ...another option

Ian

https://www.dropbox.com/sh/jszdyxnj25w52i7/AACCEeSmkZvGE4TiHz9GP1d_a?dl=0

Pt does not like how she looks goofy

The patient is a moderate class 2 skeletal pattern, with an increased FMPA and a high FH. The lips are competent and full with a 90 degree nasiolabial angle.

The incisors are a class 2 div 1 with an OJ of 6-7mm and an average OB. The centre lines upper and lowers appear to be to be OK - the upper 2's are displaced palatally by 3mm

There is mild crowding in the upper labial segment and the teeth are aligned in the lower labial segment. The buccal segment on the upper and lowers are aligned.

Molars on the LHS and the RHS are class 1. The canines on the LHS are class 2 and RHS are class 2.

I was thinking upper 4's out with upper and lower fixed with class 2 later on in treatment ??????