ortho the international C.E. magazine of orthodontics

I 17ortho3_2012 C.E. article_ Bent Wire System I and ectopic erupting canines (Fig. 8a–8d). This is far fromanidealstagetobeconsideringnon-extraction treatment; however, the parent insisted that the case was attempted non-extraction. The lower an- terior teeth were also considerably crowded, and it would regularly be justified in extracting the first four premolar teeth and going into upper and lower straight wire fixed appliances. It could be argued that treating non-extraction willprolongthetreatmentandcertainlyincurgreater expense on the parent. However, there is a growing demand from parents who have had extraction or- thodonticsinthepasttoavoidthisapproachfortheir children.Therefore,theBWSOrthodonticSystemcan be a beneficial technique that the orthodontist can use in these exceptional cases. Treatment was similar to case 1. An upper BWS was fitted and combined with the use of the i-2n Trainer initially for four months, after which time the BWS wire was removed, leaving the molar bands in place. The i-2 Trainer was introduced at this stage for a further three months to maintain the expan- sion prior to a second phase of treatment using the BWSandi2nTrainerforthreemonths(asmentioned earlier in this article). This allows the dentition to “catch up” and pre- vents excessive tooth mobility. It is thought that much of the expansion achieved by this system is dento-alveolar rather than sutural, as with a rapid maxillaryexpanderandotheracrylicexpanders.Also, there is more development in the anterior arch form, whichisaneffectpreviouslyfoundintheresearchon the Trainer (Ramirez-Yañez, 2005b). The difficulty in cases like this, requiring large amounts of expansion to achieve a non-extraction result, is a tendency to create an open bite. Although this occurs to some extent, the BWS Orthodontic Systemdoesnotopenthebiteasmuchasmorecon- ventional techniques because the tongue position is favorablyalteredbyuseoftheTrainer.Thisconjecture may require further investigation to ratify. Once again, spontaneous alignment of the lower anterior dentition has occurred without the require- ment for an additional BWS for the lower arch. This effectisnotjustrestrictedtothesetwocasesbutisa routineobservationoftheBWSOrthodonticSystem. This case also illustrates the stability achieved in the lowerdentitionasnoretainerswereusedapartfrom night use of the Trainer. Although this patient is not attheidealage,thepicturesshowthatitwaspossible to obtain space for all permanent canines, without extractions and with good stability. Thebiteopeningisminimalandtendstodecrease withfurtherdentaldevelopment.Althoughthiscase Fig. 8c Fig. 8d Fig. 8a Fig. 8b