Case Study: Ramona

This patient’s mother was referred to our office with the chief concern that, “she didn’t like the way that her daughter’s front teeth stuck out.” The orthodontic evaluation revealed the root cause of the problem was an under-developed lower jaw and a subsequent lip interposition habit. The dental arches were narrowed by the forward tongue posture that the patient exhibited when swallowing. The posterior teeth did not fit together properly thus predisposing the patient to grinding of her teeth at night and a predisposition to excessive enamel wear.

Upon further evaluation of the patient’s cervical vertebrae, we were able to determine that the patient was in the post-pubertal growth phase in which the lower jaw has all but completed the latent anterior growth. Had the patient been referred at an earlier age, we could have employed a growth-driven treatment plan to advance the lower jaw, but post pubertal growth in the lower jaw is minimal at best thereby necessitating a different approach to treatment.

In her case we used a camouflage approach to treat the upper jaw by retracting the upper teeth until they fit together with the lower teeth using temporary anchorage implants in conjunction with the Damon Brace System. Treatment time was less than two years and the patient and her mother were extremely happy with the results achieved by our team.