© 2006 - The Charles H. Tweed International Foundation

Fig. 7a. Post orthopedic cephalometric tracing (II)Fig. 7b. Pretreatment and post orthopedicgeneral superimpositionin the smile. Now the craniofacial analysis shows a CFIndex of 33. The patient will be treated without premolarextraction. A Tweed multibonded appliance is placed. Thefirst step is to level and idealize the lower arch. Later, theupper arch is bonded and the classic levelling and closingarchwires are used (Fig 9a/9b/9c). Treatment time of thissecond phase has been greatly reduced (10 months).Because of their position, the four third molars wereremoved in the year following the end of treatment.Fig. 8. Postorthopedic dental castsAt the end of treatment, posttreatment facial photographs(Fig. 10) illustrate a well balanced face, a nice profile and apleasant smile. The posttreatment casts (Fig. 11) show a goodclass I relationship. Overjet and overbite have been corrected. Thecephalometric values (Fig. 12) are ideal for a low angle patient-IMPA is 98°and FMA is 18°. The lower incisor remains in itspretreatment position. The FMA angle decreased from 23° to 18°.The vertical index increased from .81 to .89. The occlusal planeremained stable at 6°.The general superimposition (Fig. 13) shows the totalmandibular response, in height and length due to orthopedics andTweed Merrified therapy. Local superimpositions (Fig. 14)illustrate the tooth movement, especially the increase of the lowerposterior facial height, which is favorable in hypodivergentpatients, but over all, the maintenance of the lower incisor positionwas very positive.Fig. 9a Finishing (phase II)Fig. 9b. Space closure (phase II)Fig. 9c. Posttreatment44