The overjet (prominence of the upper teeth) was 12mm. The dental arches were well aligned and slightly spaced, with an upper midline gap.

Treatment started with the placement of sectional fixed appliances on the upper and lower teeth. These produced an initial alignment.

After a few months, heavy stainless steel wires were in place and a fixed functional appliance called an MPA (Mandibular Protraction Appliance) was attached to the archwires.

The MPA is a sliding jig which ensures that the mandible is held in a forward position. The mandible is then encouraged to grow forwards while the upper teeth move back.

After 7 months the MPA was removed and a full conventional fixed brace fitted. At this stage, the improvement can be clearly seen.

The case was finished with a full fixed brace.

The end result after 15 months of non extraction MPA treatment.