This was a mild case, with only slight crowding and malalignment.

The finished result - a lovely dentition. A beautiful smile and a nice profile that has not been worsened by mid-arch extractions.

Treatment was commenced with a "Nudger". This is an upper removable appliance, with two springs, designed to push back the upper first molars, thus creating room further forwards. Since the adult dentition was fully established, it was necessary to extract all four second molars, so that this backward movement could easily occur. Similar cases treated in the mixed dentition, before the eruption of the second molars, do not require extractions. The extractions in this case do, however, have the advantage of providing room for the wisdom teeth (third molars) to erupt.Considerable backward movement of the molars has occurred between the two photos (below to the right). This space will then be used for the alignment of the slightly crowded front teeth.

A lip bumper was provided to commence the alignment of the lower arch.In the first picture below, progress on the right side can be seen - the upper molars have moved well back and the lower arch is aligning naturally. Fixed upper and lower appliances were placed and an improvement in anterior alignment becomes rapidly obvious (picture 2 and 3 below).

The upper arch sequence. Note how space created by the backward movement of the molars is used to align the front teeth. Headgear was not used in this case.

To retain the finished result, removable retainers are provided. These are only worn at night time.