CCO Case File: Class I, Anterior Open Bite, Extraction/ Male 14.9 yrs.
Author: Dr. Antonino Secchi


Case summary:
14:9 yo Male with Class I, Anterior Open Bite malocclusion. His vertical pattern is mildly high, his sagittal pattern is mildly Class II and his transverse dimension is normal. His anterior open bite was due a thumb sucking habit he had as a child. Due to his protruded lips, lack of mental sulcus definition and lower crowding, I decided to extract four premolars (see details at the end).
Tx Strategy by Stages:
Stage I: leveling and aligning taking advantage of the “passive space closure”.
Stage II: Coordinate upper and lower arches, consolidate all remaining spaces and finishing leveling the occlusal plane.
Stage III: Achieve optimal intercuspation of the buccal segment using vertical triangular elastics.
Appliance:
In-Ovation ‘R’ CCO System
Wire Sequence:
Stage I: 0.014” Sentalloy AccuForm Medium.
0.018” Sentalloy AccuForm Medium.
0.020” x 0.020” Bioforce AccuForm Medium.
Stage II: 0.019” x 0.019” SS AccuForm Medium.
Stage III: 0.019” x 0.019” Braided AccuForm Medium.
Auxiliaries:
Elastics 3/16” 6oz (Thailand).
Elastics 3/16” 8oz (Africa).
Stage I. In-Ovation ‘R’ CCO System with upper and lower 0.014” Sentalloy AccuForm Medium wires.
Stage I. In-Ovation ‘R’ CCO System with upper and lower 0.018” Sentalloy AccuForm Medium wires. 8 weeks in treatment.
Stage I. Upper and lower 0.020” x 0.020” Bioforce AccuForm Medium wires. 16 weeks in treatment.
Stage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Upper and lower remaining spaces were consolidated using power chain and short Class II elastics 3/16” 6oz.
Stage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Upper and lower occlusal planes leveled and paralleled. All spaces are closed. Vertical triangular elastics 3/16” 6oz to improve intercuspation.
Stage III. Upper 0.019” x 0.025” Braided AccuForm Medium wire and vertical triangular elastics 3/16” 6oz or 8 oz.


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