A practical treatise on the technics and principles of dental orthopedia and prosthetic correction of cleft palate . lty, and rarely with repose, and whenthe patient is talking or laughing, they often rise to an impleasant exposure of,not only the entire crowns, but also the gums above; this produces at times anexceedingly displeasing expression. 274 CHAPTER XXXVII. TYPE D. DIVISION 2. CLASS II. 275 The beginning facial and dental casts shown in Figs. 191 and 192 will serve toillustrate this Type. They were both eighteen years of age at the commencementof the operations. It will be seen that t
A practical treatise on the technics and principles of dental orthopedia and prosthetic correction of cleft palate . lty, and rarely with repose, and whenthe patient is talking or laughing, they often rise to an impleasant exposure of,not only the entire crowns, but also the gums above; this produces at times anexceedingly displeasing expression. 274 CHAPTER XXXVII. TYPE D. DIVISION 2. CLASS II. 275 The beginning facial and dental casts shown in Figs. 191 and 192 will serve toillustrate this Type. They were both eighteen years of age at the commencementof the operations. It will be seen that the apical zones were greatly protruded, asshown by the facial casts before treatment. The incisal edges of the centrals inthese cases, as is common with this malposition, hugged the lower incisors neartheir gingival margins. As in all cases of this Type, the occipital force is an impor-tant auxiliary, particularly because of its intruding direction. The photograph on the right of Fig. 191 was taken about ten years after theoperation was completed. Note the perfect pose of the upper lip in the finished Fig. illustrations, with the decided protrusion of the upper apical zone and flare of thenostrils entirely removed. This was accomplished by the extraction of the firstupper premolars, followed with a bodily lingual movement of the roots of the frontteeth, and a slight labial movement of the occlusal zone of the incisors. Fig. 193 illustrates the common contour retruding apparatus. In markedcases of Types B and D of this class the first premolars shotild be extracted,because every opportunity shoiold be given for the retrusive movement of the rootsand alveolar ridge. The anchorages for all apparatus requiring considerable force are now ofthe two or three-band stationary type with power applied from root-wise attach-ments, the construction of which is fuUy described in Chapter XV. The powerarch-bow is No. 16 extra hard nickel silver. The lower, or fulcrum arch-bow is No. 17.
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