Case Study


Matthew started treatment for his severe underbite at age 9. The first two photos show severe cross-bite of the front teeth but a normal bite of the back teeth. In addition, by this age the permanent laterals should be in place but because of the restricted space the deciduous or baby laterals are in place. This indicates that the front upper teeth need to be repositioned.

The photos immediately below show the removable expansion appliance that Matthew wore full time. A screw activates the front portion of the plate and slowly progresses the front teeth forward as the screw is turned weekly by a parent.

The fifth and sixth photos show the smile seven months into treatment. The last two photos in the series were taken 12 months into treatment and show how well the bite has settled as the front top teeth come down over the bottom teeth into a comfortable position.

This is a remarkable transformation in 12 months, which if left would not be possible without surgery if it were not managed before puberty.

Matthew: Before

Matthew: After