Initial intra-oral photographs showing moderate crowding, dental class II, late mixed dention with cuspids mesial to normal eruption pattern. Our treatment: establish the lower arch to eliminate crowding by utilizing the lip bumper to preserve "E" space, resolving crowding by lateral development rather than anterior incisor movement.
Two month progress photos detail the level, align and rotating of the maxillary arch with archwire sequence. Lower arch is developing with the aid of the lip bumper to maintain molar position allowing the anterior crowding to resolve by distal migration of the cuspids and erupting premolars.
The lip bumper is activated by "flattening" the omega and widening the molar area to advance the lip bumper forward and upright the first molars. The transpalatal arch on the upper maintains the lateral position of the molars to be synchronized with the lower molar development.