Class II malocclusion, upper crowding.

Treatment: Fixed Therapy; extraction – 14, 24.

Time: 18 months.

Lingual Pearl: 6 months. The Pearl was bonded one year after finishing treatment.

Retention: Thermoformed splint (upper 4 – 4) for 6 months, lower bonded 3 – 3.

Note: One year after finishing the treatment, the patient calls our service and said that the lower incisors came forward. This dental movement to Class III relationship was due to the pressure of the tongue against the lower incisors, as related by his mother. I decided to debond the lower retainer and bond a Lingual Pearl.

This is a case where we can see the benefit of tongue education. Before bond the pearl the patient presents an anterior cross bite, and Class III canine relationship. Two months after, we achieved a better occlusion (look the upper left canine) without anterior cross bite. Four months after the stability was achieved only with tongue exercises.