This case shows a "distalizing" ortho appliances used in treatment. While ortho appliances may seem intimidating, they provide very smooth gradual movement and growth. Patients often say they are painless. 
They are esthetic as most are hidden behind the teeth. 
On a child, this type of treatment is fairly simple as growth can be guided. We selected to show you this case because Stephanie was an adult which meant that growth could no longer be guided but rather bone would have to be reshaped. 
Dr. King proceeded to treat without extraction by using the following "Distalizing Expander" appliance:
This picture shows the result of approximately two months of appliance therapy.

Orthopedic Consideration: This patient had a great facial profile with nice full lips. Dr. King was conscious that by doing extractions and orthodontics only, her upper dental arch would have been “retracted” which would have caused the pull back of her upper lip. A sunken lip would have diminished her full lip appearance and would have resulted in a weaker looking face. Instead Stephanie was treated “orthopedically” with an upper expansion that grew her dental arch resulting in even greater lip support.  
Patient Review:
-Upper central teeth were "pulled back". The upper central teeth were tipped inward and they could not simply be "flared out" or tipped forward because they were trapped behind her two maxillary lateral teeth. 
-Dental occlusion is non-functional. The stone model (3rd photo) shows that the lower front teeth were close to hitting the inside of the patient's upper palate upon closure which prevented the proper occlusion of all teeth.

Patient was told to stop activating the rapid palatal expander screw 62 days after the “Distalizing Expander” appliance was inserted in her mouth. 
​Before Treatment Photo
After Treatment Photo