INTERMEDIATE SEQUENCE (from page 14)
The sequence takes into account:
- the distance between the palatal cusps of teeth 14 and 24
- the shape of the arch in its final stage (narrow, rounded, or square)
- the dental class and the type of malocclusion (deep bite, open bite, overjet)
For pediatric patients, the universal protocol is followed, but more adjustments are made to the Eq.
In Class I patients, in addition to the Starter appliance (nasal or lingual NIKI), the Universal appliance is always used as the first appliance. The selection of the second, third, and fourth appliances is based on the distance between the palatal cusps and the shape of the arch.
In Class II patients, in addition to the Starter appliance (nasal or lingual NIKI), the Universal appliance is always used as the first expansion appliance. The selection of the second and third expansion appliances is based on the distance between the palatal cusps and the type of malocclusion. The selection of the fourth appliance is based on the distance between the palatal cusps and the shape of the dental arch.
For Class III patients, the standard protocol is followed, but the lower anchor is modified as shown in the illustration.
MANUAL CHANGES: As per the change protocol