Well we would start off with a rapid pallet expander/herbst combination appliance.  Then lower expander w/thick plastic biteplates surrounding your back 3-4 molars on both sides  followed by full set of metal braces.  Now the bright pink upper lip bumper and a smaller lime green lower lip bumper.

Right when you think your done an oversized cushioned loop facebow is slid into your upper headgear tubes then wired into place connecting to a heavy leather combination headgear strap. You are then leaned up in the chair and told to come back for check up in 2 months and to have a good day....... 

Those sound horrible and awesome at the same time!

If you wish not to be able to talk I think some jaw wiring is in order, just to help you get used to your new braces and start the process of bite correction.

So I see you havent been wearing your headgear! So give me a second while I discuss something with your parents. I will be back in 5 mins.

Ok so I understand your a highschool student and Prom is coming up which im sure you and your significant other will be attending, but you did not follow up with what I asked from you which was simply wearing your headgear atleast 14-16hrs a day. Your parents were unaware you were even given headgear at your last appointment! Your jaw had moved a substantial amount too I see.

So heres what is going to happen. We are going to continue your headgear so we can catch up and progress through your treatment. So lets fit your facebow here...  10 mins later. Ok now lets slip the highpull strap on... Good.  Now the neck strap..... Good.   Okay so what I did was after I reinserted your facebow into your headgear tubes, I tool metal ligerature ties to both sides of your top molars and placed them around the facebow and headgear tubes so your headgear is wired in to your molarbands securly leaving it permenantly fixed in place... Lets make an appointment for 6 weeks from now..

So it looks like everything is finally falling into its place and good movment is finally happening. Now with that being said, it's going to be a very very slow active treatment because of the careful movments that we need to perform since you have literally just ended your groth spurt.

So Im going to add basically a bite plate or bite blocks on your back top and bottom molars.  20mins later.    Now I am going to install what is called a Lip Bumper on your lower jaw. So just like I did with your headgear last appointment when I wired your facebow into your top molar tubes with metal ligerature ties leaving the headgear a fixed appliance, I am going to be doing the same exact thing with the Lip Bumper. 10 mins later.   

Ok we are all done here today (as you are being leaned back upwards in the ortho chair) and jist like the headgear, it will probably be a bit awkward eating and chewing food with the biteblocks and lip bumper for the first 2 weeks but you will adapt. Just give it time and remember to keep your headgear straps on at ALL TIMES extept for shower. The facebow is not coming disconnected quite a good while so remember that the fixed facebow is useless without your headgear straps on.... See you in 6 weeks ; )