Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Met...Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Methodology: A prospective study was designed on young adults with Class II malocclusion on account of a deficient mandible. A total of 45 subjects were divided into three groups of 15 individuals each. The patients were treated either by camouflage, fixed functional appliances or by orthognathic surgery. Pre and post treatment cephalograms were used to assess the skeletal, dental and soft tissue changes. Pre and post treatment profile photographs were assessed on a Visual Analogue Scale (VAS) by orthodontists, oral surgeons and laypersons. Results: Each group achieved a reduction in facial convexity, but the results obtained from the surgical group were more pronounced than the camouflage and the fixed functional group. Conclusion: The reduction in convexity in the camouflage group was by retracting the upper anteriors, which increases the nasolabial angle. In the fixed functional appliance a combination of skeletal and dentoalveolar changes can be observed. However the most appropriate reduction in profile convexity can be obtained by combined orthodontic and surgical treatment of malocclusion.展开更多
Treatment of skeletal Cl II includes functional orthopedic treatment, head-gears, extraction of the upper premolars and orthognathic surgery. To treat any patient with functional appliances (bite jumping) an adequate ...Treatment of skeletal Cl II includes functional orthopedic treatment, head-gears, extraction of the upper premolars and orthognathic surgery. To treat any patient with functional appliances (bite jumping) an adequate overjet is necessary. In this case an 11 years old female patient has skeletal CLII due to mandibular deficiency with ANB angle 8 degrees, overbite: 3 mm, overjet: 1 mm, extremely convex profile and underdeveloped chin due to the hyper muscle contraction of the lower lip to obtain oral seal. To obtain an adequate overjet lower first premolars were extracted and maximum retraction using mini screws (for maximum anchorage) was applied. Afterwards Rahhal functional appliance was used by the patient 16 hours a day for 6 months and 10 hours a day for another 6 months for retention. After that fixed orthodontic treatment was completed. Lateral cephalometrics were taken, traced and analyzed. In the result Skeletal CLI was obtained (ANB 4 degree), straight facial profile, normal over bite overjet and particular chin development were noticed. As a conclusion, in skeletal CLII malocclusions, lower incisor protrusion will cause a contraindication for functional treatment. Extraction of the lower premolars and retraction of the lower incisors followed by functional orthopedic treatment is an efficient method to treat these cases instead of waiting for orthognathic surgery, also reducing the muscle pressure on the chin will change the development characteristics of it.展开更多
文摘Introduction: Borderline Class II malocclusion due to deficient mandible can be treated either by orthodontic camouflage, fixed functional appliances or by orthodontics followed by surgical mandibular advancement. Methodology: A prospective study was designed on young adults with Class II malocclusion on account of a deficient mandible. A total of 45 subjects were divided into three groups of 15 individuals each. The patients were treated either by camouflage, fixed functional appliances or by orthognathic surgery. Pre and post treatment cephalograms were used to assess the skeletal, dental and soft tissue changes. Pre and post treatment profile photographs were assessed on a Visual Analogue Scale (VAS) by orthodontists, oral surgeons and laypersons. Results: Each group achieved a reduction in facial convexity, but the results obtained from the surgical group were more pronounced than the camouflage and the fixed functional group. Conclusion: The reduction in convexity in the camouflage group was by retracting the upper anteriors, which increases the nasolabial angle. In the fixed functional appliance a combination of skeletal and dentoalveolar changes can be observed. However the most appropriate reduction in profile convexity can be obtained by combined orthodontic and surgical treatment of malocclusion.
文摘Treatment of skeletal Cl II includes functional orthopedic treatment, head-gears, extraction of the upper premolars and orthognathic surgery. To treat any patient with functional appliances (bite jumping) an adequate overjet is necessary. In this case an 11 years old female patient has skeletal CLII due to mandibular deficiency with ANB angle 8 degrees, overbite: 3 mm, overjet: 1 mm, extremely convex profile and underdeveloped chin due to the hyper muscle contraction of the lower lip to obtain oral seal. To obtain an adequate overjet lower first premolars were extracted and maximum retraction using mini screws (for maximum anchorage) was applied. Afterwards Rahhal functional appliance was used by the patient 16 hours a day for 6 months and 10 hours a day for another 6 months for retention. After that fixed orthodontic treatment was completed. Lateral cephalometrics were taken, traced and analyzed. In the result Skeletal CLI was obtained (ANB 4 degree), straight facial profile, normal over bite overjet and particular chin development were noticed. As a conclusion, in skeletal CLII malocclusions, lower incisor protrusion will cause a contraindication for functional treatment. Extraction of the lower premolars and retraction of the lower incisors followed by functional orthopedic treatment is an efficient method to treat these cases instead of waiting for orthognathic surgery, also reducing the muscle pressure on the chin will change the development characteristics of it.
