Camouflage of a high-angle skeletal Class II open-bite malocclusion in an adult after mini-implant failure during treatment: an update

Summary Background and objectives High-angle skeletal Class II malocclusion is one of the most challenging dentofacial deviations to treat and, in adults, a combination of orthodontic treatment and bimaxillary orthognathic surgery is often indicated. This study examines the rate of clinically significant relapse and whether a genioplasty affects the treatment outcome of high-angle Class II malocclusions. Material and methods Cephalometric tracings of 36 consecutively treated high-angle Class II patients were evaluated from pre-surgery to 3 years post-surgery. All patients had undergone bimaxillary surgery (Le Fort I and BSSO), 13 of them had in addition a genioplasty. Results The maxilla remained stable, whereas relapse (greater than or equal to 2 mm) of the mandibular advancement was seen in 40 per cent of the patients. Advancement greater than 10 mm increased the risk for horizontal relapse. The overjet was normalized and remained stable despite mandibular relapse. Half of the patients had an anterior open bite 3 years post-surgery. A supplemental genioplasty did not affect the relapse rate. Conclusions and implications Overjet was normalized and remained stable long term; there was an open bite in half of the patients. Combined orthodontic and bimaxillary surgical treatment of high-angle Class II patients showed skeletal relapse (greater than or equal to 2 mm) of the mandible in 40 per cent of patients. Mandibular advancement greater than 10 mm increased the risk for relapse. There was no increased risk for dental or skeletal instability associated with a genioplasty in combination with maxillary and mandibular surgery in the treatment of high-angle skeletal Class II malocclusion.

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Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect – relato de caso

Orthodontic Science and Practice ◽

10.24077/2021;1453-97106 ◽

2021 ◽

Vol 14 (53) ◽

pp. 97-106

Author(s):

Roberto Hideo Shimizu ◽

Isabela Almeida Shimizu ◽

Ana Cláudia M. Melo Toyoffuku ◽

Rebecca Marquesini ◽

Tatiane Travizan Lima ◽

...

Keyword(s):

Treatment Time ◽

Low Complexity ◽

Class Ii ◽

Open Bite ◽

Class Ii Malocclusion ◽

Anterior Open Bite ◽

Skeletal Class ◽

Posterior Crossbite ◽

Skeletal Class Ii ◽

High Predictability

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.

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Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars

The Angle Orthodontist ◽

10.2319/030718-189.1 ◽

2018 ◽

Vol 89 (3) ◽

pp. 505-517. ◽

Cited By ~ 1

Author(s):

Tung Nguyen ◽

Eui Seon Baek ◽

Soonshin Hwang ◽

Kyung-Ho Kim ◽

Chooryung J. Chung

Keyword(s):

Treatment Outcome ◽

Three Dimensional ◽

Class Ii ◽

Open Bite ◽

Third Molars ◽

Second Molar ◽

Skeletal Class ◽

Long Term Stability ◽

Skeletal Class Ii

ABSTRACT This report illustrates the successful nonsurgical and nonprosthetic camouflage treatment of a skeletal Class II open bite malocclusion combined with missing mandibular first molars bilaterally. In the mandible, the second and third molars were uprighted and protracted, substituting for the missing first molars. In the maxilla, anterior bodily retraction and full-arch intrusion were achieved following premolar and second molar extraction, which also induced autorotation of the mandible. The treatment outcome and prognosis were confirmed with three-dimensional superimposition techniques, along with long-term stability.

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Correction of skeletal class II severe open bite with temporomandibular joint disorder treated by miniscrew anchorage and molar extraction: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2132-6 ◽

2019 ◽

Vol 13 (1) ◽

Author(s):

Masato Kaku ◽

Taeko Yamamoto ◽

Yuka Yashima ◽

Jin Izumino ◽

Haruka Kagawa ◽

...

Keyword(s):

Case Report ◽

Temporomandibular Joint ◽

Class Ii ◽

Open Bite ◽

Temporomandibular Joint Disorder ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Joint Disorder ◽

Molar Extraction

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Orthopedic approach in the treatment of a skeletal class II division 1 malocclusion with an anterior open bite

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.29.3.u4j7243557374248 ◽

2005 ◽

Vol 29 (3) ◽

pp. 205-210

Author(s):

N. Al-Sulaiti ◽

G. White

Keyword(s):

Class Ii ◽

Open Bite ◽

Mixed Dentition ◽

Class Ii Malocclusion ◽

Facial Bones ◽

Anterior Open Bite ◽

Correct Position ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Division 1

The patient presented with it skeletal class II malocclusion characterized by an anterior open bite and maxillary midline deviation. This mixed dentition case was treated orthopedically with MRI appliance to rotate and impact the maxilla. A Bionator was used advance the mandible. The case was completed using Occlus-O-Guide. The result showed that the facial bones and teeth appear in the correct position.

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Orthodontic Treatment of Skeletal Class II Adolescent with Anterior Open Bite using Mini-Screws and Modified Palatal Anchorage Plate

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.2.b5317m147r228760 ◽

2015 ◽

Vol 39 (2) ◽

pp. 187-192 ◽

Cited By ~ 4

Author(s):

YA Kook ◽

JH Park ◽

Y Kim ◽

CS Ahn ◽

M Bayome

Keyword(s):

Orthodontic Treatment ◽

Class Ii ◽

Open Bite ◽

Anterior Open Bite ◽

Posterior Teeth ◽

Skeletal Class ◽

Skeletal Class Ii ◽

And Control

This article presents a non-extraction orthodontic treatment case using mini-screws and a modified palatal anchorage plate (MPAP) to intrude the maxillary posterior teeth, and distalize the whole arch dentition and control the extrusion of the maxillary posterior dentition during distalization.

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