scholarly journals Surgical Orthodontic Treatment of Severe Skeletal Class II

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Fahad F. Alsulaimani ◽  
Maisa O. Al-Sebaei ◽  
Ahmed R. Afify

This paper describes an adult Saudi male patient who presented with a severe skeletal class II deformity. The case was managed with a combination of presurgical orthodontic treatment followed by a double jaw orthognathic surgery and then another phase of orthodontic treatment for final occlusal detailing. Extraction of the four first premolars was done during the presurgical orthodontic phase of treatment to decompensate upper and lower incisors and to give room for surgical setback of the maxillary anterior segment. Double jaw surgery was performed: bilateral sagittal split ramus osteotomy for 8 mm mandibular advancement combined with three-piece Le Fort I maxillary osteotomy, 6 mm setback of the anterior segment, 8 mm impaction of the maxilla, and 5 mm advancement genioplasty. Although the anteroposterior discrepancy and the facial convexity were so severe, highly acceptable results were obtained, both esthetically as well as occlusally.

2021 ◽  
Author(s):  
Mitsuhiro Hoshijima ◽  
Naoki Oka ◽  
Tatsushi Matsumura ◽  
Seiji Iida ◽  
Hiroshi Kamioka

Abstract BackgroundAppropriate operations in severe anterior open bite (AOB) cases are extremely complicated to perform because of the multiple surgical procedures involved, difficulty of predicting posttreatment aesthetics and high relapse rate.Case reportWe herein report a 16-year-old girl with skeletal Class II, severe AOB malocclusion and crowding with short roots and aesthetic and functional problems. Four-piece segmental LeFort I osteotomy combined with a posterior horseshoe-like osteotomy was performed for maxillary intrusion, and sagittal split ramus osteotomy (SSRO) and genioplasty were performed for mandibular advancement. The malocclusion and skeletal deformity were significantly improved by the surgical orthodontic treatment. Functional and aesthetic occlusion with an improved facial profile was established, and no further root shortening was observed. Acceptable occlusion and dentition were maintained after a two-year retention period.ConclusionThis strategy of surgical orthodontic treatment with a complicated operative procedure might be effective for managing severe AOB malocclusion.


2021 ◽  
Vol 3 (2) ◽  
pp. 82-87
Author(s):  
Prathyaksha Shetty ◽  
Dipjyothi Baruah ◽  
Amit Rekhawat ◽  
Karthik Cariappa ◽  
Sujala Ganapati Durgekar ◽  
...  

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.


2021 ◽  
pp. 030157422110054
Author(s):  
Prachi Gohil ◽  
Sonali Mahadevi ◽  
Bhavya Trivedi ◽  
Neha Assudani ◽  
Arth Patel ◽  
...  

We are in the process of discovery of new vistas for technological advances in terms of various appliances with a vision of making orthodontic treatment compliance free as well as successful. Due to improved technology, the enigma of treating the Class II syndrome is palliated. “Out of the box” thinking has become a norm to treat certain situations that were not corrected in noncompliant patients. Fixed functional appliances are valuable tools introduced to assist the correction of skeletal Class II malocclusion with mandibular retrognathia at the deceleration stage of growth for achieving stable results. In this direction a case series is reported of patients having the above conditions and undergoing orthodontic treatment using a Forsus FFA. Joining hands with technology is a win-win situation for both the patient and the orthodontist.


2021 ◽  
Vol 20 (4) ◽  
pp. 926-929
Author(s):  
Haytham Jamil Alswairki ◽  
Mohammad Khursheed Alam

Background: A unique clinical challenge presents when dealing with a compromised first permanent molars with bilateral posterior crossbite, severe crowding and impacted maxillary canines with skeletal class II base malocclusion patient. Case presentation: 14-year-old female patient had dental Class II skeletally, complicated with increase overjet, badly destructed permanent mandibular 1st molars constricted maxillary arch. Extraction of 1st molars followed by expansion have been planned to relieve crowding. Extraction of 1st molars in this time (furcation of 3rd molars start to develop) help in replacement by 2nd molars. In the progression of treatment, Conclusion: A well-balanced and esthetic occlusion by edge wise orthodontic treatment has been archived in this case. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.926-929


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Mehran Bahrami ◽  
Seyed Mehran Falahchai

A 61-year-old female patient with adenoid cystic carcinoma (ACC) of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO) and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO) is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD) was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient’s normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.


2018 ◽  
Vol 8 ◽  
pp. 146-160
Author(s):  
Ariel Wong ◽  
Chris Chang ◽  
W. Eugene Roberts

A 21-year-old female presented with chief complaints of crooked teeth, canine impaction, deep bite, and “gummy smile” (excessive maxillary gingival exposure when smiling). Increased facial convexity (15.5°), increased lower facial height (56%), and incompetent protrusive lips (E-line to upper left 2 mm, E-line to lower left 2 mm) were associated with a severe Class II malocclusion (nearly a full cusp bilaterally). There was 7.5 mm of overjet, 100% anterior deepbite, and a left posterior buccal crossbite. Cephalometrics revealed a skeletal discrepancy due to a protrusive maxilla and a retrusive mandible (SNA 85°, SNB 78°, and ANB 7°). Cone-beam computed tomography imaging revealed a palatally impacted right maxillary canine (UR3) near to the adjacent lateral incisor (UR2). The retained right primary canine (URc) was extracted. A simplified open-window technique was utilized to surgically expose its impacted successor. A maxillary anterior mini-screw provided anchorage to align the UR3 in its correct anatomical position. Nonextraction treatment with a passive self-ligating fixed appliance was indicated to align and level both arches. Anchorage provided by infrazygomatic crest bone screws, and maxillary anterior miniscrews were used for the correction of Class II malocclusion and gummy smile. To achieve more esthetic crown lengths in the maxillary anterior segment, gingivectomy was performed with a diode laser 2 months after fixed appliances were removed. This challenging skeletal Class II malocclusion with a Discrepancy Index of 38 was treated in 32 months to excellent outcomes: Cast-radiograph evaluation score of 25 and an pink and white dental esthetic score of 2. All facial and dental corrections were stable at the 6 months follow-up evaluation (Int J Orthod Implantol 2017;48:24-46). Republished with permission from: Ariel Wong, Chang CH, Roberts WE. Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine. Int J Orthod Implantol 2017;48:24-46.


2016 ◽  
Vol 1 (1) ◽  
pp. 27
Author(s):  
Setiarini Widiarsanti ◽  
Darmawan Sutantyo ◽  
Pinandi Sri Pudyani

Perawatan ortodontik interseptif efektif untuk mengurangi keparahan maloklusi disertai dengan kebiasaan buruk. Pemilihan waktu perawatan sangat penting agar perawatan dapat berhasil. Periode percepatan pertumbuhan berkisar antara 10-12 tahun untuk perempuan dan 12-14 tahun untuk laki-laki. Aktivator dengan skrup ekspansi digunakan untuk menstimulasi pertumbuhan mandibula, untuk mendapatkan ruang dari ekspansi pada kedua lengkung rahang dan untuk menghentikan kebiasaan buruk. Tujuan dari studi kasus ini adalah untuk memaparkan tata laksana perawatan dengan aktivator pada masa percepatan pertumbuhan. Pasien seorang laki-laki berusia 12 tahun datang dengan keluhan utama gigi atas maju dan kurang menarik. Kebiasaan buruk pasien adalah bernafas melalui mulut. Pemeriksaan objektif menunjukkan hubungan klas I pada kedua sisi, pola skeletal klas II, jarak inter P1 atas 35,7 mm dan jarak inter P1 bawah 30,3 mm. Maloklusi Angle Klas I tipe dentoskeletal dengan tipe skeletal kelas II dan incisivus maksila protrusif, overjet: 9,5 mm, overbite: 6,2 mm, palatal bite, scissorbite, malposisi gigi individual, kebiasaan buruk bernafas melalui mulut dan pergeseran midline RA kekanan sebesar 1,6 mm. Setelah 4 bulan perawatan, kebiasaan buruk telah berhenti, overjet menjadi 5 mm, overbite menjadi 3,2 mm, jarak inter P1 atas 36,5 mm dan jarak inter P1 bawah 31,6 mm. Aktivator dengan skrup ekspansi efektif untuk mencegah terjadinya disharmoni rahang dengan modifikasi pertumbuhan dan perkembangan rahang serta untuk menghentikan kebiasaan buruk dalam waktu singkat. Beberapa hal tersebut dapat dicapai dengan ketepatan pemilihan waktu perawatan yaitu dalam periode percepatan pertumbuhan. ABSTRACT: Interceptive Orthodontic Treatment Using Activator in Growth Spurt Period. Interceptive orthodontic treatment is effective to reduce the severity of malocclusion with oral bad habits. Time treatment is an important thing to make the treatment become successful. Growth spurt period in range 10-12 years old for female and 12-14 years old for male. Activator with an expansion screw was used to stimulate the mandibula growth, to create space by expanding both arches and to stop the bad habit. A 12 years old male patient with a chief complaint of protruded maxillary teeth and unpleasant appearance. The oral bad habit of patient was mouth breathing. Objective examination showed class I molar relationship on both sides, skeletal class II pattern, inter upper premolars was 35,7 mm and inter lower premolars was 30,3 mm. Angle malocclusion class I with skeletal class II and protruded incisive maxilla, overjet 9,5 mm, overbite 6,2 mm, mouth breathing bad habit, upper midline shifting 1,6 mm to the right side. After 4 months of treatment the oral bad habit was stop, overjet 5 mm, overbite 3,2 mm, inter upper premolars 36,5 mm and inter lower premolars 31,6 mm. Activator with an expansion screw was effectively prevent the skeletal disharmony by modification of growth and development of jaw, and stop the oral bad habit in short period of time. Those can be achieved by the right time choosing in growth spurt period for the treatment.


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