Nonsurgical Orthodontic Intervention of a Severe Class II Case Accompanied by Posterior Crossbite Using a Miniscrew-Assisted Straight Wire Technique

Class II malocclusion in nongrowing patients is a great challenge in treatment especially if the degree of malocclusion is severe. In such cases, the use of miniscrews for orthodontic camouflage can produce results comparable to that of orthognathic surgery. This case report presents an adult patient with severe Class II malocclusion combined with bilateral posterior crossbite, deep bite, a crowded lower arch, and a history of extraction of the lower right first molar. The treatment involved upper arch expansion by a quad helix appliance followed by the extraction of the right and left upper 1st premolars. A miniscrew-assisted straight wire technique was used to close the extraction space and reduce the overjet. Lower molar protraction was done to close the previous extraction space in the lower arch. At the end of treatment, overjet was reduced, lower arch crowding was relieved, lip competency was established, and the wide buccal corridor was reduced with a pleasing smile and normal facial proportions.

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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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Limited Evidence Suggests that a History of Suboptimal Breastfeeding May Increase the Risk of Developing Anterior Open Bite, Posterior Crossbite, and Class II Canine Relationship

Journal of Evidence Based Dental Practice ◽

10.1016/j.jebdp.2017.12.004 ◽

2018 ◽

Vol 18 (1) ◽

pp. 79-81 ◽

Cited By ~ 1

Author(s):

Carlos Flores-Mir

Keyword(s):

Class Ii ◽

Open Bite ◽

Limited Evidence ◽

Anterior Open Bite ◽

Posterior Crossbite ◽

History Of ◽

Suboptimal Breastfeeding

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Freeman-Sheldon Syndrome: Case Management from Age 6 to 16 Years

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1997_034_0151_fsscmf_2.3.co_2 ◽

1997 ◽

Vol 34 (2) ◽

pp. 151-153 ◽

Cited By ~ 3

Author(s):

Kimie Ohyama ◽

Takafumi Susami ◽

Yoshiyuki Kato ◽

Hiromi Amano ◽

Takayuki Kuroda

Keyword(s):

Case Management ◽

Orthodontic Treatment ◽

Mouth Opening ◽

Class Ii ◽

Class Ii Malocclusion ◽

Limited Mouth Opening ◽

Deep Bite ◽

Long Term Follow Up

Objective This is the first description of long-term follow-up of a case of Freeman-Sheldon syndrome. Microstomia was treated with a mouth expander for 2 to 3 hours per day before active orthodontic treatment. Separate impressions were necessary in each quadrant of both upper and lower jaws because of limited mouth opening. Conclusion Orthodontic treatment improved the patient's Class II malocclusion, which was accompanied by crowding and a deep bite.

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Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics

Case Reports in Dentistry ◽

10.1155/2019/8152793 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Daniel Gheur Tocolini ◽

Priscila de Oliveira Silva ◽

Iduilton Grabowski ◽

Julia Carelli ◽

Nathaly Dias Morais ◽

...

Keyword(s):

Anterior Segment ◽

Class Ii ◽

Open Bite ◽

Functional Improvement ◽

Maxillary Incisor ◽

Class Ii Malocclusion ◽

Anterior Open Bite ◽

Bone Segment ◽

The Right ◽

Dental Crowding

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

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Relation between Angle Class II malocclusion and deleterious oral habits

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512012000600022 ◽

2012 ◽

Vol 17 (6) ◽

pp. 111-117

Author(s):

José Tarcísio Lima Ferreira ◽

Maria do Rosário Ferreira Lima ◽

Luciana Zappeloni Pizzolato

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Class Iii ◽

Chi Square ◽

Significance Level ◽

Oral Habits ◽

Angle Class Ii ◽

Stomatognathic System ◽

Chi Square Test ◽

History Of

INTRODUCTION: Oral habits may interfere on the growth and development of the stomatognathic system and orofacial myofunctional conditions, producing changes in the position of teeth in their dental arches. OBJECTIVE: The purpose of this study was to verify the presence of deleterious oral habits in individuals with malocclusion and see if there is a predominance of Class II malocclusion in these individuals. METHODS: The records of 140 patients treated at the Clinic of Preventive Orthodontics FORP-USP who had already completed treatment were randomly selected and analyzed. Their ages ranged from 6 to 10 years and 11 months. Associations were made between the presence or absence of deleterious oral habits, type and number of habits found in each individual and the type of malocclusion according to Angle classification. The statistical analysis used was the Chi-square test with a significance level of 5%. History of deleterious oral habits was found in 67.1% of individuals. RESULTS: The Class I malocclusion was most frequent (82.9%), followed by Class II malocclusion (12.1%) and Class III (5%). CONCLUSION: There was a predominance of Class II malocclusion in individuals with a history of deleterious oral habits.

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Upper anterior intrusion with mini-implants to correct anterior deep bite in a periodontally compromised class II malocclusion. Case report

Revista Mexicana de Ortodoncia ◽

10.1016/s2395-9215(16)30136-2 ◽

2014 ◽

Vol 2 (2) ◽

pp. e105-e111

Author(s):

Carlos Eder Zamudio López ◽

Silvia Tavira Fernández

Keyword(s):

Case Report ◽

Class Ii ◽

Class Ii Malocclusion ◽

Deep Bite ◽

Mini Implants

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Republication: Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine

APOS Trends in Orthodontics ◽

10.4103/apos.apos_51_18 ◽

2018 ◽

Vol 8 ◽

pp. 146-160

Author(s):

Ariel Wong ◽

Chris Chang ◽

W. Eugene Roberts

Keyword(s):

Conservative Management ◽

Anterior Segment ◽

Class Ii ◽

Class Ii Malocclusion ◽

Maxillary Canine ◽

Deep Bite ◽

Fixed Appliance ◽

Skeletal Class ◽

Skeletal Class Ii ◽

Gummy Smile

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.

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Use of a Modified Twin Block Appliance following Partial Maxillectomy: Case Report

British Journal of Orthodontics ◽

10.1179/bjo.23.2.103 ◽

1996 ◽

Vol 23 (2) ◽

pp. 103-108 ◽

Cited By ~ 1

Author(s):

H. C. Moseley ◽

E. N. Horrocks ◽

R. R. Welfare

Keyword(s):

Case Report ◽

Orthodontic Treatment ◽

Class Ii ◽

Growth Spurt ◽

Class Ii Malocclusion ◽

Pubertal Growth Spurt ◽

Twin Block ◽

Pubertal Growth ◽

Skeletal Pattern ◽

The Right

A case is described in which a Class II malocclusion with severe Class II skeletal pattern was treated with a modified Twin Block Appliance. The patient, an II-year-old girl, had initially presented with an ameloblastoma located in the right maxilla. The subsequent defect produced by surgery was obturated by the appliance during her orthodontic treatment, which was undertaken during her pubertal growth spurt Two years later the result was stable, allowing the provision of a more definitive prothesis to restore the occlusion.

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Class II malocclusion with accentuated occlusal plane inclination corrected with miniplate: a case report

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.21.3.094-103.oar ◽

2016 ◽

Vol 21 (3) ◽

pp. 94-103 ◽

Cited By ~ 1

Author(s):

Marcel Marchiori Farret ◽

Milton M. Benitez Farret

Keyword(s):

Case Report ◽

Orthognathic Surgery ◽

Class Ii ◽

Occlusal Plane ◽

Class Ii Malocclusion ◽

Prosthetic Rehabilitation ◽

End Of Treatment ◽

Mandibular Teeth ◽

Deciduous Molar ◽

The Right

ABSTRACT Introduction: A canted occlusal plane presents an unesthetic element of the smile. The correction of this asymmetry has been typically considered difficult by orthodontists, as it requires complex mechanics and may sometimes even require orthognathic surgery. Objective: This paper outlines the case of a 29-year-old woman with Class II malocclusion, pronounced midline deviation and accentuated occlusal plane inclination caused by mandibular deciduous molar ankylosis. Methods: The patient was treated with a miniplate used to provide anchorage in order to intrude maxillary teeth and extrude mandibular teeth on one side, thus eliminating asymmetry. Class II was corrected on the left side by means of distalization, anchored in the miniplate as well. On the right side, maxillary first premolar was extracted and molar relationship was kept in Class II, while canines were moved to Class I relationship. The patient received implant-prosthetic rehabilitation for maxillary left lateral incisor and mandibular left second premolar. Results: At the end of treatment, Class II was corrected, midlines were matched and the canted occlusal plane was totally corrected, thereby improving smile function and esthetics.

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