Management of Skeletal Class II in a Growing Patient Using a Headgear and a Fixed Functional Appliance, with a Three-Year Follow-up : An Indian Board of Orthodontics Case Report

This case was submitted to the Indian Board of Orthodontics under category II for phase III examination, in December 2018. SP, a 13-year-old female patient, presented with the chief complaint of forwardly placed upper front teeth. On clinical examination, she was found to have class II division 1 malocclusion with an increased overjet and overbite, a class II skeletal pattern due to a prognathic maxilla and a retrognathic mandible with positive visual treatment objective (VTO), moderate crowding in the upper and lower arches, retained deciduous 54 and 55, an exaggerated Curve of Spee, and a midline discrepancy of 6 mm. The treatment objectives were to correct the skeletal pattern and molar and canine relation. The patient was treated with fixed mechanotherapy, along with a headgear and a fixed functional appliance (Forsus). At the end of the treatment, she showed improvement in the skeletal pattern, good posterior occlusion, and an improved overjet and overbite. A bonded fixed retainer in the lower arch and a Begg’s wraparound retainer in the upper arch were used. Occlusion remained stable 3 years after the treatment.

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Indian Board of Orthodontics Case Report: Management of Skeletal Class II Division 1 Malocclusion With Single-Phase Fixed Orthodontic Treatment Along With Forsus FRD Fixed Functional Appliance

The Journal of Indian Orthodontic Society ◽

10.1177/03015742211004436 ◽

2021 ◽

Vol 55 (2) ◽

pp. 202-208

Author(s):

Ashish Garg

Keyword(s):

Case Report ◽

Single Phase ◽

Critical Appraisal ◽

Class Ii ◽

Functional Appliance ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii ◽

Division 1 ◽

Class Ii Division 1

This case report was submitted to the board under category II for the Indian Board of Orthodontics examination in November 2017. This case report illustrated the treatment of class II division 1 malocclusion by pre-adjusted appliance along with Forsus Fatigue Resistance Device (FRD) fixed functional appliance (single-phase treatment) in a 13.6 year-old female patient whose growth was about to cease. The summary of the treatment, various records, treatment progress, and critical appraisal are reprinted here with minimal editing and reformatting, and hence, the presentation resembles the actual documents submitted to the board.

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Management of Class II Division 1 Subdivision malocclusion using unilateral bicuspid extractions and fixed functional appliance: A Two Year Follow-Up

South European Journal of Orthodontics and Dentofacial Research ◽

10.5937/sejodr8-27254 ◽

2021 ◽

Vol 8 (1) ◽

pp. 12-19

Author(s):

Sarvraj Kohli ◽

Virinder Kohli ◽

Gagan Deep Kochhar

Keyword(s):

Class Ii ◽

Mandibular Advancement ◽

Treatment Modalities ◽

Functional Appliance ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii ◽

Division 1 ◽

Unique Approach ◽

Class Ii Division 1

Introduction: Management of Class II Subdivision cases pose a clinical dilemma and require a careful diagnosis to ascertain the source of asymmetry. Various treatment modalities involving: different protocols of tooth extractions; molar distalization; fixed functional appliances or orthognathic surgery have been proposed for the same. Objective: This article reports a unique approach for management of a severe skeletal Class II with Angle’s Class II Division 1 subdivision malocclusion using unilateral bicuspid extractions in mandibular and maxillary arches and a fixed functional appliance. Results: A 13 year 1 month old male in CVMI transition stage was successfully treated. Extraction of #44 was done to alleviate crowding in the mandibular anterior region and #15 was extracted to protract #16 to achieve a Class II molar relationship. A pre-functional Class II molar and canine relationship with co-incident midlines was achieved. The functional phase consisted of a fixed functional appliance (Forsus FRD) for mandibular advancement to correct the severe skeletal Class II. Class I molar and canine relationships were achieved with reduction of facial convexity and overjet. Result remained stable 24 months after treatment. The improvement can be quantified by the reduction in scores of orthodontic indices measured pre and post treatment. Conclusions: Management of Class II subdivision malocclusion requires careful planning. This paper presents a unique approach utilizing unilateral extractions and fixed functional appliance to address severe skeletal Class II discrepancy and the subdivision dilemma.

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TADs assisted Camouflage Orthodontic Treatment of Class II Division 1 Malocclusion in a Non Growing Patient: A case report

Orthodontic Journal of Nepal ◽

10.3126/ojn.v8i2.23073 ◽

2018 ◽

Vol 8 (2) ◽

pp. 55-59

Author(s):

Ankita Gupta ◽

Trilok Shrivastava

Keyword(s):

Case Report ◽

Class Ii ◽

Maxillary Incisor ◽

Mandibular Incisor ◽

Anterior Crowding ◽

Skeletal Class ◽

Curve Of Spee ◽

Skeletal Class Ii ◽

Division 1 ◽

Class Ii Division 1

Class II, Division I malocclusion has been described as the most frequent treatment problem in orthodontic practice. Aim & objectives of the present case report was to evaluate the management of skeletal Class II division 1 malocclusion in non growing patient with extraction of upper first premolars. Clinical and cephalometric evaluation revealed skeletal Class II with Angles Class II division 1 malocclusion with mild mandibular anterior crowding and increased overjet, severe maxillary incisor proclination, mild mandibular crowding, exaggerated curve of spee, convex profile, incompetent lips, increased overjet and overbite. Maxillary first premolars were extracted followed by en-masse retraction of anteriors with the help of temporary anchorage devices (TADs) to avoid anchorage loss. Mandibular incisor was extracted to correct curve of spee. Following treatment marked improvement in patient’s smile, facial profile and lip competence were achieved and there was a remarkable increase in the patient’s confidence and quality of life.

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Treatment of a skeletal Class II malocclusion using fixed functional appliance with miniplate anchorage

European Journal of Dentistry ◽

10.4103/1305-7456.130637 ◽

2014 ◽

Vol 08 (02) ◽

pp. 276-280 ◽

Cited By ~ 15

Author(s):

Mevlut Celikoglu ◽

Tuba Unal ◽

Mehmet Bayram ◽

Celal Candirli

Keyword(s):

Class Ii ◽

Class Ii Malocclusion ◽

Functional Appliance ◽

Present Case Report ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii ◽

Fixed Appliances ◽

Mandibular Retrusion ◽

Leveling And Alignment

ABSTRACTBased on our literature search, we found that the use of miniplate anchorage with Forsus fatigue-resistance device (FRD) has not yet been reported. Therefore, the aim of the present case report was to present the treatment of a patient with skeletal Class II malocclusion with mandibular retrusion using Forsus FRD with miniplate anchorage. Fixed appliances with 0.022-inch slots were attached to the maxillary teeth and after 8 months of the leveling and alignment of the upper arch, 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back. Two weeks after the placement of the miniplates bilaterally at the symphysis of the mandible, Forsus FRD was adjusted to the miniplates with a 35-mm length of rod chosen. Nine months after the skeletal anchored Forsus worn, Class I canine and molar relations were achieved and overjet was eliminated.

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Management of Skeletal Class II Malocclusion in Non-Complaint Patient using Powerscope - A Case Report

Orthodontic Journal of Nepal ◽

10.3126/ojn.v9i2.28421 ◽

2019 ◽

Vol 9 (2) ◽

pp. 77-81

Author(s):

Akram Ansari ◽

Abhay Kumar Jain ◽

Ankit Singh ◽

Priya Sharma ◽

Muneeb Adil

Keyword(s):

Case Report ◽

Class Ii ◽

Ease Of Use ◽

Patient Comfort ◽

Adolescent Male ◽

Class Ii Malocclusion ◽

Functional Appliance ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii

Class II malocclusion in pubertal phase presents a major and a common challenge to orthodontists. Proper diagnosis and treatment planning in early stage help in preventing and intercepting the severity of malocclusion. In pubertal phase skeletal Class II malocclusion due to mandibular retrusion are best treated with functional appliance. In recent time PowerScope fixed functional appliance is gaining immense popularity as noncompliant Class II corrector. In the present case report an adolescent male patient having Class II division 1 malocclusion with functional jaw retrusion was treated using MBT 0.022” prescription and PowerScope appliance. 7-8 months of PowerScope wear obtained stable and successful results with improvement in facial profile, skeletal jaw relationship and mild increase in IMPA. It can thus be concluded that PowerScope gives good results in Class II correction with a combination of patient comfort and ease of use that was unmatched among other appliances

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Therapeutic effectiveness of AdvanSync2 at different stages of skeletal maturity in skeletal Class II malocclusion: A single-blind clinical trial

APOS Trends in Orthodontics ◽

10.25259/apos_29_2020 ◽

2020 ◽

Vol 10 ◽

pp. 111-119

Author(s):

Pradeep Raghav ◽

Shivani Mathur ◽

Kumar Amit ◽

Stuti Mohan

Keyword(s):

Skeletal Maturity ◽

Class Ii ◽

Functional Appliance ◽

Functional Therapy ◽

Lower Incisor ◽

Skeletal Class ◽

Fixed Functional Appliance ◽

Skeletal Class Ii ◽

Group A ◽

Group B

Objectives: AdvanSync2 (Ormco, Glendora, California, USA) is a molar-to-molar fixed Class II corrector, based on the philosophy of Herbst which allows the bonding of the both upper and lower arches simultaneously along with fixed functional therapy. The purpose of this study was to cephalometrically compare the skeletal and dentoalveolar effects of AdvanSync2 in the correction of Class II malocclusions in circumpubertal and post-pubertal patients. Materials and Methods: Forty-eight samples were selected and divided into two groups based on their CVMI staging, Group A, i.e., at CVMI Stages 2 and 3 (18 girls and six boys) and Group B, i.e., CVMI Stages 4, 5, and 6 (19 girls and five boys). Cephalograms taken at pre- and post-AdvanSync2 stages were compared and analyzed. Results: The results showed that there was a significant increase in mandibular length in both groups. Both the groups also showed sagittal maxillary restriction, maxillary molar distalization, and retroclination of maxillary incisors. On comparison between Group A and Group B, there was no statistically significant differences in terms of maxillary position, size of maxilla, as well as upper and lower incisor inclinations in Group A except for improvement of mandibular position (SNB; P ≤ 0.01) and greater amount of chin growth (B -Pg; P ≤ 0.01) with respect to Group B. Conclusion: AdvanSync2 can be used as an effective fixed functional appliance in post-pubertal group for sagittal mandibular correction in skeletal Class II patients.

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