scholarly journals Differential Diagnosis of Skeletal Class II: Orthodontic-Surgical Approach with Surgery First

2021 ◽  
Vol 23 (4) ◽  
pp. 257-263
Author(s):  
Jessica Rico Bocato ◽  
Daiara Paula Pacheco ◽  
Mauro Toma ◽  
Ricardo Lima Navarro ◽  
Thais Maria Freire Fernandes ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Time ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Skeletal Class ◽  
Angle Class Ii ◽  
Main Complaint ◽  
Skeletal Class Ii ◽  
Surgery First

AbstractOrthodontic-surgical treatment with the “Surgery First Approach” provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient’s aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results. Keywords: Malocclusion, Angle Class II. Orthognathic Surgery. Orthodontics, Corrective. ResumoO tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados. Palavras-chave: Maloclusão Classe II de Angle. Cirurgia Ortognática. Ortodontia Corretiva.

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

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.

scholarly journals Orthodontic Camouflage Treatment of Class II Malocclusion in Non-growing Patient - A Case Report

2015 ◽  
Vol 5 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Lubna Khan ◽  
Hemant Kumar Halwai ◽  
Rajiv Yadav ◽  
Ourvind Jeet Singh Birring
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Asian Population ◽  
Class Ii ◽  
Adult Patients ◽  
Treatment Modalities ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Skeletal Class ◽  
Skeletal Class Ii

The prevalence of skeletal Class II malocclusion is high amongst Asian population. Various treatment modalities have been presented for the treatment of Class II malocclusions in adult patients. We come across many adult patients who desire a costeffective and non-surgical correction and they accept dental camouflage as a treatment option to mask skeletal discrepancy. This case report presents a 26-year-old non-growing female who had a skeletal Class II malocclusion with prognathic maxilla and retrognathic mandible with an overjet of 7 mm, severe crowding, but did not want surgical treatment. We considered the camouflage treatment by extracting upper first premolars. Following the treatment, a satisfactory result was achieved with an acceptable static and functional occlusion, facial profile, smile and lip competence with patient satisfaction.

scholarly journals Gummy smile and facial profile correction using miniscrew anchorage

2011 ◽  
Vol 82 (1) ◽  
pp. 170-177 ◽  
Author(s):  
Masato Kaku ◽  
Shunichi Kojima ◽  
Hiromi Sumi ◽  
Hiroyuki Koseki ◽  
Sara Abedini ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Therapy ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Retention Period ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Profile Correction ◽  
Gummy Smile

Abstract This case report describes the treatment of a case involving a skeletal Class II facial profile with a gummy smile. While treating a facial profile and a gummy smile, the outcome may not always be successful with orthodontic therapy alone. For this reason, surgical therapy is often chosen to gain an esthetic facial profile and a good smile. However, sometimes the patients reject surgical treatment and an alternative method must be considered. Skeletal anchorage systems such as miniscrews are now frequently used for correcting severe malocclusion that should be treated by surgical therapy. In this case report, we treated a skeletal Class II malocclusion with a convex profile and a gummy smile using miniscrews, which were placed in the upper posterior and anterior areas. The active treatment period was 3.5 years, and the patient's teeth continued to be stable after a retention period of 36 months.

Management of Skeletal Class II Malocclusion by Surgery-First Approach

2017 ◽  
Vol 28 (1) ◽  
pp. e40-e43 ◽  
Author(s):  
Gagan Deep Kochar ◽  
Ashish Chakranarayan ◽  
Sanjay M. Londhe ◽  
Bensy Varghese ◽  
Balakrishna Jayan ◽  
...  
Keyword(s):  
Class Ii ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Surgery First

scholarly journals Evaluation of Postsurgical Stability And Condylar Morphology In Skeletal Class II Patients With Condylar Resorption Following Orthognathic Surgery

2021 ◽  
Author(s):  
Minjiao Wang ◽  
Hanjiang Zhao ◽  
Xiangyu Wang ◽  
Yifeng Qian ◽  
Hongbo Yu ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Condylar Morphology ◽  
Ramus Height ◽  
Condylar Volume

Abstract Background: To retrospectively evaluate postsurgical stability and condylar morphology for skeletal class II malocclusion patients with condylar resorption (CR) treated with orthognathic surgery.Methods: Thirty-five patients treated with combined orthodontic and orthognathic surgery between 2014 and 2018 were enrolled in this retrospective study. CT scans were acquired preoperatively (T0), 2–7 days after surgery (T1), and 1 year postoperatively (T2). The amount of mandibular advancement, postsurgical relapse, condylar morphology and joint spaces were analysed respectively. Statistical analysis was performed using R, version 3.4.3 (R Development Core Team 2010).Results: The average mandibular advancement and counter-clockwise rotation were 5.51 mm and -2.82 degrees respectively. The average relapse was 1.08 mm (19.6% of the advancement) and 1.13 degrees. The condylar volume showed a postoperative reduction of 161.86 mm3(13.7% of initial condylar volume). AJS increased after surgery and gradually returned to its original state, while SJS and PJS decreased and remained stable. Surgical advancement of B point was significantly correlated with skeletal relapse. The optimal cut-off values were as follows: MP-FH (40.75°); ramus height (51.125 mm); SJS (1.63 mm); surgical displacement (4.72 mm); CCR (-4.3°); AJSC (1.07 mm).Conclusions: Skeletal class II patients with CR have a high risk of postsurgical condylar resorption, which was most related to nonsurgical risk factors such as gender(female) and condylar angle. Condylar had moved posteriorly to the concentric position after surgery and remained quite stable through the 1-year follow-up. Preoperative skeletal patterns such as lower ramus height and surgical procedures such as larger advancement of the mandible were closely associated with sagittal relapse of the mandible.

Bimaxillary surgery to correct high-angle class II malocclusion: does a simultaneous genioplasty affect long-term stability?

2019 ◽  
Vol 42 (4) ◽  
pp. 426-433
Author(s):  
Nina Torgersbråten ◽  
Arild Stenvik ◽  
Lisen Espeland
Keyword(s):  
Class Ii ◽  
Open Bite ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
High Angle ◽  
Skeletal Class ◽  
Angle Class Ii ◽  
Post Surgery ◽  
Angle Class ◽  
Skeletal Class Ii

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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