Preventive and Interceptive Orthodontics Treatment

Preventive orthodontics is that part of orthodontic practice which is concerned with patients and parents education, supervision of the growth and development of the dentition and cranio-facial structures. The diagnostic procedures undertaken to predict the appearance of malocclusion and the treatment procedures instituted to prevent the onset of malocclusion. Interceptive orthodontics has been defined as that phase of science that can recognize and eliminate potential irregularities and malpositions of the developing dento-facial complex. Many of procedures are common in preventive and interceptive orthodontics, but the timings are different. Preventive procedures are undertaken in anticipation of development of a problem, whereas interceptive procedures are taken when the problem has already manifested. Orthodontic problems in children can be divided conveniently into non skeletal and skeletal problems, which are treated by tooth movement and by growth modification. Such treatment may take place in deciduous or transitional dentition and may include redirection of ectopically erupting teeth, slicing or extraction of deciduous teeth, correction of isolated dental crossbites of recovery of minor space loss.

Indian Board of Orthodontics Case Report: Management of Class II Skeletal Malocclusion Using 2-Phase Treatment

KL, a 12-year-old boy, presented with a class II Div I malocclusion on a class II skeletal base (retrognathic mandible) with a 7-mm overjet and a horizontal growth pattern. He had a convex profile, incompetent lips, lip trap, deep mentolabial sulcus, everted lower lip, and positive visual treatment objective (VTO). KL had a CS2 cervical maturation stage, which indicates 65% to 85% adolescent growth remaining. Treatment involved growth modification using a removable Twin Block with midpalatal expansion screw. This was followed by upper and lower fixed appliance using 0.022” × 0.028” slot Mclaughlin Bennet and Trevisi (MBT) prescription. The retention protocol involved upper wrap around and lower lingual bonded retainer.

Growth Pattern in Skeletal Class I Malocclusion: A Cephalometric Study

Introduction: Great emphasis has been given to the evaluation of sagittal apical base relationship in orthodontic diagnosis and treatment planning. The prediction of magnitude and direction of facial growth based on sagittal relationship will help in orthodontic treatment with growth modification. The objective of the study is to assess the growth pattern in skeletal Class I malocclusion. Materials and Method: 104 subjects (52 male and 52 female) with the age between 18-30 years with Class I skeletal relation was selected from lateral cephalograms of patients visiting the Department of Orthodontics, Kantipur Dental College. The ANB angle was measured to assess the sagittal jaw relationship and the Jarabak’s ratio to access the growth pattern. Descriptive statistics were calculated for each parameter. Pearson’s test was done to evaluate the correlation between the parameters. Independent t-test was done to compare Anterior Facial height (AFH), Posterior Facial Height (PFH) and Jarabak’s ratio between male and female subjects. Result: Among the total subjects with skeletal Class I malocclusion; hyperdivergent growth pattern was least (10.57%), followed by normodivergent (18.26%) and hypodivergent growth pattern (71.15%). Mean Jarabak’s ratio for hyperdivergent, normodivergent and hypodivergent growth pattern were 58.65±1.94, 63.98±0.85 and 69.98±4.13 respectively. Very strong correlation was found between AFH and PFH in hyperdivergent (r = 0.821) and normodivergent group (r =0.978). Strong correlation was found in hypodivergent group between AFH and PFH (r =0.743). Also, strong correlation was found in hypodivergent group between PFH and Jarabak’s ratio (r =0.643). Conclusion: Hypodivergent growth pattern was the dominant growth pattern in skeletal Class I malocclusion. PFH influenced the determination of Jarabak’s ratio more than the AFH in hypodivergent growth pattern. Hypodivergent growth pattern is correlated with large SNB angle.

Managing Class II Malocclusion Using Twin Block Therapy in a Young Adolescent Female: A Case Report

Twin block therapy is highly effective in patients with remaining growth potential. However, its successful use is confounded by many patient related factors such as age, gender, compliance of the patient and other miscellaneous criteria’s. If treated within time, growth modification and orthopedics can harness suitable forces to cause skeletal correction of the malocclusion. The appliance is highly successful in a patient with retruded mandible and presenting with a positive visual treatment objective. This paper discusses a case of 11-year-old female patient with characteristic twin block appliance indication in which successful skeletal modification was achieved.

Effective and Efficient Correction of Severe Skeletal Class II Division 1 Malocclusion with Intermaxillary Elastics

Treatment of Class II malocclusion accompanied with a skeletal discrepancy is challenging. The approach of correction depends on several factors such as the status and pattern of growth, severity of the malocclusion, and patient cooperation. This case report describes a successful management of a 12-year-old young adolescent boy that was presented with a Class II division 1 malocclusion with an underlying skeletal discrepancy in horizontal and vertical dimensions. Growth modification was achieved by means of bite opening and unlocking the mandible together with Class II elastics and mechanics. Treatment was highly effective and efficient by achieving all treatment goals within a period of 18 months.

Multistage Treatment of a Class II Division 1 Malocclusion With Severe Crowding

The improvement of facial aesthetics is one of the main reasons why patients with a class II division 1 malocclusion seek orthodontic treatment. There are various techniques available to treat class II malocclusions, one of which is a two-phase approach that includes functional jaw orthopedics as well as fixed orthodontic treatment. The following case report describes the case of a 12-year-old growing female patient AK with a severe class II division 1 malocclusion. The patient was treated initially with Haas-type rapid maxillary expansion. Pre-functional orthodontics was followed with a removable twin block functional appliance and a combination pull headgear for growth modification and correction of her overjet and profile. Thereafter, a fixed, pre-adjusted MBT (McLaughlin Bennet Trevsi) prescription orthodontic appliance was utilized following the extractions of the maxillary first premolars and two lower incisors in the final phase, to ensure well-aligned arches and improved aesthetics and function.