Class II Division 1 malocclusion with a high mandibular plane angle corrected with 2-phase treatment

Am J Orthod Dentofacial Orthop. 2009 Feb;135(2):241-51. doi: 10.1016/j.ajodo.2006.09.059.

Abstract

A 10-year-old girl with maxillary protrusion and crowding of the maxillary and mandibular anterior teeth was treated in 2 phases. In the first phase of treatment, maxillary anterior growth was restrained and mandibular anterior growth promoted for skeletal improvement. In the second phase, at age 13, 4 first premolars were extracted, and an edgewise appliance was used for alveolar improvement. Because the patient had a high mandibular plane angle with a large Frankfort-mandibular plane angle, special care was taken from the beginning to prevent mandibular clockwise rotation. The Frankfort-mandibular plane angle decreased 3.1 degrees at posttreatment. In addition to the skeletal changes, we obtained a favorable lateral profile. This was achieved by the alveolar changes from the lingual movement of the maxillary and mandibular anterior teeth, and the anterior growth of the nasal apex region. The occlusion was stable at the 38-month postretention follow-up.

Publication types

  • Case Reports

MeSH terms

  • Bicuspid / surgery
  • Cephalometry
  • Child
  • Extraoral Traction Appliances
  • Female
  • Follow-Up Studies
  • Humans
  • Malocclusion, Angle Class II / therapy*
  • Mandible / growth & development
  • Mandible / pathology
  • Maxilla / growth & development
  • Maxilla / pathology
  • Nose / growth & development
  • Orthodontic Appliances
  • Orthodontics, Corrective / instrumentation
  • Orthodontics, Corrective / methods*
  • Palatal Expansion Technique / instrumentation
  • Patient Care Planning*
  • Retrognathia / therapy
  • Rotation
  • Serial Extraction
  • Tooth Movement Techniques / instrumentation