Combining different treatment philosophies and techniques to reach the desired treatment goal using butterfly system-customizing orthodontic treatment

Abstract

This case report describes the orthodontic treatment of an 18-year-old male patient who presented with Straight profile; tongue thrust habit, proclined upper incisors, generalised spacing in upper and lower arches, Katz's class II premolar relation unilaterally, class II canine relation unilaterally with increased overjet and overbite. A butterfly system was used in the treatment combined with frictionless biomechanics in the initial stage of treatment followed by continuous arch mechanics in the later part of treatment. A tongued crib was used to stop the tongue thrust habit along with one elastic swallow exercise. Micro-implant anchorage was used unilaterally in the upper arch for retraction of the entire segment and correction of the unilateral class II canine and premolar relationship. To avoid a dished in profile, a non-extraction treatment was executed. Final corrections of distally tipped canines were achieved using conventional Begg’s uprighting auxiliaries in the vertical slots of butterfly system in the finishing stage. The case was finished using bite settling elastics. Total treatment time was 1 year 2 months. Aesthetic and functional goals were achieved satisfactorily with proper selection of biomechanics.