Functionally orientated/systemic approach to orthodontic treatment of severe class II division 1 malocclusions: an adapted device, the FABP

J.-L Raymond

doi:10.1051/odfen/2018063

Abstract

The orthodontic treatment of severe class II division 1 malocclusions is often difficult, which leads some specialists to offer a surgical correction of the overjet. Treatment is made complex by the value of the horizontal overlap as much as the « depth » of deep bite that is very often present alongside the malocclusion. This is why we are offering a treatment protocol including a FABP (Fixed Anterior Bite Plate) which will allow, if the patient cooperates, to correct the anatomic anomaly while concurrently establishing new masticatory cycles in order to stabilize and preserve the results obtained. It is this systemic approach of treatment that is the focus of this article.

Highlights

The orthodontic treatment of severe class II division 1 malocclusions is often difficult, which leads some specialists to offer a surgical correction of the overjet
For various reasons, it is relatively common that early correction is not done, which forces the clinician to deal with these severe class II/1 cases in adolescents or, in other words, at the orthodontic age
Establishing anatomically normal arch ratios is not sufficient if they are not fitted, concomitantly, with a functional anterior guide, that is to say adapted to a new masticatory functional scheme on which the stability of the correction depends

Summary

DEFINITION OF SYSTEMIC ORTHODONTICS

Systemic orthodontics differs from “contemporary” orthodontics in that it takes into account the masticatory system as a whole ( its name); in other words, it considers the links between arch morphology and mastication. What we call “contemporary orthodontics” is an orthodontic treatment that focuses primarily on the esthetic alignment of the teeth—for a beautiful smile—often ignoring mastication[9] and its morphogenetic influence[3,4,5,6,10,12,14,16]. Systemic orthodontics is at the heart of any therapeutic project involving masticatory rehabilitation, whose architectural role is, in our opinion, essential[12,14]. The alignment of the teeth is not considered as an end in itself but as a means to achieve masticatory rehabilitation, which constitutes the fundamental objective of the treatment since it conditions its durability. The employed treatment methods can be of any type and adapted to any malocclusion, provided that they make it possible to achieve the fixed functional objective, and among other things, conventional multi-attachment devices can often be used in combination with specific auxiliary devices

Morphological description of severe class II cases

Correction of occlusal plane orientation

Fixed anterior bite plate

CONCLUSION