Abstract
Background:Class II malocclusion is the most common sagittal skeletal discrepancy, with a prevalent skeletal pattern of mandibular retrusion. The correction of mandibular retrusion with functional removable appliance needs a good patient’s compliance; for this reason, some clinicians prefer to use no compliance apparatus.Objective:Objective of the present therapy note is to demonstrate that the use of no compliance apparatus can provide a good correction of skeletal class II malocclusion.Methods:In the present study, authors report a therapy note referred to a 10 years old patient, woman, affected by Class II, with mandibular retrusion and deep bite, treated in 2013 at the Dep. of Orthodontics of Messina University. An orthodontic treatment has been planned with the aim of stimulating mandibular growth; an Herbst appliance with a cantilever design, bonded on first maxillary and mandibular molars, has been used. After eleven months of functional therapy a bilateral molar class I have been obtained.Results:In the therapy note proposed, authors obtained a resolution of mandibular retrusion, a correction of overjet, overbite and dental crowding in both arches, and a bilateral molar and canine class I has been achieved.Conclusion:Herbst appliance seems to be efficient in the correction of II Class Malocclusion, independently from patient’s cooperation; moreover , early correction of Class II malocclusion with functional appliances produces several clinical advantages.
Highlights
Class II malocclusion is the most prevalent sagittal skeletal discrepancy [1, 2]
The orthodontic treatment reported in the present study showed that the use of noncompliance appliances produces a significant correction of the sagittal discrepancy: this correction is related to different effects such as mandibular growth increasing, glenoid fossa remodeling [5] and lower incisor proclination
A multicenter Randomized Clinical Trials (RCTs) conduced by O’Brien et al [26] showed that early treatment of Class II malocclusion with functional appliances resulted in a correction of overjet and molar class relationships reducing the severity of malocclusion
Summary
Class II malocclusion is the most prevalent sagittal skeletal discrepancy [1, 2]. Different skeletal pattern can participate in the development of a Class II malocclusion [3]: mandibular retrusion, sagittal maxillary hyperplasia, or a posterior position of the glenoid fossa [4, 5]. The possibility to achieve an effective treatment results in the absence of patient cooperation, entail that functional fixed appliance used for the correction of skeletal Class II malocclusion produces the best and more predictable clinical outcomes. Some Randomized Clinical Trials (RCTs) [15] and different meta-analyses including prospective studies [16 - 18] showed that functional appliances can increase mandibular growth in a statistically significant manner. This increment seems insufficient to determine a clinically significant effect on the skeletal Class II resolution [19]. The correction of mandibular retrusion with functional removable appliance needs a good patient’s compliance; for this reason, some clinicians prefer to use no compliance apparatus
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