Abstract
Abstract Objectives The present case report describes the orthodontic retreatment of a skeletal Class II postpubescent female patient who presented following previous orthodontic treatment that involved the extraction of the four first premolars, temporomandibular disorders and a convex facial profile. Methods The patient, aged 15 years, sought treatment for the chief complaints of an unaesthetic facial profile and difficulty in opening her mouth. The examination revealed a convex facial profile and a moderate skeletal Class II relationship within a long face. The patient had bilateral pain around the temporomandibular joints and her maximum mouth opening was only 11 mm. The treatment plan was to initially relieve the temporomandibular symptoms and then to retract the upper dentition using miniimplants. Results The patient’s mouth opening ability reached 37 mm and a significantly improved harmonious facial profile was achieved. Conclusions Cases that present with previous unsuccessful orthodontic treatment may be retreated to achieve a satisfactory aesthetic and functional result by precise control of tooth movement in three dimensions.
Highlights
Orthodontic treatment results are determined by many factors and not all patients experience a desirable outcome
A Class II malocclusion is a common problem occurring in approximately one-third of the Australasian Orthodontic Journal Volume 35 No 2 November 2019 older population and accompanying mandibular retrusion is the most common feature.[5,6]
Orthodontic treatment objectives have evolved from the correction of dental malocclusion to the improvement of facial aesthetics, oral health, and the creation of a functional occlusion with long-term stability.[8]
Summary
Orthodontic treatment results are determined by many factors and not all patients experience a desirable outcome. Patients seek orthodontic retreatment to improve their aesthetics as well as their oral function, but a second orthodontic course of care has particular concerns and complexities.[1,2,3] A patient seeking retreatment may have increased oral disease related to caries and periodontal problems and temporomandibular disorders and may have higher expectations regarding the treatment result and may have psychological anxiety.[4]. A Class II malocclusion is a common problem occurring in approximately one-third of the Australasian Orthodontic Journal Volume 35 No 2 November 2019 older population and accompanying mandibular retrusion is the most common feature.[5,6] Since Class II postpubescent patients have minimal growth potential to advance the mandible, the correction protocol is either combined orthodontic-orthognathic surgery or camouflage orthodontic treatment. While many patients and their parents accept camouflage treatment because of a reluctance to undergo surgery, orthodontic treatment requires more accurate space management, anchorage design and vertical control.[7]
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