TADs assisted Camouflage Orthodontic Treatment of Class II Division 1 Malocclusion in a Non Growing Patient: A case report

Ankita Gupta,Trilok Shrivastava

doi:10.3126/ojn.v8i2.23073

Ankita Gupta, Trilok Shrivastava

Open Access

https://doi.org/10.3126/ojn.v8i2.23073

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Abstract

Class II, Division I malocclusion has been described as the most frequent treatment problem in orthodontic practice. Aim & objectives of the present case report was to evaluate the management of skeletal Class II division 1 malocclusion in non growing patient with extraction of upper first premolars. Clinical and cephalometric evaluation revealed skeletal Class II with Angles Class II division 1 malocclusion with mild mandibular anterior crowding and increased overjet, severe maxillary incisor proclination, mild mandibular crowding, exaggerated curve of spee, convex profile, incompetent lips, increased overjet and overbite. Maxillary first premolars were extracted followed by en-masse retraction of anteriors with the help of temporary anchorage devices (TADs) to avoid anchorage loss. Mandibular incisor was extracted to correct curve of spee. Following treatment marked improvement in patient’s smile, facial profile and lip competence were achieved and there was a remarkable increase in the patient’s confidence and quality of life.

Highlights

Non-growing patients with skeletal Class II malocclusions can be treated by only two possible treatment approaches: (1) orthodontic camouflage, based on selective extraction of permanent teeth followed by retraction of the protruding maxillary incisors to improve both dental occlusion and facial aesthetics without correcting the underlying skeletal problem; or (2) orthognathic surgery to reposition the mandible or the maxilla
Studies have shown that patient satisfaction with camouflage treatment is similar to that achieved with surgical mandibular advancement[6] and that treatment with two maxillary premolar extractions gives a better occlusal result than treatment with four premolars extractions
Anchorage loss is the reciprocal reaction of the anchor unit that can obstruct the success of orthodontic treatment by complicating anteroposterior correction.[9]

Summary

INTRODUCTION

Non-growing patients with skeletal Class II malocclusions can be treated by only two possible treatment approaches: (1) orthodontic camouflage, based on selective extraction of permanent teeth followed by retraction of the protruding maxillary incisors to improve both dental occlusion and facial aesthetics without correcting the underlying skeletal problem; or (2) orthognathic surgery to reposition the mandible or the maxilla. Anchorage loss is the reciprocal reaction of the anchor unit that can obstruct the success of orthodontic treatment by complicating anteroposterior correction.[9] To address this problem, many appliances and techniques have been devised; Nance holding arch, transpalatal bars, extraoral traction, multiple[10] teeth at the anchorage segment, and differential moments[11,12] are some commonly used ones All these methods have a few inherent disadvantages - complicated designs, need for exceptional patient cooperation, elaborate wire bending, and so on. The patient and her parents were very happy with complete satisfaction

DISCUSSION

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CONCLUSION