The Treatment Of An Adult Patient With Deep Bite Malocclusion Using The Lingual Orthodontics

Objective: With the increases of the adult orthodontic patients, esthetic concern hasgrown considerably during the orthodontic treatment. The purpose of this study was toevaluate the clinical treatment effect of the lingual orthodontics on an adult patient withdeep bite malocclusion.Method: An adult with deep bite admitted to Dalian stomatology hospital’sorthodontics apartment in2012was selected. The patient was a23-years old male,skeletal classⅠwith low mandibular angle. Her lips were incompetent, and his profilewas straight with the short lower1/3face height and increased labiomental fold of thelower lip. There were the Ⅱ°deep overbite and Ⅰ°deep overjet (almost4mm). Theupper dental midline was shifted to the right2mm, while the lower dental midline was inthe facial midline. The bi-lateral molar relationships were in the ClassⅠrelationship. Thecanines were in ClassⅡrelationship on the both sides. The upper dental arch of thispatient had almost2.0mm spaces in the anterior arch, while2.5mm crowding in the loweranterior arch. The curve of Spee was7mm. The panoramic film showed that the38,48were impacted mesially, the18,28were not found. There were a little bit horizontalresorption on the both alveolar bone. The bi-lateral morphous of the angle of mandibularwere dissymmetric. The patient required the treatment technique should be aesthetic, sothe lingual orthodontics was his final choice. The treatment plan were drawn according tothe analysis results: non-extraction; leveling and aligning the both arches by the wires’resilience; using the special biomechanics of the lingual orthodontics to open the biteeffectively and the power chain to close the upper anterior space; Making the lingual fixed retainers on the anterior arch after debonding the lingual appliance. Thecephalometric radiograph pre-treatment and post-treatment were traced and analyzed.Results: The treatment duration was13months. Dental midlines of the both jawcoincide with the facial midline. Dentition was properly aligned and leveled. Themaxillary space was closed. A good anteroposterior relationship was achieved with thenormal overbite and overjet. The molar relationship kept in the ClassⅠrelationship. andcanine Class Ⅰrelationship was obtained. The post-treatment panoramic radiographshowed that there was little or no resorption of the roots of all the teeth. Comparison ofthe pre-treatment and post-treatment cephalometric tracing indicates:(1) Mostcraniofacial bone measurement values had little change. SNA and SNB respectively had aslight decrease, ANB increased to4.1°.(2) The maxillary incisors were retractedpalatally significantly, U1-NA distance reduced3.3mm, U1-NA°reduced6.3°. L1-NBdistance increased1.9mm, L1-NB°increased9.7°.(3) The angle of the mandibularplane (MP-SN) increased3.8°,and the patient’s mandibular did the clockwise rotationwhich increased the lower facial height. The profile was improved. The lip and chinrelationship tended to be coordinated.Conclusion: The special biomechanics of the lingual orthodontics can openthe bite and intruse the anterior teeth effectively. So the lingual orthodontics is auseful treatment technique in cases of the deep bite with low angle ClassⅠskeletalmalocclusion to obtain the normal profile and occlusion relationship.