| Objective: Based on treatment of skeletal Class II deformity in adolescents and in adults,analyze the treatment plan and treatment timing,take into consideration the patients’ growth potential and severity of malocclusion,extraction teeth position,the treatment process and effect.Materials and Methods:Three cases of skeletal Class II malocclusion were selected during my postgraduate study.Case 1:CZQ,11-year-old male with chief complaint of prominent anterior tooth.He had convex profile and skeletal Class Ⅱ malocclusion with maxillary protrusion and mandibular deficiency.Angle of ANB is 5.9 °with decreased mandibular plane angle.Canine and molars relationship were Angle Class II with scissors-bite posterior molar on both sides.Proclination of upper incisors with congenital absence of lower anterior teeth.The bolton index were lower than the norm.The lower posterior teeth were extended by fixed lingual arch,and the lower anterior teeth were depressed by maxillary plane guide plate to open the occlusion.Then 14 and 24 teeth were extracted,the anchorage was reinforced by extraoral anchorage to retrude the anterior teeth.The patient was of horizontal growth pattern,and there was a great growth potential in the lower jaw,and open the space of lower anterior teeth to improve the facial profile.Case 2:GQY,27-year-old female with chief complaint of prominent anterior tooth.She had convex profile and skeletal Class Ⅱ malocclusion with mandibular retraction and increased mandibular plane angle.Angle of ANB is 9.3°.Based on CVM,the patient was at the growth stagnation.Canine and molars relationship were Angle Class II on the left side and Angle Class I on the right side.The maxillary central incisor was injured in 2011 and has been treated with root canal.The mandibular midline shifted to left 5mm.The 32 teeth was missing with Bolton index uncoordinated,which were lower than the norm.After extraction of 11,21 and 42 teeth,anchorage was reinforced during the treatment,maxillary central incisors and lateral incisors were replaced by lateral incisors and canines,the maxillary anterior teeth were retruded.Control the vertical height of the posterior teeth,prevent the deterioration of the facial frofile.Case 3:FJB,11-year-old male with chief complaint of prominent anterior tooth.He had convex profile and skeletal Class Ⅱ malocclusion with mandibular retraction.Angle of ANB is 9.0 °.Based on CVM,the patient was at the early stage of growth peak.Canine and molars relationship were Angle Class II with increased overbite(III)and overjet(III).The lower anterior teeth was retroinclination and extension.In the first stage,the lower anterior teeth were depressed by the maxillary plane guide plate,then utilized the patients’ growth potential to guided the mandible forward by the activator functional appliance,the bad habit of mouth breathing was broken.In the second stage,the upper and lower teeth were aligned by the fixed appliance,the normal overbite,overjet and good occlusion relationship were established.Results:After the three cases were treated with different treatment plans,they all achieved harmonious facial profile,the convexity of facial profile improved significantly.Achieved good occlusal relationship with normalized overbite and overjet and good cusp socket relationship.All three patients were satisfied with the effect of treatment.Conclusion: For the skeletal Class II malocclusion in adolescents,we should comprehensively analyze the patient’s data,the potential factors and mechanism of the malocclusion,terminated the obstructive factors in time,according to the severity of the malocclusion and patient’s growth potential,combined with the patient’s individual situation to develop the most appropriate treatment for patients.For the skeletal Class II malocclusion in adults,through the comprehensive and objective analysis of the patient’s situation,maked the appropriate treatment plan,through the camouflage orthodontic treatment can also achieve good effect. |
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