Correction of Skeletal Class ll Malocclusion｜【Chris Chang Ortho】CC423
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- čas přidán 27. 08. 2024
- Correction of Skeletal Class ll Malocclusion: Replacement of One First Molar and Three Second Molars by Four Third Molars
Abstract
A 25-year-3-month female sought orthodontic treatment due to dissatisfaction with her upper anterior alignment. The patient presented a skeletal Class ll malocclusion (ANB 8˚), a high mandibular plane angle (38˚) as well as a convex profile( UL→E-line: 4mm, LL→E-line: 5mm). Furthermore, the lateral view revealed a full Class ll dental occlusion on the right side and a Class l dental occlusion on the left side. The intra-oral frontal view indicated the dental midline shifted to the right by 3mm and bulky bony structure in the anterior segment. When smiling, the incisor display was uneven, and smile arc was not visible.
The treatment began by extracting bilateral maxillary second molars, right mandibular second molar, and left mandibular first molar. The latter two molars were root canal-filled with crown. Finally, the extractions were replaced with 4 third molars. Class ll elastics and bite turbos were applied on the maxillary central incisors to correct the intermaxillary relationship. The extraction spaces were closed with power chains. Rebonding the posterior segment was repeated multiple times for better intercusptation. Miniscrews were placed in the infrazygomatic crest(IZC) and between central and lateral incisors, to control protrusion and excessive gingival display, preventing the side effect of Class II elastics. Surgical crown lengthening procedure was performed for enhancing maxillary anterior esthetics.
In 38 months, this difficult malocclusion, with a Discrepancy Index score of 31 points, was treated to a Cast-Radiograph Evaluation score of 24 points and a Pink and White esthetic score of 4 points. The results were stable at the three-year follow-up evaluation.
摘要
患者為25歲女性因前牙排列不整齊尋求矯正治療，側顱分析結果為第二類骨性異常(ANB 8˚); 高下顎平面 (SN-MP 38˚)，合併凸臉型( convex profile: UL→E-line: 4mm, LL→E-line: 5mm)。 口內側面觀可見右後牙咬合關係呈安格氏第二類咬合關係(Full Class ll)，左後牙為安格氏第一類咬合關係(Class l )，口內正面觀可見下顎齒中線相對於上顎齒中線向右偏斜3mm; 前牙根部明顯的骨隆凸。患者微笑時，門牙展現不平均且缺乏微笑曲線(smile arc)。
治療有三大重點 ：(1)利用四顆智齒取代拔掉的上頷雙側第二大臼齒, 右下頷第二大臼齒和左下頷第一大臼齒(後兩者為根管治療併固定假牙)。(2) 使用第二類橡皮筋和兩側上正中門齒墊上咬合墊高物以改善顎間關係。 (3)使用橡皮筋關閉拔牙空間。除此之外,，在後牙區重複的黏著矯正器幫助咬合更密合; 在介於門牙和側門牙間, 及顳下嵴 (infrazygomatic crest)處植入迷你骨釘來改善凸臉型以及避免因使用第二類橡皮筋而導致的微笑露齦; 最後，利用牙冠增長術再進一步改善前牙美觀。
此複雜的咬合(DI=31)，經過38個月的矯正治療，獲得良好改善(CRE=24, Pink and White esthetic score=4)，患者十分滿意治療結果。
Does this case where the sunken face could improved or remains as it is after braces.
Superb treatment.
i liked the before more tbh. what's wrong with the before look?
Same.
Hello friend, nice case. because it places the fixed retention only in the maxilla from lateral to lateral and not to the canines? I await your response, greetings from Peru.
Excellent, thanks flor good vídeo
Can rubber bands fix a mentalis strain and lip incompetence? I have a minor open and its making lip incompetence and mentalis strain.
Yea it can
do u this in philippines? or do u know doctor knows how to fix underbite like yours?
Why not just distalize lower right side
from schoolgirl to mother in law
Sunken face after using braces
hola amigo, bonito caso. porque coloca la retención fija solo en maxilar superior de lateral a lateral y no a los caninos? espero su respuesta, saludos desde Perú.
did you any ortognatik operetion?i mean mandibula or maxilla surgery ?
Good video but this music though
hi I think this case could be finalize better, if she choose to extract 8 tooth. Now, the chin still feels much attention. NOW It can not be a successful case.
I have this problem I want to contact you sir
Allah rızası için beni de tedavi edin mükemmel işler çıkarıyorsunuz 👏👏👏👏👏👏👏
I am sorry that I can't understand your language. But still thanks!
He is speaking Turkish and saying “Can you guys do this on me? This is amazing!”
It seems adult braces ruins the face .
howw
@@hi-nq5mm her face looked better before imo. Both profile and front
Dentition looks great. Face looks worse.
James Lovell that's the problem .
I think her face look nice now
Dont ever let your dentist move you teeth inward, always outward.
Why
@@LiSa-xm6hy if you hace a class 2 maloclussion It Will just be an aesthetic fix. You still feel the issues unless they bring the jaw forward.
Not entirely true. Female patients with class 2 and high mandibular plan angle have a high risk for condyle reabsorption (ICR) from doing maxillary and mandibular expansion. This result is far better than risks associated with ICR.
GOODE
还是凸嘴啊
0:54 5:04 7:12 7:21
Wow her face is sunken.. She look way older after braces.