Case report
A novel method for the treatment of Class II malocclusion

https://doi.org/10.1016/j.ajodo.2019.05.025Get rights and content

Highlights

  • Class II malocclusion treatment with occlusal prematurities to enhance growth modification.

  • Technique is based on bite raisers placed on the occlusal surface of molars and/or premolars.

  • Light Class II elastics are used to guide the intended mandibular closure direction.

  • Results show profile improvements and Class I canine and molar relationship.

Growth modification is a feasible approach for the treatment of skeletal Class II malocclusion. A positive association was found between the lateral functional shift of the mandible due to occlusal prematurities and skeletal changes. This finding is reminiscent of an equivalent anteroposterior skeletal effect of the anterior functional shift of the mandible. Inclined planes can be considered as a form of premature contact. In this case, bonded occlusal maxillary and mandibular bite raisers were used to create occlusal prematurities artificially. These bonded inclined bite raisers are used in conjunction with full-time light short Class II elastics. The results showed an improvement in profile convexity and achievement of Class I canines and molars. The bonded inclined bite raisers combined with light and short intermaxillary elastics can correct Class II malocclusion and improve the soft tissue profile.

Section snippets

Bibre construction: indirect method

A 2 mm symmetric advancement wax bite was made for the patient. Maxillary and mandibular impressions were taken, and the poured models were mounted on an articulator using the wax bite. A separating medium was applied to the models and allowed to dry. Complimentary inclined bite raisers were constructed on the occlusal surfaces of 2 occluding molars or premolars on the patient's model using light cure glass ionomer, triad gel, compomer, or colored filled composite. The selection of sites for

Diagnosis and etiology

A 13-year-old girl reported to the clinic with the chief complaint of an unpleasant profile. Clinical examination showed a convex profile with accentuated mentolabial sulcus. She showed a nonconsonant smile. The patient was in the permanent dentition stage. She had Class II molars and canines, with 8 mm of overjet and complete overbite. She had mild maxillary and mandibular arch crowding (Figs 2 and 3). The panoramic radiograph showed normal bone and tooth forms with developing third molars.

Diagnosis and etiology

A 13-year-old girl reported to the clinic with the chief complaint of deep overbite. Clinical examination showed a convex profile with an increased nasolabial angle and accentuated mentolabial sulcus. The patient was in the permanent dentition stage. She had Class II molars and canines, with 3 mm of overjet and 50% overbite. She had mild maxillary anterior arch crowding (Figs 10 and 11). The panoramic radiograph showed normal bone and tooth forms with developing third molars. Cephalometric

Discussion

The results of our two cases reports showed correction of Class II malocclusion and improvement of the facial profile. This finding was achieved using bonded maxillary and mandibular inclined bite raisers used in conjunction with fixed appliances and short light Class II elastics.

There are obvious advantages to the use of the BIBRE over various fixed functional appliances; it is inexpensive, easy to fabricate, adjust, and replace chair-side. It is also unobtrusive, easy to clean by the patient,

Conclusion

The BIBRE combined with light and short intermaxillary elastics can correct Class II malocclusion and improve the soft tissue profile.

References (11)

There are more references available in the full text version of this article.

Cited by (3)

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.

View full text