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Univ. Assist. PhD, „Gr. T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
Corresponding author: Tinela Panaite; e-mail: tinelap@yahoo.com
2. CASE REPORT
Class II malocclusion is the most prevalent
arch malrelationship in Caucasian
populations, affecting 15% up to 27% The case report describes the orthodontic
of its people [1]. Modifications are necessary treatment of an 11 year-old male patient, with an
when the patient has unbalanced growth between uncrowded Class II division 1 malocclusion,
the upper and lower jaws. This type of treatment presenting a good archform and a full unit distal
can be applied only to patients who are still occlusion during the second transitional period
growing. Correction of a Class II division 1 of mixed dentition, who addressed the clinic
malocclusion with functional appliances is a with the main complaint of having excessively
common treatment approach in young patients protruded teeth (Fig. 1). Clinical examination
[2]. The activator, a widely used functional revealed a satisfactory hygiene and a low caries
appliance, prevents the mandible from sliding prevalence.
Patient’s face presented muscle hypotonia naso-labial angle was normal and the smile
and an everted lower lip. The patient also line was tending from normal to high. Intraoral
lacked passive lip closure (5.0 mm), and a assessment (Fig. 1) revealed a Class II division
rather hypotonic upper lip. His lower lip was 1 malocclusion, 8 mm overjet, increased
both hypotonic and everted. Although the overbite and deep bite. Lower midline was 2
profile was quite slightly convex, the mm shifted fowards right.
Cephalometric assessment (Fig. 2) and the result of a retrognathic mandible and reduced
values measured during the treatment revealed vertical facial proportions, there is a lip catch, the
a severe Class II skeletal pattern (ANB = 5o), with lower lip lying habitually behind the upper
a retrognatic mandible (SNA = 79o, SNB = 74o). incisors.
A counterclockwise rotation tendency was Treatment plan
observed in patient’s profile (SNGoGn= 31o).
Upper and lower incisors were proclined Functional correction of Class I occlusion by
(Interincisal angle = 122o), with increased axial means of combined maxillary retraction and
inclination (I/NA = 39o; i/ NB = 14o). The mandibular advancement, with reduction of
increased overjet was due to the presence of a overjet and overbite values using the Andresen
signifcant skeletal class II discrepancy, caused appliances for correction of uncrowded Class II
primarily by mandibular retrognathia. As a division 1 malocclusion (Fig. 3).
The antero-posterior skeletal pattern has proclined and the lower incisors retroclined,
improved, the maxilla has been restrained, the along with a decrease in the SNMP angle value.
mandible has come forward and the ANB angle This functional stage treatment with Andresen
was reduced (Fig. 5). The lower facial profile appliance efficiently reduced the overjet, so
was considerably improved and lip catch than fixed appliances are effective in finishing
disappered. The upper incisors have been the case.