Applied Micro-Implant Treatment Down Anterior Teeth Angle Class â…¡ Division â…  Malocclusion

Objective: For adult patients with Angle class II DivisionⅠ, extraction of tooth to improve the profile and adjust occlusion, and explore the technology of micro-implant anchorage which effect on lower anterior tooth and after orthodontic treatment result is soft and hard tissue changes.Materials and methods: Select Dalian Friendship Hospital in 2013, adult patients admitted with malocclusion example. Female, 23 years old, Class Ⅱ division ⅠMalocclusion. Permanent teeth together, to maintain good oral hygiene, periodontal health; Positive outlook on the incisor protrusion, gummy smile, mouth straight; lateral view, the upper lip little shorter, upper lip muscle tension, after chin reduction;overbite Ⅲ degree, overjet 10 mm, overbite 5mm; 1mm space between the left mandibular lateral incisors and canines, both side molars are classⅡrelations; and both side canines are class Ⅱrelations;the spee curve of low jaw slightly deeper, depth of Spee curve is 4mm, located in the middle of the upper and lower midline.We present a case based on oral and maxillofacial clinical findings, and results of the analysis cephalometric, panoramic radiographs, and the model, through communication with the patient, and select the final treatment plan for: Removal of the patient’s right upper jaw and right mandibular impacted tooth, dual jaw subtrahend extraction, plus full mouth straight wire appliance, and then came up with the micro-implant anchorage dental technology. Came down and adduction of anterior teeth,nickel titanium wire and stainless steel wire neat rows of flat dentition, closed loop method and sliding method extraction space closure, used classⅡ elastic to adjust themandibular relations. A week before and after treatment, take cephalometric and panoramic radiographs, within a clear opening photo and face photo, and take a good research model. By comparing before and after treatment retained the X-ray film,photographs, and models to evaluate the effect of treatment.Results: The total course of treatment is 24 months. The mouth examination revealed full dentition arranged flush gums in good condition, as well as the space between 32 and 33 closed completely, no mandibular midline deviations, good occlusion,Measurement model was: anterior teeth overbite 2mm, overjet 2mm, Spee curve for2 mm improved; both side molars and canines relationships are classⅠ; By panoramic radiographs before and after treatment of comparison, full-mouth periodontal and alveolar bone showed no abnormalities, dentition was properly aligned and levelled,root substantially parallel, no obvious root resorption, the left and right sides of the condyle symmetry without exception; Comparison of cephalometric X-ray films showed: SNA and SNB angle changes slightly, SNA treatment by the former decreases1 ° to 85 ° 84 °, SNB angle from 80 ° becomes 81 °, ANB angle from 5 ° down to 3 °after treatment, suggesting that patients with class Ⅱ improved; U1-PP distance decreases 4 mm tips anterier have been down clealy;U1-NA value decreases around 10 °,U1-NA distance decreases 7mm, there is a clear description of the upper incisors adduction and depression; lower incisors there is slightly adduction and upright, L1-NB angle decreases 1 °, L1-NA distance decreases 2mm; co-po increase0.2mm, N-ANS increased hanve no change, ANS-Me growth 0.1mm, tips mandible have grown; FMA value by 30 ° before treatment reduces the 0.5 ° to 29.5 °, Slight changes prompt us to change the vertical jaw, well-controlled soft tissue profile also improved after orthodontic treatment, ULEP reduces4.5mm,LLEP decreased 2mm upper lip and lower lip that have varying degrees of adduction. H 5 ° angle decreases, Z angle becomes 72 ° by 65 ° to reach the normal standard, mentolabial relationship tends more coordination.Conclusion: In adult patients with Class Ⅱ division Ⅰ classification of treatment,the use of micro-screw implant anchorage, which can effectively suppress adduction and maxillary anterior teeth, deep overbite correction, reducing the depth of coverage,solve gummy smile, so that patients get satisfactory side appearance.