Class 1 Bimaxillary Protrusion

BackgroundClass one bimaxillary protrusion cases are common cases characterized by lips procumbency,proclination of both the upper and the lower teeth,giving an unaesthetic appearance.A primary objective in treatment class one bimaxillary protrusion is retraction of both mandibular and maxillary anterior teeth with decrease in soft tissue procumbency and convexity of profile.MethodThis article reports the successful re-treatment of orthodontic by using palatal arch and in conjunction with straight wire.The original treatment was done 8 years ago.A female patient 24 years old,presented to the orthodontic department with chief complaint of having lip protrusion.She was diagnosed as class 1 malocclusion,high angle skeletal pattern.ResultsThere was a decrease in anterior protrusion and achievement of a correct profile after active treatment over a period of several months.A proper alignment and leveling,correction of a cross bite in relation to the left upper lateral incisor was achieved along with a correct functional occlusion.The treatment course lasted 22 months in total.In comparison:(1)SNA Changed from 83°to 81°,SNB changed from 87°to 77.8°,ANB from 5to 3.7°,Wits appraisal from 3.5mm to3 mm,FMA decreased by 2°,,and counterclockwise Mandibular rotation occurred.(2)U1-NA changed from 37°to 26°,U1-NA changed from 10 mm to6.29 mm,IMPA decreased from 96 °to 90°,this Indicated that the lingual movement of the lower incisors.(3)Soft tissue profile changed a more esthetic face following Treatment.DiscussionFacial profile is considered when planning orthodontic treatment,many factors effect on it,one of these factors extractions of first premolar.After the extraction of first four premolar,upper and lower jaws and the treatment of bimaxillary proclination,we focus on effects resulted to inter incisoal angle,nasolabial angle,lower and upper lip protrusion.ConclusionIn case a patient has interior teeth protrusion with crowding,it is impossible to improve the patients profile and Anteroposterior relationship of the teeth with extractions.Palatal arch appliance can be an effective method for anchorage especially when an extraction space is need all.