The Treatment Of Angle Class ? Malocclusion With Posterior Crossbite

Objective: This report is an adolescent patient Class ? has the growth potential of the malocclusion with dental crossbite patients with orthopedic orthodontic treatment methods,indicators and soft tissue imaging appearance before and after treatment were compared to discuss of adolescent Class ? with improvement after crossbite patients and the effect of the measurement data.Case and Methods:A 15 years old male patient presented in dentistry department of the Dalian Medical University in March 2014.His intraoral examination found Angle class III malocclusion,bilateral posterior crossbite.Maxillary hypoplasia and mandibular growth is normal.The relationship of left side first molar is.mesial.and the right side is neutral and also the left side of canine relationship is mesial and right canine neutral,anterior teeth open bite 1mm,with partial anterior teeth crossbite and shallow coverage,Posterior bilateral crossbite.Upper midline shifted to left side 2 mm,Lower midline shifted to left side 1 mm,Curve of Spee is flat.Frontal view,chin midpoint is at the centre of the facial symmetry.Lateral view,facial profile has the prominent lower lip,lower one third of face is longer.Cephalometric analysis based on a patient,cervical growth model assessment and measurement results and combined with the age and physical characteristics of the patient,it is determined that the patient is in the latter part of the growth and development and still has growth potential.From these reasons,orthopedic orthodontic force non-extraction treatment was choose for the patient by using of the four corners ring springs with fixed appliance device first for expansionarch expansion gap relieve congestion on dentition,the mandibular dentition rapid neat row on the flat,and the lifting of crossbite,correct bite to remove the interference fit,re-use between Class ? intermaxillary traction to correct the sagittal jaw do not adjust the relationship between use of triangles together to build traction,the front teeth were intermaxillary traction box fine adjustments,establish a good relationship between the posterior and anterior teeth occlusion overbite after that adjust upper and lower midline.Comparing before and after treatment cephalometric analysis data,analysis positional relationship between the upper and lower jaw changes,changes in the mandible and the lower third of the face,and to explore the effect of the entire treatment regimen for cases.Results: Patient undergoes 23 months of orthodontic treatment,after treatment changes:(1)patient's teeth arranged in good position,after crossbite lift bilateral relations neutral first molars,canines bilateral relations neutral occlusion normal,normal overjet,no deviation in upper and lower midline.After the opening of the examination and treatment normally open type,bilateral TMJ has no noise sound,masticatory muscles are tenderness,lower third of face reduced in height and lower lip protrusion decreases.(2)analysis of the data measured before and after treatment comparison: SNA by the77.19 ° to 78.98 °,ANB from the 1.22 ° to 3 °,Wits value decreased to-5 °,FMA value remains stable,indicating that the lower face height has been effectively controlled,FMIA increases,Z angle increases,improved appearance of the side.APDI reduced from preoperative 89 ° to 84 °,so skeletal class ? relations have improved;ODI increased from preoperative 59 ° to 72 °,anterior open bite tendencies under control,the upper jaw to establish normal overbite together covering relationship.Improved front teeth axis,U1-NA by the 28 ° is reduced to 25 °,U1-NA is reduced by the 7.9 ° to 5.8 °,L1-NB is increased by the 23 ° to 25 °,FMIA reduced,IMPA increase side looks good.Patient treatment satisfaction.Conclusion: An adolescent patient with class ? malocclusion in general still have some growth potential should be select orthopedic orthodontic force with non-extraction treatment,for treatment with class ? maxillary teeth due to poor development cause ofanti-together,crowded dentition with mild to moderate malocclusion significant effect,However,a patient does not need to extraction of any teeth,get a good and stable occlusion and appearance so orthopedic orthodontic treatment for class ? after teenagers with crossbite is the best treatment for the patient.