Double-Phase Treatment Of Adolescent Patients With Skeletal Type ? With Anterior Teeth Deep Overjet

Introduction: Discussion of the clinical effects of orthodontic treatment by using the functional appliance combined with the fixed orthodontic appliance in a Class II malocclusion adolescent patient.Method: A 11 years old boy presented in the stomatology department in 2014,As the intraoral examination showed a mixed dentition,class II molar relationships on both sides,the overjet was 11 mm and overbite was 4 mm,generalize spacing in maxillary and mandibular aches,deep Curve of Spee and upper and lower midline were coincident.The facial profile was convex and chin point was in the normal position.During the mixed dentition stage,the mandible retraction was corrected by using the functional appliance.After the mixed dentition stage,the fixed orthodontic treatment was used for leveling and aligning teeth,closing the spaces,control torquing of the anterior teeth and using Class II elastic for improvement of the overjet,overbite and occlusal relationships.The pre-and post-treatment model and lateral cephalometric radiographs were analyzed.Result: At the end of 36 months of double-phase treatment,Increased mandibular ramus volume and the length of the mandible growth.The maxillar bone underlying of the soft tissue(A point)showed a significant backward while the mandibular bone underlying of the soft tissue(B point)showed a significant increased which can be interpreted as its move into a forward position.As SNB was increased by 4.22° and ANB and AO-BO were decreased by 5.54° and 3.5 mm,respectively which indicated that the sagittal difference of the upper and lower jaws decreased significantly.The deep overjet and the anterior teeth with the deep remodeling symptoms as a result from U1-L1 was increased by 12.99° and U1-SN and U1-NA were decreased by 9° and 6.64°,respectively.Also,the mandibular plane angle was decressed and the lower front inceressed At the end of the first phase treatment,both of the first molar on the right and left sides were in a neutral position.Both sides of the fangs for class II relationship,in the state of cusp to cusp.However,at the end of the second phase of treatment,the molar relationship was improved.There are no spaces in the upper and lower arches and the deep Curve of Spee became flat.Upper and lower midlines were nearly coincident.Although the thickness of the upper and lower lips of the patient were still less than a normal number as the Z angle was 17.01° and the nasolabial angle was 8°.The soft tissue profile of the patient showed improved significantly.Facial profile view was coordination when he was smiled.As a result,the patient's skeletal has been improved significantly but also the occlusal relationship has been improved.The patient and parents are satisfied with the results of the treatment.Conclusion: This case was a skeletal Class II malocclusion with the mandible retraction patient,the functional appliance combined with the fixed orthodontic treatment by used the straight wire technique for treated this patient.Also,as the growth period,its stimulated the growth of the mandible which was changed the growth direction of the temporomandibular joint as a result the joint was remodeled into the concave shape.The used of the Class II elastic combined with controlled torque of the anterior teeth and used reverse Curve or Spee to leveling the deep Curve of Spee.Obviously,the patient's occlusal relationship and facial profile were improved.Achievement of optimal results was avoided the periodontal problems which was caused by an overcompensation.The chief complaints of the patient were solved with the optimal results.