Orthodontic Treatment Of Skeletal Class ? Malocclusion

Objective: To investigate the treatment design and effects of camouflaged orthodontic technique in the treatment of skeletal Class ? malocclusion.Materials and Methods: We select two patients who were skeletal Class ?malocclusion during the graduate.Case 1: NM,a 18-year-old female in a permanent present with crowded dentition,protruding upper anterior teeth and a convex profile.She had increased overjet and deep overbite of ? °.There was slight crowding in both upper and lower arch.She presented with Class ? canine relationship and Class ? molar relationship,and decreased lower anterior face height.The temporo-mandibular joints were asymptomatic.The cephalometric analysis showed the ANB value of 5.9 °,which suggested a Class ? skeletal base.The upper incisors were retroclined,and normal Frankfort-mandibular planes angle.Treatment involved removing two upper first premolars and two lower second premolars by placement of fixed appliances to relief of crowding,align and level dental arches,retract anterior teeth,close superfluous space,co-ordinate occlusion between arches,normalize the incisors overjet and overbite,improve the profile and lips relationship.The active treatment lasted for 24 months.Case 2: KM was a 12-year-old female,whose chief complaint was the protrudent upper anterior teeth.She had a convex profile with facial asymmetry,increased overjet and deep overbite of ?°in a permanent dentition.There was 3.5 mm crowding in upper arch and 7.4 mm crowding in lower arch.She presented with Class ? canine relationship and molar relationship on both sides.Her upper lip was protrudent,mandible was retrusive and the chin growed deficiently.The cephalometric analysis showed a skeletal Class ?relationship with increased value of ANB.The patient had a tendency of counterclockwise growth pattern with a high maxillary-mandibular planes angle.The lateral radiograph of cervical spine indicated that she was after the growth accelerated phase.Treatment involved removing two upper first premolars and two lower second premolars by placement of fixed appliances.The treatment aims and objectives were to alleviate the arches crowding,align and level dental arches,retract anterior teeth,close superfluous space,co-ordinate occlusion between arches,normalize the incisors overjet and overbite,use the late growth modification to promote the growth of mandible and protrude the chin,improve the profile and lips relationship.The active treatment lasted for 18 months.Result: After the orthodontic treatment,there was a good alignment and leveling of teeth in both arches without gaps,the incisors overbite and overjet was improved.Occlusal relationship was corrected with Class ? canine and molar relationship on both sides.With a more prominent chin it resulted in a pleasing profile.Conclusion: A combination of correct diagnosis,applicable treatment plans enable a pleasing final result to be achieved in the treatment of skeletal Class ? by removing two upper first premolars and two lower second premolars.