Two-stage Treatment Of Skeletal Class ? Malocclusion Of Patient With Maxillary Dysplasia

Introduction:Face mask and rapid maxillary expansion appliance were used to treat skeletal class ? malocclusion with maxillary deficiency during growth and development stage.Combined with straight wire orthodontic treatment,two stages of orthodontic treatment were carried out to study the effect of two stage orthodontic treatment on skeletal ? class during growth period.Method: A patient with maxillary hypoplasia of skeletal class ? malocclusion who came to the the second affiliated hospital of Dalian Medical University in November 2016 was selected,who was 10 years old.The patients were examined,and the original data were made,given a definite diagnosis,and double phase treatment was made.The first stage was treated with the face mask and the rapid maxillary expansion of the arch.The second stage was treated with the straight wire orthodontic technique and class ? elastic.The clinical data of the patients were retained and the clinical data of the treatment were compared and analyzed.Result:At present,the treatment is 18 months.The development of the maxilla is promoted.In the first stage of correction,the patient was improved by wearing a anterior traction device,promoting the forward growth of the maxilla.After the cephalometric measurement,the patient's SNA angle was 77.16°,which was 1.77° higher than that at the first diagnosis,while the patient's APDI was small and the ODI increased,indicating that the patient's class ? malocclusion was reduced.However,the U1-NA angle and line distance of maxillary anterior teeth showed that during the first stage of orthodontic treatment,the anterior teeth were inclined to the labial direction due to the use of anterior traction.But what is more gratifying is that the FMA of the mandibular plane angle does not increase.During the two period correction,class ? elastic was used early,which made the SNA angle of the patient reached 77.91°,and the ANB reached 0.79°,indicating that the patient's bone problem was further improved,and the lip direction of the maxillary anterior teeth was also improved,and the angle of the maxillary incisor and the line distance were all better than stage one.When the treatment was completed,maxillary anterior teeth was improved.The decrease of APDI and the increase of ODI indicate that the class ? malocclusion tendency and opening tendency are better than those at the end of primary treatment.At the end SNA increased by 2.52°,ANB improved by 2.06°,Wits increased by4.01°,and APDI decreased by 8.23°,which indicated that the relationship between the upper and lower jaw was improved.At the same time,there was a slight compensation after removment of anterior crossbite.The U1-NA31.47°,L1-NB 24.16°,which maintained a better overjet and overbite.Removed the second bicuspid teeth on both sides to relieve the severe crowding in the upper jaw,and created gaps for both sides of the immature molars at the same time,finally the we achieve class I relationship of the canines and the complete class II relationship of the first molars.The patients afterment the treatment get 170°of TFA,the ideal state,while maintaining the NLA at 92°,and 135° of LMA.At the same time,the lip staircase was changed.Although the patient's smile is still slightly asymmetrical,it is obviously improved from the early stage of the treatment.Their families and the patient were satisfied with the treatment.Conclusion : 1.The patients with maxillary deficiency during the growth and development period,which use of maxillary anterior traction and rapid arch extender can achieve more satisfactory results in promoting the growth of maxillary and maxillofacial bones.2.At the same time,the straight wire orthodontic technique was used in the two stage correction,combined with ? intermaxillary traction,and the patient's residual growth potential was fully utilized to achieve good occlusal and more coordinated soft tissue profile.