Treatment Of Class II Malocclusion In The Growing Patient
A male patient aged 11 years with an ANB angle of + 5° reported to the Department of Orthodontics. Discuss the management of the case.
Answer. ANB angle of +5° suggests the skeletal class 2 malocclusion. As the age of the child is 11 years he is in a growing stage so the management of cthe hild is as follows.
Management of Skeletal Class 2 Pattern
Management of Class 2 Skeletal Malocclusion.
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- Growing patient with skeletal class 2 malocclusion is treated through growth modulation.
- Hands wrist radiographs and lateral cephalograms are taken to assess skeletal age and growth potential.
Maxillary Prognathism
- Growth inhibition of the maxilla for maxillary prognathism, with distalization of upper buccal segments is achieved by using extraoral orthopedic force.
- Headgears are recommended for orthopedic force.
- Patient wears the appliance for around 12–14 hours daily.
- Orthopedic force of 350–450 g/side is applied with the help of headgear.
- High pull or occipital pull headgear is used in case of patients whose maxilla is growing vertically.
- Cervical pull headgear is used for patients whose maxilla is growing horizontally.
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Mandibular Retrognathism
- Retrognathic mandible with average FMA angle and lower facial height.
- Activator or FR – 1 is commonly used but bionator, biomodulator, cybernator, propulsor etc. are other functional appliances which are used less commonly.
- Functional appliance acts by placing the mandible in anterior position and also by eliminating the functional retrusion.
- Retrognathic mandible with higher FMA angle and lower facial height
- Activator is used along with high pull headgear.
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Combination of Maxillary Prognathism and Mandibular Retrognathism
- Combination of headgear and functional appliances is used for growth modification.
- Most commonly used combination is Activator with headgear.
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