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The treatment of severe class II division 2 patients with deep overbites and gummy smiles using lingual appliances: a case series


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Figure 1.

Case 1: initial extraoral and intraoral photographs.
Case 1: initial extraoral and intraoral photographs.

Figure 2.

Case 1: initial panoramic and cephalometric radiographs and tracing.
Case 1: initial panoramic and cephalometric radiographs and tracing.

Figure 3.

Entire upper arch distalisation using mini-screws, crimpable hooks, and coil springs.
Entire upper arch distalisation using mini-screws, crimpable hooks, and coil springs.

Figure 4.

Finishing and detailing stage. Gingival black triangles before interproximal stripping.
Finishing and detailing stage. Gingival black triangles before interproximal stripping.

Figure 5.

Case 1: post-treatment extraoral and intraoral photographs.
Case 1: post-treatment extraoral and intraoral photographs.

Figure 6.

Case 1: two-year post-retention extraoral and intraoral photographs.
Case 1: two-year post-retention extraoral and intraoral photographs.

Figure 7.

Case 1: post-retention panoramic and cephalometric radiographs and tracing.
Case 1: post-retention panoramic and cephalometric radiographs and tracing.

Figure 8.

Case 1: general and regional superimpositions of pretreatment and post-retention cephalometric tracings.
Case 1: general and regional superimpositions of pretreatment and post-retention cephalometric tracings.

Figure 9.

Case 2: initial extraoral and intraoral photographs.
Case 2: initial extraoral and intraoral photographs.

Figure 10.

Case 2: initial panoramic and cephalometric radiographs and tracing.
Case 2: initial panoramic and cephalometric radiographs and tracing.

Figure 11.

Entire upper arch distalisation using mini-screws, crimpable hooks, and power chains.
Entire upper arch distalisation using mini-screws, crimpable hooks, and power chains.

Figure 12.

Re-levelling stage after bonding the upper second molar brackets.
Re-levelling stage after bonding the upper second molar brackets.

Figure 13.

Case 2: post-treatment extraoral and intraoral photographs.
Case 2: post-treatment extraoral and intraoral photographs.

Figure 14.

Case 2: post-treatment panoramic and cephalometric radiographs and tracing.
Case 2: post-treatment panoramic and cephalometric radiographs and tracing.

Figure 15.

Case 2: general and regional superimpositions of pretreatment and post-treatment cephalometric tracings.
Case 2: general and regional superimpositions of pretreatment and post-treatment cephalometric tracings.

Figure 16.

Case 2: one-year post-retention extraoral and intraoral photographs.
Case 2: one-year post-retention extraoral and intraoral photographs.

Figure 17.

Counter-clockwise moments created by the arch wire intrusion force and occlusal force make the upper incisor further retroclined. Fi: intrusion forces applied by arch wires. Fo: occlusal forces applied by lower incisors.
Counter-clockwise moments created by the arch wire intrusion force and occlusal force make the upper incisor further retroclined. Fi: intrusion forces applied by arch wires. Fo: occlusal forces applied by lower incisors.

Figure 18.

Torque control using the double-slotted bracket. Blue arrows: couples generated by rectangular arch wires. Orange arrows: couples generated by relative positions of the two arch wires.
Torque control using the double-slotted bracket. Blue arrows: couples generated by rectangular arch wires. Orange arrows: couples generated by relative positions of the two arch wires.

Figure 19.

An incisor intrusion force (Fi) generates counter-clockwise moments (orange arrows) to increase incisor torque and counteract the clockwise moment (blue arrows) created by the entire arch retraction force (Fr).
An incisor intrusion force (Fi) generates counter-clockwise moments (orange arrows) to increase incisor torque and counteract the clockwise moment (blue arrows) created by the entire arch retraction force (Fr).

Cephalometric measurements of case 2

Pretreatment Posttreatment
Skeletal
  SNA (°) 85.5 83.0
  SNB (°) 75.8 75.0
  ANB (°) 9.7 8.0
  FMA (°) 21.4 22.1
Dental
  U1-SN (°) 73.9 94.1
  U1-PP (°) 83.1 104.3
  U1-NA (°) -11.7 11.1
  U1-NA (mm) -5.7 -2.2
  IMPA (°) 103.4 106.0
  L1-NB (°) 29.4 33.0
  L1-NB (mm) 5.3 6.8
  Interincisal angle (°) 152.5 127.9
  Upper incisal display (mm) 3.7 2.3
Soft tissue
  E-line/UL (mm) 1.9 -1.5
  E-line/LL (mm) 0.2 -0.9

Cephalometric measurements

Pretreatment Posttreatment
Skeletal
  SNA (°) 85.7 84.8
  SNB (°) 79.6 80.1
  ANB (°) 6.1 4.7
  FMA (°) 20.0 20.5
Dental
  U1-SN (°) 80.3 92.4
  U1-PP (°) 89.2 101.1
  U1-NA (°) -5.5 7.6
  U1-NA (mm) -3.4 -1.2
  IMPA (°) 94.2 95.1
  L1-NB (°) 22.1 22.7
  L1-NB (mm) 2.8 3.1
  Interincisal angle (°) 157.3 144.9
  Upper incisal display (mm) 5.8 3.8
Soft tissue
  E-line/UL (mm) -0.7 -0.9
  E-line/LL (mm) -1.2 -1.2
eISSN:
2207-7480
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
Volume Open
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere