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Erschienen in:
01.12.2012 | case study
Class II division 2 adult orthodontic treatment
A case report
Erschienen in: international journal of stomatology & occlusion medicine | Ausgabe 4/2012
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Background
This article presents a case of non-extraction orthodontic treatment of an adult patient with class II division 2 malocclusion following the multiloop edgewise archwire (MEAW) philosophy.
Methods
A 24-year-old patient wished to correct a class II division 2 deep bite with gingival contact. A purely orthodontic treatment was jointly agreed as there was no desire for combined orthodontic maxillofacial surgery and there was no need to change the facial profile. The therapy was based on an adaptation of the MEAW philosophy using the technique of a straight wire system. Strategic leveling was applied first to achieve molar uprighting and derotation followed by occlusal reconstruction. Using short class II elastics and by establishing a curve of Spee in the maxilla it was now possible to achieve a stable class I interaction with physiological positioning of the condyle and mandible by correctly adjusting the incisors and overbite.
Results
Using multibracket treatment it was possible to establish stable class I teeth within a period of 22 months. The front teeth were set to a correct inclination and the bite was raised. This treatment strategy is systematically documented using the example given here. Special design features, biomechanical problems, the incorporation of low friction self-ligating bracket systems and retention issues will be discussed.
Conclusions
With a favorable response, the establishment of a compensation curve in the maxilla and the leveling of the lower jaw, it is possible, even postpuberty, to convert a class II division 2 into a class I. Crucially, the correct axial adjustment and decoupling of the molars are considered strategic leveling. If a significant change in the profile is desired, however, orthognathic surgery remains the method of choice.