Govea SLA, Ballesteros LM

Language: Spanish
References: 8
Page: 56-61
PDF size: 519.60 Kb.

ABSTRACT

Introduction: Poor anteroposterior mandibular relations comprise the largest number of cases. In this group class II malocclusion is the most frequent. Orthodontists began using extraoral forces with modified Hawley retainers many years ago. Margolis realized that removable appliances combined with extraoral forces could not only serve as good containers, but be used as effective correction mechanisms. He called his appliance ACCO (AC acrylic, CO cervico occipital anchorage). Objective: The objectives of the case hereby presented were maxillary growth control and try to protrude the mandible. Case presentation: A 10 year-3 month-old female patient attended the Orthodontics Clinic at the Division of Postgraduate Studies and Research at the National Autonomous University of Mexico. She presented a skeletal class II due to mandibular retrusion and maxillary protrusion, a vertical growth pattern, excessive growth of the nasomaxillary complex and protrusive incisors. Treatment: Orthopedic: ACCO with high traction and impact to retrude the maxilla and decrease vertical growth; with expansion screw (one turn a week). Headgear: nocturnal use and three to four hours in the afternoon. Active plate 24 hours and the patient was told to remove it for eating. Orthodontic treatment: .022 Roth fixed appliances retention: bimaxillary appliance for nocturnal use. Results: After five months of ACCO use, cephalometric tracings were performed again and the following values were obtained: maxillomandibular relationship: ANB 5^o (initial 11^o), Wits 2 mm (initial 3 mm), Bimler overjet 9 mm (initial 10 mm) convexity 6 mm (initial 11 mm). Maxillary position: SNA 82^o (initial 87^o) mandibular position: SNB: 78^o (initial 76^o). Facial pattern: facial cone of 67^o (61^o initial dolicofacial). Vertical dimension: SN-mandibular 36.5^o (initial 42^o), FMA (Tweed) 35^o (initial 43^o), Goniac (Jarabak) 130^o (initial 128^o). Incisor Inclination: UpI/SN 114^o (initial 117^o), LowI/Mand remained the same (95^o). Conclusions: Orthopedics in conjunction with orthodontics harmonizes the maxilla and mandible and at the same time provides natural facial aesthetics, while maintaining proper functions: chewing, swallowing, phonation and breathing. It is vitally important to perform a timely diagnosis in order to intervene orthopedically, correct this kind of malocclusions and limit or prevent its severity.

REFERENCES

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