Skeletal Class II Correction Using Headgear-Activatortherapy
AB Shetty Memorial Institute of Dental Science, Mangalore
A 12 year old growing female patient reported to our department with the chief complaint of forwardly placed irregular upper front teeth. On Extra-oral Examination, patient was having a convex facial profile, leptoprosopic facial index with incompetent lips, recessive chin, shallow mentolabial sulcus with a vertical growth pattern. She had incompetent lips with a high smile line and a recessive chin.
On Intra-oral examination, the molar relation was Angle’s Class II, Canine relation was Class II and an Incisor relationship of Class II Div I with an overjet 7mm and overbite of 4mm.
DIAGNOSIS
Growing female patient having Skeletal Class II malocclusion with a retrusive mandible, steep mandibular plane angle, recessive chin with incompetent lips and a high smile line.
TREATMENT OBJECTIVES
- Correction of Skeletal Class II Malocclusion
- To attain Class I molar and canine relationship
- Obtain ideal overjet and overbite
- To obtain proper lip competency and achieve a harmonious profile
TREATMENT PLAN
- Removable appliance with Z spring to correct relation of 12
- Growth Modulation appliance (ACTIVATOR) together and HEADGEAR
- Non extraction with PEA 0.022MBT Prescription mechanotherapy
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FIRST PHASE(GROWTH MODULATION)
In order to improve the Skeletal Class II relationship in a vertically growing patient with a retrusive mandible and to restrain the growth of prognathic maxilla, an Activator with High pull Headgear was chosen as the treatment of choice.Activator moves the mandible in a forward and downward direction with posterior disocclusion and the headgear to restrict the maxillary growth.
Removable appliance with Z spring was delivered to correct the lingually locked 12 for 3 months before starting with the Activator-Headgear combination therapy. The Activator was advised to be worn full day except eating to take the maximum benefit of all the functional forces applied to the dentition. The patient was advised to wear the headgear 14hours a day for best results. The appliance was delivered with force delivery of 300 gms which was gradually increased to 500gms over a period of next few months. The patient wore the activator for a period of 8 months. This resulted in a forward mandibular posture with improved upper to lower incisor relationship.
POST GROWTH MODULATION PHASE
Post growth modulation with sagittal correction achievedfrom Skeletal Class II to Class Iand also dental correction from Class II to Class I which is evident from the profile and intra oral photographs.
SECOND PHASE
Non Extraction treatment was undertaken with fixed mechano therapy using 0.022slot MBT bracket system.
POST TREATMENT OUTCOME
The post treatment photographs show proper alignment and intercuspation of the arches together with a harmonious soft tissue profile. The treatment results showed significant improvement in the patient’s stomatognathic system with best possible esthetics and function.
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How to cite this article
Dr. Upasak Mukherjee, Dr. Arjun Nayak, Dr. Krishna Nayak US Department of Orthodontics and Dentofacial Orthopedics. Skeletal Class II Correction Using Headgear-Activatortherapy. Guident. 2017 Jun;10(7). Available from: https://guident.in/articles/orthodontics/skeletal-class-ii-correction-using-headgear-activatortherapy.html
