The Journal
ANB angle
A to N perpendicular
B to N perependicular
FMA
U1-SN
U1-NA
L1-NB
L1-MP
Inter- incisal angle
Nasolabial angle
Pretreatment
-2°
-6mm
7mm
28°
111°
32°
5mm
84°
132°
99°
Post-treatment
-1°
-5mm
2mm
26°
115°
30°
3mm
90°
112°
98°
Treatment Progress Treatment Results
Initially posterior crossbite was treated using
quad helix. Mandibular right second pre molar
was extracted to correct canine relation and to
decrowd, 45, 43 was bonded to close extraction
space followed by bonding of maxillary arch
using pre adjusted edgewise appliance (0.022
prescription). Initial alignment and levelling
using 0.014” Niti The relationship of the right
posterior teeth was improved after 4 months of
leveling and expansion of the maxillary arch.
0.017x0.025 Niti followed by 0.019x0.025 Niti
was given for alignment followed by
0.019x0.025 Stainless steel wire followed by
0.021x0.025 Stainless steel wire for better
torque expression and to add rigidity and
maintain the arch forms. After 10 months pre
surgical orthodontics surgical crimpable hooks
were placed on the archwires in preparation for
the planned differential bilateral sagittal split
osteotomy (BSSO) of the mandible(fig 4). Post
surgically after six weeks of intermaxillary
fixation with a splint, orthodontic treatment was
resumed. Final arch coordination and minimal
occlusal equilibration were accomplished
during the next 6 months
Finishing and detailing was done and the case
was debonded. Fixed lingual bonded retainers
were placed in the maxillary as well as
mandibu lar arches. The mandibular skeletal asymmetry and
prognathism was corrected, the patient’s facial
asymmetry was much improved. The unilateral
posterior crossbite was eliminated, and the
dental midline was coincident and the minor
crowding of the maxillary arch and mandibular
arch was resolved.
16
Normal functional occlusion was established
with normal anterior overbite and overjet.
Mandibular arch form and intercanine width had
been maintained. The panoramic radiographs
show well-aligned parallel roots of the teeth,
and there are no signs of root resorption(fig 7)
The patient returned for reevaluation at 1 year
after debonding. His occlusion was well
maintained. The occlusal relationships of the
premolars and molars were improved by
settling. The facial photographs showed a
harmonious, acceptable, and symmetrical
appearance.
Vol. 14 No. 1
Jan-Apr 2018