Table 2. Suggested treatment protocol for dental malocclusion
Suggested Treatment Protocol
Non extraction: stripping, expansion, derotation, uprighting or distalisation Extraction:
CLASSIFICATION Class I malocclusion OF SKELETAL U / L 4s, U AND / L 5s, U / L DENTAL 6s, U / L 7s or a MALOCCLUSION symmetric extraction e. g. right: REVISITED
U / L 4s + left U / L 5s, U / L 6s + U / L 4s or 5s, single tooth extraction.
Class II malocclusion
Class III malocclusion
Type 1
Type 2a
Type 2b
Type 1
Type 2
Type 3a
Type 3b
Non extraction: Distalisation with headgear
Extraction: 4s,( U 4s + L 5s),( U / L 6s),( U / L 7s) or a symmetric extraction e. g.( right U / L 4s + left U / L
5s),( U / L 6s + U / L 4s or 5s). or a single U4.
Always advise non extraction treatment using a headgear + Nudger or an intra-oral distalizer. If crowding is to be relieved by extraction, then it is advisable to extract the 2 nd premolar than the 1 st premolar because of difficulty of space closure. Transfer the case to CL II / 1 and treat accordingly.
Headgear + Nudger Orthognathic surgery treatment( proclined upper anteriors and retroclined lower anteriorsdecompensation: plan for surgery)
Camouflage with stripping lower arch and proclining upper teeth. Expansion of upper arch ± fixed appliance therapy.
Expansion of upper arch ± fixed appliance therapy with CL III elastics. Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed orthodontic therapy with CL III elastics. Expansion of upper arch + extraction of a single lower central incisor + U / L fixed orthodontic therapy with CL III elastics.
Expansion of upper arch ± fixed appliance therapy with CL III elastics. Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed Orthodontic therapy with CL III elastics. Expansion of upper arch + extraction of a single lower central incisor + U / L fixed orthodontic therapy with CL III elastics.
Expansion of upper arch ± fixed Orthodontic therapy. Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed Orthodontic therapy. Expansion of upper arch + extraction of a single lower central incisor + U / L fixed Orthodontic therapy with CL III elastics.
5. Conclusion Incisor, canine and molar classification should always be used accurately to diagnose and to plan the final occlusion. A final class I incisor and canine relationship at the end of treatment is always the aim so to provide long term stability while molar relationship could be class I, II( full unit) or III relationship.
The author recommends further study on methods of classification and establishing orthodontic treatments’ protocols.
Acknowledgments The author declare no conflict of interest related to this study. There are no conflicts of interest and no financial interests to be disclosed.
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