Article

Successful treatment of postpeak stage patients with class II division 1 malocclusion using non-extraction and multiloop edgewise archwire therapy: a report on 16 cases.

State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China.
International Journal of Oral Science (Impact Factor: 2.72). 12/2009; 1(4):207-16. DOI: 10.4248/IJOS09019
Source: PubMed

ABSTRACT To determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire (MEAW) technique on postpeak Class II Division 1 patients.
In this retrospective study, 16 postpeak Class II Division 1 patients successfully corrected using a non-extraction and MEAW technique were cephalometrically evaluated and compared with 16 matched control subjects treated using an extraction technique. Using CorelDRAW software, standardized digital cephalograms pre- and post-active treatments were traced and a reference grid was set up. The superimpositions were based on the cranial base, the mandibular and the maxilla regions,and skeletal and dental changes were measured. Changes following treatment were evaluated using the paired-sample t-test. Student's t-test for unpaired samples was used to assess the differences in changes between the MEAW and the extraction control groups.
The correction of the molar relationships comprised 54% skeletal change (mainly the advancement of the mandible) and 46% dental change. Correction of the anterior teeth relationships comprised 30% skeletal change and 70% dental change.
The MEAW technique can produce the desired vertical and sagittal movement of the tooth segment and then effectively stimulate mandibular advancement by utilizing the residual growth potential of the condyle.

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    ABSTRACT: 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.
    international journal of stomatology & occlusion medicine 5(4).

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