Adult skeletal Class II high-angle case treated with a fully customized lingual bracket appliance.
To achieve optimum occlusal and facial results in a patient with high-angle maxillary protrusion, it is important to move Point A back with retraction of the anterior teeth and prevent clockwise rotation of the mandible through good vertical control. A woman, aged 42 years 5 months, with a protrusive profile sought lingual orthodontic treatment. She had a skeletal Class II high-angle pattern with maxillary protrusion and mandibular retrusion. The extraction of the 4 first premolars was indicated to correct the problems. The vertical bowing effect, a side effect known to occur with conventional lingual bracket systems owing to torque loss, would preclude adequate retraction of Point A and compromise the facial results. To prevent this issue, a fully customized lingual bracket system with vertical slots for the anterior teeth using ribbon-wise archwires was selected. A midpalatal miniscrew was used to prevent molar extrusion. As a result, the bodily retraction of the maxillary incisors and Point A was achieved, obtaining an attractive facial profile.
Clinical professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan; private practice, Kyoto, Japan. Electronic address: inami@inaortho.com.
Toru
T
Inami
Private practice, Kyoto, Japan.
Yuko
Y
Nakano
Professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
Ken
K
Miyazawa
Associate professor, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
Masako
M
Tabuchi
Professor and chairman, Department of Orthodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
Shigemi
S
Goto
D000328:Adult; D001863:Bone Screws; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D008439:Maxillary Diseases / Q000628:therapy*; D052280:Orthodontic Anchorage Procedures; D016382:Orthodontic Appliance Design; D016910:Orthodontic Brackets