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Orthodontic Operator Case Using Headway Orthodontic Bracket
Jul 24, 2018

A 13 years old children had CL III malocclusion, 15 months to end the orthodontic, no surgery, no teeth extraction, no front traction.

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After examination: joint: bilateral temporomandibular joint slightly asymmetrical, no squeaking, tenderness.

 

Face type: The double side type is slightly asymmetrical, the side appearance: the mandibular protrusion and the concave type at the CO position; the face shape at the CR position is more upright and straight.

 

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Diagnosis: Class III mismatch, skeletal class I, class III, mean angle, concave type.

Treatment plan: non-extraction treatment, MBT orthodontic technique, upper and lower anterior teeth compensation for bone deficiency.

Therapeutic goals: align the dentition and the dental arch; improve the concave shape; correct the anterior teeth and establish a normal covering; the molars reach the class I occlusion.

 

Orthodontic steps:

The first month:

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The first month: the upper and lower jaws first use MBT brackets with hooks; 11, 21, 31, 32, 41, 42 with the anterior teeth, because the lower jaw 3-3 will bite back to the upper jaw 2-2; , 21, 22 brackets, so that 11, 21 get -17 ° torque, 12, 22 get -10 ° torque, in order to prevent the upper jaw from excessive lip tilt after the type III traction expansion.

Maximal use 0.014 thermal activated archwire, mandible use0.016*0.016 thermal activated archwire.

 

The second month:

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Continue to line up, the upper jaw is fully inserted into the trough, the lower jaw is replaced with a heat-activated wire of 0.019*0.025, and the light-suspended short-class III traction is continued to correct the molars.

 

After sixth month:

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After half a year, the upper and lower jaws were all aligned, the anterior teeth were occluded to the opposite edge, and the upper and lower jaws were all use 0.019*0.025 stainless steel archwire. The teeth did not need to be moved before, and all were ligated with a ligation loop to continue the type III traction.

 

The eighth month:

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The traction for two months did not improve significantly. Therefore, one micro screw was implanted on each side of the mandible, and the micro screw used Headway company. The size was 2.0*10mm. The traction hook was placed on both sides 33, 34 and Between 43,44, the micro screw and the power chain receive the entire mandibular dentition. The center of the impedance of the mandible is located at the proximal tip of 34, 35 and 44, 45 on both sides, and the mandible is rotated counterclockwise.

 

The tenth month:

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After two months of mandibular micro screw traction, the anterior teeth should be basically covered with normal coverage, the anterior teeth should be removed, and traction should continue.

 

The thirteenth month:

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From the original 0 over the jaw to the present deep jaw, stable after 2 months waiting for dismantling

 

The fifteenth month:

 

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The appliance was removed, but the two micro screw were left to remain, because the patient was in the growth stage, and the jaws 38, 48 were still not erupted for recurrence. The entire orthodontic result achieved satisfactory results.