Two-stage orthodontic treatment outcomes of children with dentoalveolar class II malocclusion

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Abstract

Background. During the rehabilitation of children with distal occlusion, it is not always possible to achieve the desired outcomes. In this context, the factors influencing the outcomes of treatment for class II malocclusions in children at different stages of occlusion development.

Aim. To study two-stage orthodontic treatment outcomes in children with dentoalveolar class II malocclusion by the clinical case.

Material and methods. We analyzed the physical examination results of the patient within the treatment from 6 to 17 years. Facial proportion symmetry, aesthetic, type of face, plaster dental models were determined by using the photographs. Orthopantomography was used to analyze the condition of temporary and permanent teeth, jaw bone tissue and to assess functional disorders. Orthodontic treatment in a mixed dentition period was carried out using removable devices, including those improved by the authors. In the permanent dentition, orthodontic brackets with power elements were used.

Results. Untimely contacting the doctor, an insufficient level of motivation to implement recommendations for improving posture and dental care contributed to an increase in treatment duration. Keeping excessive cervical spine flexion and head tilted back, the “bad habit” of placing (pressure) the hand on the chin, and the rejection of a myo-gymnastic exercise (physical therapy) interfered with the synchronous (normal) development of the jaws. Premature loss of a temporary molar on one side led to dentoalveolar asymmetry and disruption of occlusal contacts. Additional orthodontic appliances were used to correct these deformities. Over-retained deciduous teeth led to the delayed eruption of permanent teeth and, presumably, to the curvature of their roots. Violation of the tooth’s root shape and asymmetry in permanent teeth crown size prevented the full correction of their position using highly effective modern non-removable orthodontic equipment. The anomalous position of the rudiment of the third molar, the refusal for timely tooth extraction further led to the increasing complexity of the surgical technique.

Conclusion. The timing and effectiveness of orthodontic treatment of a patient with dentoalveolar class II malocclusion were influenced by a poor body posture, extraction of a primary molar, the delayed eruption and crown size asymmetry of permanent teeth, the presence of “bad” habits and minimal cooperation of the patient with the orthodontist.

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About the authors

Farida S Ayupova

Kuban State Medical University

Author for correspondence.
Email: farida.sag@mail.ru
ORCID iD: 0000-0002-4194-664X
SPIN-code: 5187-5443
Scopus Author ID: 57193081297
ResearcherId: AAM-4413-2021

MD, Cand.Sci. (Med.), Assoc. Prof., Depart. of Pediatric Dentistry, Orthodontics and Oral Surgery

Russian Federation, Krasnodar, Russia

Rasudan A Khotko

Kuban State Medical University

Email: khotko.rasudana@yandex.ru
ORCID iD: 0000-0003-0711-0838
SPIN-code: 3593-1187
ResearcherId: AAJ-64362021

MD, Resident, Depart. of Stomatology, faculty of advanced training and professional retrai­ning of specialists

Russian Federation, Krasnodar, Russia

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2. Рис. 1. Диагностические модели челюстей пациента Л., возраст 8 лет 6 мес: А — вид справа; Б — модель верхней ­челюсти; В — модель нижней челюсти; Г — вид слева

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3. Рис. 2. Ортопантомограмма пациента Л., возраст 8 лет 6 мес

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4. Рис. 3. Ортопантомограмма пациента Л. 12 лет

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5. Рис. 4. Диагностические модели челюстей пациента Л. 13 лет: А — вид справа; Б — модель верхней челюсти; В — модель нижней челюсти; Г — вид слева

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6. Рис. 5. Диагностические модели челюстей пациента Л. 15 лет: А — вид справа; Б — модель верхней челюсти; В — модель нижней челюсти; Г — вид слева

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7. Рис. 6. Cегментарный анализ по методу Gerlach зубных рядов верхней (А–Г) и нижней (Д–З) челюстей ­пациента Л. в возрасте от 8 лет 6 мес до 17 лет

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8. Рис. 7. Ортопантомограмма пациента Л. 15 лет

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9. Рис. 8. Диагностические модели челюстей пациента Л. 17 лет: А — вид справа; Б — модель верхней челюсти; В — модель нижней челюсти; Г — вид слева

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10. Рис. 9. Ортопантомограмма пациента Л. 17 лет

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11. Рис. 10. Изменение наклона нижних третьих постоянных моляров пациента Л. относительно окклюзионной плоскости на ортопантомограммах в возрасте 15–17 лет

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