Treatment protocol for Class II malocclusion with mandibular deficiency using Forsus appliance in adult patient: case report

Fernando André Barth, Maurício de Almeida Cardoso, Renata Rodrigues de Almeida-Pedrin, Danilo Pinelli Valarelli, Ana Cláudia de Castro Ferreira Conti

Among orthodontic treatments proposed for correcting Class II malocclusion in adult patients, the protocol with dentoalveolar compensation stands out. The therapy to be applied is related to the severity of the sagittal error and also to the facial disharmony, both identified by patient and orthodontist. Although compensatory treatment does not aim to correct patient ́s facial profile, a propulsive mechanics enables dentoalveolar protrusion of the lower arch, allowing a reduction in sagittal deviation that may consequently contribute to facial balance. Thus, the present article reports the clinical case of an adult patient (initial age 29 years and 9 months) presenting Angle Class II malocclusion, mandibular deficiency, reduced lower third of the face with relative facial profile pleasantness. Corrective fixed appliances were recommended, associated with Forsus mandibular protractor, aiming particularly the inclination of mandibular incisors in order to decrease overjet, and to increase vertical dimension of the lower third of the face, as well as to improve occlusal relationships and peribucal tissues positioning. The results, after 18 months of treatment, showed improvement of occlusal relationships and a significant change in facial pleasantness, even with facial pattern being compromised by mandibular deficiency. These results were stable in the 2 years post-treatment follow-up for both occlusal aspect and facial profile. Thus, the compensatory treatment proved an adequate mechanotherapy to correct Class II in adult patients, allowing an adjustment in occlusal relationships associated with improvement of facial contours and soft tissue.

Keywords: Malocclusion. Angle Class II. Orthodontics, corrective. Mandibular advancement.

How to cite: Barth FA, Cardoso MA, Almeida-Pedrin RR, Valarelli DP, Conti ACCF. Protocolo de tratamento com Forsus em paciente adulto Classe II por deficiência mandibular: relato de caso. Rev Clín Ortod Dental Press. 2018 Fev-Mar;17(1):49-61. DOI: https://doi.org/10.14436/1676-6849.17.1.049-061.art

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