Treatment of Class II malocclusion with mandibular retrognathism using mandibular propulsion associated to passive self-ligating appliances with individualized prescriptions

Henrique Mascarenhas Villela

Introduction: Correction of Class II malocclusion with mandibular deficiency in growing patients requires an orthopedic approach associated with orthodontic treatment to, in addition to correcting tooth relationships, stimulate mandibular growth and reduce facial convexity. Mandibular propulsion can be used coupled to fixed orthodontic appliances, to carry out the orthopedic correction, together with the necessary orthodontic movements. Objective: This article presents a clinical case report, with a treatment protocol to correct this type of dentofacial deformity, associating mandibular propulsion to passive self-ligating brackets with individualized prescriptions. The aim of orthodontic treatment was to prepare the arches for orthopedic advancement, as well as to inhibit unwanted effects resulting from the forces generated by the mandibular propulsion. This approach promoted a clockwise rotation of 2.5° in the occlusal plane (FHP.Ocl Pl from 2.5° to 5.0°); however, the mandibular plane was maintained (FMA = 17°). The sagittal relationship between maxilla and mandible improved, with a 4° ANB reduction (ANB from 6° to 2°). Maxillary incisors increased inclination, promoting a horizontal trespass (overjet), allowing orthopedic correction with mandibular advancement. The inclination of the maxillary incisors increased by 19° (1.PP from 100° to 119°), and the lower incisors had an increase of 7° (IMPA from 93° to 100°). Facial convexity improved by 4° (FCA 163° to 167°). Conclusion: The association of the mandibular propulsion to passive self-ligating appliances with individualized prescriptions proved to be effective in correcting Class II malocclusion, promoting a good orthopedic effect and inhibiting unwanted orthodontic effects.

Keywords: Malocclusion, Angle Class II. Fixed functional appliance. Self-ligating appliances. Individualized prescriptions.

How to cite: Villela HM. Treatment of Class II malocclusion with mandibular retrognathism using mandibular propulsion associated to passive self-ligating appliances with individualized prescriptions. Clin Orthod. 2021 Dec-2022 Jan;20(6):58-70.

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