Aiello Domenico, Nucera Riccardo, Costa Stefania, Figliuzzi Michele Mario, Paduano Sergio
Department of Health, University "Magna Graecia" of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, University of Messina, Italy.
Case Rep Dent. 2021 Sep 30;2021:4810584. doi: 10.1155/2021/4810584. eCollection 2021.
Class II malocclusions, after class I malocclusions, are the most frequent in the juvenile Italian population. They are most often skeletal in origin and due to mandibular retrusion. Functional devices seem to have a beneficial effect on the growth of the jaw. Long-term maintenance of the achieved results is essential for therapeutic success in any orthodontic treatment; moreover, the retention phase should last as long as possible, especially in the lower anterior sector. A female patient aged 10 years and 3 months presented a visibly convex profile and a severe mandibular retrusion. The anamnesis brought to light the habit of oral breathing and lower-lip sucking. The cephalometric analysis showed a normodivergent skeletal class II. The first treatment phase involved the use of a Bass type for 12 months at the end of the functional treatment; the second phase of fixed therapy was carried out following the principles of bioprogressive techniques. The photos at the end of treatment show an important improvement in the profile; a full class I ratio of molar and canine teeth was achieved with an excellent interarch relationship and a correction of the V-shaped upper arch. The result is occlusally and profilometrically stable after 2, 4, 5, 10, 14, and 20 years. The maintenance of a stable orthodontic result over time is the result not only of a correct and physiological occlusion but also and above all of a correct diagnosis and correct identification of problems that can cause the malocclusion itself. Flawed habits such as interposition of the lower lip and oral breathing must be intercepted and corrected early in order to correct them and not affect the long-term result of orthodontic treatment. In this case, a functional device associated with an orthodontic fixed finishing and a correct retention phase were necessary to correctly treat a second-class mandibular retrusion whose result remained stable 20 years after the end of therapy.
II类错颌畸形在意大利青少年人群中是继I类错颌畸形之后最常见的。它们大多起源于骨骼问题，由下颌后缩引起。功能性矫治器似乎对颌骨生长有有益影响。在任何正畸治疗中，长期维持所取得的效果对于治疗成功至关重要；此外，保持阶段应尽可能长，尤其是在下前牙区。一名10岁3个月的女性患者表现出明显的凸面型和严重的下颌后缩。病史揭示了口呼吸和下唇吮吸的习惯。头影测量分析显示为常度散开型骨骼II类。第一治疗阶段在功能治疗结束时使用Bass型矫治器12个月；固定治疗的第二阶段按照生物渐进技术的原则进行。治疗结束时的照片显示侧面轮廓有显著改善；磨牙和尖牙达到了完全的I类关系，牙弓间关系良好，V形上牙弓得到矫正。在2年、4年、5年、10年、14年和20年后，咬合和侧貌结果稳定。随着时间的推移保持稳定的正畸结果不仅是正确和生理性咬合的结果，更重要的是正确诊断和正确识别可能导致错颌畸形本身的问题的结果。诸如下唇插入和口呼吸等不良习惯必须尽早阻断和纠正，以便纠正它们且不影响正畸治疗的长期结果。在这种情况下，需要一个与正畸固定矫治和正确的保持阶段相关联的功能性矫治器来正确治疗下颌II类后缩，其结果在治疗结束20年后仍保持稳定。
