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Treatment of a unilateral distoclusion case with an extreme overbite
TREATMENT OF A UNILATERAL DISTOCLUSION CASE WITH AN EXTREME OVERBITE RICHARD
A.
SMITH, D.D.S., EVANSTON, ILL.
H I ST OR Y and Attributed Etiology.-The
patient, a girl ten years of age, presented for treatment in August, 1931. The malocclusion was a unilateral distoclusion complicated by an extreme overbite. Her weight, height, and general development were normal for her age.N 0 constitutional disFig. 2.
Fig. 1.
Fig. 3.
orders had been experienced except the ordinary childhood diseases. The adenoids and the tonsils had not been removed. Respiration was normal. The mother's teeth were regular and in good occlusion. The father had a bad malocclusion similar to the child's. On questioning', the mother gave a history of a leaning habit in which the child rested the left hand against the left side of the mouth while reading. Inasmuch as a considerable part of the child's time was spent in reading, it was thought to be a possible etiologic factor. Presented at the Thirty-Fourth Annual .\Ieeting of the American Society of Orthodontists. St. Louis, April 20-23, 1936.
1148
Unilateral Distoclusion With Extreme Overbite
1149
Fig. 1 shows the front and occlusal views of the case. Note the extreme overbite in the incisor region. In the occlusal views note the lingual displacement of the mandibular and maxillary incisors on the left side.
Fig. 4.
Fig. 5.
Fig. 6.
Fig. 2 shows the right and left lateral views. The mesiodistal relationship is normal on the left side and is in Class II or distoclusion on the right side. Note the exaggerated curve of Spee in the lateral views of the mandibular model.
Richard A. Smith
1150
Fig. 3 shows the x-ray pictures at the beginning of treatment. The permanent teeth are all present, and tooth development seems to be normal for the age of the patient. Diagnosis.-This case was classified as a Class II Division 2 Subdivision (Angle). In my opinion, the extreme overbite was due to a supraversion of both the maxillary and the mandibular incisors. On the left side, the maxillary and the mandibular incisors and cuspids were in linguoversion. The necessities in treatment were to move the maxillary and the mandibular incisors and cuspids labially and to depress them; also, to correct the arch relationship on the right side. Treatment.-Bands were placed on all the first permanent molars. In the maxillary arch, the incisors were banded. In the mandibular arch, the incisors and the cuspids were banded. McCoy open tubes were soldered on all attachment bands. A labial arch with a 0.022 anterior section, to engage the McCoy open tubes, and a 0.040 posterior section was used. Loop springs 0.022 in diameter were soldered to the labial arch wire just anterior to the buccal tubes to exert forward pressure on the incisors. These appliances were used to move the maxillary and the mandibular incisors forward and to depress them. When normal arch form was approximated, intermaxillary elastics were worn on the right side day and night and on the left side at night only until the arch relationship was corrected. Fig. 4 shows the front and occlusal views of the completed case. Fig. 5 shows the right and left lateral views. A lateral view of the mandibular cast shows the change in the curve of Spee. Fig. 6 shows x-ray pictures of the completed case. Retention.-In November, 1933, the patient was taken off active treatment and a plain lingual appliance placed on the mandibular arch. The treatment appliance was used as a retainer in the maxillary arch for nearly a year. This was used so that the maxillary cuspids, which were just beginning to erupt, could come into place without interference. Because the patient objected to the attachment bands, a Hawley retainer was substituted at this time, although the cuspids were still not fully erupted. This retainer was worn continuously for one year and now is being worn at night only. The maxillary cuspids have been very slow in erupting, and I believe that the bow from the Hawley retainer has interfered some in their positioning. When the retainer is discarded permanently, I believe that the positions of both maxillary cuspids will improve. 636 CHURCH STREET
A.
SMITH, D.D.S., EVANSTON, ILL.
H I ST OR Y and Attributed Etiology.-The
patient, a girl ten years of age, presented for treatment in August, 1931. The malocclusion was a unilateral distoclusion complicated by an extreme overbite. Her weight, height, and general development were normal for her age.N 0 constitutional disFig. 2.
Fig. 1.
Fig. 3.
orders had been experienced except the ordinary childhood diseases. The adenoids and the tonsils had not been removed. Respiration was normal. The mother's teeth were regular and in good occlusion. The father had a bad malocclusion similar to the child's. On questioning', the mother gave a history of a leaning habit in which the child rested the left hand against the left side of the mouth while reading. Inasmuch as a considerable part of the child's time was spent in reading, it was thought to be a possible etiologic factor. Presented at the Thirty-Fourth Annual .\Ieeting of the American Society of Orthodontists. St. Louis, April 20-23, 1936.
1148
Unilateral Distoclusion With Extreme Overbite
1149
Fig. 1 shows the front and occlusal views of the case. Note the extreme overbite in the incisor region. In the occlusal views note the lingual displacement of the mandibular and maxillary incisors on the left side.
Fig. 4.
Fig. 5.
Fig. 6.
Fig. 2 shows the right and left lateral views. The mesiodistal relationship is normal on the left side and is in Class II or distoclusion on the right side. Note the exaggerated curve of Spee in the lateral views of the mandibular model.
Richard A. Smith
1150
Fig. 3 shows the x-ray pictures at the beginning of treatment. The permanent teeth are all present, and tooth development seems to be normal for the age of the patient. Diagnosis.-This case was classified as a Class II Division 2 Subdivision (Angle). In my opinion, the extreme overbite was due to a supraversion of both the maxillary and the mandibular incisors. On the left side, the maxillary and the mandibular incisors and cuspids were in linguoversion. The necessities in treatment were to move the maxillary and the mandibular incisors and cuspids labially and to depress them; also, to correct the arch relationship on the right side. Treatment.-Bands were placed on all the first permanent molars. In the maxillary arch, the incisors were banded. In the mandibular arch, the incisors and the cuspids were banded. McCoy open tubes were soldered on all attachment bands. A labial arch with a 0.022 anterior section, to engage the McCoy open tubes, and a 0.040 posterior section was used. Loop springs 0.022 in diameter were soldered to the labial arch wire just anterior to the buccal tubes to exert forward pressure on the incisors. These appliances were used to move the maxillary and the mandibular incisors forward and to depress them. When normal arch form was approximated, intermaxillary elastics were worn on the right side day and night and on the left side at night only until the arch relationship was corrected. Fig. 4 shows the front and occlusal views of the completed case. Fig. 5 shows the right and left lateral views. A lateral view of the mandibular cast shows the change in the curve of Spee. Fig. 6 shows x-ray pictures of the completed case. Retention.-In November, 1933, the patient was taken off active treatment and a plain lingual appliance placed on the mandibular arch. The treatment appliance was used as a retainer in the maxillary arch for nearly a year. This was used so that the maxillary cuspids, which were just beginning to erupt, could come into place without interference. Because the patient objected to the attachment bands, a Hawley retainer was substituted at this time, although the cuspids were still not fully erupted. This retainer was worn continuously for one year and now is being worn at night only. The maxillary cuspids have been very slow in erupting, and I believe that the bow from the Hawley retainer has interfered some in their positioning. When the retainer is discarded permanently, I believe that the positions of both maxillary cuspids will improve. 636 CHURCH STREET