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Treatment of neutroclusion with mesioclusion of the maxillary right first permanent molar
TREAT ME NT OF NEUTROC LUS I ON WITH ME SIO CLUSION OF THE MAXILLAR Y IU GHT FIRST PERMAN E NT MOL AR'"
C. J .
VOSMIK ,
D.D.S. ,
CLEVELAND, O HIO
H ISTORY.-Boy, a ged thirteen years, wei gh t eight y-one pounds, h eight fifty-eight inches. The child weighed six po unds and birth.
He was placed on a synt het ic diet in fourt h week .
nine ounces at He walked at
Fig. 1.
F ig . 2.
eleven months. Th e firs t deci duous t ooth erupted at seve n months. Childhood dis eases cons isted of bronchi ti s at fo ur and a half years, dip htheria at six ye ars, and measles at eight and a half years . Tonsils and adenoids we re removed at seven ye ars. Th e facial form was nor mal. Ther e was no hist ory of habits. Gen eral h ealth wa s n ormal at t he ti me treatment was begu n. Bec au se of their carious condit ion the maxillary left first and second deciduous molars and right second deciduous molar wer e extracted at six ye ars. ·Pres ented to the America n B oa r d of Ort ho do ntia, May, 1932.
54
Neutroclusion
55
Oral examination revealed pit cavities in both mandibular first permanent molars. Radiographic examination revealed the maxillary left second premolar in a semi-impacted state. Fig. 1 shows extraoral radiographs taken July, 1928.
Fig. 3.
Fig. 4.
I"ig. 5.
Atiriouied. Etiology.-The premature loss of the maxillary left first and second deciduous molars and the late retention of the mandibular deciduous molars may be considered the etiologic factors in causing malocclusion. Diagnosis.-Impressions were taken from which casts of the denture were constructed. Fig. 2 shows views of the casts made at the beginning of treatment, July, 1928. After studying the casts the malocclusion was classified as a neutroclusion with a mesioclusion of the maxillary left first permanent molar.
56
O. J . Vo smik
Tr eatment .-The te eth wer e r est ored to a n orm al funetional and anatomic r elationship by the followin g plan of treatment: (1) a distal movement of th e maxillary first molars t o provid e space for the eruption of the maxillary second premolars; and (2) an ali gnm ent of the mandibular in cisors. Plain molar bands ca rrying half round lin gual t ubes and 0.040 in ch buccal tubes were construct ed for th e four first molars. A r emovable lingual wire wa s placed into th e mandibular dental arch, the purpose of which was the stabilization of th e molars. A plain labial wire was also placed into the mandibular dental arch. At the beginning of t r eatment the maxillary arch mer ely car r ied a labial wire with hooks for int erm axillary elastics and spring loops of 0.022 inch wire just anter ior to the buccal t ubes. Later in the course of treatment, when the maxillary left first molar had been placed in its proper position, a lingual wire carrying simple auxiliary springs, the purpose of which was the buccal movement of the second premolars, was placed into the maxillary dental arch. The mandibular incisors were brought into alignment by means of the labial wire and wire ligatures. 'I'he maxillary left first molar was moved distally by g ra dually opening the loop anterior to its buccal tube while force was bein g applied with intermaxillary elastics. R esults.-The pati ent prese nted for t re at ment J uly 19, 1928. Eleven and a h alf months lat er, June, 1929, t he appliances were r emoved and a lingual r etaining wire was placed into th e mandibular dent al a rch. The re tainer was r emoved in March, 1930. F ig. 3 show s t he casts ma de in December, 1932. Fig. 4 shows pho to graphs of t he patient in Decemb er , 1932. Fig. 5 shows extr aoral r adi ogr aphs taken Dec ember, 1932. Prognosis.-The prognosis is fa vorable t h at a norm al functional anatomic relati onship will be main t ained.
C. J .
VOSMIK ,
D.D.S. ,
CLEVELAND, O HIO
H ISTORY.-Boy, a ged thirteen years, wei gh t eight y-one pounds, h eight fifty-eight inches. The child weighed six po unds and birth.
He was placed on a synt het ic diet in fourt h week .
nine ounces at He walked at
Fig. 1.
F ig . 2.
eleven months. Th e firs t deci duous t ooth erupted at seve n months. Childhood dis eases cons isted of bronchi ti s at fo ur and a half years, dip htheria at six ye ars, and measles at eight and a half years . Tonsils and adenoids we re removed at seven ye ars. Th e facial form was nor mal. Ther e was no hist ory of habits. Gen eral h ealth wa s n ormal at t he ti me treatment was begu n. Bec au se of their carious condit ion the maxillary left first and second deciduous molars and right second deciduous molar wer e extracted at six ye ars. ·Pres ented to the America n B oa r d of Ort ho do ntia, May, 1932.
54
Neutroclusion
55
Oral examination revealed pit cavities in both mandibular first permanent molars. Radiographic examination revealed the maxillary left second premolar in a semi-impacted state. Fig. 1 shows extraoral radiographs taken July, 1928.
Fig. 3.
Fig. 4.
I"ig. 5.
Atiriouied. Etiology.-The premature loss of the maxillary left first and second deciduous molars and the late retention of the mandibular deciduous molars may be considered the etiologic factors in causing malocclusion. Diagnosis.-Impressions were taken from which casts of the denture were constructed. Fig. 2 shows views of the casts made at the beginning of treatment, July, 1928. After studying the casts the malocclusion was classified as a neutroclusion with a mesioclusion of the maxillary left first permanent molar.
56
O. J . Vo smik
Tr eatment .-The te eth wer e r est ored to a n orm al funetional and anatomic r elationship by the followin g plan of treatment: (1) a distal movement of th e maxillary first molars t o provid e space for the eruption of the maxillary second premolars; and (2) an ali gnm ent of the mandibular in cisors. Plain molar bands ca rrying half round lin gual t ubes and 0.040 in ch buccal tubes were construct ed for th e four first molars. A r emovable lingual wire wa s placed into th e mandibular dental arch, the purpose of which was the stabilization of th e molars. A plain labial wire was also placed into the mandibular dental arch. At the beginning of t r eatment the maxillary arch mer ely car r ied a labial wire with hooks for int erm axillary elastics and spring loops of 0.022 inch wire just anter ior to the buccal t ubes. Later in the course of treatment, when the maxillary left first molar had been placed in its proper position, a lingual wire carrying simple auxiliary springs, the purpose of which was the buccal movement of the second premolars, was placed into the maxillary dental arch. The mandibular incisors were brought into alignment by means of the labial wire and wire ligatures. 'I'he maxillary left first molar was moved distally by g ra dually opening the loop anterior to its buccal tube while force was bein g applied with intermaxillary elastics. R esults.-The pati ent prese nted for t re at ment J uly 19, 1928. Eleven and a h alf months lat er, June, 1929, t he appliances were r emoved and a lingual r etaining wire was placed into th e mandibular dent al a rch. The re tainer was r emoved in March, 1930. F ig. 3 show s t he casts ma de in December, 1932. Fig. 4 shows pho to graphs of t he patient in Decemb er , 1932. Fig. 5 shows extr aoral r adi ogr aphs taken Dec ember, 1932. Prognosis.-The prognosis is fa vorable t h at a norm al functional anatomic relati onship will be main t ained.