Two Phase Orthodontic Treatment: A Case Report.

Myofunctional appliances become active through muscular forces that bring about the dentoalveolar and skeletal changes. Functional appliances can be both removable or fixed. Twin block appliance given by William Clark is one of the most popular functional appliance owing to its ease of fabrication for the orthodontist and its ease of wear for the patient. It is known to bring about both skeletal and dental changes and has been used extensively in Class II growing patients. This was a case report of a 12-year-old patient treated in two phases, first the functional phase using the twin block, followed by the second phase of fixed orthodontic appliance.

Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: A cephalometric and computed tomography comparative study.

Objective: Evaluate the changes in alveolar bone as a result of maxillary and mandibular incisor retraction in patients with bimaxillary protrusion by means of using lateral cephalograms and computed tomography (CT) scans and to investigate any occurrence of bony defects like dehiscence and fenestration. Subjects and Methods: Ten patients (age 15 ± 3 years) with bimaxillary protrusion treated by extraction of four first premolars were investigated by lateral cephalograms and CT scans during pre‑treatment (T1) and after 3 months of completion of incisor retraction (T2). The labial and lingual cortex of all the incisors were assessed on the CT scan with measurements taken at site adjacent to widest point of the labiolingual root in three slices separated by 3 mm at crest level (S1), mid root level (S2), and apical level (S3). Result: In the mandibular arch, after lingual movement of the incisors, the bone labial to the anterior teeth decreased in thickness at the coronal level of the left lateral and left central incisors. Left lateral incisor showed significant changes in all the three levels. In the maxilla the change in the labial bone thickness was not statistically significant. Lingual bone of all the incisors showed significant changes in S1 level and S3 levels. Few patients demonstrated bone dehiscence that was not visible macroscopically or cephalometrically. Conclusions: When incisors are retracted, the risk of adverse effect is present. This must be carefully monitored to avoid negative iatrogenic effects. This study needs follow up after 6 months or 1 year after completion of the orthodontic treatment to assess the long‑term consequences.

Treatment of division II malocclusion in young adult with Forsus™ fatigue-resistant device.

The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus™ fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus™ FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus™ FRD.