Treatment of Class II malocclusion with a customized lingual appliance combined with a Class II corrector.

Correcting a complete Class II malocclusion in an adult patient can be quite difficult. If the patient has a large skeletal discrepancy, orthognathic surgery is the treatment of choice. However, if the discrepancy is small or if the situation is borderline and the mandibular incisors are retroclined, Class II correctors can be used. This clinical report presents the orthodontic treatment of a 24-year-old woman with Class II malocclusion. Clinically, her maxilla was slightly protruded, and the mandible was well-positioned. She had uprighted maxillary and mandibular anterior teeth and a deepbite, and she opted for a more esthetically appealing orthodontic appliance. The treatment plan included leveling and alignment of the teeth in both arches, Class II correction, establishing Class I molar and canine relationships, correction of overbite and overjet, adjustment of midlines, and improvement of facial and dental esthetics. Orthodontic treatment consisted of customized lingual appliances combined with a Class II fixed corrector.

Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics.

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

Ortodontia lingual x alinhadores removíveis: quando utilizar / Lingual orthodontics x removable aligners: when to use

A Ortodontia está passando por uma nova fase. Muitos pacientes adultos estão buscando o tratamento atualmente e não querem usar um aparelho convencional. Isso tem feito com que a Ortodontia desenvolva novos métodos de tratamento mais estéticos e também aprimore os já existentes. Duas modalidades de tratamento têm ganhado muito destaque nos últimos anos: a Ortodontia Lingual e os Alinhadores Removíveis. O objetivo deste artigo é descrever a técnica lingual Harmony e os alinhadores removíveis Essix e Clear Aligner, comparando-os e mostrando o tratamento de dois casos clínicos. Para o caso tratado com a técnica Lingual foi escolhido o aparelho Harmony devido à necessidade de grande controle de torque nos incisivos superiores. O caso tratado com alinhadores era um caso simples de recidiva pós-tratamento ortodôntico. Os casos clínicos descritos evidenciaram o papel importante que as novas modalidades de tratamento estético podem ter na Ortodontia contemporânea. Cabe ao ortodontista clínico conhecer essas ferramentas e as utilizar nos casos apropriados.(AU)

Orthodontics is going through a new phase. Many adult patients are currently seeking treatment and do not want to use a conventional device. This has led Orthodontics to develop new aesthetic treatment methods, as well as to improve existing ones. Two treatment modalities have gained much prominence in recent years: Lingual Orthodontics and Removable Aligners. The purpose of this article isx to describe the Harmony lingual technique and the Essix and Clear Aligner removable aligners, comparing them and showing the treatment of two clinical cases. For the case treated with the lingual technique, the Harmony device was chosen due to the need for great torque control in the upper incisors. The case treated with aligners was a simple case of orthodontic posttreatment relapse. The clinical cases described evidenced the important role that the new modalities of aesthetic treatment can have in contemporary Orthodontics. It is up to the clinical orthodontist to know these tools and use them in appropriate clinical cases.(AU)