ANGLE SINIF II DİVİZYON 1 TEDAVİSİNDE FARKLI BİR YAKLAŞIM: OLGU SUNUMU
Sınıf II divizyon 1 maloklüzyonlara ortodonti kliniğinde sıklıkla karşılaşılmaktadır. Sınıf konumlanması, konumlanması kombinasyonu farklılıklar ve bu farklılıkların doğru teşhis edilmesi düzeltilmesinde çok önemlidir. Bu vaka raporunda, iskeletsel sınıf II anomali, dişsel Angle Sınıf II divizyon 1 maloklüzyona sahip adelosen anlatılmaktadır. Tedavi hedefleri; Angle Sınıf I molar ve kanin ilişkiyi elde etmek, overjet ve overbite miktarlarını azaltmak ve hasta profilini düzeltmektir. Tedavi planı iki aşamalı olarak düşünülmüştür. İlk aşamada slow maksillar ekspaniyon uygulanmıştır. Aynı anda mandibulanın sagital yön büyümesini stimule etmek amacıyla, plağa ısırtma izi, Angle Sınıf I molar ve kanin ilişkiyi sağlayacak aşamada; yeterli genişletme elde edildikten sonra, ısırtma izleri plaktan kaldırılmıştır. Yeni ısırtma izleri overbiteı düzeltebilmek amacıyla anterior Maksillomandibular ardından, sabit ortodontik tedavi uygulanmıştır. Aktif tedavi süresi 15 aylık ortopedik tedaviyi takip eden 12 aylık sabit ortodontik tedaviyi içeren 27 aydır. Angle Sınıf I molar ilişki elde edilmiştir ve hasta profili düzeltilmiştir. Isırma izi plağı iskeletsel Sınıf II anomalilerin tedavisinde aktivatörlere iyi bir alternatif olabilir.
A DİFFERENT APPROACH IN ANGLE CLASS II DİVİSİON 1 TREATMENT: CASE REPORT
Class II division 1 malocclusions are frequently seen in orthodontic practice. Class II anomalies are characterized with a protruded maxilla, retruded mandible or combination of these two situations. Individiual variations and the correct diagnose of these differences are indispensable for the correction of Class II malocclusion. In this case report; orthodontic treatment of an adolescent patient with skeletal class II anomaly is described. Treatment objectives were to obtain Angle Class I molar and canine relationship, reduce the amount of overjet and overbite and to improve patient’s profile. Treatment plan was decided to be twophased. In the first phase slow maxillary expansion was applied with a removable device. To stimulate the saggital growth of mandible at the same time with maxillary expansion, the device was also designed with bite registration, which was Angle Class I molar and canine relationship. In the second phase, after achieveing enough amount of expansion, the bite registration was removed. New bite registration was made on the anterior part of the device to correct the overbite. At the same time servical headgear was applied to the patient to control the growth of the maxilla. After correcting the maxillomandibular relationship, fixed orthodontic treatment was applied. Active treatment time was 27 months , including 15 months of orthopedic treatment following 12 months of fixed orthodontic treatment. Angle Class I molar relation was obtained, and the patient’s profile improved. Bite registration device can be a good alternative to activators for skeletal Class II anomaly treatment
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