Orthodontic Treatment with Tooth Extraction for Mandibular Retrognathia

Age:24
Gender:Female
Chief complaint:Crooked Teeth
Use product:PT 5 Self-ligating Brackets
Treatment cycle:23 months
Issues & Diagnosis:
Angle Class I malocclusion.
Moderate overbite (Class II).
Crowded dentition with irregular alignment.
Protrusive facial profile.
Short roots of teeth 11, 21, 31, and 41 following root canal treatment on tooth 27.

Chronic periodontitis.

Temporomandibular joint (TMJ) clicking on both sides, with a ribbon-like opening pattern.


Treatment Approach and Plan:
Extraction of teeth 14, 24, 34, and 44.
Use of PT 5 self-ligating brackets to align and level the upper and lower dental arches.
Closure of extraction spaces and retraction of anterior teeth to improve facial profile.
Occlusal adjustments.

Retention.


Treatment Progress:




Summary:

This case employed personalized labial orthodontic treatment. The use of customized brackets with compensations in the orthodontic appliance baseplate allowed for better three-dimensional tooth movement and achieved the desired treatment outcomes.
The patient presented with mandibular retrusion and a protrusive facial profile. Post-treatment, the anterior teeth are more upright, contributing to improved facial aesthetics while considering the position of the anterior tooth roots.
The customized appliance, being positioned based on the archwire plane, resulted in brackets for the upper anterior teeth leaning more toward the lingual. To achieve controlled torque during anterior retraction, mini-screws and extended traction hooks were employed for space closure, aiding in torque control and preventing torque loss.

The close interdigitation of upper and lower occlusal pits post-treatment is a stable foundation. One year after the review, the occlusion remains tight and stable.



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