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Common Mistakes in the Treatment of Class II
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Class II malocclusion does not self-correct in growing patients. The Class II skeletal pattern is established early and remains until puberty if no orthodontic intervention is performed. To this date, several authors have discussed the relationship of the initial malocclusion characteristics with the effectiveness of orthodontic treatment and the stability of the corrections obtained.
Normally, orthodontic treatment takes a long time and uses complex techniques, usually achieving good results; however, these results may be lost in varying degrees after the removal of appliances and retainers. Orthodontic relapse includes crowding or spacing of teeth, and loss of overbite, overjet correction, and loss of Class II molar relationship correction.
Orthodontic changes of the position of the first permanent molars have a great tendency to relapse. Some authors affirm the with time, in adults, changes that occur in molar relationship are always towards Class II relation. The changes are of small magnitude and independent of the type of initial malocclusion and the type of treatment. Other authors suggest that, in the long-term, there is relapse in molar relationship and that changes in incisor position and intercuspation of the posterior teeth are statistically significant.
The real problem is that we don’t have clear the real etiology of a Cl II malocclusion. Only if we have the understanding of the morphologic characteristics of a malocclusion can we know what needs to be changed in order to treat our patients, growing and adults, from a full Cl II molar relationship, to a stable Cl I, correcting also the skeletal Cl II.
Some of the common mistakes in treating a Cl II is wrong diagnosis, high pull headgear, premolar extractions and the use of Cl II elastics.
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Orthodontics and Facial Orhtopedics Specialist.
PhD in Medical Sciences (Orthodontics and Facial Orhtopedics).
Member of the orthodontic society in Brazil, member of the World Orthodontics Federation.
Graduated as a dentist in 1995 at the the prestigious School of Dentistry of Piracicaba - UNICAMP, which is acknowledged as one of the best in Brazil and renowned for its excellence at both undergraduate and postgraduate levels in Latin America.
Went on to post graduate in the Faculty of Dentistry at the University of Sao Paulo - FOUSP / FUNDECTO.
Have been in private orthodontic practice since 2000, as well as being a course coordinator, instructor, and clinical professor for a mini-residency program in UPS as well as other Universities, including in other countries.
After some 10 years in practice, she decided that she wished to treat her son (a braquifacial skeletal Cl III without a face mask) as well as raise the level of excellence of her treatment and enrolled in various programs around the world in this pursuit. This journey led her to the courses in the USA, Taiwan, Korea, Germany, Colombia as well as the ones conducted by Professors Sadao Sato, Japan, and Rudolf Slavicek, Vienna, both giants in their respective disciplines.
She has lectured extensively all over the world, in private venues, International Orthodontic Meetings as well as at the prestigious Vienna School of Interdisciplinary Dentistry (VieSID), Vienna School of Medicine, where she is an instructor.
In her private practice in Brazil she has become renowned for treating the most difficult of malocclusions and disorders of the Craniomandibular system and is testimony to the dictum that we should be practising as Physicians of Occlusal Medicine of the Craniomandibular System.
She is proficient in GEAW (Gummetal edgewise archwire) technique which enable her to treat very complex malocclusions, many of which, most would have believed would have required surgery, as well as extra-alveolar TADs and MOPS (micro-osteoperforation) for bone remodeling and modeling.
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