Figure 1.
Pretreatment records, including extraoral and intraoral photographs, cephalogram, panoramic radiograph, and three-dimensional virtual model.
Table I.
List of abbreviations
| Abbreviations | Definition |
|---|---|
| MFT | Myofuncional therapy |
| VHA | Vertical holding appliance |
| TPA | Transpalatal arch |
| CBCT | Cone-beam computed tomography |
Table II.
Cephalometric measurements
| Measurements | Pre treatment | 3 months | 30 months | Post treatment | 3-year retention | |
|---|---|---|---|---|---|---|
| Anteroposterior | SNA (°) | 78.1 | 78.1 | 78.3 | 78.3 | 76.3 |
| SNB (°) | 76.8 | 78.1 | 78.4 | 77.7 | 78.1 | |
| ANB (°) | 1.4 | 0 | -0.1 | 0.6 | -1.8 | |
| A to N-perp (mm) | -6.72 | -7.7 | -7.2 | -6.9 | -7.4 | |
| Pog to N-perp (mm) | -14.4 | -11.8 | -10.2 | -11.7 | -9.8 | |
| Vertical | SN to palatal plane angle (°) | 4.1 | 4.1 | 2.9 | 2.9 | 2.5 |
| SN to occlusal plane angle (°) | 25.2 | 25.4 | 26.7 | 26.8 | 24.6 | |
| SN-GoMe (°) | 38.5 | 36.4 | 37.4 | 38.5 | 38.4 | |
| Anterior Facial Height (AFH) (mm) | 117 | 113.5 | 119.2 | 122.3 | 128.8 | |
| Posterior Facial Height (PFH) (mm) | 72.1 | 70.8 | 73.9 | 75.2 | 80.4 | |
| Facial height ratio (PFH/ AFH) | 0.62 | 0.62 | 0.62 | 0.61 | 0.62 | |
| Dental | U1 to FH (°) | 114.9 | 114.2 | 115.2 | 106.3 | 113.4 |
| IMPA (°) | 90.6 | 87.3 | 87.3 | 83.7 | 83.6 | |
| Interincisal Angle (°) | 120.9 | 126.3 | 124.8 | 136.3 | 132.8 |
Figure 2.
Vertical holding appliance. A, Mechanism of the vertical holding appliance combined with the smile–clenching–swallow exercise. (a) Resin button of the appliance. A space of approximately 3 mm is present between the resin button and palate. (b) Dorsal surface of the tongue. (c) Functional force applied on the resin button by the tongue. (d) Vertical force acting on the first molars transmitted through the appliance. (e) Tongue-reminding effect by the resin button. B, Positive feedback chain between the smile–clenching–swallow exercise and the vertical holding appliance. C, Upper occlusal view. D, Pressure mark on the dorsal surface of the tongue after the smile–clenching–swallow exercise.
Figure 3.
Records at 3 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition of radiographs taken before treatment and after 3 months of treatment.
Figure 4.
Intraoral photographs. (A) At 16 months of treatment. (B) At 25 months of treatment.
Figure 5.
Records at 30 months of treatment, including extraoral and intraoral photographs, cephalogram, and superimposition between 3 months and after 30 months of treatment. The photographs were taken immediately after bonding braces.
Figure 6.
Post-treatment records, including extraoral and intraoral photographs, three-dimensional virtual model, panoramic radiograph, cephalogram, and superimposition of radiographs taken at 30 months of treatment and post-treatment. All post-treatment records were taken after debonding braces.
Figure 7.
Retention records. (A) Extraoral photographs at 1-year follow-up. (B) Extraoral photographs at 3-year follow-up. (C) Intraoral photographs at 1-year follow-up. (D) Intraoral photographs at 3-year follow-up.
Figure 8.
Cone-beam computed tomography superimposition between post-treatment and 3-year follow-up images. Yellow and red dots denote the post-treatment measurements and 3-year follow-up measurements, respectively. (A) Lateral view. More prominent forward growth of the mandible than the maxilla. (B) Frontal view. Menton deviation to the left.