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The treatment of severe class II division 2 patients with deep overbites and gummy smiles using lingual appliances: a case series Cover

The treatment of severe class II division 2 patients with deep overbites and gummy smiles using lingual appliances: a case series

Open Access
|Apr 2024

Figures & Tables

Figure 1.

Case 1: initial extraoral and intraoral photographs.
Case 1: initial extraoral and intraoral photographs.

Figure 2.

Case 1: initial panoramic and cephalometric radiographs and tracing.
Case 1: initial panoramic and cephalometric radiographs and tracing.

Figure 3.

Entire upper arch distalisation using mini-screws, crimpable hooks, and coil springs.
Entire upper arch distalisation using mini-screws, crimpable hooks, and coil springs.

Figure 4.

Finishing and detailing stage. Gingival black triangles before interproximal stripping.
Finishing and detailing stage. Gingival black triangles before interproximal stripping.

Figure 5.

Case 1: post-treatment extraoral and intraoral photographs.
Case 1: post-treatment extraoral and intraoral photographs.

Figure 6.

Case 1: two-year post-retention extraoral and intraoral photographs.
Case 1: two-year post-retention extraoral and intraoral photographs.

Figure 7.

Case 1: post-retention panoramic and cephalometric radiographs and tracing.
Case 1: post-retention panoramic and cephalometric radiographs and tracing.

Figure 8.

Case 1: general and regional superimpositions of pretreatment and post-retention cephalometric tracings.
Case 1: general and regional superimpositions of pretreatment and post-retention cephalometric tracings.

Figure 9.

Case 2: initial extraoral and intraoral photographs.
Case 2: initial extraoral and intraoral photographs.

Figure 10.

Case 2: initial panoramic and cephalometric radiographs and tracing.
Case 2: initial panoramic and cephalometric radiographs and tracing.

Figure 11.

Entire upper arch distalisation using mini-screws, crimpable hooks, and power chains.
Entire upper arch distalisation using mini-screws, crimpable hooks, and power chains.

Figure 12.

Re-levelling stage after bonding the upper second molar brackets.
Re-levelling stage after bonding the upper second molar brackets.

Figure 13.

Case 2: post-treatment extraoral and intraoral photographs.
Case 2: post-treatment extraoral and intraoral photographs.

Figure 14.

Case 2: post-treatment panoramic and cephalometric radiographs and tracing.
Case 2: post-treatment panoramic and cephalometric radiographs and tracing.

Figure 15.

Case 2: general and regional superimpositions of pretreatment and post-treatment cephalometric tracings.
Case 2: general and regional superimpositions of pretreatment and post-treatment cephalometric tracings.

Figure 16.

Case 2: one-year post-retention extraoral and intraoral photographs.
Case 2: one-year post-retention extraoral and intraoral photographs.

Figure 17.

Counter-clockwise moments created by the arch wire intrusion force and occlusal force make the upper incisor further retroclined. Fi: intrusion forces applied by arch wires. Fo: occlusal forces applied by lower incisors.
Counter-clockwise moments created by the arch wire intrusion force and occlusal force make the upper incisor further retroclined. Fi: intrusion forces applied by arch wires. Fo: occlusal forces applied by lower incisors.

Figure 18.

Torque control using the double-slotted bracket. Blue arrows: couples generated by rectangular arch wires. Orange arrows: couples generated by relative positions of the two arch wires.
Torque control using the double-slotted bracket. Blue arrows: couples generated by rectangular arch wires. Orange arrows: couples generated by relative positions of the two arch wires.

Figure 19.

An incisor intrusion force (Fi) generates counter-clockwise moments (orange arrows) to increase incisor torque and counteract the clockwise moment (blue arrows) created by the entire arch retraction force (Fr).
An incisor intrusion force (Fi) generates counter-clockwise moments (orange arrows) to increase incisor torque and counteract the clockwise moment (blue arrows) created by the entire arch retraction force (Fr).

Cephalometric measurements of case 2

PretreatmentPosttreatment
Skeletal
  SNA (°)85.583.0
  SNB (°)75.875.0
  ANB (°)9.78.0
  FMA (°)21.422.1
Dental
  U1-SN (°)73.994.1
  U1-PP (°)83.1104.3
  U1-NA (°)-11.711.1
  U1-NA (mm)-5.7-2.2
  IMPA (°)103.4106.0
  L1-NB (°)29.433.0
  L1-NB (mm)5.36.8
  Interincisal angle (°)152.5127.9
  Upper incisal display (mm)3.72.3
Soft tissue
  E-line/UL (mm)1.9-1.5
  E-line/LL (mm)0.2-0.9

Cephalometric measurements

PretreatmentPosttreatment
Skeletal
  SNA (°)85.784.8
  SNB (°)79.680.1
  ANB (°)6.14.7
  FMA (°)20.020.5
Dental
  U1-SN (°)80.392.4
  U1-PP (°)89.2101.1
  U1-NA (°)-5.57.6
  U1-NA (mm)-3.4-1.2
  IMPA (°)94.295.1
  L1-NB (°)22.122.7
  L1-NB (mm)2.83.1
  Interincisal angle (°)157.3144.9
  Upper incisal display (mm)5.83.8
Soft tissue
  E-line/UL (mm)-0.7-0.9
  E-line/LL (mm)-1.2-1.2
DOI: https://doi.org/10.2478/aoj-2024-0009 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 95 - 110
Submitted on: Dec 1, 2023
Accepted on: Mar 1, 2024
Published on: Apr 24, 2024
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2024 Nguyen Viet Anh, Dinh Vinh Ninh, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.