A Case of Skeletal Mandibular Protrusion and Mandibular Deformity Required Re-treatment with Growth

Abstract

Growth prediction is important in orthodontic treatment during the growth period. In this case, a patient in a growth period displayed signs of skeletal maxillary protrusion at the age of 11 years and 5 months. To treat this skeletal maxillary protrusion, the right and left maxillary first premolars were removed at another dental clinic, and orthodontic treatment with a multi-bracket device was initiated. Dynamic treatment was completed after 2 years and 5 months of its implementation, when the patient reached the age of 13 years and 10 months. During a follow-up for retainer use after the completion of treatment, change of jaw position in response to growth was observed, and the patient was referred this hospital where an examination was conducted.
The initial diagnosis from this department was skeletal mandibular protrusion with deviation in the left direction, as well as deformity of the left side of the mandibular neck deviating inward and the mandibular head.
The treatment approach was based upon surgical orthodontic treatment, with follow-ups implemented until the completion of jaw growth. After the growth follow-ups were completed, we employed surgical orthodontic treatment to correct the occlusion without maxillomandibular tooth extraction. The rationale behind this selection of treatment was that the maxillary teeth were already extracted with congenital missing of the mandibular canines on both sides.
We would like to report on the consideration of the change observed in this case during the growth period and dynamic treatment, as well as the occlusion maintenance during the retention period.