Properties of non-surgical treatment in the mandibular protrusion.

Abstract

Objectives
In Japan, there are many situations that necessitate changes in treatment plan from orthognathic surgery to orthodontics alone for various reasons. The objectives of this presentation are to present anterior crossbite cases treated with orthodontics alone based on computer simulations of orthognathic surgery and to discuss the dental, occlusal, and facial improvements achieved with the treatment.
Methodologies
Mandibular setback with sagittal split ramus osteotomy was proposed to both Case 1 and Case 2 during the initial consultation because of mild chin protrusion and anteriorly positioned B point. However, the patients opted for non-surgical treatment and were thus treated non-surgically by lingual orthodontics. Upper and lower premolars were extracted to move the upper molars mesially and retract the lower incisors by lingual tippling in order to obtain a positive overjet.
Results
While the anteroposterior position of the maxilla remained unchanged, the initial Angle Class III molar relationship was corrected to Class I in both cases with mesial movement of the upper molars using moderate anchorage. Because of the change in treatment plan from orthognathic surgery to non-surgical treatment, the lower incisors were retracted by lingual tipping, resulting in improved overbite and overjet.
Conclusions
Concave profiles were improved with orthodontics alone by changing the inclination of teeth. Lingual orthodontics, which provides strong mandibular anchorage and facilitates lingual tipping of the anterior teeth, can be an effective option to successfully treat patients who do not wish to undergo surgery.