Italian Board of Orthodontics. Case Nr. 1: early treatment

The patient was a 9 year 3 month old female with a normodivergent skeleto-dental Class II malocclusion in the mixed dentition characterized by maxillary incisors which were both protrusive and spaced. There was by a deep Curve of Spee and a deep bite with palatal impingement. Facially, the profile was convex when compared to the esthetic line. The nasolabial angle was normal and the face was symmetrical (Figs. 1-8, Tab. I). The functional movements and T.M.J analysis were within normal limits. The periodontum and hygeine were good. Because of the patient's age, a 2 phase non extraction treatment approach was planned. In the first phase, the intent was to reduce the overbite and overjet for funtional reasons, reducing the possibility of trauma to the maxillary incisors, and control the Class II skeltodental relationships. In the second phase, Class I relationships would be obtained with a normal overjet and overbite and an improved profile. However, in reality, treatment became a 1 phase treatment because there was no interruption between the first and second phase of treatment.