Case report. Adult Class II malocclusion with constricted arches, excessive vertical overlap and malposed teeth

Area of Science:

• Orthodontics
• Dental Arch Development
• Temporomandibular Joint (TMJ) Disorders

Background:

• Patient presented with significant malocclusion including constricted arches, moderate crowding, posterior crossbite, and severe deep bite.
• Co-existing temporomandibular joint (TMJ) symptoms and facial pain complicated the clinical presentation.

Observation:

• The Crozat appliance was utilized to effectively upright posterior segments and expand the dental arches.
• Following initial arch development, a straight-wire appliance was employed for alignment and leveling.

Findings:

• The combined orthodontic treatment achieved efficient alignment, leveling, and functional occlusion.
• Facial balance and lip support were successfully maintained throughout the treatment.
• Periodontal health remained excellent with no evidence of stripping.
• Significant improvements were noted in the patient's smile esthetics and TMJ symptomology.

Implications:

• This case demonstrates the efficacy of a phased orthodontic approach using Crozat and straight-wire appliances for complex malocclusions.
• The treatment resulted in stable, long-term results, as evidenced by three-year post-retention follow-up.
• Successful management of TMJ symptoms alongside orthodontic correction highlights a comprehensive treatment strategy.