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Main Instructor 曾于娟
Department / Institution Jiao Zheng Dental Clinic, Kaohsiung, Taiwan
Classification Case report
「Objective」 The purpose of this report to show the fixed edgewise appliance combined with myofunctional appliance on the case of Class II division 1 malocclusion with chronic nasal congestion. Nowadays many children suffer from chronic nasal congestion, they will breathe through the mouth, which in turns leads to the development of a low-resting tongue and result in narrow upper arch, high arched palate, associated dental crowding, retrognathic mandible, Class II malocclusion.. Myofunctional appliance can train the lips and tongue, may reduce the treatment time and maintain the treatment outcome.
「Case」 A 17-year-old female complained of protrusive upper teeth and crooked teeth. She also had the problem of chronic nasal allergies. The diagnosis were distal jaw relation, retrognathic mandible, Class II division 1 malocclusion, narrow upper arch, low tongue position, 14-16/44-46 and 25/35 lingual crossbite, moderate crowding of upper and lower arch, lower midline deviation. The treatment plan included extractions of bilateral maxillary first premolars and mandibular second premolars, and combination of myobrace appoiance and myofuctional training. After about 20 months treatment, we obtained good improvement of profile and occlusion. Class I canine and molar relation were achieved.
「Discussion and Summary」 The etiology of this case may be the long term mouth breathing and  low tongue position due to chronic nasal congestion. The use of myobrace appliance at night and myofunctional training of tongue and lips my reduce the treatment time and improve the stability after treatment. 
Orthodontic Treatment Combined with Myofunctional Appliance of Class II Division 1 Malocclusion- Case Report