Main Instructor Meng-Yen Chen
Department / Institution Department of Stomatology , National Cheng Kung University Hospital, Tainan, Taiwan
Classification Case report
The aims of this case report are to present the orthodontic traction of palatally impacted canine and activator treatment of skeletal class II and deep overbite.
A 12Y boy came to our department with chief complaints of unerupted upper right canine, deep bite and retrusive chin. Cephalometric analysis revealed skeletal class II div 2, which was due to mandible retrognathism, and hypodivergent facial pattern. About dental aspect, bilateral class II molar relationship, 100% overbite, and palatal impaction of upper right canine. The treatment started with upper fixed appliance to create space for palatally impacted canine traction. The angle of SN-UI improved from 83°to 102°and overjet increased from 3 to 5 mm after fixed appliance treatment. He has been wearing activator since 14. With the aid of teeth eruption and favorable condylar growth, the final result was class I canine and molar relationship and stable occlusion.
Discussion and Summary
In growing skeletal class II patients, we could either stimulate mandibular growth or restrain maxillary growth. For Class II division 2 patients, upper incisors should be aligned before starting functional appliances so that the mandible can position forward. Also, the palatal impaction seldom erupts without intervention. The key to successful treatment of Class II division II adolescent with palatally impacted canine depends on the definitive diagnosis, proper selection of treatment mechanism, and patient’s compliance.
Combined Fixed and Functional Appliance Treatment for a Patient with Class II Division 2 Malocclusion and Palatally Impacted Canine