Horizontal overcorrection

It is often necessary to consider horizontal overcorrection of Class II and Class III cases. During the finishing stages of treatment, it is important to fully correct the A/P position of the dentition using methods such as Class II or ("lass III elastics, or headgear, for example. After correction has been completed, then these methods of tooth movement can be discontinued or worn on a part-time basis. The patient may then be observed for a period of 6 to 8 weeks. If the case appears to be stable, the appliances can be removed. If not, these cases can be horizontally overcorrected.

In Class II cases, the anterior teeth can be brought to an edge-to-edge position and held for approximately 6 to 8 weeks (Fig. 10.12). After this, elastics can be discontinued or worn at night only, to see how the case is settling.

A Class 111 case can be horizontally overcorrected by producing 2-3 mm of additional overjet, and this may then be held or observed in a similar manner to Class II cases.

Fven if these overcorrection techniques are carefully followed, problems can occur during retention. These can be due to late aberrant growth, or to re-established tongue or finger habits, for example. These concerns need to be explained to patients, and observation at regular intervals during retention is in their best interest.

Fig. 10.11 When treating premolar extraction cases, figure-8 ligature wires should be placed across the extraction site during the settling stage to prevent spaces from opening.

Fig. 10.12A and B This low-angle Class 11/1 malocclusion was managed without headgear, but included the extraction of upper second permanent molars. Standard metal brackets were used. The case is seen here before treatment, and after placement of initial .015 multistrand upper and lower aligning wires.

Fig. 10.12A and B This low-angle Class 11/1 malocclusion was managed without headgear, but included the extraction of upper second permanent molars. Standard metal brackets were used. The case is seen here before treatment, and after placement of initial .015 multistrand upper and lower aligning wires.

Fig. 10.12C and D Upper and lower rectangular steel wires and Class II elastics were used for overjet correction. When finishing the case, a .014 round wire was used in the upper arch, with light Class II mechanics to ensure over correction of the overjet and overbite.

Fig. 10.12E and F Here the case is seen prior to band removal, after a small amount of settling has occurred with the appliances in place. Finally, the case is seen 18 months after band removal, with good settling and improved oral hygiene.

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