Class II Division I Malocclusion

CCO Case File: Class II Non-Extraction Male 12.4 yrs.

Author: Dr. Antonino Secchi

Initial extraoral photos
Initial extraoral photos

 

Secchi Case 2 Before 2

Intraoral photos before treatment.
Intraoral photos before treatment.

 

Secchi Case 2 Pre Tx

Case summary:
12:4 yo Male with a Class II division 1 malocclusion. He is low angle with a good mandibular body as well as ramus height. Excessive proclination of upper incisors with a deep curve of Spee. Skeletal
transverse dimension is normal (Mx-Mx 62mm, Ag-Ag 76mm).

Tx Strategy by Stages:
Stage I: leveling and aligning, correct all rotations and tip of incisors. Start leveling curve of Spee.
Stage II: Coordinate upper and lower arches, leveling curve of Spee with a 0.019” x 0.019” SS with reverse curve of Spee added manually. Use Sentalloy compressed coils and Class II elastics to help with Class II correction.
Stage III: Achieve optimal intercuspation of the buccal segment using vertical triangular elastics.

Appliance:
In-Ovation ‘R’ CCO System

Wire Sequence:
Stage I: 0.014” Sentalloy AccuForm Medium.
0.020” x 0.020” Bioforce AccuForm Medium.
Stage II: 0.019” x 0.019” SS AccuForm Medium.
Stage III: 0.019” x 0.019” Braided AccuForm Medium.

Auxiliaries:
Sentalloy compressed Coils
Elastics 3/16” 6oz (Thailand).

Secchi Case 2 Stage IAStage I. In-Ovation ‘R’ CCO System with upper and lower 0.014” Sentalloy AccuForm Medium wires. Upper premolars were skipped in order to facilitate the placement of the compressed Sentalloy coil.

Secchi Case 2 Stage IBStage I. Upper and lower 0.020” x 0.020” Bioforce AccuForm Medium wires.

Secchi Case 2 Stage IIAStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Wires must be coordinated before placement. Compressed Sentalloy coils were added between upper canines and first molars. Class II elastics 3/16”, 6oz (Thailand). Reverse curve of Spee added manually to lower wire.

Secchi Case 2 Stage IIBStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Notice how the lower archwire is now much more leveled. Right side in Class I, Left side almost in Class I at the molars, still end on at the canines. However, there is space distal of upper canine to move the anterior teeth back to a Class I and correct the midlines.

Secchi Case 2 Stage IICStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Upper and lower occlusal planes leveled and paralleled. Sentalloy coils were removed. Elastics short Class II 3/16” 6oz. (upper 3, lower 5).

Secchi Case 2 Stage IIDStage II. Upper and lower 0.019” x 0.025” ss. AccuForm Medium wires. Spaces are consolidated. Power chain upper 3 to 3. Good Class I on both sides. Start vertical triangular elastics 3/16” 6oz. (upper 3, lower 3 and 4).

Secchi Case 2 Stage IIIStage III. These pictures were taken just before we changed the upper archwire. 0.019” x 0.025” Braided AccuForm Medium wire was used only in the upper arch. Vertical triangular elastics 3/16” 6oz were used until braces were removed.

Secchi Case 2 FinalIntraoral final photos. 24 months of active Tx.

It is important to clarify that the active tx could have been several months shorter. Patient “disappear” for 7 months (family reasons) toward the end of tx.

Extraoral final photos.
Extraoral final photos.

 

Intraoral final photos
Intraoral final photos.

 

Secchi Case 2 Post Tx - Superimpositions

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