Vertical Control for the Class II Patient: The Key to Anterior Mandibular Response

Controlling the vertical eruption of molars and the lower incisor position is critical in achieving a forward mandibular response, especially for the high-angle case. Far too often the very first archwire placed will facilitate the extrusion of molars. Controlling the molar vertical position throughout treatment is critical. 1 mm of molar extrusion will elicit a 3 mm opening of the mandibular plane at the lower incisor area and a downward and backward mandibular rotation. This leads to an increase in facial height, a receded chin and a gummy smile. With proper diagnosis, treatment planning and mechanotherapy, vertical control can be achieved resulting in maintenance or closing of the mandibular and occlusal planes and a forward mandibular response. With the mechanics shown you will be able to not only achieve a forward mandibular response, but gingival display of up to 1 cm and greater can be eliminated.

Learning Objective:

Diagnostic criteria and mechanotherapy for achieving a forward mandibular response in Class II treatment will be given leading to an ideal occlusion in harmony with facial balance, function, periodontal health and long-term stability

Treatment of Borderline Surgical/non-surgical Patients with Emphasis on Class III and Open Bite Malocclusions

Patients with Class III and/or open-bite malocclusions can often be treated without orthognathic surgical intervention, provided their final facial appearance is acceptable to the patient. Three techniques to treat the "borderline patient" will be illustrated by a case series: nonsurgical maxillary expansion, the multiple loop edgewise archwire technique (MEAW), and the use of bone plates. The limits of non-surgical treatment will also be explained.

Learning Objectives:

Using the multiple-loop edgewise arch wire technique to close open bites and moderate Class III malocclusions
Correcting posterior cross bite without surgical assist
The limitations of nonsurgical treatment of the "borderline patient"

Chester S. Handelman DMD

Appearances