Case example 2
A 22-year-old female presented with the chief complaint of a lack of contact between the anterior teeth and a poor esthetic appearance of her smile (Figure 7A–C ). The patient demonstrated a severe Class II malocclusion with a 1.9-mm open bite and posterior crossbite tendency. Cephalometric analysis revealed an obtuse mandibular plane angle and excessive vertical development of the maxilla (Table 2 ).
Maxillary expansion was accomplished using a spring jet appliance.17 Initial leveling and alignment was achieved with a preadjusted appliance and a mandibular lingual arch. After four months, RMI modules were placed bilaterally (Figure 8A ).
Molar intrusion and concurrent counterclockwise rotation of the mandible was achieved in about five months (Figure 8B ). No use of vertical elastics was applied to this case at any time of treatment, and only a limited use of Class II intermaxillary elastics was used for finishing the occlusion. Treatment was completed in a total of 19 months (Figure 9A–C ). The occlusion and skeletal results have remained stable 21 months after the removal of the appliance for intrusion (eight months after the end of treatment) (note that the T3 cephalometric radiograph was taken eight months after the end of treatment) (Figure 10A–D ).
Honestly that case sounds nearly identical to mine. I feel like if there was an image to go along with this description it would be like looking in a mirror. I am wondering if this is what my orthodontist meant when he said my problems might be able to be corrected without surgery. Does anybody think this sounds plausible and legit? I go in to get braced a week from tomorrow. I plan on talking it over with the orthodontist one more time. I was planning on campaigning for maxillary impaction, but now I am not so sure. I am so confused. This whole situation has caused me so much emotional distress and has essentially consumed my life.
The main things that bother me are lip incompetence, a bit of a gummy smile, slightly narrow smile, slightly recessed chin, appearance of a long narrow face, TMJ pain, headaches, obstructed nose breathing especially when sleeping.
Does this treatment plan sound viable?