Early treatment of a Class II division 1 with severe mandibular retrognatic : mandibular unlocking
This is a clinical case of an 8 years old patient who suffer from a sever upper protrusion and lower retrusion which lock on the mandibular, due also to a permanent labial interposition.
The treatment plan is to unlock the mandible by advancement, giving the chance to grow and suppression of labial interposition. The appliance prescribed was a PUL and was worn 22 hours per day until eruption of four first bicuspids, and then night wearing to maintain the results.
Intra-oral pictures 11 to 15 show the setting of Class 1 and the uprighting of upper incisors without any anterior accessory like elastic or metal arch.
Pictures 16 and 17 show the facial harmonization benefit of mandibular advancement.
Teleradios before and after PUL :
- What do you think about this case ?
- What would it be your treatment plan and appliances ?