Orthodontic treatment of severely protruded maxillary anterior teeth in a middle age adult female

The multi-disciplinary concept of dental care in the adult patient, especially the middle age group, has recently received considerable attention in orthodontics. The author presents the orthodontic treatment of a middle age female with severe overjet. The patient was forty-one years and eleven months old female with a Class II, Division 1, malocclusion. Besides a severe skeletal discrepancy in the anterior-posterior relationship, the U1-SN was 123.5 degrees. There were spaces in the maxillary anterior segment and a large space was present between the canine and first premolar. The mandibular right first and second premolars occluded in lingual position. Begg plastic brackets were placed in the maxilla and C.A.T. brackets were placed in the mandible. The severe curve of Spee was eliminated by the use of a tandem depression archwire system in the mandibular arch. Both light wire mechanics and edgewise straight wire mechanics were used effectively during the treatment process. The active treatment period was three years. Overjet changed from 15.5mm to 6.0mm and overbite from 7.0mm to 3.3mm. The U1-SN and U1-AP were greatly reduced. The lower anterior teeth were labially inclined, increasing the IMPA from 96.5 degrees to 107.5 degrees. The periodontal tissue suffered no damage from the mechanical orthodontic procedures. The patient was significantly pleased with the treatment results.