Chris' Top 11 Cases: 4. Class II, Excessive Overjet and Deep Bite｜【Chris Chang Ortho】CC456

Class II, Excessive Overjet and Deep Bite with a Congenitally Missing Lower Incisor Abstract A 9-year-11-month female was placed on recall until her buccal segments erupted. At 13-years of age she returned with a severe dentofacial malocclusion: (1) convex facial profile, (2) protrusive and everted upper lip, (3) Class II buccal segments, 5 mm on the right and 2 mm on the left (4) overjet 11 mm, (5) overbite 9 mm, and (6) a congenital missing lower left lateral incisor. The Discrepancy Index (DI) for this complex malocclusion was 22. Treatment involved extraction of both upper first premolars as well as the lower left central incisor. The overjet was corrected by retraction with miniscrews placed in the infrazygomatic crest (IZC). The lower canines were moved into the lateral incisor positions (canine substitution). The treatment outcomes were excellent, as evidenced by the Cast Radiograph Evaluation (CRE) of 24 and a Pink and White dental esthetics score of 3. (Int J Orthod Implantol 2016;41:42-55) Key words: Maxillary lip protrusion, severe overjet, deep bite, congenital missing lower incisor, mandibular canine substitution