Retreatment of a skeletal class ii postpubescent patient with a convex facial profile and temporomandibular disorders

Abstract

Objectives: The present case report describes the orthodontic retreatment of a skeletal Class II postpubescent female patient who presented following previous orthodontic treatment that involved the extraction of the four first premolars, temporomandibular disorders and a convex facial profile. Methods: The patient, aged 15 years, sought treatment for the chief complaints of an unaesthetic facial profile and difficulty in opening her mouth. The examination revealed a convex facial profile and a moderate skeletal Class II relationship within a long face. The patient had bilateral pain around the temporomandibular joints and her maximum mouth opening was only 11 mm. The treatment plan was to initially relieve the temporomandibular symptoms and then to retract the upper dentition using mini-implants. Results: The patient’s mouth opening ability reached 37 mm and a significantly improved harmonious facial profile was achieved. Conclusions: Cases that present with previous unsuccessful orthodontic treatment may be retreated to achieve a satisfactory aesthetic and functional result by precise control of tooth movement in three dimensions.