KEMİK DESTEKLİ KELEŞ SLİDER APAREYİ İLE SINIF II DİVİZYON 2 MALOKLÜZYONUN TEDAVİSİ: VAKA RAPORU

Year 2025, Volume: 34 Issue: 2, 312 - 316, 15.08.2025

Aybuke Asena Atasever İşler , Nurhan Bayındır Durna

https://doi.org/10.34108/eujhs.1536865

Abstract

Üst kesici dişlerin yetersiz görünümü, yüz estetiği üzerinde olumsuz bir etkiye sahip olabilir. Derin kapanışın düzeltilmesi, ortodontik tedavide genellikle zorlu bir süreçtir. Tedavi edilmeyen derin kapanışlar, maksiller anterior dişlerde çapraşıklıkların artmasına, bu dişlerin anterior hareketine, periodontal sorunlara ve temporomandibular eklem bozukluklarına yol açabilir; ayrıca mandibulanın lateral ve anterior hareketlerini sınırlayabilir. Bu çalışmanın amacı, yetişkin bir kadın hastada Sınıf II maloklüzyon ve derin kapanış tedavisini incelemektir. Sınıf II maloklüzyonun tedavisi ve dikey boyutu artırmak amacıyla molardistalizasyonu yapılmıştır. Seviyeleme aşamasından sonra, üst çenede artırılmış spee’liNiTi teller ve alt çenede reverseNiTi teller kullanılarak alt ve üst kesici dişlerin intrüzyonu ve molar dişlerin ekstrüzyonu sağlanmış, böylece derin kapanış başarılı bir şekilde tedavi edilmiştir. Hastanın final oklüzyonu, Sınıf I kapanışı olarak elde edilmiş ve overbite ile overjet ideal aralıklar içinde tamamlanmıştır. Hastanın gülüş estetiği, başlangıç durumuna kıyasla iyileştirilmiştir. Sonuç olarak, yetişkin hastalarda derin kapanışın tedavisinin, maksiller ve mandibular kesici dişlerin intrüzyonu ile etkili bir şekilde tamamlanabildiği görülmektedir.

Keywords

Sınıf II tedavisi , derin kapanış , distalizasyon

TREATMENT OF CLASS II DIVISION 2 MALOCCLUSION WITH A BONE-SUPPORTED KELES SLIDER APPLIANCE: A CASE REPORT

Abstract

Inadequate maxillary incisor display can have a negative impact on faciala esthetics. Correcting a deep bite is typically a challenging step in orthodontic treatment. Untreated deep bites can lead to increased anterior tooth crowding, flaring of the maxillary teeth, periodontal issues, and temporo mandibular joint disorders; it may also limit lateral and anterior mandibular movements. This study aims to examine the treatment of Class II malocclusion and deep bite in a non-growing female patient. In order to correct the Class II malocclusion and to increase the vertical dimension, molardistalization was performed. Subsequently, the intrusion of the lower and upper incisors and the extrusion of the molar teeth were achieved using accentuated curve wires in the upper jaw and rever securve of speearch wires in the lower jaw, thus successfully treating the deep bite. The patient's final occlusion is a Class I closure, and the overbite and overjet have been completed with in the ideal ranges. The patient's smile's aesthetic has improved compared to the irinitial presentation. Therefore, the correction of bite through the intrusion of maxillary and mandibular incisors, along with the extrusion of the molar teeth, can be considere deffectively accep table in non-growing patients.

Keywords

Class II treatment , deep bite , distalization

References

• Watted N, Lone IM, Zohud O, Midlej K, Proff P, Iraqi FA. Comprehensive deciphering the complexity of thedeep bite: insight from animal model tohuman subjects. J Pers Med. 2023;13(10):1472. doi:10.3390/jpm13101472.
• Thilander B, Pena L, Infante C, Parada SS, De Mayorga C. Prevalence of malocclusion and orthodontic treatment need in children and adolescents in Bogota, Colombia. An epidemiological study related to different stages of dental development. Eur J Orthod. 2001;23(2):153-168. doi:10.1093/ejo/23.2.153.
• Upadhyay M, Nanda R. Etiology, Diagnosis and Treatment of Deep Overbite. Current Therapy in Orthodontics, 1 ed. Missouri, MosbyElsevier, 2010;186-198.
• Baccetti T, Franchi L, McNamara Jr JA. Longitudinalgrowthchanges in subjects with deep bite. Am J Orthod Dentofacial Orthop. 2011;140(2):202-209. doi:10.1016/j.ajodo.2011.04.015.
• Ceylan I, Eröz ÜB. TheEffects of Overbite on the Maxillary and Mandibular Morphology. Angle Orthodontist. 2001;71:110-115. doi:10.1043/0003-3219(2001)071<0110:TEOOOT>2.0.CO;2.
• Watted N, Lone IM, Zohud O, Midlej K, Proff P, Iraqi FA.Comprehensive Deciphering the Complexity of the Deep Bite: Insight from Animal Model to Human Subjects. J Pers Med. 2023;8;13(10):1472. doi:10.3390/jpm13101472.
• NandaR. Biomechanics and esthetic strategies in clinical orthodontics. Elsevier Health Sciences; 2005.
• Cakan DG, Ulkur F, Taner TU. The genetic basis of facial skeletal characteristics and its relation with orthodontics. Eur J Orthod. 2012;6(03):340-345.PMID:22904665.
• MorenoUribe LM,Miller SF. Genetics of the dent ofacial variation in humanmalocclusion. Orthod Craniofac Res. 2015;18:91-99. doi:10.1111/ocr.12083.
• Millett DT, Cunningham, SJ, O'Brien, KD, Benson, PE, De Oliveira CM. Treatment and stability of class II division 2 malocclusion in children and adolescents: a systematic review. Am J Orthod Dentofacial Orthop. 2012;142(2):159-169. doi:10.1016/j.ajodo.2012.03.022.
• Lindauer SJ, Lewis SM, Shroff B. Overbite Correction and Smile Aesthetics. Semin Orthod.2005;11:62-66. doi:10.1053/j.sodo.2005.02.003.
• Graber TM, Vanarsdall RL, Vig K. Current principles and techniques. Orthodontic Book, USA; 2005: 607-611.
• Preston CB, Maggard MB, Lampasso J, Chalabi O. Long-term effective ness of the continuous and the sectional archwire techniques in leveling the curve of Spee. Am J Orthod Dentofacial Orthop. 2008;133(4):550-555. doi:10.1016/j.ajodo.2006.02.039.
• Kuroda S, Sugawara Y, Deguchi T, Kyung HM, Takano-YamamotoT. Clinicaluse of miniscrew implants as orthodontic anchorage: successrates and postoperatived is comfort. Am J Orthod Dentofacial Orthop. 2007;131(1):9-15.doi:10.1016/j.ajodo.2005.02.032.
• Rédua RB. Different approaches to thetreatment of skeletal Class II malocclusion during growth: Bionatorversus extra oral appliance. Dent Press J Orthod. 2020;25(2): 69-85. doi:10.1590/2177-6709.25.2.069-085.bbo.
• Papadopoulos MA. Orthodontic treatment of the Class II non compliant patient. Current principles and techniques. Edinburgh: Mosby Elsevier; 2006:125-145.
• Keles A. Maxillaryunilateral molar distalization with sliding mechanics: a preliminary investigation, Eur J Orthod. 2001;23:507-515. doi:10.1093/ejo/23.5.507.
• Franchi L, Alvetro L, Giuntini V, Masucci C, Defraia E, Baccetti T. Effective ness of comprehensive fixed appliance treatment used with the Forsus Fatigue Resistant Device in Class II patients. Angle Orthodontist. 2011;81(4):678-683. doi:10.2319/102710-629.1.
• Özdemir, G. Kemik ve diş-doku destekli Keleş Slider apareylerinin etkilerinin 3 boyutlu görüntüleme yöntemiyle karşılaştırılması (Doctoral Dissertation). 2013.
• Al-Zoubi EM, Al-Nimri KS. A comparative study between the effect of reversecurve of Spee archwires and anterior bite turbos in the treatment of deep over bite cases: A randomized clinicaltrial. Angle Orthodontist, 2022;92(1):36-44. doi:10.2319/020921-117.1
• Proffit WR, Fields HW, Sarver DM. Contemporary Orthodontics. 5.ed. St. Louis, Missouri;2013:218-221.
• Caldas SGFR, Ribeiro AA, Simplício H, Machado AW. Segmented arch or continuous arch technique? A rational approach. Dental Press J Orthod. 2014;19(02):126-141. doi:10.1590/2176-9451.19.2.126-141.sar.
• Burstone CJ. Biomechanics of deep over bite correction. Semin Orthod. 2001;7(1):26-33. doi:10.1053/sodo.2001.21059.
• Keles A. The Keles sliderappliance for bilateral and unilateral maxillary molar distalization. In Orthodontic treatment for the Class II non compliant patient: current principles and techniques. Elsevier-Mosby, Edinburgh;2006:273-281.
• Sinha A, Jain S, Kunjappan SM, Jai VA, Kamble R, Jadhav AV. Assessing Cephalometric Changes in Deep Bite Correction: An Analysis of Class II Division 1 Orthodontic Patients Treated with the Reverse Curve of Spee Archwire. J Pharm Bioallied Sci. 2024;16(4):3245-3247.