Combined Orthodontic and Prosthetic Treatment of a Patient with Angle Class II Division 1 Malocclusion: A Case Report

Abstract

Skeletal class II division 1 malocclusion is primarily characterized by maxillary protrusion, mandibular retrusion or a combination of both. Treatment modalities for these patients are different depending on the age and the severity of the case. In adult patients with skeletal class II division 1, where the discrepancy is very severe, orthodontic and orthognathic surgery combined are often necessary to ensure an appropriate treatment, while prosthodontic treatment may be a challenge due to the skeletal discrepancies of the maxilla and the mandible. This clinical report presents a 45-year-old patient with a diagnosis of Angle Class II division 1 malocclusion. After clinical and radiographic observation and consultation with an orthodontist and maxillofacial surgeon, a combination of surgical and orthodontic therapy was proposed. Considering that the patient refused the surgical procedure due to fear, orthodontic therapy was carried out first, which improved the aesthetic and functional characteristics, but did not give results in increasing the vertical dimension of the occlusion. Therefore, further therapy was prosthetic, and was carried out by making all-ceramic maxillary and mandibular fixed dental prostheses; the patient was successfully rehabilitated and the anteroposterior discrepancy between the dental arches was corrected. Combined orthodontic and prosthetic treatment can be a good option in the complex treatment of patients with skeletal class II division 1 malocclusion providing functional rehabilitation of the stomatognathic system and improving facial appearance and the quality of life of the patient.