Orthodontic Case Study – Jonathan

Jonathan is a 13 year old who presented with upper molars that were too far forward (Class II Division 2 malocclusion). Jonathan also had a 5mm overbite and 3mm overjet. His upper posterior (rear) teeth had drifted forward significantly. This forward movement results in the upper canine teeth being blocked from erupting correctly.

Orthodontic Treatment Options

Our orthodontists carefully assessed Jonathan’s condition and reviewed all the possible treatment options with Jonathan and his family. The approaches considered were:

A) Spacing (distallisation) therapy to achieve a class I buccal relationship (optimal bite). This option would gain sufficient space for the upper canine teeth to erupt correctly.

B) Extraction of the 14 and 24 (teeth) to create space in the middle arch allows better alignment for the 13 and 23 (canine teeth).

C) Non-extraction, but due to the Class II buccal relationship (upper molars being too far forward) there would have been significant overjet. This would need to be resolved with a functional orthodontic appliance.

Orthodontic Treatment Plan

Our team adopted a very conservative approach to treatment. Tooth extraction would only be considered if adequate space (distallisation) therapy was unsuccessful and remained an absolute worst-case scenario.

Treatment began with a Carriere appliance and was worn for approximately 6 months. During that time we achieved an ideal alignment of the molars (Class I buccal relationship).

Jonathan then wore upper and lower arch braces with some minor assistance from elastics. After approximately 14 months, Jonathan’s molar alignment was perfect. Overbite and overjet were also significantly improved. The overall improvement in bite alignment and appearance was a success and was accomplished without extracting any teeth.

Overall, Jonathan and his family were delighted and an exceptionally happy family left our practice smiling.