Management of Class I Bimaxillary Protrusion malocclusion by Camouflage Orthodontic Treatment

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 Diagnosis:

    A female patient came with the chief complain of forwardly placed upper front teeth. The extraoral examination reveals mesoprosopic faceform, mesoocephalic headform, convex profile, incompetent lips, acute nasolabial angle. The intraoral examination shows Class I molar relation, Class I canine relation on left side and Class II (end on) relation on right side with increased overjet and spacing in upper & lower anterior teeth. Diagnosis is Angle's Class I bimaxillary protrusion malocclusion with anterior spacing.


Treatment Objectives: 
  • To correct proclination of upper anterior teeth
  • To achieve ideal overjet and overbite
  • To close spacing in upper & lower anterior teeth
  • To improve profile
  • To correct nasolabial angle
  • To correct smile

Treatment Plan: 
  • Extraction irt 14,24,34,44
  • Leveling and alignment 
  • Space Closure
  • Finishing and detailing

Treatment Progress: 

    The orthodontic treatment is started with banding and bonding in upper and lower arches with standard 0.022 inch MBT preadjusted edgewise appliance.  The initial leveling and alignment process is started. The sequential change of arch wires were 0.016 nickel‑titanium (NiTi), 0.017 x 0.025 NiTi, 0.019 x 0.025 NiTi, 0.019 x 0.025 SS. After the leveling & alignment is completed, extraction of all first premolars are done. Then retraction is started on 0.019 x 0.025 SS wire by sliding mechanics. Elastomeric chain is changed every six weeks. After space closure, finishing is done on 0.019 x 0.025 braided SS wire by settling elastics. The overall treatment duration is approximate 1.5 year. After removal of orthodontic appliance, lingual fixed retainer and removable essix retainer are given.

Treatment Results: 

    The posttreatment photographs showed Class I molar and canine relation, ideal overjet and overbite, average nasolabial angle, competent lips, well coordinated arches. The profile is also improved. The pleasing smile is obtained with proper interdigitation of occlusion. 

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