Lucas L – 8yo – Close Diastema before MFT – Class II div 1 and 2 Mixed Dentition

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Pre-Op 2023-02-14

Analysis

• Mixed Dentition
• Molar Class II div 1 and 2
• Mod/Severe Overjet and Deep bite
  • Tongue thrust is likely the etiology.
  • Associated diastema of the upper centrals
  • Struggles to close lips verging on lower lip entrapment.

Treatment Plan

• Stage 1
  • Close diastema between upper centrals to address lip incompetence and facilitate the eruption of the laterals
• Stage 2
  • Myofunctional Therapy using Myobrace

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Stage 1 Close Upper central Diastema and the Commencement of Stage 2

Treatment plan

• Buttons and Power Chains
• Space closed in 2 weeks and held closed for a further 4 weeks as we attempted using in conjunction with K3 myobrace to try to get MFT while holding the diastema space closed. k3 was use to try to protect the buttons from debonding. Since making this attempt I have tried the K3 on myself and realized that this was way too ambitious.

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Stage 2 – 1st Progress Scan 2023-05-16

ANALYSIS

Used the K3 to accommodate buttons but this was too ambitious and compliance is low. At this stage we removed the buttons. There was little progress as the compliance was too low. However the diastema space closure was established and stable.

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Stage 2 – 2nd Progress Scan – 2023-08-21

ANALYSIS

• Buttons were removed from the 11,21 at the end of the previous review and K1 appliance medium. Compliance has been better
• Upper anterior stable

• Diastema opening on lower incisors – Tongue thrusting towards the lower

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Stage 2 Progress Scan 3 – 2023-11-14

ANALYSIS

Arch expansion on both arches

Molar Class 2 correction progressing

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Progress Scan 4 – 2024-03-20

ANALYSIS

Maintained arch expansion and positive rotation of the incisors

Lower arch expansion maintained.

Molar Class II correction maintained but has not progress since previous review

Deep Bite Correction

SUMMARY OF THE CONCLUSION OF MFT STAGE

Lucas still has mixed dentition at this stage. We have established compliance and will continue use of the K1 Myobrace appliance and review in his routine dental maintenance. We will reassess his orthodontic needs may continue with the next stages of the Myobrace system. In any case the appliance is an effective way to mitigate the damages of abfraction, tooth wear and attrition associated with bruxism.