Table 2 . Suggested treatment protocol for dental malocclusion
Suggested Treatment Protocol
Non extraction : stripping , expansion , derotation , uprighting or distalisation Extraction :
CLASSIFICATION Class I malocclusion OF SKELETAL U / L 4s , U AND / L 5s , U / L DENTAL 6s , U / L 7s or a MALOCCLUSION symmetric extraction e . g . right : REVISITED
U / L 4s + left U / L 5s , U / L 6s + U / L 4s or 5s , single tooth extraction .
Class II malocclusion
Class III malocclusion
Type 1
Type 2a
Type 2b
Type 1
Type 2
Type 3a
Type 3b
Non extraction : Distalisation with headgear
Extraction : 4s , ( U 4s + L 5s ), ( U / L 6s ), ( U / L 7s ) or a symmetric extraction e . g . ( right U / L 4s + left U / L
5s ), ( U / L 6s + U / L 4s or 5s ). or a single U4 .
Always advise non extraction treatment using a headgear + Nudger or an intra-oral distalizer . If crowding is to be relieved by extraction , then it is advisable to extract the 2 nd premolar than the 1 st premolar because of difficulty of space closure . Transfer the case to CL II / 1 and treat accordingly .
Headgear + Nudger Orthognathic surgery treatment ( proclined upper anteriors and retroclined lower anteriorsdecompensation : plan for surgery )
Camouflage with stripping lower arch and proclining upper teeth . Expansion of upper arch ± fixed appliance therapy .
Expansion of upper arch ± fixed appliance therapy with CL III elastics . Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed orthodontic therapy with CL III elastics . Expansion of upper arch + extraction of a single lower central incisor + U / L fixed orthodontic therapy with CL III elastics .
Expansion of upper arch ± fixed appliance therapy with CL III elastics . Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed Orthodontic therapy with CL III elastics . Expansion of upper arch + extraction of a single lower central incisor + U / L fixed orthodontic therapy with CL III elastics .
Expansion of upper arch ± fixed Orthodontic therapy . Extraction of lower 1 st premolars and upper 2 nd premolars + U / L fixed Orthodontic therapy . Expansion of upper arch + extraction of a single lower central incisor + U / L fixed Orthodontic therapy with CL III elastics .
5 . Conclusion Incisor , canine and molar classification should always be used accurately to diagnose and to plan the final occlusion . A final class I incisor and canine relationship at the end of treatment is always the aim so to provide long term stability while molar relationship could be class I , II ( full unit ) or III relationship .
The author recommends further study on methods of classification and establishing orthodontic treatments ’ protocols .
Acknowledgments The author declare no conflict of interest related to this study . There are no conflicts of interest and no financial interests to be disclosed .
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