Class II malocclusion cases possess a constant challenge to orthodontists since time immemorial. Mandibular retrusion is the most common feature of class II malocclusion, rather than maxillary prognathism. Association of class II with asymmetry, a condition called asymmetric mandibular retrognathia (AMR), gives a tougher challenge to orthodontists for management. The following case presents effective management of AMR using differential loading technique. A young boy aged 12 years presented with mandibular retrognathia associated with facial asymmetry. He was treated with a differential force loading technique using a fixed functional appliance.
Results: Improved facial profile with increased mandibular length achieved. A significant reduction in facial asymmetry was also appreciable.
Conclusion: Differential force loading technique using fixed functional appliance while being least troublesome for the patient may prove beneficial to harness excellent and satisfactory results with minimal efforts in such cases of mandibular retrusion with facial asymmetries and also decrease the need for surgical correction.
Khumanthem S, Kumar M, Ansari A, et al. Correction of class II using PowerScope appliance – a case report. Arch of Dent and Med Res 2016;2(3):120–125.
Proffit WR. Malocclusion and dentofacial deformity in contemporary society. Contemporary Orthodontics. 4th ed., St. Louis: Mosby Elsevier; 2007. pp. 3–23.
McNamara JA. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981;51(3):177–202. DOI: 10.1043/0003-3219(1981)0512.0.CO;2.
Kuo AA, Tritasavit S, John M, et al. Congenital muscular torticollis and positional plagiocephaly. Pediat Rev 2014;35(2):79. DOI: 10.1542/pir.35-2-79.
Amin Y, Parameswaran R, Soundararajan Nagachandran K, et al. A hybrid myofunctional appliance for hemifacial hypertrophy – a case report. J Dentofacial Anom Orthod 2017;20(8):411. DOI: 10.1051/odfen/2017100.
Gandini P, Orsi L, Grampi B, et al. Functional approach with hybrid orthodontic appliances in mandibular asymmetries. Mondo Ortod 2008;33(4):229–238.
Vig PS, Vig KW. Hybrid appliances: a component approach to dentofacial orthopedics. Am J Orthod Dentofac Ortho 1986;90(4):273–285. DOI: 10.1016/0889-5406(86)90084-3.
Paulose J, Antony PJ, Suresh Kumar B, et al. PowerScope a class II corrector– a case report. Contemp Clin Dent 2016;7(2):221–225. DOI: 10.4103/0976-237X.183044.
Pancherz H, Ruf S, Kohlhas P. Effective condylar growth” and chin position changes in Herbst treatment: a cephalometric roentgenographic long-term study. Am J Orthod Dentofacial Orthop 1998;114(4):437–446. DOI: 10.1016/s0889-5406(98)70190-8.
McNamara JA, Franchi L. The cervical vertebral maturation method: a user's guide. Angle Orthodontist 2018;88(2):133–143. DOI: 10.2319/111517-787.1.
Clarren SK, Smith DW, Hanson JW. Helmet treatment for plagiocephaly and congenital muscular torticollis. J Pediatr 1979;94(1):43–46. DOI: 10.1016/s0022-3476(79)80347-9.
Kharbanda OP, Sidhu SS, Sundaram KR. Cephalometric profile of north Indians: Tweed's analysis. Int J Orthod 1991;29(3-4):3–5.
