TREATMENT OF CLASS II DIVISION 1 MALOCCLUSION IN GROWING PERIOD USING BIONATOR APPLIANCE FOLLOWED BY THE RADIAL EXPANSION PLATE (CASE REPORT)
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The bionator is one of the effective myofunctional appliance in treating Class II division 1 malocclusion because it spured the antrerior mandibular growth by improving response condyle remodelling. The radial expansion plate (REP) is used to get a space for correction of malpositioned teeth and transverse discrepancy of the maxillary intercanine. Objectives: to explained dentalveolar, skeletal and profil changes after treatment of class II division 1 malocclusion using bionator followed by REP. Case Report and Management: Female, 11 years old,Angle Class II division malocclusion, class II skeletal pattern, retrusion mandible, overjet 6,8mm, palatal bite with "tonge thrust" habits and mouth breathe. The treatmen was planned using bionator to correct mandibular retrusion followed by REP. Result: The bionator was used for 6 months results in the first molar Class I relationship, open bite posterior segment, reduced overbite and overjet, a changes in the position of the mandible forward. The REP completed used for 6 months result in increase maxillary intercanine width, upper teeth anterior crowding corrected, open bite corrected. At the end of the treatment result decrease in facial convexity and interinsicial relationships corrected. Discussion and Conclusion: the position of the mandible forward after treatment by bionator was not stable because its was blocked by segment curved narrow maxillary anterior teeth. Increased maxillary intercanine width after treatment by REP had resolved this problem. Conclusions is the bionator followed by REP can be used treatment of class II division 1 in growing period and has improve the profile to harmonious.