Anterior either alveolar or skeletal infraocclusions are known as recurrent pathologies, creating problems of etiological, functional and aesthetic type.
Aim. The study aims at evidencing the difficulties of the treatment of anterior infraocclusions and the impact of the premolar or molar extractions upon facial and profile aesthetics.
Materials and method. The study was performed on a reference group of 12 patients with infraocclusions associated to a skeletal class III, with a hyper-divergent growth scheme. The cephalometric architectural study of the vertical size by the Danguy method permitted evaluation of the various therapeutical effects upon the vertical size.
Results and discussion. The possibility of a precocious interception of an infraocclusion, concomitantly with the interception of a skeletal class III, modifies the intermaxillary ratios, re-establishes the prehension organ and reduces the masticator angle. Reduction of the Np-Es-Tm masticator angle was observed both in patients with premolar and molar extractions, being less important in cases of molar extractions, as due to the pressure of lingual interposition. As a matter of fact, similar skeletal modifications could be observed in the patients with molar extractions, the skeletal modifications in the patients with premolar extraction being slightly different. No matter if the patient was a child or an adolescent, correction of an anterior infraocclusion has always improved facial and smile aesthetics.
Conclusions. Trophic infraocclusions represent a real challenge for the realization of an orthodontic treatment. Premolar extractions improve the prehension organ, while molar extractions solve the problems of the posterior and anterior direction, even if it is not certain whether these extractions could change the vertical size.
- difficulty of the treatment
- impact of extractions