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Abstract

S8-SGTB: Correzione di una grave discrepanza mascellare di Classe II

1.Three-depth malocclusion and clear S8-SGTB appliance 2.Working mechanism of S8-SGTB 3.S8-SGTB is effective in adult According to Shen’s classification system for malocclusions with facial convexity, there are three groups who share the common traits of mandibular postural retrusion and the subsequent three-depth malocclusion, i. e., deep overjet, deep overbite, and deep curve of Spee together with Class II intercuspation. Rather than resorting to conventionally dentitional camouflage treatment, the optimal and appropriate approach is to restore the retruded position of the mandible first before correcting dentitional malocclusion, a treatment regime termed mandibular advancement repositioning technology (MART). The working mechanism of MART is best described on three facets: (1) forcible relocation of the mandible which solicits TMJ adaptive reaction and thus consolidates the forward positioning of the mandible. (2) flattening of deep curve of Spee under the new positioning of the mandible and (3) manipulation of malpositioned teeth or dentition. Independent of growth spurt, the core working mechanism of MART lies in TMJ adaptability which is a life-long phenotype, suggesting MART treatment remains efficacious in non-growing adults. This new paradigm makes it possible to minimize or even circumvent the requirement for surgical intervention. The treatment of three-depth malocclusion is executed by S8-SGTB, a clear appliance incorporated with digitalization and algorithms. The clinical procedure of S8-SGTB includes two stages, with stage 1 implementing mandibular repositioning and stage 2 achieving dental interdigitation. As an indispensable part of the whole clinical formality of S8-SGTB, bite registration assisted by wax placement aims to record the new position of the mandible, the foundation based on which the precise fabrication of S8-SGTB is accomplished.