5 years and 4 month old child having small chin, he clinically presents with distal step 2nd molar relation and narrow width of maxilla, having normal SNA angle, decreased SNB angle, with low FMA angle, then. What would be the appropriate treatment protocol for this patient?
Wait and watch for 6 years
Kloehn head gear to treat maxillary protrusion
FR II appliance
Twin block appliance
When the facial growth pattern is viewed against the perspective of the cephalocaudal gradient, it is not surprising that the mandible, being farther away from the brain, tends to grow more and later than the maxilla, which is closer.
Growth of the mandible continues at a relatively steady rate before puberty. Ramus height increases 1 to 2 mm per year and body length increases 2 to 3 mm per year. These cross-sectional data tend to smooth out the juvenile and pubertal growth spurts, which do occur in growth of the mandible.
Growth in length and height of both jaws continues through the period of puberty.
Since the age of the child is less than 6 years and growth spurts are yet to occur. So at this point of time, in this patient, the best treatment protocol will be wait and watch.
Ref: Proffit 4th Edition