How would you classify this Malocclusion?
Class II Malocclusion with an adverse dental interlock and resulting trauma to the maxillary mucosa from the deciduous mandibular incisors and canine teeth.
How would you initially manage this condition?
Extract all mandibular incisors and canines.
What does this accomplish?
Extraction eliminates pain and removes the interlock that prevents the mandible from reaching its genetic potential for rostral movement. This provides the patient with the best chance at preventing similar problems with the adult canines.
Note: Extracting the canines alone will not eliminate discomfort or interlock. Once the canines are extracted the incisors become the point of maximal palatal contact and must be removed as well.
As seen here, the incisors are also causing indentations in the palatal mucosa.
Careful technique is required to extract deciduous teeth. Note the relative size of the crown vs. the root in the canine and incisor teeth.