Evolution of Class III treatment in orthodontics.

PubMed

Ngan, Peter; Moon, Won

2015-07-01

Angle, Tweed, and Moyers classified Class III malocclusions into 3 types: pseudo, dentoalveolar, and skeletal. Clinicians have been trying to identify the best timing to intercept a Class III malocclusion that develops as early as the deciduous dentition. With microimplants as skeletal anchorage, orthopedic growth modification became more effective, and it also increased the scope of camouflage orthodontic treatment for patients who were not eligible for orthognathic surgery. However, orthodontic treatment combined with orthognathic surgery remains the only option for patients with a severe skeletal Class III malocclusion or a craniofacial anomaly. Distraction osteogenesis can now be performed intraorally at an earlier age. The surgery-first approach can minimize the length of time that the malocclusion needs to worsen before orthognathic surgery. Finally, the use of computed tomography scans for 3-dimensional diagnosis and treatment planning together with advances in imaging technology can improve the accuracy of surgical movements and the esthetic outcomes for these patients. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Camouflage treatment of skeletal class III malocclusion with asymmetry using a bone-borne rapid maxillary expander.

PubMed

Seo, Yu-Jin; Chung, Kyu-Rhim; Kim, Seong-Hun; Nelson, Gerald

2015-03-01

This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25 months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.

Severe Angle Class III skeletal malocclusion associated to mandibular prognathism: orthodontic-surgical treatment

PubMed Central

Souki, Marcelo Quiroga

2016-01-01

ABSTRACT The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate. PMID:28125146

Comparison of natural head position in different anteroposterior malocclusions.

PubMed

Hedayati, Zohreh; Paknahad, Maryam; Zorriasatine, Farbod

2013-05-01

The facial esthetics after orthodontic treatment and orthognathic surgery may be affected by the patient's natural head position. The purpose of this study was to evaluate the natural head position for the three skeletal classes of malocclusion. Our sample consisted of 102 lateral cephalometric radiographs of patients aged 15 to 18 years; class I (n=32), class II (n=40) and class III (n=30). Nine landmarks of the craniofacial skeleton and three landmarks of the cervical vertebrae were determined. Variables consisted of two angles for cervical posture (OPT/Hor and CVT/Hor), three angles for craniofacial posture (SN/Ver, PNS-ANS/Ver, and ML/Ver ) and five for craniofacial angulation (SN/OPT, SN/CVT, PNS-ANS/OPT, PNS-ANS/CVT, ML/CVT). The data were analyzed statistically using ANOVA and post hoc tests. PNS-ANS/Ver and SN/Ver differed significantly (p<0.05) among the three groups. There were no significant differences between class I and class II malocclusions for the indicator angles of cranial posture except for ML/Ver. The SN/CVT was significantly different for class I compared to class III patients. A head posture camouflaging the underlying skeletal class III was observed in our population. A more forward head posture was observed in skeletal class III participants compared to skeletal class I and II and that class III patients tended to incline their head more ventral compared to class I participants. These findings may have implications for the amount of jaw movements during surgery particularly in patients with a class III malocclusion.

Efficiency of compensatory orthodontic treatment of mild Class III malocclusion with two different bracket systems

PubMed Central

Aragón, Mônica L. C.; Bichara, Lívia M.; Flores-Mir, Carlos; Almeida, Guilherme; Normando, David

2017-01-01

ABSTRACT Objective: The purpose of this study was to assess the efficiency of compensatory orthodontic treatment of patients with mild Class III malocclusion with two preadjusted bracket systems. Method: Fifty-six matched patients consecutively treated for mild Class III malocclusion through compensatory dentoalveolar movements were retrospectively evaluated after analysis of orthodontic records. The sample was divided into two groups according to the brackets used: Group 1 = non-Class III compensated preadjusted brackets, Roth prescription (n = 28); Group 2 = compensated Class III preadjusted brackets, Capelozza III prescription (n = 28). Cephalometric analysis, number of appointments and missed appointments, months using Class III elastics, and bond/band failures were considered. Treatment time, Peer Assessment Rating (PAR) index at the beginning (PAR T1) and end of treatment (PAR T2) were used to calculate treatment efficiency. Comparison was performed using a MANOVA at p< 0.05. Results: Missed appointments, bond or band failures, number of months using the Class III intermaxillary elastics, and cephalometric measurements showed no statistically significant difference (p> 0.05) between groups. Patients treated with Roth brackets had a treatment time 7 months longer (p= 0.01). Significant improvement in the patient’s occlusion (PAR T2-T1) was observed for both groups without difference (p= 0.22). Conclusions: Orthodontic brackets designed for compensation of mild Class III malocclusions appear to be more efficient than non-compensated straight-wire prescription brackets. Treatment time for Class III patients treated with brackets designed for compensation was shorter than with Roth prescription and no difference in the quality of the occlusal outcome was observed. A prospective randomized study is suggested to provide a deeper look into this subject. PMID:29364379

Maxillary canine-first premolar bilateral transposition in a Class III patient: A case report.

PubMed

Potrubacz, Maciej Iancu; Tepedino, Michele; Chimenti, Claudio

2016-05-01

Tooth transposition is a rare dental anomaly that often represents a challenge for the clinician. The case of a girl with skeletal Class III malocclusion and concomitant maxillary canine-first premolar bilateral transposition, followed from 7 to 17 years of age, is presented. After a first phase of treatment aimed at resolving the Class III malocclusion, the transposition was maintained and the case finalized with a multibracket appliance.

Relationship between foot posture and dental malocclusions in children aged 6 to 9 years

PubMed Central

Marchena-Rodríguez, Ana; Moreno-Morales, Noelia; Ramírez-Parga, Edith; Labajo-Manzanares, María Teresa; Luque-Suárez, Alejandro; Gijon-Nogueron, Gabriel

2018-01-01

Abstract The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children. The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H). This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification. A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II. The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other. PMID:29742725

Relationship between foot posture and dental malocclusions in children aged 6 to 9 years: A cross-sectional study.

PubMed

Marchena-Rodríguez, Ana; Moreno-Morales, Noelia; Ramírez-Parga, Edith; Labajo-Manzanares, María Teresa; Luque-Suárez, Alejandro; Gijon-Nogueron, Gabriel

2018-05-01

The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children.The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H).This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification.A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II.The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other.

A new modified tandem appliance for management of developing Class III malocclusion.

PubMed

Sukh, Ram; Singh, Gyan P; Tandon, Pradeep

2013-10-01

Most developing Class III patients display a retruded maxilla. Early intervention in mixed dentition is associated with better patient compliance and possibly a better orthopedic response, which can produce favorable results. The aim of this article is to present the fabrication of the new modified tandem appliance and its use in management of developing Class III malocclusion. The therapeutic results of a new modified tandem appliance are presented in an 8 year-old male patient with anterior cross bite and retrognathic maxilla at the mixed dentition stage. Anterior cross bite was corrected in 3 months and the positive overjet of 4 mm after continued use of the appliance for 1 year. There was a significant improvement in profile of the patient. The use of this appliance in this type of malocclusion enabled the correction of malocclusion in a few months and encouraging favorable skeletal growth in the future.

Crown-root morphology of lower incisors in patients with class III malocclusion.

PubMed

Wang, Bo; Shen, Guofang; Fang, Bing; Zhang, Li

2012-07-01

The purpose of this study was to investigate the crown-root morphology of lower incisors in patients with class III malocclusion using cone-beam computed tomography. Cone-beam computed tomography images were analyzed from 53 adult class I patients (group 1), 37 preadolescent class III patients (group 2), and 66 adult class III patients (group 3) comprising 3 divisions (divisions 1, 2, and 3 corresponded to mild, moderate, and severe class III malocclusions). The size and crown-root angulations of lower incisors in different groups and divisions were statistically appraised with group 1 used as the control group. No significant differences were found for the size of lower incisors among different groups and divisions (P > 0.05). Compared with group 1, the crown-root angulations of lower incisors in groups 2 and 3 were significantly larger (P < 0.01), and among 3 divisions, the lower incisors of division 3 rather than divisions 2 and 3 exhibited larger crown-root angulations (P < 0.01). Attention should be paid to the enlarged crown-root angulations of lower incisors in class III patients during orthodontic and orthognathic treatment, especially in severe ones.

Thin-plate spline analysis of the cranial base in subjects with Class III malocclusion.

PubMed

Singh, G D; McNamara, J A; Lozanoff, S

1997-08-01

The role of the cranial base in the emergence of Class III malocclusion is not fully understood. This study determines deformations that contribute to a Class III cranial base morphology, employing thin-plate spline analysis on lateral cephalographs. A total of 73 children of European-American descent aged between 5 and 11 years of age with Class III malocclusion were compared with an equivalent group of subjects with a normal, untreated, Class I molar occlusion. The cephalographs were traced, checked and subdivided into seven age- and sex-matched groups. Thirteen points on the cranial base were identified and digitized. The datasets were scaled to an equivalent size, and statistical analysis indicated significant differences between average Class I and Class III cranial base morphologies for each group. Thin-plate spline analysis indicated that both affine (uniform) and non-affine transformations contribute toward the total spline for each average cranial base morphology at each age group analysed. For non-affine transformations, Partial warps 10, 8 and 7 had high magnitudes, indicating large-scale deformations affecting Bolton point, basion, pterygo-maxillare, Ricketts' point and articulare. In contrast, high eigenvalues associated with Partial warps 1-3, indicating localized shape changes, were found at tuberculum sellae, sella, and the frontonasomaxillary suture. It is concluded that large spatial-scale deformations affect the occipital complex of the cranial base and sphenoidal region, in combination with localized distortions at the frontonasal suture. These deformations may contribute to reduced orthocephalization or deficient flattening of the cranial base antero-posteriorly that, in turn, leads to the formation of a Class III malocclusion.

Non-surgical Management of Skeletal Class III Malocclusion with Bilateral Posterior Crossbite: A Case Report.

PubMed

Kumari, Lalima; Nayan, Kamal

2016-12-01

A 16-year-old female patient with skeletal Class III malocclusion and bilateral posterior cross bite complaining of difficulty in chewing was treated orthodontically without surgery (camouflage treatment). The treatment comprised of fixed orthodontic treatment with MBT prescription (0.022˝×0.028˝ slot) using quad helix appliance for bilateral expansion of maxillary arch and Class III elastics for occlusal correction. Post-treatment records showed normal overbite and overjet with acceptable occlusion. So with this treatment strategy of expanding the maxillary arch using a quad helix appliance and use of Class III elastics, we achieved a good result with optimal occlusion.

Epidemiology of Malocclusion and Assessment of Orthodontic Treatment Need for Nepalese Children.

PubMed

Singh, Varun Pratap; Sharma, Amita

2014-01-01

Objective. To evaluate the prevalence of malocclusion and orthodontic treatment needs among 12- to 15-year-old schoolchildren in eastern Nepal and compare the findings with those of other populations. Methods. Two thousand seventy-four children (1149 males and 925 females) aged between 12 and 15 years were evaluated. Their orthodontic treatment need was assessed using the Index of Orthodontic Treatment Needs (IOTN) (dental health component (DHC)). Angle's classes of malocclusion were also evaluated. Results. The prevalence of classes I, II, and III was 48.50%, 32.68%, and 4.32%, respectively. The IOTN showed that 21.59% had an extreme treatment need, 24.67% had severe treatment need, 24.07% had moderate treatment need, 14.7% had mild treatment need, and 15.02% had no treatment need. Conclusion. Class I malocclusion is the most common, while class III is the least prevalent in eastern Nepal. The majority of the children need orthodontic treatment.

Orthognathic Surgery for the Correction of Severe Skeletal Class III Malocclusion.

PubMed

Kafle, D; Upadhayaya, C; Chaurasia, N; Agarwal, A

2016-01-01

Skeletal Malocclusions results from the abnormal position of maxilla and mandible in relation with cranial base. These types of malocclusion are commonly treated by orthodontic teeth movement known as camouflage orthodontics. However severe skeletal malocclusions cannot be treated by orthodontics alone. Such cases need surgical intervention to align the position of the jaw along with orthodontic correction. This procedure is commonly known as Orthognathic Surgery. Orthognathic Surgery dates back to early eighteenth century but became popular on mid twentieth century. Though the prevalence of skeletal malocclusion is more than 1% the treatment facility was not available in Nepal till 2012. Here we present a case of Skeletal Class III malocclusion treated at Dhulikhel Hospital, Kathmandu University Hospital. For this case, double jaw surgery was performed by le-Fort I osteotomy and Bilateral Sagital Split Osteotomy. Orthognathic surgery has been routinely performed at this centre since then.

Surgical-orthodontic treatment of a skeletal class III malocclusion.

PubMed

Katiyar, Radha; Singh, G K; Mehrotra, Divya; Singh, Alka

2010-07-01

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment option left. One indication for surgery obviously is a malocclusion too severe for orthodontics alone. It is possible now to be at least semiquantitative about the limits of orthodontic treatment, in the context of producing normal occlusion as the diagrams of the "envelope of discrepancy" indicate. In this case report we present orthognathic treatment plan of an adult female patient with skeletal class III malocclusion. Patient's malocclusion was decompensated by orthodontic treatment just before the surgery and then normal jaw relationship achieved by bilateral sagittal split osteotomy.

Morphometric analysis of treatment effects of bone-anchored maxillary protraction in growing Class III patients

PubMed Central

De Clerck, H. J.; Cevidanes, L. H.; Franchi, L.

2011-01-01

The aim of the present morphometric investigation was to evaluate the effects of bone-anchored maxillary protraction (BAMP) in the treatment of growing patients with Class III malocclusion. The shape and size changes in the craniofacial configuration of a sample of 26 children with Class III malocclusions consecutively treated with the BAMP protocol were compared with a matched sample of 15 children with untreated Class III malocclusions. All subjects in the two groups were at a prepubertal stage of skeletal development at time of first observation. Average duration of treatment was 14 months. Significant treatment-induced modifications involved both the maxilla and the mandible. The most evident deformation consisted of marked forward displacement of the maxillary complex with more moderate favourable effects in the mandible. Deformations in the vertical dimension were not detected. The significant deformations were associated with significant differences in size in the group treated with the BAMP protocol. PMID:21187527

Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report

PubMed Central

Farret, Marcel Marchiori; Farret, Milton M. Benitez; Farret, Alessandro Marchiori

2016-01-01

ABSTRACT Introduction: Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. Objective: To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. Methods: The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. Results: After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results. PMID:27653269

Orthodontic camouflage of skeletal Class III malocclusion with miniplate: a case report.

PubMed

Farret, Marcel Marchiori; Farret, Milton M Benitez; Farret, Alessandro Marchiori

2016-01-01

Skeletal Class III malocclusion is often referred for orthodontic treatment combined with orthognathic surgery. However, with the aid of miniplates, some moderate discrepancies become feasible to be treated without surgery. To report the case of a 24-year-old man with severe skeletal Angle Class III malocclusion with anterior crossbite and a consequent concave facial profile. The patient refused to undergo orthognathic surgery; therefore, orthodontic camouflage treatment with the aid of miniplates placed on the mandibular arch was proposed. After 18 months of treatment, a Class I molar and canine relationship was achieved, while anterior crossbite was corrected by retraction of mandibular teeth. The consequent decrease in lower lip fullness and increased exposure of maxillary incisors at smiling resulted in a remarkable improvement of patient's facial profile, in addition to an esthetically pleasing smile, respectively. One year later, follow-up revealed good stability of results.

Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review

PubMed Central

Pithon, Matheus Melo; Santos, Nathalia de Lima; dos Santos, Camila Rangel Barreto; Baião, Felipe Carvalho Souza; Pinheiro, Murilo Costa Rangel; Matos, Manoel; Souza, Ianderlei Andrade; de Paula, Rafael Pereira

2016-01-01

ABSTRACT Introduction: the treatment of Class III malocclusion in early age is one of the greatest challenges for orthodontists, and the establishment of more effective treatment method is a constant concern for these professionals. Thus, the objective of this systematic review is to verify the effectiveness of the therapy protocol for alternate rapid maxillary expansion and constriction (Alt-RAMEC) in the early treatment of Class III malocclusion. Methods: searches were performed in the following electronic databases: Cochrane Library, Medline (EBSCO and PubMed), SciELO, LILACS and Scopus. The following inclusion criteria were used: in vivo studies conducted with early intervention (patient in craniofacial development phase) with the use of the Alt-RAMEC protocol. Reviews, case reports, editorials, and studies with syndromic patients or under use of systemic drug were excluded. Duplicates were also excluded. The studies were assessed for methodological quality using the Cochrane tool for assessment of risk of bias, and classified as high or low risk of bias. Results: 53 articles were found. Duplicates exclusion was thus performed and 35 articles remained. After inclusion analysis, only 5 matched the criteria. Two articles were classified as low risk of bias and three as high risk of bias. It was observed that the Alt-RAMEC enable protraction in less time and with better results, promoting greater effectiveness in the protraction treatment of Class III malocclusion. Conclusions: Although there is positive evidence of the effectiveness of early treatment with the Alt-RAMEC protocol in patients with Class III malocclusion, further studies are needed to confirm its effectiveness using long-term methodology. PMID:28125138

Surgical–orthodontic treatment of a skeletal class III malocclusion

PubMed Central

Katiyar, Radha; Singh, G. K.; Mehrotra, Divya; Singh, Alka

2010-01-01

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment option left. One indication for surgery obviously is a malocclusion too severe for orthodontics alone. It is possible now to be at least semiquantitative about the limits of orthodontic treatment, in the context of producing normal occlusion as the diagrams of the “envelope of discrepancy” indicate. In this case report we present orthognathic treatment plan of an adult female patient with skeletal class III malocclusion. Patient's malocclusion was decompensated by orthodontic treatment just before the surgery and then normal jaw relationship achieved by bilateral sagittal split osteotomy. PMID:22442586

Anteroposterior condylar position: a comparative study between subjects with normal occlusion and patients with Class I, Class II Division 1, and Class III malocclusions.

PubMed

Fraga, Marcelo Reis; Rodrigues, Andréia Fialho; Ribeiro, Luiz Claudio; Campos, Marcio José da Silva; Vitral, Robert Willer Farinazzo

2013-10-29

The present study aimed to determine and compare the anteroposterior position of the condyle in the mandibular fossa between groups of asymptomatic subjects with normal occlusion and asymptomatic subjects with Class I, Class II Division 1, and Class III malocclusions. Thirty persons with normal occlusion, 30 with Class I malocclusion, 30 with Class II Division 1, and 30 with Class III had computed tomography scans of their temporomandibular joints. The anterior joint space/posterior joint space (AJS/PJS) ratio was determined for the right and left joints. The paired t test was used to analyze the AJS/PJS ratio between both sides for each group. The ANOVA test was applied to verify the differences between the groups for the measurements of the right and left sides. In case the ANOVA test confirmed significance, the Dunnett's t test was performed to compare the groups of malocclusion with that of normal occlusion. The paired t test between the AJS/PJS relationships in the right and left sides showed the following p values: Class I (0.168), Class II Division 1 (0.662), Class III (0.991), and normal occlusion (0.390). The ANOVA test showed a p value of 0.445 for the comparisons of the right side and 0.040 for the left side. The Dunnett's t test demonstrated a statistically significant difference between the Class II group and the normal occlusion group (p value of 0.026) in the joints of the left side. Bilateral symmetry and lack of condyle centralization were common characteristics among all groups. The greatest condylar decentralization was observed in the Class II group, whereas the least condylar decentralization was found in the normal occlusion group.

Thin-plate spline analysis of treatment effects of rapid maxillary expansion and face mask therapy in early Class III malocclusions.

PubMed

Baccetti, T; Franchi, L; McNamara, J A

1999-06-01

An effective morphometric method (thin-plate spline analysis) was applied to evaluate shape changes in the craniofacial configuration of a sample of 23 children with Class III malocclusions in the early mixed dentition treated with rapid maxillary expansion and face mask therapy, and compared with a sample of 17 children with untreated Class III malocclusions. Significant treatment-induced changes involved both the maxilla and the mandible. Major deformations consisted of forward displacement of the maxillary complex from the pterygoid region and of anterior morphogenetic rotation of the mandible, due to a significant upward and forward direction of growth of the mandibular condyle. Significant differences in size changes due to reduced increments in mandibular dimensions were associated with significant shape changes in the treated group.

Prevalence of Malocclusion among 6 to 10 Year old Nalgonda School Children

PubMed Central

Reddy, E Rajendra; Manjula, M; Sreelakshmi, N; Rani, S Thabitha; Aduri, Rajesh; Patil, B Dharamraj

2013-01-01

Background: To evaluate the prevalence of malocclusion among 6 to 10 year old children of Nalgonda District. Materials & Methods: A total of 3000 children were examined, out of which 2135 children (1009 boys and 1126 girls) who fulfilled the inclusion criteria were included. The selected sample was examined for Class I, Class II, Class III molar relationship, lower anterior crowding, cross bite (anterior and posterior), open bite, and pseudo class III [edge to edge bite] discrepancies after obtaining the written consent from the concerned school authorities. The collected data was tabulated and statistically analysed using chi-square test. Results: Among the selected sample, 648 (30.35%) children had minor tooth alignment discrepancies. Angle’s Class I molar relation with and without minor discrepancies was observed in 78.6%, Class II in 13.9%, Class III in 7.8% of the subjects surveyed. Lower anterior crowding in 11.8%, anterior cross bite in 4.5%, posterior cross bite in 3.75%, openbite in 3% and Pseudo class III [edge to edge] in 5.97% was noticed among the studied population. There was no statistical significant difference observed gender wise. Conclusion: In the current study, 52% of the studied population had malocclusion with a higher prevalence of Angle’s Class I molar relation with lower anterior crowding. How to cite this article: Reddy ER, Manjula M, Sreelakshmi N, Rani ST, Aduri R, Patil BD. Prevalence of Malocclusion among 6 to 10 Year old Nalgonda School Children. J Int Oral Health 2013; 5(6):49-54 . PMID:24453444

Class III malocclusion treated with distalization of the mandibular dentition with miniscrew anchorage: A 2-year follow-up.

PubMed

Chen, Kun; Cao, Yang

2015-12-01

This case report describes the orthodontic camouflage treatment for a 16-year-old Chinese girl with a Class III malocclusion. The treatment included extractions of the mandibular second molars, fixed appliance therapy, and miniscrew-aided mandibular arch distalization. Pretreatment, posttreatment, and 2-year follow-up records are shown. The anterior negative overjet and the Class III molar and canine relationships were corrected. The patient's facial profile was greatly improved. The mandibular third molars erupted into the second molar spaces, with acceptable intercuspation with the maxillary dentition. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Curve of Spee and its relationship to vertical eruption of teeth among different malocclusion groups.

PubMed

Veli, Ilknur; Ozturk, Mehmet Ali; Uysal, Tancan

2015-03-01

Our objectives were to assess the depth of the curve of Spee (COS) in different malocclusion groups, to relate this to the eruption of anterior or posterior teeth quantitatively, and to determine whether the depth of the COS is affected by the vertical eruption of anterior or posterior teeth. Two hundred conventional lateral cephalograms and 3-dimensional models of untreated patients (70 boys, mean age: 16.4 ± 1.4 years; 130 young women, mean age: 18.1 ± 1.8 years) were included and assigned to 4 malocclusion groups as Class I, Class II Division 1, Class II Division 2, and Class III. The depth of the COS, overjet, and overbite were measured on 3-dimensional models. The perpendicular distance between the incisal tip of the mandibular central incisor (L1-MP), the deepest point of the COS (S-MP), and the distobuccal cusp tip of the mandibular second molar (L7-MP) to the mandibular plane were calculated and proportioned with each other. The Pearson correlation coefficient was calculated, and multiple linear regression analysis was carried out. Also, multivariate analysis of variance was performed at the P <0.05 level. The mesiobuccal cusp of the first molar was the deepest part of the COS in all groups, with a maximum depth of 2.44 ± 0.73 mm in the Class II Division 1 subjects and a minimum depth of 1.76 ± 0.94 in the Class III subjects. The depth of the COS changed as follows: Class II Division 1 > Class II Division 2 > Class I > Class III malocclusion groups. Statistically significant positive correlations were found between the depth of the COS and L1-MP/S-MP (r = 0.541) and L7-MP/S-MP (r = 0.269) in the Class I and Class III subjects, and between the depth of the COS and overjet (r = 0.483) and L7-MP/S-MP (r = 0.289) in the Class II Division 1 subjects. All variables except overjet had positive correlations with the depth of the COS in Class II Division 2 subjects. The multivariate analysis of variance showed statistically significant differences in overjet, overbite, L1-MP/S-MP, L7-MP/S-MP, and the depth of the COS (P <0.001) among the groups. Although the overjet differed, vertical eruption of the anterior teeth did not differ among the different malocclusion groups and had a significant contribution to the depth of the COS in subjects with Class I and Class III malocclusions. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Control of lower incisor inclination with a completely customized lingual appliance for dentoalveolar compensation of class III malocclusion.

PubMed

Lossdörfer, Stefan; Schwestka-Polly, Rainer; Wiechmann, Dirk

2013-09-01

Bracket slots and orthodontic archwires offering high dimensional precision are needed for fully customized lingual appliances. We aimed to investigate whether high-precision appliances of this type enable dentoalveolar compensation of class III malocclusion so that lower incisor inclination at the end of treatment will closely match the anticipated situation as defined in a pretreatment setup. This retrospective study included a total of 34 consecutive patients who had worn a fully customized lingual appliance to achieve dentoalveolar compensation for class III malocclusion by intermaxillary elastics, or proximal enamel reduction, or extraction of teeth in one or both jaws. Casts fabricated at different points in time were three-dimensionally scanned to analyze how precisely the lower incisor inclinations envisioned in the setup were implemented in clinical practice. Aside from minor deviations of ±3.75°, the lower incisor inclinations were clinically implemented as planned even in patients with major sagittal discrepancies. Treatment goals predefined in a setup of dentoalveolar compensation for class III malocclusion can be very precisely achieved via a customized lingual appliance. Correct planning can prevent undesirable lingual tipping of the lower incisors. This finding should not encourage a more liberal use of dentoalveolar compensation, but it should heighten clinicians' awareness of how essential it is to sufficiently consider the individual anatomy of the dentoalveolar complex during treatment planning.

Temporomandibular disorders in growing patients after treatment of class II and III malocclusion with orthopaedic appliances: a systematic review.

PubMed

Jiménez-Silva, Antonio; Carnevali-Arellano, Romano; Venegas-Aguilera, Matías; Tobar-Reyes, Julio; Palomino-Montenegro, Hernán

2018-05-01

To determine if the use of orthopaedic appliances in growing patients applied to correct Class II and III malocclusion is related to the development of temporomandibular disorders (TMD). A systematic review was conducted between 1960 and July 2017, based on electronic databases: PubMed, Cochrane Library, Embase, Medline, Scopus, EBSCOhost, Scielo, Lilacs and Bireme. Controlled clinical trials (CCTs) and randomized controlled trials (RCTs) were identified. The articles were selected and analyzed by two authors independently. The quality of the evidence was determined according to the guidelines of the Cochrane Risk Bias Assessment Tool and the Cochrane Quality Study Guide. Seven articles were included, four CCTs and three RCTs. The studies were grouped according to malocclusion treatment in (a) class II appliances (n = 4) and (b) class III appliances (n = 3). The quality of evidence was low due to the high risk of bias, independent of the association reported. All studies concluded that the use of orthopaedic appliances would not contribute to the development of TMD. The quality of evidence available is insufficient to establish definitive conclusions, since the studies were very heterogeneous and presented a high risk of bias. However, it is suggested that the use of orthopaedic appliances to correct class II and III malocclusion in growing patients would not be considered as a risk factor for the development of TMD. High-quality RCTs are required to draw any definitive conclusions.

Camouflage treatment of skeletal Class III malocclusion with multiloop edgewise arch wire and modified Class III elastics by maxillary mini-implant anchorage.

PubMed

He, Shushu; Gao, Jinhui; Wamalwa, Peter; Wang, Yunji; Zou, Shujuan; Chen, Song

2013-07-01

To evaluate the effect of the multiloop edgewise arch wire (MEAW) technique with maxillary mini-implants in the camouflage treatment of skeletal Class III malocclusion. Twenty patients were treated with the MEAW technique and modified Class III elastics from the maxillary mini-implants. Twenty-four patients were treated with MEAW and long Class III elastics from the upper second molars as control. Lateral cephalometric radiographs were obtained and analyzed before and after treatment, and 1 year after retention. Satisfactory occlusion was established in both groups. Through principal component analysis, it could be concluded the anterior-posterior dental position, skeletal sagittal and vertical position, and upper molar vertical position changed within groups and between groups; vertical lower teeth position and Wits distance changed in the experimental group and between groups. In the experimental group, the lower incisors tipped lingually 2.7 mm and extruded 2.4 mm. The lingual inclination of the lower incisors increased 3.5°. The mandibular first molars tipped distally 9.1° and intruded 0.4 mm. Their cusps moved 3.4 mm distally. In the control group, the upper incisors proclined 3°, and the upper first molar extruded 2 mm. SN-MP increased 1.6° and S-Go/N-ME decreased 1. The MEAW technique combined with modified Class III elastics by maxillary mini-implants can effectively tip the mandibular molars distally without any extrusion and tip the lower incisors lingually with extrusion to camouflage skeletal Class III malocclusions. Clockwise rotation of the mandible and further proclination of upper incisors can be avoided. The MEAW technique and modified Class III elastics provided an appropriate treatment strategy especially for patients with high angle and open bite tendency.

Combined orthodontic and surgical treatment of a severe skeletal Class III malocclusion: a case report.

PubMed

Nene, Salil; Gautam, Rajaganesh; Sharif, Kanaan; Gupta, Gaurav

2012-01-01

This report describes a combined orthodontic and surgical treatment approach for a severe skeletal Class III malocclusion in a young Indian woman with serious esthetic concerns. The case required significant surgical correction in the anteroposterior and vertical planes, involving surgeries in both the maxilla and the mandible. The case required the use of mini-implant anchorage in the presurgical phase as well as postorthodontic prosthodontic rehabilitation to replace missing posterior teeth to restore the occlusal table.

Thin-plate spline (TPS) graphical analysis of the mandible on cephalometric radiographs.

PubMed

Chang, H P; Liu, P H; Chang, H F; Chang, C H

2002-03-01

We describe two cases of Class III malocclusion with and without orthodontic treatment. A thin-plate spline (TPS) analysis of lateral cephalometric radiographs was used to visualize transformations of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. These case analyses indicate that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopaedic therapy, and visualization of these deformations is feasible using TPS graphical analysis.

Skeletal maturation of the cervical vertebrae: association with various types of malocclusion.

PubMed

Armond, Mônica Costa; Generoso, Rodrigo; Falci, Saulo Gabriel Moreira; Ramos-Jorge, Maria Letícia; Marques, Leandro Silva

2012-01-01

The identification of the skeletal maturation stage of the cervical vertebrae has proven an important reference for orthodontic diagnosis. The aim of the present study was to determine the association between the skeletal maturation stage of the cervical vertebrae and types of malocclusion according to the age and gender of participants. A total of 361 individuals (168 males and 193 females) between 8 and 14 years of age were selected from a convenience sample. Malocclusions were diagnosed through study models using the Angle classification. Maturation stages of the cervical vertebrae were determined using the method proposed by Hassel and Farman. Statistical analysis involved the chi-square test (p £ 0.05) and multiple logistic regression (forward stepwise procedure). Significant differences were observed between the stage of skeletal maturation of the cervical vertebrae and gender at ages 11, 12 and 14 years. Males with Class II malocclusion were twice as likely to be in Stage 1 or 2 of cervical vertebra maturation than individuals with Class I malocclusion (OR = 2.1 [CI 95%, 1.33-3.18]). There were no differences between individuals with Class I and Class III malocclusions. The association between skeletal maturation of the cervical vertebrae and type of malocclusion was significant, suggesting a skeletal component in the determination of Class II malocclusions.

Skeletal pattern in subjects with temporomandibular joint disorders

PubMed Central

Almăşan, Oana Cristina; Almăşan, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; Băciuţ, Grigore

2013-01-01

Introduction To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Material and methods Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Results Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Conclusions Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD. PMID:23515361

Modern trends in Class III orthognathic treatment: A time series analysis.

PubMed

Lee, Chang-Hoon; Park, Hyun-Hee; Seo, Byoung-Moo; Lee, Shin-Jae

2017-03-01

To examine the current trends in surgical-orthodontic treatment for patients with Class III malocclusion using time-series analysis. The records of 2994 consecutive patients who underwent orthognathic surgery from January 1, 2004, through December 31, 2015, at Seoul National University Dental Hospital, Seoul, Korea, were reviewed. Clinical data from each surgical and orthodontic treatment record included patient's sex, age at the time of surgery, malocclusion classification, type of orthognathic surgical procedure, place where the orthodontic treatment was performed, orthodontic treatment modality, and time elapsed for pre- and postoperative orthodontic treatment. Out of the orthognathic surgery patients, 86% had Class III malocclusion. Among them, two-jaw surgeries have become by far the most common orthognathic surgical treatment these days. The age at the time of surgery and the number of new patients had seasonal variations, which demonstrated opposing patterns. There was neither positive nor negative correlation between pre- and postoperative orthodontic treatment time. Elapsed orthodontic treatment time for both before and after Class III orthognathic surgeries has been decreasing over the years. Results of the time series analysis might provide clinicians with some insights into current surgical and orthodontic management.

Localisation of deformations of the midfacial complex in subjects with class III malocclusions employing thin-plate spline analysis

PubMed Central

SINGH, G. D.; McNAMARA JR, J. A.; LOZANOFF, S.

1997-01-01

This study determines deformations of the midface that contribute to a class III appearance, employing thin-plate spline analysis. A total of 135 lateral cephalographs of prepubertal children of European-American descent with either class III malocclusions or a class I molar occlusion were compared. The cephalographs were traced and checked, and 7 homologous landmarks of the midface were identified and digitised. The data sets were scaled to an equivalent size and subjected to Procrustes analysis. These statistical tests indicated significant differences (P<0.05) between the averaged class I and class III morphologies. Thin-plate spline analysis indicated that both affine and nonaffine transformations contribute towards the total spline for the averaged midfacial configuration. For nonaffine transformations, partial warp 3 had the highest magnitude, indicating the large scale deformations of the midfacial configuration. These deformations affected the palatal landmarks, and were associated with compression of the midfacial complex in the anteroposterior plane predominantly. Partial warp 4 produced some vertical compression of the posterior aspect of the midfacial complex whereas partial warps 1 and 2 indicated localised shape changes of the maxillary alveolus region. Large spatial-scale deformations therefore affect the midfacial complex in an anteroposterior axis, in combination with vertical compression and localised distortions. These deformations may represent a developmental diminution of the palatal complex anteroposteriorly that, allied with vertical shortening of midfacial height posteriorly, results in class III malocclusions with a retrusive midfacial profile. PMID:9449078

Localisation of deformations of the midfacial complex in subjects with class III malocclusions employing thin-plate spline analysis.

PubMed

Singh, G D; McNamara, J A; Lozanoff, S

1997-11-01

This study determines deformations of the midface that contribute to a class III appearance, employing thinplate spline analysis. A total of 135 lateral cephalographs of prepubertal children of European-American descent with either class III malocclusions or a class I molar occlusion were compared. The cephalographs were traced and checked, and 7 homologous landmarks of the midface were identified and digitised. The data sets were scaled to an equivalent size and subjected to Procrustes analysis. These statistical tests indicated significant differences (P < 0.05) between the averaged class I and class III morphologies. Thinplate spline analysis indicated that both affine and nonaffine transformations contribute towards the total spline for the averaged midfacial configuration. For nonaffine transformations, partial warp 3 had the highest magnitude, indicating the large scale deformations of the midfacial configuration. These deformations affected the palatal landmarks, and were associated with compression of the midfacial complex in the anteroposterior plane predominantly. Partial warp 4 produced some vertical compression of the posterior aspect of the midfacial complex whereas partial warps 1 and 2 indicated localised shape changes of the maxillary alveolus region. large spatial-scale deformations therefore affect the midfacial complex in an anteroposterior axis, in combination with vertical compression and localised distortions. These deformations may represent a developmental diminution of the palatal complex anteroposteriorly that, allied with vertical shortening of midfacial height posteriorly, results in class III malocclusions with a retrusive midfacial profile.

Influence of the cranial base flexion on Class I, II and III malocclusions: a systematic review.

PubMed

Almeida, Kélei Cristina Mathias de; Raveli, Taísa Boamorte; Vieira, Camila Ivini Viana; Santos-Pinto, Ary Dos; Raveli, Dirceu Barnabé

2017-01-01

The aim of this study was to perform a systematic review on the morphological characteristics of the skull base (flexion, anterior length and posterior length) and the concomitant development of malocclusions, by comparing differences in dimorphism, ethnicity and age. The articles were selected by means of electronic search on BBO, MEDLINE and LILACS databases from 1966 to 2016. A qualitative evaluation of the methodologies used on the articles was also performed. Although the literature on this topic is abundant, only 16 articles were selected for the present systematic review. The cranial base angle itself does not seem to play a significant role in the development of malocclusions. In fact, the cranial base angle is relatively stable at the ages of 5 to 15 years. A more obtuse angle at the skull base, in association or not with a greater anterior length of the cranial base, can contribute to the development of Class II division 1 malocclusions. On the other hand, a more acute angle at the skull base can contribute to a more anterior positioning of the mandible and to the development of Class III malocclusions.

Influence of the cranial base flexion on Class I, II and III malocclusions: a systematic review

PubMed Central

de Almeida, Kélei Cristina Mathias; Raveli, Taísa Boamorte; Vieira, Camila Ivini Viana; dos Santos-Pinto, Ary; Raveli, Dirceu Barnabé

2017-01-01

ABSTRACT Objective: The aim of this study was to perform a systematic review on the morphological characteristics of the skull base (flexion, anterior length and posterior length) and the concomitant development of malocclusions, by comparing differences in dimorphism, ethnicity and age. Methods: The articles were selected by means of electronic search on BBO, MEDLINE and LILACS databases from 1966 to 2016. A qualitative evaluation of the methodologies used on the articles was also performed. Results: Although the literature on this topic is abundant, only 16 articles were selected for the present systematic review. The cranial base angle itself does not seem to play a significant role in the development of malocclusions. In fact, the cranial base angle is relatively stable at the ages of 5 to 15 years. Conclusions: A more obtuse angle at the skull base, in association or not with a greater anterior length of the cranial base, can contribute to the development of Class II division 1 malocclusions. On the other hand, a more acute angle at the skull base can contribute to a more anterior positioning of the mandible and to the development of Class III malocclusions. PMID:29160345

Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis.

PubMed

Rodríguez de Guzmán-Barrera, Jorge; Sáez Martínez, Carla; Boronat-Catalá, Montserrat; Montiel-Company, Jose María; Paredes-Gallardo, Vanessa; Gandía-Franco, José Luís; Almerich-Silla, José Manuel; Bellot-Arcís, Carlos

2017-01-01

Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results.

Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis

PubMed Central

Rodríguez de Guzmán-Barrera, Jorge; Sáez Martínez, Carla; Boronat-Catalá, Montserrat; Montiel-Company, Jose María; Paredes-Gallardo, Vanessa; Gandía-Franco, José Luís; Almerich-Silla, José Manuel; Bellot-Arcís, Carlos

2017-01-01

Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results. PMID:28328995

[Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region].

PubMed

Wang, Bo; Shen, Guo-fang; Fang, Bing; Sun, Liang-yan; Wu, Yong; Jiang, Ling-yong; Zhu, Min

2012-10-01

To investigate the changes of periodontal conditions after micro-osteotomy assisted lower incisor decompensation for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region. The sample consisted of 22 cases diagnosed as skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region, selected from consecutive patients of Department of Oral & Cranio-maxillofacial Science of Shanghai Ninth People's Hospital during 2009-2012. The samples were divided into 2 groups; G1 comprised 10 patients who accepted micro-osteotomy assisted lower incisor decompensation; G2 comprised 12 patients who chose traditional pre-surgical decomposition. The changes of periodontal conditions of both groups were evaluated with the help of cone-beam CT(CBCT). Data was processed using SAS8.02 software package. For subjects in G1, during the micro-osteotomy assisted pre-surgical orthodontics, no significant difference was found in the amount of root resorption of lower incisors.But labial and lingual vertical alveolar bone loss were 2.60 mm and 2.22 mm; alveolar bone thickness increased by 3.05 mm on the labial side and decreased by 0.88 mm on the lingual side (P<0.05). Better periodontal conditions were reserved compared with those of G2. Micro-osteotomy assisted pre-surgical orthodontics was much safer than traditional orthodontics for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region.

Management of severe skeletal Class III malocclusion with bimaxillary orthognathic surgery

PubMed Central

Haryani, Jitesh; Nagar, Amit; Mehrotra, Divya; Ranabhatt, Rani

2016-01-01

Orthognathic surgery in conjunction with fixed orthodontics is a common indication for interdisciplinary management of severe skeletal Class III malocclusion. A thorough analysis of pretreatment investigations and development of a surgical visual treatment objective is essential to plan the type of surgical technique required. Bimaxillary orthognathic surgery is the most common type of surgical procedure for severe skeletal discrepancies. The present case report is a combined ortho-surgical team management of a skeletally Class III patient. The severity of the case required bilateral upper first premolar extraction for dentoalveolar decompensation and simultaneous “Two-jaw surgery” with maxillary advancement of 4 mm and mandibular setback of 7 mm. Postsurgery, a pleasing good facial profile was achieved with Class II molar relation and positive overjet. PMID:27994433

Videofluoroscopy of the oral phase of swallowing in eight to twelve years old children with dental malocclusion.

PubMed

Junqueira, Patricia; Costa, Milton Melciades

2013-11-01

The objective of this study was to describe the oral phase of swallowing in individuals with dental malocclusion and to generate data that would contribute to the rehabilitation of those patients. The study was based on the evaluation of the swallowing system through videofluoroscopy on thirty-four children of both genders, aged eight to twelve years old who present with Angle Class II and III dental malocclusions. Thirteen children of similar age and gender presenting normal dental occlusion formed the control group. The results indicated that the oral phase of swallowing is different between individuals with normal occlusion and malocclusion. Dental occlusion types Angle Class II and III did not present a swallowing pattern, independently of the amount of liquid ingested. The swallowing appeared effective in the oral phase of individuals with dental malocclusion, even though adaptations were identified. The outcome, in the absence of a single pattern and the efficiency of the adapted swallowing demonstrates, first a need for additional research investigating orofacial myofunctional treatment for patients with malocclusion and second how such analyses should focus on contributing positively to the rehabilitation of these patients.

Comprehensive surgical. Orthodontic treatment of class III malocclusion in cleft patient involving minimally invasive surgery Case report and literature review.

PubMed

Stojkovic, Goran; Stojkovic, Miodrag; Stojkovic, Jasna; Nikolic, Dejan; Stajcic, Zoran

2016-12-19

Surgical and orthodontic treatment of a teenage cleft patient. Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16. Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention. This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery. Alveolar bone grafting, Cleft, Malocclusion.

Tooth size discrepancies in Class II division 1 and Class III malocclusion requiring surgical-orthodontic or orthodontic treatment.

PubMed

McSwiney, Timothy P; Millett, Declan T; McIntyre, Grant T; Barry, Mark K; Cronin, Michael S

2014-06-01

To compare mean anterior (AR) and mean overall (OR) tooth size ratios, prevalence of clinically significant tooth size discrepancies (TSDs) and correlation between AR and OR in subjects with Class II division 1 and Class III malocclusion treated by surgical-orthodontic or orthodontic means. Retrospective, cross-sectional. State-funded and private clinics. From pre-treatment cohorts of 770 surgical and 610 non-surgical subjects, Class II division 1 and Class III malocclusion groups were identified with 60 surgical and 60 non-surgical subjects, comprising 30 males and 30 females, in each. AR and OR were calculated by landmarking digital models. Differences in AR and OR and their relationship were analysed using two-way analysis of variance (ANOVA) and a correlation coefficient, respectively. The proportions of the surgical and non-surgical groups with a TSD were assessed using logistic regression. Intra-examiner reproducibility involved re-landmarking 30 randomly selected image sets and differences in ARs and ORs were compared using a paired t-test. Random error was assessed using the intraclass correlation coefficient (ICC). Analyses were performed using SAS (SAS Institute Inc., Cary, NC, USA) at the 5% level of significance. There were no statistically significant differences associated with the measurement of either the mean AR (P = 0·913) or the mean OR (P = 0·874). ICC values were very high (AR = 0·95; OR = 0·90). Differences existed between both Class II and Class III surgical (AR: P<0·001; OR: P<0·001) and non-surgical groups (AR: P = 0·012; OR: P = 0·003). The AR and OR relationship was strong (correlation coefficient = 0·72). The highest percentage of clinically significant TSDs was seen in the AR of both Class II and Class III surgical groups (23·3%). In the cohort examined: AR and OR differed significantly for malocclusion groups. The prevalence of clinically significant TSDs did not differ significantly between surgical and non-surgical groups although the highest percentage of clinically significant TSDs was recorded for AR in Class II and Class III surgical cases. AR and OR were closely related. © 2014 British Orthodontic Society.

Variations in tooth size and arch dimensions in Malay schoolchildren.

PubMed

Hussein, Khalid W; Rajion, Zainul A; Hassan, Rozita; Noor, Siti Noor Fazliah Mohd

2009-11-01

To compare the mesio-distal tooth sizes and dental arch dimensions in Malay boys and girls with Class I, Class II and Class III malocclusions. The dental casts of 150 subjects (78 boys, 72 girls), between 12 and 16 years of age, with Class I, Class II and Class III malocclusions were used. Each group consisted of 50 subjects. An electronic digital caliper was used to measure the mesio-distal tooth sizes of the upper and lower permanent teeth (first molar to first molar), the intercanine and intermolar widths. The arch lengths and arch perimeters were measured with AutoCAD software (Autodesk Inc., San Rafael, CA, U.S.A.). The mesio-distal dimensions of the upper lateral incisors and canines in the Class I malocclusion group were significantly smaller than the corresponding teeth in the Class III and Class II groups, respectively. The lower canines and first molars were significantly smaller in the Class I group than the corresponding teeth in the Class II group. The lower intercanine width was significantly smaller in the Class II group as compared with the Class I group, and the upper intermolar width was significantly larger in Class III group as compared with the Class II group. There were no significant differences in the arch perimeters or arch lengths. The boys had significantly wider teeth than the girls, except for the left lower second premolar. The boys also had larger upper and lower intermolar widths and lower intercanine width than the girls. Small, but statistically significant, differences in tooth sizes are not necessarily accompanied by significant arch width, arch length or arch perimeter differences. Generally, boys have wider teeth, larger lower intercanine width and upper and lower intermolar widths than girls.

Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

PubMed

Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

2016-01-01

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The Effects of Maxillary Protraction with or without Rapid Maxillary Expansion and Age Factors in Treating Class III Malocclusion: A Meta-Analysis

PubMed Central

Zhang, Wei; Qu, Hong-Chen; Yu, Mo; Zhang, Yang

2015-01-01

We conducted a comprehensive meta-analysis of 12 studies to examine whether maxillary protraction face mask associated with rapid maxillary expansion (FM/RME) could be an effective treatment for Class III malocclusion and to evaluate the effect of timing on treatment response. Patients with a maxillary deficiency who were treated with FM with or without RME were compared with those who had an untreated Class III malocclusion. In both treatment groups, forward displacement of the maxilla and skeletal changes were found to be statistically significant. In addition, posterior rotation of the mandible and increased facial height were more evident in the FM group compared with the control group. However, no significant differences were observed between the early treatment groups and late treatment groups. The results indicated that both FM/RME and FM therapy produced favorable skeletal changes for correcting anterior crossbite, and the curative time was not affected by the presence of deciduous teeth, early mixed dentition or late mixed dentition in the patient. PMID:26068221

Sella size and jaw bases - Is there a correlation???

PubMed

Neha; Mogra, Subraya; Shetty, Vorvady Surendra; Shetty, Siddarth

2016-01-01

Sella turcica is an important cephalometric structure and attempts have been made in the past to correlate its dimensions to the malocclusion. However, no study has so far compared the size of sella to the jaw bases that determine the type of malocclusion. The present study was undertaken to find out any such correlation if it exists. Lateral cephalograms of 110 adults consisting of 40 Class I, 40 Class II, and 30 Class III patients were assessed for the measurement of sella length, width, height, and area. The maxillary length, mandibular ramus height, and body length were also measured. The sella dimensions were compared among three malocclusion types by one-way ANOVA. Pearson correlation was calculated between the jaw size and sella dimensions. Furthermore, the ratio of jaw base lengths and sella area were calculated. Mean sella length, width and area were found to be greatest in Class III, followed by Class I and least in Class II though the results were not statistically significant. 3 out of 4 measured dimensions of sella, correlated significantly with mandibular ramus and body length each. However, only one dimension of sella showed significant correlation with maxilla. The mandibular ramus and body length show a nearly constant ratio to sella area (0.83-0.85, 0.64-0.65, respectively) in all the three malocclusions. Thus, mandible has a definite and better correlation to the size of sella turcica.

Thin-plate spline analysis of mandibular morphological changes induced by early class III treatment: a long-term evaluation.

PubMed

Franchi, Lorenzo; Pavoni, Chiara; Cerroni, Silvia; Cozza, Paola

2014-08-01

To evaluate the long-term mandibular morphological changes induced by early treatment of class III malocclusion with rapid maxillary expansion (RME) and facial mask (FM). Twenty-five subjects [10 boys, 15 girls; mean age at T1 (start of treatment) 9.3±1.6 years] with class III disharmony were treated with RME and FM therapy followed by fixed appliances. The patients were re-evaluated at the end of growth (T2), about 8.5 years after the end of the treatment (mean age, 18.6±2.0 years). Sixteen subjects with untreated class III malocclusion comprised the control group. Mandibular shape changes were analysed on the lateral cephalograms of the subjects of both groups by means of thin-plate spline (TPS) analysis. Procrustes average mandibular configurations were subjected to TPS analysis by means of both cross-sectional between-group comparisons at T1 and at T2 and longitudinal within-group comparisons. Statistical analysis of shape differences was performed using a generalized Goodall F test. In the long term, the treated group exhibited a significant upward and forward direction of condylar growth. On the contrary, untreated class III subjects showed an upward and backward direction of condylar growth associated with a downward and forward deformation of the mandibular symphysis. Limitations are related to the small sample size of both treated and control groups and to the retrospective nature of the study. Early treatment of class III malocclusion with RME and FM is able to produce significant and favourable long-term mandibular shape changes characterized by an anterior morphogenetic rotation. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

[Morphological analysis of alveolar bone of anterior mandible in high-angle skeletal class II and class III malocclusions assessed with cone-beam computed tomography].

PubMed

Ma, J; Jiang, J H

2018-02-18

To evaluate the difference of features of alveolar bone support under lower anterior teeth between high-angle adults with skeletal class II malocclusions and high-angle adults presenting skeletal class III malocclusions by using cone-beam computed tomography (CBCT). Patients who had taken the images of CBCT were selected from the Peking University School and Hospital of Stomatology between October 2015 and August 2017. The CBCT archives from 62 high-angle adult cases without orthodontic treatment were divided into two groups based on their sagittal jaw relationships: skeletal class II and skeletal class III. vertical bone level (VBL), alveolar bone area (ABA), and the width of alveolar bone were measured respectively at the 2 mm, 4 mm, 6 mm below the cemento-enamel junction (CEJ) level and at the apical level. After that, independent samples t-tests were conducted for statistical comparisons. The ABA of the mandibular alveolar bone in the area of lower anterior teeth was significantly thinner in the patients of skeletal class III than those of skeletal class II, especially in terms of the apical ABA, total ABA on the labial and lingual sides and the ABA at 6 mm below CEJ level on the lingual side (P<0.05). The thickness of the alveolar bone of mandibular anterior teeth was significantly thinner in the subjects of skeletal class III than those of skeletal class II, especially regarding the apical level on the labial and lingual side and at the level of 4 mm, 6 mm below CEJ level on the lingual side (P<0.05). The ABA and the thickness of the alveolar bone of mandibular anterior teeth were significantly thinner in the group of skeletal class III adult patients with high-angle when compared with the sample of high-angle skeletal class II adult cases. We recommend orthodontists to be more cautious in treatment of high-angle skeletal class III patients, especially pay attention to control the torque of lower anterior teeth during forward and backward movement, in case that the apical root might be absorbed or fenestration happen in the area of lower anterior teeth.

Association of Dental Anomalies with Different Types of Malocclusions in Pretreatment Orthodontic Patients.

PubMed

Dwijendra, K S; Parikh, Vishal; George, Soja Sara; Kukkunuru, Gururam Tej; Chowdary, Gali Nagarjuna

2015-06-01

The study is planned to correlate the existence of dental anomalies with different types of malocclusion as the occurrence of anomalies is common in malocclusion. The present study was conducted among 430 patients with different types of malocclusion as 161 patients having Class I, 203 with Class II, and 66 with Class III malocclusion. The age of the patients ranged from 12 to 15 years. Diagnosis was done on the basis of history, clinical, cephalometric, radiographs, and dental cast examination. The level of significance was set at P = 0.05. Most common anomaly was rotation of teeth (18.80%), followed by hypodontia (10.90%), and least occurring was gemination, fusion, talon's cusp, and dilacerations. 31.4% showed one dental anomaly, whereas 11.9% exhibited two or more dental anomalies. The highest mean value of all the dental anomalies was seen with severe cases of malocclusion and also significant differences were observed according to gender. The present study investigated various dental anomalies in relation to malocclusion. It was found that 31.4% showed one dental anomaly, whereas 11.9% exhibited two or more dental anomalies. Hence, careful prior investigation of dental anomalies is necessary for better orthodontic treatment planning to reduce the complications.

Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment.

PubMed

Song, Han-Sol; Choi, Sung-Hwan; Cha, Jung-Yul; Lee, Kee-Joon; Yu, Hyung-Seog

2017-07-01

To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, -1.8° ± 2.8°, p = 0.044; nondeviated side, -3.7° ± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0° ± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

Augmented corticotomy-assisted surgical orthodontics decompensates lower incisors in Class III malocclusion patients.

PubMed

Wang, Bo; Shen, Guofang; Fang, Bing; Yu, Hongbo; Wu, Yong; Sun, Liangyan

2014-03-01

To quantitatively evaluate lower incisor decompensation and the surrounding periodontal region after augmented corticotomy-assisted surgical orthodontics in patients with Class III malocclusion. This prospective study enrolled patients with severe Class III malocclusion who underwent augmented corticotomy in the lower anterior region before orthodontic surgery. Cone-beam computed tomograms and lateral cephalograms were obtained before treatment (T0), after presurgical orthodontic treatment (T1), and at removal of the orthodontic surgical appliances (T2). Repeated measures analysis of variance was used to compare variables at each time point: root length (RL), anterior vertical alveolar bone level at the labial side (AVBL), posterior vertical alveolar bone level at the lingual side (PVBL), labial alveolar bone thickness at the apex (LA), lingual alveolar bone thickness at the apex (LP), and angle of the incisor to the mandibular plane (L1-MP). In the 8 subjects studied, RL was maintained from T0 to T2 (P > .05), whereas AVBL and PVBL increased from T0 to T1 (P < .05) and then decreased from T1 to T2 (P < .05). LA and L1-MP increased from T0 to T1 (P < .001) but remained steady from T1 to T2 (P > .05). LP decreased from T0 to T1 (P < .05) but increased from T1 to T2 (P < .05) with no further change. Augmented corticotomy-assisted surgical orthodontics can achieve adequate tooth decompensation with minimal periodontal side-effects in the lower anterior region in patients with Class III malocclusion. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Camouflage of moderate Class III malocclusions with extraction of lower second molars and mandibular cervical headgear.

PubMed

Mora, Diego Rey; Oberti, Giovanni; Ealo, Martha; Baccetti, Tiziano

2007-01-01

Orthodontic camouflage in patients with slight or moderate skeletal Class III malocclusions, can be obtained through different treatment alternatives. The purpose of this paper is to present a treatment that has not been described in the literature and which consists of the extraction of lower second molars and distal movement of the posterior segments by means of mandibular cervical headgear (MCH) and fixed appliances as a camouflage alternative. The force applied by the MCH was 250 gr per side (14hr/day). The total treatment time was 1 1/2 years. the extraction of lower second molars along with the use of mandibular cervical headgear is a good treatment alternative for camouflage in moderate Class III patients in order to obtain good occlusal relationships without affecting facial esthetics or producing marked dental compensations.

Early orthodontic treatment for Class III malocclusion: A systematic review and meta-analysis.

PubMed

Woon, See Choong; Thiruvenkatachari, Badri

2017-01-01

Class III malocclusion affects between 5% and 15% of our population. The 2 most common dilemmas surrounding Class III treatment are the timing of treatment and the type of appliance. A number of appliances have been used to correct a Class III skeletal discrepancy, but there is little evidence available on their effectiveness in the long term. Similarly, early treatment of Class III malocclusion has been practiced with increasing interest. However, there has been no solid evidence on the benefits in the long term. The aim of this systematic review was to evaluate the effectiveness of orthodontic/orthopedic methods used in the early treatment of Class III malocclusion in the short and long terms. Several sources were used to identify all relevant studies independently of language. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase (Ovid), and MEDLINE (Ovid) were searched to June 2016. The selection criteria included randomized controlled trials (RCTs) and prospective controlled clinical trials (CCTs) of children between the ages of 7 and 12 years on early treatment with any type of orthodontic/orthopedic appliance compared with another appliance to correct Class III malocclusion or with an untreated control group. The primary outcome measure was correction of reverse overjet, and the secondary outcomes included skeletal changes, soft tissue changes, quality of life, patient compliance, adverse effect, Peer Assessment Rating score, and treatment time. The search results were screened for inclusion, and the data extracted by 2 independent authors. The data were analyzed using software (version 5.1, Review Manager; The Nordic Cochrane Centre, The Cochrane Collaboration; Copenhagen, Denmark). The mean differences with 95% confidence intervals were expressed for the continuous data. Random effects were carried out with high levels of clinical or statistical heterogeneity and fixed affects when the heterogeneity was low. Fifteen studies, 9 RCTs and 6 CCTs, were included in this review. In the RCT group, only 3 of 9 studies were assessed at low risk of bias, and the others were at high or unclear risk of bias. All 6 CCT studies were classified as high risk of bias. Three RCTs involving 141 participants looked at the comparison between protraction facemask and untreated control. The results for reverse overjet (mean difference, 2.5 mm; 95% CI, 1.21-3.79; P = 0.0001) and ANB angle (mean difference, 3.90°; 95% CI, 3.54-4.25; P <0.0001) were statistically significant favoring the facemask group. All CCTs demonstrated a statistically significant benefit in favor of the use of each appliance. However, the studies had high risk of bias. There is a moderate amount of evidence to show that early treatment with a facemask results in positive improvement for both skeletal and dental effects in the short term. However, there was lack of evidence on long-term benefits. There is some evidence with regard to the chincup, tandem traction bow appliance, and removable mandibular retractor, but the studies had a high risk of bias. Further high-quality, long-term studies are required to evaluate the early treatment effects for Class III malocclusion patients. PROSPERO CRD42015024252. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Diagnosis and conservative treatment of skeletal Class III malocclusion with anterior crossbite and asymmetric maxillary crowding.

PubMed

Tseng, Linda L Y; Chang, Chris H; Roberts, W Eugene

2016-04-01

A man, aged 28 years 9 months, came for an orthodontic consultation for a skeletal Class III malocclusion (ANB angle, -3°) with a modest asymmetric Class II and Class III molar relationship, complicated by an anterior crossbite, a deepbite, and 12 mm of asymmetric maxillary crowding. Despite the severity of the malocclusion (Discrepancy Index, 37), the patient desired noninvasive camouflage treatment. The 3-Ring diagnosis showed that treatment without extractions or orthognathic surgery was a viable approach. Arch length analysis indicated that differential interproximal enamel reduction could resolve the crowding and midline discrepancy, but a miniscrew in the infrazygomatic crest was needed to retract the right buccal segment. The patient accepted the complex, staged treatment plan with the understanding that it would require about 3.5 years. Fixed appliance treatment with passive self-ligating brackets, early light short elastics, bite turbos, interproximal enamel reduction, and infrazygomatic crest retraction opened the vertical dimension of the occlusion, improved the ANB angle by 2°, and achieved excellent alignment, as evidenced by a Cast Radiograph Evaluation score of 28 and a Pink and White dental esthetic score of 3. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Study on the difference of corresponding age at cervical vertebral maturation stages among different skeletal malocclusions].

PubMed

Zuo, Changyan; Cong, Chao; Wang, Shihui; Gu, Yan

2015-10-01

To compare the difference of corresponding age at cervical vertebral maturation (CVM) stages among different skeletal malocclusions and provide clinic guideline on optimal treatment timing for skeletal malocclusion. Based on ANB angle, 2 575 cephalograms collected from Department of Orthodontics, Peking University School and Hospital of Stomatology from May, 2006 to November, 2014 were classified into skeletal Class I (ANB 0°~5°, 1 317 subjects), Class II (ANB > 5°, 685 subjects) and Class III (ANB < 0°, 573 subjects) groups. CVM stages were evaluated with the modified version of CVM method. Independent sample t test was performed to analyze the difference of age at different CVM stages among various skeletal groups. Significant gender difference of age was found at CS3 to CS6 for skeletal Class I group (P < 0.05), at CS5 and CS6 for skeletal Class II group (P < 0.05), and at CS3 and CS5 for skeletal Class III group (P < 0.05). At CS3 stage, the average age of male in skeletal Class II and skeletal Class III groups was (11.6 ± 1.5) years old and (10.3 ± 1.9) years old, respectively; the average age of females in those two groups was (11.7 ± 1.3) years old and (9.3 ± 1.5) years old, respectively, and significant difference was found in both comparisons (P < 0.05). Compared average age at CS5 and CS6 between skeletal Class II and skeletal Class III groups [the ages of male was (15.1 ± 1.7) and (16.8 ± 1.6) years old, the ages of male was (14.6 ± 1.2) and (15.7 ± 2.5) years old], significant difference was also found (P < 0.05). Significant gender differences were found when evaluated CVM stage and age in skeletal Class I, II and III groups. Significant differences of age at different CVM stage was noted when skeletal Class II was compared with skeletal Class III groups.

Craniofacial bone abnormalities and malocclusion in individuals with sickle cell anemia: a critical review of the literature

PubMed Central

Costa, Cyrene Piazera Silva; de Carvalho, Halinna Larissa Cruz Correia; Thomaz, Erika Bárbara Abreu Fonseca; Sousa, Soraia de Fátima Carvalho

2012-01-01

This study aims to critically review the literature in respect to craniofacial bone abnormalities and malocclusion in sickle cell anemia individuals. The Bireme and Pubmed electronic databases were searched using the following keywords: malocclusion, maxillofacial abnormalities, and Angle Class I, Class II and lass III malocclusions combined with sickle cell anemia. The search was limited to publications in English, Spanish or Portuguese with review articles and clinical cases being excluded from this study. Ten scientific publications were identified, of which three were not included as they were review articles. There was a consistent observation of orthodontic and orthopedic variations associated with sickle cell anemia, especially maxillary protrusions. However, convenience sampling, sometimes without any control group, and the lack of estimates of association and hypotheses testing undermined the possibility of causal inferences. It was concluded that despite the high frequency of craniofacial bone abnormalities and malocclusion among patients with sickle cell anemia, there is insufficient scientific proof that this disease causes malocclusion PMID:23049386

Prevalence of malocclusion in primary dentition in mainland China, 1988-2017: a systematic review and meta-analysis.

PubMed

Shen, Lu; He, Fang; Zhang, Cai; Jiang, Haofeng; Wang, Jinhua

2018-03-16

Malocclusion is a common oral disease affecting children with various reported prevalence rates. This meta-analysis aimed to determine the epidemiological characteristics of malocclusion among pre-schoolers in mainland China from 1988 to 2017. A total of 31 qualified papers describing 51,100 Chinese children aged 2-7 years were selected. The pooled malocclusion prevalence was 45.50% (95% confidence interval (CI): 38.08-52.81%) with 26.50% Class I (CI: 19.96-33.12%), 7.97% Class II (CI: 6.06-9.87%) and 12.60% Class III (CI: 9.45-15.68%) cases. The most common type of malocclusion was overbite (33.66%, CI: 27.66-39.67%), and the flush terminal type (47.10%, CI: 28.76-65.44%) was the most common in the terminal plane relationship. An increasing trend and wide variations across the country were observed. Additionally, there was no significant difference in malocclusion by gender (relative risk (RR) = 1.01, [0.96-1.06]) or urban/rural area (RR = 0.99, [0.82-1.20]). Although this study represents a narrow view of deciduous-dentition malocclusion in mainland China, the results provide sample evidence that can aid clinicians and policy makers towards early prevention and timely treatment.

Camouflage treatment of skeletal Class III malocclusion with conventional orthodontic therapy.

PubMed

Park, Jae Hyun; Yu, Joseph; Bullen, Ryan

2017-04-01

Nonextraction camouflage treatment along with Class III elastics was used to treat a 39-year-old woman with a skeletal Class III pattern and a low mandibular plane angle and short lower anterior facial height. The total active treatment time was 26 months. Her occlusion, smile esthetics, and soft tissue profile were significantly improved after treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Using Networks To Understand Medical Data: The Case of Class III Malocclusions

PubMed Central

Scala, Antonio; Auconi, Pietro; Scazzocchio, Marco; Caldarelli, Guido; McNamara, James A.; Franchi, Lorenzo

2012-01-01

A system of elements that interact or regulate each other can be represented by a mathematical object called a network. While network analysis has been successfully applied to high-throughput biological systems, less has been done regarding their application in more applied fields of medicine; here we show an application based on standard medical diagnostic data. We apply network analysis to Class III malocclusion, one of the most difficult to understand and treat orofacial anomaly. We hypothesize that different interactions of the skeletal components can contribute to pathological disequilibrium; in order to test this hypothesis, we apply network analysis to 532 Class III young female patients. The topology of the Class III malocclusion obtained by network analysis shows a strong co-occurrence of abnormal skeletal features. The pattern of these occurrences influences the vertical and horizontal balance of disharmony in skeletal form and position. Patients with more unbalanced orthodontic phenotypes show preponderance of the pathological skeletal nodes and minor relevance of adaptive dentoalveolar equilibrating nodes. Furthermore, by applying Power Graphs analysis we identify some functional modules among orthodontic nodes. These modules correspond to groups of tightly inter-related features and presumably constitute the key regulators of plasticity and the sites of unbalance of the growing dentofacial Class III system. The data of the present study show that, in their most basic abstraction level, the orofacial characteristics can be represented as graphs using nodes to represent orthodontic characteristics, and edges to represent their various types of interactions. The applications of this mathematical model could improve the interpretation of the quantitative, patient-specific information, and help to better targeting therapy. Last but not least, the methodology we have applied in analyzing orthodontic features can be applied easily to other fields of the medical science. PMID:23028552

Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery.

PubMed

Rabie, A-Bakr M; Wong, Ricky W K; Min, G U

2008-01-01

To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5 masculine. Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people.

[Distal movement of the mandibular dentition in the treatment of patients with Class III skeletal pattern].

PubMed

Mou, Lan; Xu, Gengchi; Han, Yaohui; Ge, Zhenlin

2015-06-01

To evaluate the outcome of patients with skeletal Class III malocclusion treated with extraction of mandibular third molars and distalization of molars using implant anchorage combined with MBT appliance. Fifteen patients (mean age 24.0 ± 5.8) with skeletal Class III malocclusion were selected. The mandibular third molars were extracted and the mandibular molars were moved distally using implant combined with MBT appliance. Cephalometric analysis was carried out before and after treatment. After active treatment, ANB, Wits distance, AB-NP and the distance between upper and lower lip position to SnPg' increased by 1.65° ± 1.04°, (4.39 ± 1.93) mm, 3.20° ± 1.61° and (1.13 ± 0.99) mm, respectively. The differences were statistically significant (P < 0.05). The skeletal Class III patients in the permanent dentition could be treated successfully with extraction of mandibular third molars and distalization of mandibular molars using implant anchorage combined with MBT appliance. The soft-tissue profile was improved.

Lower lip deformity in patients with cleft and non-cleft Class III malocclusion before and after orthognathic surgery.

PubMed

Park, Joo Seok; Koh, Kyung S; Choi, Jong Woo

2015-10-01

Orthognathic surgery does not yield the same cosmetic benefits in patients with Class III jaw deformities associated with clefts as for patients without clefts. Preoperative upper lip tightness caused by cleft lip repair may not fully explain this difference, suggesting that a lower lip deformity is present. The study compared the outcomes of orthognathic surgery in patients with cleft and non-cleft Class III malocclusion, focusing on lip relationship. The surgical records of 50 patients with Class III malocclusion, including 25 with and 25 without clefts, who had undergone orthognathic surgery, were retrospectively analyzed. Lateral cephalometric tracings, preoperatively and at 6 months postoperatively, were superimposed to analyze the soft tissue changes at seven reference points. At 6 months after surgery, there were no significant differences in skeletal location, whereas the soft tissues of the lower lip differed significantly between patients with and without cleft (p=0.002), indicating the persistence of a lower lip deformity in cleft patients. Moreover, the soft tissues of the lower lip receded in non-cleft patients and protruded in cleft patients after orthognathic surgery. Lower lip deformity and upper lip tightness may result in an unsatisfactory relationship between the upper and lower lips of patients with cleft-related jaw deformity after orthognathic surgery. Other factors were less important than the pathology of the lower lip. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Treatment of Class III malocclusion in a young adult patient: a case report.

PubMed

Kiran, B H Jyothi; Kumar, Prashanth; Ravi, S; Shivalinga, B M; Bhagyalaxmi; Pradeep; Kudagi, Vishal

2012-01-01

This article describes the treatment of a young adult male with a concave profile, skeletal class III malocclusion because of a prognathic mandible and proclined upper incisors. The therapy included stages: 1. Pre-surgical orthodontics involving leveling and aligning of upper and lower arches, protraction of lower molars and retraction of upper incisors; 2. Surgical phase involving BSSO with mandibular setback and 3. Post-surgical orthodontics for finishing and detailing. The treatment lasted 23 months and improved facial esthetics significantly The treatment resulted in a functional occlusion with a lack of lateral cuspid guidance that could be accepted considering the difficulty of the case. Over jet and overbite are within norms.

The William Houston Medal of the Royal College of Surgeons of Edinburgh 2002.

PubMed

Teague, A M

2004-06-01

The William Houston medal is a prestigious prize awarded to the individual achieving the most outstanding examination performance at the Membership in Orthodontics examination for the Royal College of Surgeons of Edinburgh. Five clinical cases treated by the candidate are presented as part of the final examination; two of these cases are described below. The first a Class III malocclusion, and the second a Class II division 1 malocclusion, were both treated by orthodontic camouflage.

BOS MOrth cases prize 2011.

PubMed

Patel, Jigar Vipinchandra

2013-12-01

This paper describes the orthodontic treatment of two cases awarded the prize by the British Orthodontic Society for best treated cases submitted for the Membership in Orthodontics. The first case reports on the treatment of a class III malocclusion with increased vertical lower anterior facial proportions and dentoalveolar compensation that was treated with orthodontic camouflage. The second case reports on the treatment of a class II division II malocclusion with reduced vertical lower anterior facial proportions and an overbite complete to the palate, which was treated with orthodontic camouflage.

Evaluation of Bone Thickness and Density in the Lower Incisors' Region in Adults with Different Types of Skeletal Malocclusion using Cone-beam Computed Tomography.

PubMed

Al-Masri, Maram M N; Ajaj, Mowaffak A; Hajeer, Mohammad Y; Al-Eed, Muataz S

2015-08-01

To evaluate the bone thickness and density in the lower incisors' region in orthodontically untreated adults, and to examine any possible relationship between thickness and density in different skeletal patterns using cone-beam computed tomography (CBCT). The CBCT records of 48 patients were obtained from the archive of orthodontic department comprising three groups of malocclusion (class I, II and III) with 16 patients in each group. Using OnDemand 3D software, sagittal sections were made for each lower incisor. Thicknesses and densities were measured at three levels of the root (cervical, middle and apical regions) from the labial and lingual sides. Accuracy and reliability tests were undertaken to assess the intraobserver reliability and to detect systematic error. Pearson correlation coefficients were calculated and one-way analysis of variance (ANOVA) was employed to detect significant differences among the three groups of skeletal malocclusion. Apical buccal thickness (ABT) in the four incisors was higher in class II and I patients than in class III patients (p < 0.05). There were significant differences between buccal and lingual surfaces at the apical and middle regions only in class II and III patients. Statistical differences were found between class I and II patients for the cervical buccal density (CBD) and between class II and III patients for apical buccal density (ABD). Relationship between bone thickness and density values ranged from strong at the cervical regions to weak at the apical regions. Sagittal skeletal patterns affect apical bone thickness and density at buccal surfaces of the four lower incisors' roots. Alveolar bone thickness and density increased from the cervical to the apical regions.

Progressive changes in patients with skeletal Class III malocclusion treated by 2-jaw surgery with minimal and conventional presurgical orthodontics: A comparative study.

PubMed

Zhou, Yang; Li, Zili; Wang, Xiaoxia; Zou, Bingshuang; Zhou, Yanheng

2016-02-01

In this study, we aimed to compare treatment efficacy and postsurgical stability between minimal presurgical orthodontics and conventional presurgical orthodontics for patients with skeletal Class III malocclusion. Forty patients received minimal presurgical orthodontics (n = 20) or conventional presurgical orthodontics (n = 20). Lateral cephalograms were obtained before treatment, before orthognathic surgery, and at 1 week, 3 months, 6 months, and 12 months after surgery. Changes of overjet and mandibular incisal angle before surgery were greater in the conventional presurgical orthodontics group than in the minimal presurgical orthodontics group. Postsurgical horizontal changes in Points A and B, overjet, and mandibular incisal angle showed significant differences among the time points. Most of the horizontal and vertical relapses in the maxilla and the mandible occurred within the first 6 months in both groups. Minimal presurgical orthodontics and conventional presurgical orthodontics showed similar extents and directions of skeletal changes in patients with Class III malocclusion. However, orthodontists and surgeons should preoperatively consider the postsurgical counterclockwise rotation of the mandible when using minimal presurgical orthodontics. Close and frequent observations are recommended in the early postsurgical stages. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Spline analysis of the mandible in human subjects with class III malocclusion.

PubMed

Singh, G D; McNamara, J A; Lozanoff, S

1997-05-01

This study determines deformations that contribute to a Class III mandibular morphology, employing thin-plate spline (TPS) analysis. A total of 133 lateral cephalographs of prepubertal children of European-American descent with either a Class I molar occlusion or a Class III malocclusion were compared. The cephalographs were traced and checked, and eight homologous landmarks on the mandible were identified and digitized. The datasets were scaled to an equivalent size and subjected to statistical analyses. These tests indicated significant differences between average Class I and Class III mandibular morphologies. When the sample was subdivided into seven age and sex-matched groups statistical differences were maintained for each group. TPS analysis indicated that both affine (uniform) and non-affine transformations contribute towards the total spline, and towards the average mandibular morphology at each age group. For non-affine transformations, partial warp 5 had the highest magnitude, indicating large-scale deformations of the mandibular configuration between articulare and pogonion. In contrast, partial warp 1 indicated localized shape changes in the mandibular symphyseal region. It is concluded that large spatial-scale deformations affect the body of the mandible, in combination with localized distortions further anteriorly. These deformations may represent a developmental elongation of the mandibular corpus antero-posteriorly that, allied with symphyseal changes, leads to the appearance of a Class III prognathic mandibular profile.

Influence of pharyngeal airway respiration pressure on Class II mandibular retrusion in children: A computational fluid dynamics study of inspiration and expiration.

PubMed

Iwasaki, T; Sato, H; Suga, H; Takemoto, Y; Inada, E; Saitoh, I; Kakuno, K; Kanomi, R; Yamasaki, Y

2017-05-01

To examine the influence of negative pressure of the pharyngeal airway on mandibular retraction during inspiration in children with nasal obstruction using the computational fluid dynamics (CFD) method. Sixty-two children were divided into Classes I, II (mandibular retrusion) and III (mandibular protrusion) malocclusion groups. Cone-beam computed tomography data were used to reconstruct three-dimensional shapes of the nasal and pharyngeal airways. Airflow pressure was simulated using CFD to calculate nasal resistance and pharyngeal airway pressure during inspiration and expiration. Nasal resistance of the Class II group was significantly higher than that of the other two groups, and oropharyngeal airway inspiration pressure in the Class II (-247.64 Pa) group was larger than that in the Class I (-43.51 Pa) and Class III (-31.81 Pa) groups (P<.001). The oropharyngeal airway inspiration-expiration pressure difference in the Class II (-27.38 Pa) group was larger than that in the Class I (-5.17 Pa) and Class III (0.68 Pa) groups (P=.006). Large negative inspiratory pharyngeal airway pressure due to nasal obstruction in children with Class II malocclusion may be related to their retrognathia. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Occlusal status in Asian male adults: prevalence and ethnic variation.

PubMed

Soh, Jen; Sandham, Andrew; Chan, Yiong Huak

2005-09-01

The purpose of this study was to determine the occlusal status in young Asian male adults of three ethnic groups. Study models of a sample of male army recruits (N = 339, age 17-22 years) with no history of orthodontic treatment were assessed. The ethnic proportions of the sample were Chinese 76.1% (n = 258), Malay 17.7% (n = 60), and Indian 6.2% (n = 21). British Standard Institute (BSI) and Angle's classification were used to determine incisor and molar relationships, respectively. Chi-square test or Fisher's Exact test was performed to compare the occlusal traits between ethnic groups. The distribution of incisor relationships of the total sample consisted of Class I = 48.1%, Class II/1 = 26.3%, Class II/2 = 3.2%, and Class III = 22.4%. Right Angle's molar relationships were 49.9%, 24.5%, and 24.2% whereas left Angle's molar relationships were 53.1%, 25.1%, and 21.2% for Class I, II, and III, respectively. Comparison between ethnic groups found that Indian subjects were more likely to have Class II/1 malocclusions and clinically missing permanent teeth (P < .05). The study found that the overall prevalence of malocclusion (BSI) was Class I, Class II/1, Class III, and Class II/2 in descending order of proportions. Angle's Class I molar was most prevalent followed by Class II and Class III relations. A significant difference in occlusal status between the ethnic groups was found regarding incisor relationship and missing permanent teeth (P < .05).

Comparison of Maxilla Mandibular Transverse Ratios With Class II Anteroposterior Discrepancies

DTIC Science & Technology

2014-03-20

the structure points has shown to be at best unreliable (Jacobson 1995). “2D landmarks may be hindered by rotational, geometric , and head positioning...deficiency in Class II and Class III malocclusions: a cephalometric and morphometric study on postero‐ anterior films. Orthodontics & Craniofacial

Class III malocclusion with complex problems of lateral open bite and severe crowding successfully treated with miniscrew anchorage and lingual orthodontic brackets.

PubMed

Yanagita, Takeshi; Kuroda, Shingo; Takano-Yamamoto, Teruko; Yamashiro, Takashi

2011-05-01

In this article, we report the successful use of miniscrews in a patient with an Angle Class III malocclusion, lateral open bite, midline deviation, and severe crowding. Simultaneously resolving such problems with conventional Class III treatment is difficult. In this case, the treatment procedure was even more challenging because the patient preferred to have lingual brackets on the maxillary teeth. As a result, miniscrews were used to facilitate significant asymmetric tooth movement in the posterior and downward directions; this contributed to the camouflage of the skeletal mandibular protrusion together with complete resolution of the severe crowding and lateral open bite. Analysis of the jaw motion showed that irregularities in chewing movement were also resolved, and a stable occlusion was achieved. Improvements in the facial profile and dental arches remained stable at the 18-month follow-up. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Long-term Stability of a Camouflage Retreatment of an Asymmetric Class III/Posterior Open Bite Using Sliding Jigs.

PubMed

Oliveira, Dauro Douglas; de Oliveira, Bruno Franco; Figueiredo, Daniel Santos Fonseca; Antunes, Alberto Nogueira da Gama; Seraidarian, Paulo Isaías

2017-10-01

This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.

Treatment in Borderline Class III Malocclusion: Orthodontic Camouflage (Extraction) Versus Orthognathic Surgery

PubMed Central

Rabie, A-Bakr M.; Wong, Ricky W.K.; Min, G.U.

2008-01-01

Aims: To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Materials and Methods: Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5º. Results: Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Conclusions: Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people. PMID:19088881

Occlusal features and need for orthodontic treatment in persons with osteogenesis imperfecta.

PubMed

Nguyen, Minh Son; Binh, Ho Duy; Nguyen, Khac Minh; Maasalu, Katre; Kõks, Sulev; Märtson, Aare; Saag, Mare; Jagomägi, Triin

2017-02-01

The aim of the study was to (a) analyse dental occlusion and determine the need for orthodontic treatment of persons with osteogenesis imperfecta (OI) in comparison with the healthy population and (b) investigate the associations between OI and malocclusion. A case-control study included 26 OI persons and 400 healthy participants (control group). Occlusal features and the need for orthodontic treatment were defined according to Dental Health Component-Index of Orthodontic Treatment Need and Dental Aesthetic Index. Results showed that Angle Class I, II, and III relationship was found in 23.1%, 3.8%, and 73.1% of OI group, and in the control group, it was 67%, 17.5%, and 15.5%, respectively. OI group had significantly higher prevalence of reverse overjet >1 mm (76.9%), missing teeth (42.3%), posterior crossbite (34.6%), and open bite >2 mm (19.2%) compared to the control group (8.5%, 2.2%, 6.2%, and 3.5%, respectively). OI group had less incisal segment crowding and more incisal segment spacing than the control group ( p  < 0.05). The need for orthodontic treatment of OI group according to Dental Health Component-Index of Orthodontic Treatment Need and Dental Aesthetic Index was 88.5% and 61.5%, respectively, while in the control group, it was 24.8% and 51.8%. The malocclusion in OI persons was associated with reverse overjet > 1 mm (OR = 13.3, 95% CI = 3.9-44.7, p  < .001), Angle Class III malocclusion (OR = 8.0, 95% CI = 2.0-30.8, p  = .003), and missing teeth (OR = 4.7, 95% CI = 1.0-22.4, p  = .049). In conclusion, there is the high probability of malocclusion in OI persons. Persons with OI require early orthodontic treatment because of significant correlation of OI disease with Angle Class III malocclusion, reverse overjet, and missing teeth.

The "beauty arch: " a new aesthetic analysis for malar augmentation planning.

PubMed

Marianetti, Tito Matteo; Cozzolino, Salvatore; Torroni, Andrea; Gasparini, Giulio; Pelo, Sandro

2015-05-01

Midface is a critical area for the aesthetics of the face. Despite malar hypoplasia is often combined with a class III malocclusion, there are few studies focusing on the results of a combined approach of malar implants and Le Fort I. We describe a new aesthetic analysis, named "beauty arch" analysis, for the assessment of sagittal projection of the malar region. We took a reference group of 74 Italian women participating in a national beauty contest in 2011 on which we performed our analysis. We used the ideal values to elaborate the surgical treatment planning of a second group of 45 consecutive female patients affected by skeletal class III malocclusion.Twenty-three patients undergo simultaneous Le Fort I osteotomy and malar implants. From the descriptive statistical comparison of the patients' values before and after orthognathic surgery and malar implants with the reference values, we observed how all parameters considered got closer to the ideal population. We consider our beauty arch a useful help for surgeon in the treatment planning of patients with skeletal malocclusions and malar implants.

Volumetric changes in the upper airway after bimaxillary surgery for skeletal class III malocclusions: a case series study using 3-dimensional cone-beam computed tomography.

PubMed

Lee, Yoonjung; Chun, Youn-Sic; Kang, Nara; Kim, Minji

2012-12-01

Postsurgical changes of the airway have become a great point of interest and often have been reported to be a predisposing factor for obstructive sleep apnea after mandibular setback surgery. The purpose of this study was to evaluate the 3-dimensional volumetric changes in the upper airway space of patients who underwent bimaxillary surgery to correct Class III malocclusions. This study was performed retrospectively in a group of patients who underwent bimaxillary surgery for Class III malocclusion and had full cone-beam computed tomographic (CBCT) images taken before surgery and 1 day, 3 months, and 6 months after surgery. The upper and lower parts of the airway volume and the diameters of the airway were measured from 2 different levels. Presurgical measurements and the amount of surgical correction were evaluated for their effect on airway volume. Data analyses were performed by analysis of variance and multiple stepwise regression analysis. The subjects included 21 patients (6 men and 15 women; mean age, 22.7 yrs). The surgeries were Le Fort I impaction (5.27 ± 2.58 mm impaction from the posterior nasal spine) and mandibular setback surgery (9.20 ± 4.60 mm set back from the pogonion). No statistically significant differences were found in the total airway volume for all time points. In contrast, the volume of the upper part showed an increase (12.35%) and the lower part showed a decrease (14.07%), with a statistically significant difference 6 months after surgery (P < .05). Predictor variables affecting the upper and lower parts of the airway volume were presurgical A point to Nasion-perpendicular (A to N-perp) and vertical surgical correction of the pogonion and the posterior nasal spine (P < .05). Bimaxillary surgery for the correction of Class III malocclusion affected the morphology by increasing the upper part and decreasing the lower part of the airway, but not the total volume. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite

PubMed Central

Valladares Neto, José

2014-01-01

Introduction This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. Methods The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extraction of mandibular first premolars. For maxillary retraction, the vertical dimension was temporarily increased to avoid obstacles to orthodontic movement. Results At the end of the treatment, ideal overjet and overbite were achieved. Conclusion Examination eight years after orthodontic treatment revealed adequate clinical stability. This case report was submitted to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements to become a BBO diplomate. PMID:24713568

Compensatory orthodontic treatment of skeletal Class III malocclusion with anterior crossbite.

PubMed

Valladares Neto, José

2014-01-01

This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extraction of mandibular first premolars. For maxillary retraction, the vertical dimension was temporarily increased to avoid obstacles to orthodontic movement. At the end of the treatment, ideal overjet and overbite were achieved. Examination eight years after orthodontic treatment revealed adequate clinical stability. This case report was submitted to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements to become a BBO diplomate.

Orthodontic decompensation in skeletal Class III malocclusion: redefining the amount of movement assessed by Cone-Beam Computed Tomography

PubMed Central

Cappellozza, José Antonio Zuega; Guedes, Fabio Pinto; Nary, Hugo; Capelozza, Leopoldino; Cardoso, Mauricio de Almeida

2015-01-01

Introduction: Cone-Beam Computed Tomography (CBCT) is essential for tridimensional planning of orthognathic surgery, as it allows visualization and evaluation of bone structures and mineralized tissues. Tomographic slices allow evaluation of tooth inclination and individualization of movement performed during preoperative decompensation. The aim of this paper was to assess maxillary and mandibular incisors inclination pre and post orthodontic decompensation in skeletal Class III malocclusion. Methods: The study was conducted on six individuals with skeletal Class III malocclusion, surgically treated, who had Cone-Beam Computed Tomographic scans obtained before and after orthodontic decompensation. On multiplanar reconstruction view, tomographic slices (axial, coronal and sagittal) were obtained on the long axis of each incisor. The sagittal slice was used for measurement taking, whereas the references used to assess tooth inclination were the long axis of maxillary teeth in relation to the palatal plane and the long axis of mandibular teeth in relation to the mandibular plane. Results: There was significant variation in the inclination of incisors before and after orthodontic decompensation. This change was of greater magnitude in the mandibular arch, evidencing that natural compensation is more effective in this arch, thereby requiring more intensive decompensation. Conclusion: When routinely performed, the protocols of decompensation treatment in surgical individuals often result in intensive movements, which should be reevaluated, since the extent of movement predisposes to reduction in bone attachment levels and root length. PMID:26560818

Occlusal features and need for orthodontic treatment in persons with osteogenesis imperfecta

PubMed Central

Binh, Ho Duy; Nguyen, Khac Minh; Maasalu, Katre; Kõks, Sulev; Märtson, Aare; Saag, Mare; Jagomägi, Triin

2017-01-01

Abstract The aim of the study was to (a) analyse dental occlusion and determine the need for orthodontic treatment of persons with osteogenesis imperfecta (OI) in comparison with the healthy population and (b) investigate the associations between OI and malocclusion. A case‐control study included 26 OI persons and 400 healthy participants (control group). Occlusal features and the need for orthodontic treatment were defined according to Dental Health Component‐Index of Orthodontic Treatment Need and Dental Aesthetic Index. Results showed that Angle Class I, II, and III relationship was found in 23.1%, 3.8%, and 73.1% of OI group, and in the control group, it was 67%, 17.5%, and 15.5%, respectively. OI group had significantly higher prevalence of reverse overjet >1 mm (76.9%), missing teeth (42.3%), posterior crossbite (34.6%), and open bite >2 mm (19.2%) compared to the control group (8.5%, 2.2%, 6.2%, and 3.5%, respectively). OI group had less incisal segment crowding and more incisal segment spacing than the control group (p < 0.05). The need for orthodontic treatment of OI group according to Dental Health Component‐Index of Orthodontic Treatment Need and Dental Aesthetic Index was 88.5% and 61.5%, respectively, while in the control group, it was 24.8% and 51.8%. The malocclusion in OI persons was associated with reverse overjet > 1 mm (OR = 13.3, 95% CI = 3.9–44.7, p < .001), Angle Class III malocclusion (OR = 8.0, 95% CI = 2.0–30.8, p = .003), and missing teeth (OR = 4.7, 95% CI = 1.0–22.4, p = .049). In conclusion, there is the high probability of malocclusion in OI persons. Persons with OI require early orthodontic treatment because of significant correlation of OI disease with Angle Class III malocclusion, reverse overjet, and missing teeth. PMID:29744175

Compensation trends of the angulation of first molars: retrospective study of 1403 malocclusion cases.

PubMed

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-09-01

We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First, angulation of the upper first molar varied significantly with age and tipped most distally in cases aged <12 years and least distally in cases aged >16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability.

The John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow 2015.

PubMed

Ahmed, Farooq

2017-03-01

This paper describes the clinical treatment of two cases presented by the recipient of the 2015 Bi-collegiate Membership in Orthodontics John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow. The first case describes the management of an 11-year-old male with a class II Division 1 malocclusion with a 9 mm overjet complicated by an upper anterior odontome and moderate upper arch crowding. The second case describes a 14-year-old female with a class III malocclusion with a reverse overjet complicated by moderate lower arch crowding and previously removed upper permanent canines.

Skeletal Malocclusion: A Developmental Disorder With a Life-Long Morbidity

PubMed Central

Joshi, Nishitha; Hamdan, Ahmad M.; Fakhouri, Walid D.

2014-01-01

The likelihood of birth defects in orofacial tissues is high due to the structural and developmental complexity of the face and the susceptibility to intrinsic and extrinsic perturbations. Skeletal malocclusion is caused by the distortion of the proper mandibular and/or maxillary growth during fetal development. Patients with skeletal malocclusion may suffer from dental deformities, bruxism, teeth crowding, trismus, mastication difficulties, breathing obstruction and digestion disturbance if the problem is left untreated. In this review, we focused on skeletal malocclusion that affects 27.9% of the US population with different severity levels. We summarized the prevalence of class I, II and III of malocclusion in different ethnic groups and discussed the most frequent medical disorders associated with skeletal malocclusion. Dental anomalies that lead to malocclusion such as tooth agenesis, crowding, missing teeth and abnormal tooth size are not addressed in this review. We propose a modified version of malocclusion classification for research purposes to exhibit a clear distinction between skeletal vs. dental malocclusion in comparison to Angle’s classification. In addition, we performed a cross-sectional analysis on orthodontic (malocclusion) data through the BigMouth Dental Data Repository to calculate potential association between malocclusion with other medical conditions. In conclusion, this review emphasizes the need to identify genetic and environmental factors that cause or contribute risk to skeletal malocclusion and the possible association with other medical conditions to improve assessment, prognosis and therapeutic approaches. PMID:25247012

Maxillary Advancement for Unilateral Crossbite in a Patient with Sleep Apnea Syndrome.

PubMed

Hoshijima, Mitsuhiro; Honjo, Tadashi; Moritani, Norifumi; Iida, Seiji; Yamashiro, Takashi; Kamioka, Hiroshi

2015-01-01

This article reports the case of a 44-year-old male with skeletal Class III, Angle Class III malocclusion and unilateral crossbite with concerns about obstructive sleep apnea syndrome (OSAS), esthetics and functional problems. To correct the skeletal deformities, the maxilla was anteriorly repositioned by employing LeFort I osteotomy following pre-surgical orthodontic treatment, because a mandibular setback might induce disordered breathing and cause OSAS. After active treatment for 13 months, satisfactory occlusion was achieved and an acceptable facial and oral profile was obtained. In addition, the apnea hypopnea index (AHI) decreased from 18.8 preoperatively to 10.6 postoperatively. Furthermore, after a follow-up period of 7 months, the AHI again significantly decreased from 10.6 to 6.2. In conclusion, surgical advancement of the maxilla using LeFort I osteotomy has proven to be useful in patients with this kind of skeletal malocclusion, while preventing a worsening of the OSAS.

SEGMENTAL LEFORT I OSTEOTOMY FOR TREATMENT OF A CLASS III MALOCCLUSION WITH TEMPOROMANDIBULAR DISORDER

PubMed Central

Janson, Marcos; Janson, Guilherme; Sant'Ana, Eduardo; Nakamura, Alexandre; de Freitas, Marcos Roberto

2008-01-01

This article reports the case of a 19-year-old young man with Class III malocclusion and posterior crossbite with concerns about temporomandibular disorder (TMD), esthetics and functional problems. Surgical-orthodontic treatment was carried out by decompensation of the mandibular incisors and segmentation of the maxilla in 4 pieces, which allowed expansion and advancement. Remission of the signs and symptoms occurred after surgical-orthodontic intervention. The maxillary dental arch presented normal transverse dimension. Satisfactory static and functional occlusion and esthetic results were achieved and remained stable. Three years after the surgical-orthodontic treatment, no TMD sign or symptom was observed and the occlusal results had not changed. When vertical or horizontal movements of the maxilla in the presence of moderate maxillary constriction are necessary, segmental LeFort I osteotomy can be an important part of treatment planning. PMID:19089265

Oral Rehabilitation With Orthognathic Surgery After Dental Implant Placement for Class III Malocclusion With Skeletal Asymmetry and Posterior Bite Collapse.

PubMed

Ohba, Seigo; Nakatani, Yuya; Kawasaki, Takako; Tajima, Nobutaka; Tobita, Takayoshi; Yoshida, Noriaki; Sawase, Takashi; Asahina, Izumi

2015-08-01

Increasing numbers of older patients are seeking orthognathic surgery to treat jaw deformity. However, orthodontic and orthognathic surgical treatment is difficult in cases without occlusal vertical stop. A 55-year-old man presented with Class III malocclusion and mandibular protrusion including esthetic problems and posterior bite collapse. He underwent dental implant treatment to reconstruct an occlusal vertical stop before orthognathic surgery. His occlusal function and esthetic problems improved after surgery, and his skeletal and occlusal stability has been maintained for 6 years. Dental implant placement at appropriate positions could help to determine the position of the proximal segment at orthognathic surgery and could shorten the time required to restore esthetic and occlusal function. This case demonstrates how skeletal and dental stability can be maintained long after surgery in a patient with jaw deformity and posterior bite collapse.

Reliability of Beta angle in assessing true anteroposterior apical base discrepancy in different growth patterns

PubMed Central

Sundareswaran, Shobha; Kumar, Vinay

2015-01-01

Introduction: Beta angle as a skeletal anteroposterior dysplasia indicator is known to be useful in evaluating normodivergent growth patterns. Hence, we compared and verified the accuracy of Beta angle in predicting sagittal jaw discrepancy among subjects with hyperdivergent, hypodivergent and normodivergent growth patterns. Materials and Methods: Lateral cephalometric radiographs of 179 patients belonging to skeletal Classes I, II, and III were further divided into normodivergent, hyperdivergent, and hypodivergent groups based on their vertical growth patterns. Sagittal dysplasia indicators - angle ANB, Wits appraisal, and Beta angle values were measured and tabulated. The perpendicular point of intersection on line CB (Condylion-Point B) in Beta angle was designated as ‘X’ and linear dimension XB was evaluated. Results: Statistically significant increase was observed in the mean values of Beta angle and XB distance in the vertical growth pattern groups of both skeletal Class I and Class II patients thus pushing them toward Class III and Class I, respectively. Conclusions: Beta angle is a reliable indicator of sagittal dysplasia in normal and horizontal patterns of growth. However, vertical growth patterns significantly increased Beta angle values, thus affecting their reliability as a sagittal discrepancy assessment tool. Hence, Beta angle may not be a valid tool for assessment of sagittal jaw discrepancy in patients exhibiting vertical growth patterns with skeletal Class I and Class II malocclusions. Nevertheless, Class III malocclusions having the highest Beta angle values were unaffected. PMID:25810649

The clinical outcome of skeletal anchorage in interceptive treatment (in growing patients) for class III malocclusion.

PubMed

Meyns, J; Brasil, D M; Mazzi-Chaves, J F; Politis, C; Jacobs, R

2018-04-27

A systematic review of the literature was performed regarding the clinical outcome (effectiveness) of bone anchorage devices in interceptive treatment for class III malocclusion. A search of Embase, PubMed and Web of Science databases yielded 285 papers. An additional two articles were retrieved through manual searching of the reference lists. After initial abstract selection, 32 potentially eligible articles were screened in detail, resulting in a final number of eight articles included in this review. Insufficient evidence was found regarding the effects of skeletal anchorage in interceptive class III treatment to support definitive conclusions on long-term skeletal effects and stability. In the short term, it seems that bone anchors can provide more skeletal effect with less dentoalveolar compensations and less unwanted vertical changes. This does not always exclude the use of a face mask. The use of miniscrews as skeletal anchorage device does not seem to provide more skeletal effect, although it could minimize the unwanted dental effects in the upper jaw. No information regarding the need for orthognathic surgery, orthodontic treatment time or patient compliance and complications was found in the selected articles. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

The effect of orthognathic surgery on the lip lines while smiling in skeletal class III patients with facial asymmetry.

PubMed

Kang, Sang-Hoon; Kim, Moon-Key; An, Sang-In; Lee, Ji-Yeon

2016-12-01

The aim of this study was to examine the relationship between improvements in lip asymmetry at rest and while smiling after orthognathic surgery in patients with skeletal class III malocclusion. This study included 21 patients with skeletal class III malocclusion and facial asymmetry. We used preoperative and postoperative CT data and photographs to measure the vertical distance of the lips when smiling. The photographs were calibrated based on these distances and the CT image. We compared preoperative and postoperative results with the t test and correlations between measurements at rest and when smiling by regression analyses. There were significant correlations between the postoperative changes in canting of the mouth corners at rest, canting of the canines, canting of the first molars, the slope of the line connecting the canines, and the slope of the line connecting first molars. The magnitude of the postoperative lip line improvement while smiling was not significantly correlated with changes in the canting and slopes of the canines, molars, and lip lines at rest. It remains difficult to predict lip line changes while smiling compared with at rest after orthognathic surgery in patients with mandibular prognathism, accompanied by facial asymmetry.

Effects of orthognathic surgery for class III malocclusion on signs and symptoms of temporomandibular disorders and on pressure pain thresholds of the jaw muscles.

PubMed

Farella, M; Michelotti, A; Bocchino, T; Cimino, R; Laino, A; Steenks, M H

2007-07-01

The aim of this longitudinal study was to determine the effects of orthognathic surgery on signs and symptoms of temporomandibular disorders (TMD) and on pressure pain thresholds (PPTs) of the jaw muscles. Fourteen consecutive class III patients undergoing pre-surgical orthodontic treatment were treated by combined Le Fort I osteotomy and bilateral sagittal ramus osteotomy. The clinical examination included the assessment of signs and symptoms of TMD and the assessment of PPTs of the masseter and temporalis muscles. Anamnestic, clinical and algometric data were collected during five sessions over a 1-year period. Seven out of 14 patients presented with disc displacement with reduction at baseline, whereas four patients (two of them were new cases) did so at the end of follow up (p>0.05). None of the patients were diagnosed with myofascial pain of the jaw muscles at the beginning or end of follow up. PPTs of the masseter and temporalis muscles did not change significantly from baseline values throughout the whole study period. The occurrence of signs and symptoms of TMD fluctuates with an unpredictable pattern after orthognathic surgery for class III malocclusions.

Cone Beam Computed Tomography Analysis in 3D Position of Maxillary Denture

PubMed Central

Jia, Ying; Yang, Hua; Li, Ping; Xiong, Jiangyan; Chen, Bo

2017-01-01

Abstract The dynamic correlation between teeth and denture morphology as well as the morphological positions needs to be explored. Methodology 63 adult patients with skeletal class III malocclusions that met the inclusion criteria were enrolled and imaged with Cone Beam Computed Tomography (CBCT), and Digital Imaging and Communications in Medicine (DICOM) data were collected. The torque angle and axial inclination were measured and analyzed for the corona, root, and entire body of every tooth on the maxilla. Results There is a statistically significant difference between the coronal axial inclination/coronal torque angle for the skeletal class III malocclusion cases and Andrew’s six keys of occlusion. On the sagittal plane of the maxillary denture (except that the secondary molar is inclined medial-distally), the remaining teeth are inclined towards the labia with slightly larger angles compared to the normal occlusion. In the coronal direction, the maxillary anterior teeth tend to have a corona that inclines medial-distally, whereas the posterior teeth have a buccal inclination compared to the normal occlusion. Conclusion Sagittal and transversal compensations prevail in maxillary dentures; for the camouflaged treatment design for skeletal class III, there is limited scope of sagittal and transversal movements on the maxillary denture. PMID:29104942

Surgery-first: a new approach to orthognathic surgery

PubMed Central

DE NUCCIO, F.; DE NUCCIO, F.; D’EMIDIO, M.M.; PELO, S.

2016-01-01

SUMMARY This case study describes the treatment of a 20-year-old white woman with a skeletal Class III and dental Class III malocclusion followed by a retrognathic and contracted maxilla, light mandibular crowding and a median line deviation of 5 mm. The treatment was based on the Surgery-First approach, involving LeFort I maxillary advancement surgery, and it was followed by orthodontic treatment. During the 6-month treatment period, excellent aesthetic results and good functional occlusion were achieved. PMID:28280538

Compensation trends of the angulation of first molars: retrospective study of 1 403 malocclusion cases

PubMed Central

Su, Hong; Han, Bing; Li, Sa; Na, Bin; Ma, Wen; Xu, Tian-Min

2014-01-01

We investigated the compensatory trends of mesiodistal angulation of first molars in malocclusion cases. We compared differences in the angulation of first molars in different developmental stages, malocclusion classifications and skeletal patterns. The medical records and lateral cephalogrammes of 1 403 malocclusion cases taken before treatment were measured to evaluate compensation of molar angulation in relation to the skeletal jaw. The cases were stratified by age, Angle classification and skeletal patterns. Differences in the mesiodistal angulation of the first molars were compared among the stratifications. We observed three main phenomena. First, angulation of the upper first molar varied significantly with age and tipped most distally in cases aged <12 years and least distally in cases aged >16 years. The lower first molar did not show such differences. Second, in Angle Class II or skeletal Class II cases, the upper first molar was the most distally tipped, the lower first molar was the most mesially tipped, and opposite angulation compensation was observed in Class III cases. Third, in high-angle cases, the upper and lower first molars were the most distally tipped, and opposite angulation compensation was observed in low-angle cases. These data suggest that the angulation of the molars compensated for various growth patterns and malocclusion types. Hence, awareness of molar angulation compensation would help to adjust occlusal relationships, control anchorage and increase the chances of long-term stability. PMID:24699185

A three-dimensional soft tissue analysis of Class III malocclusion: a case-controlled cross-sectional study.

PubMed

Johal, Ama; Chaggar, Amrit; Zou, Li Fong

2018-03-01

The present study used the optical surface laser scanning technique to compare the facial features of patients aged 8-18 years presenting with Class I and Class III incisor relationship in a case-control design. Subjects with a Class III incisor relationship, aged 8-18 years, were age and gender matched with Class I control and underwent a 3-dimensional (3-D) optical surface scan of the facial soft tissues. Landmark analysis revealed Class III subjects displayed greater mean dimensions compared to the control group most notably between the ages of 8-10 and 17-18 years in both males and females, in respect of antero-posterior (P = 0.01) and vertical (P = 0.006) facial dimensions. Surface-based analysis, revealed the greatest difference in the lower facial region, followed by the mid-face, whilst the upper face remained fairly consistent. Significant detectable differences were found in the surface facial features of developing Class III subjects.

A modified, lingually supported cantilevered Herbst appliance.

PubMed

Snodgrass, D

1996-01-01

This new, fixed-functional appliance/Herbst/Bioprogressive system is designed for patient comfort and mandatory compliance. It also combines the positive clinical effects of four fixed-functional systems. It allows rapid palatal expansion of the upper arch, alveolar uprighting of the lower arch, upper and lower incisor alignment, and sagittal correction of Class II malocclusions to occur simultaneously with one appliance fixed in both arches. It is indicated for use in growing patients with skeletal Class II malocclusions. The ideal timing for treatment is the late mixed dentition. Being able to remove the appliance after one year with the upper second bicuspids erupting slightly Class III so the clinician can immediately begin fixed finishing mechanics would be ideal. This new Herbst design will reduce the frequency of orthognathic surgery and upper bicuspid extraction to camouflage Class II malocclusions. At the same time, it gives total control to the clinician in treating some more difficult, non-compliant patients. Fixed-functional appliances, which improve treatment efficiency and treatment results and provide for patient comfort, while at the same time give the treating clinician almost total control of the three planes of facial growth will open new doors for orthodontic treatment and research in the next century.

Dentoskeletal Effects of the Modified Tandem Appliance vs the Facemask Appliance in the Treatment of Skeletal Class III Malocclusion: A Single-center, Randomized Controlled Trial.

PubMed

Husson, Amro H; Burhan, Ahmad S; Salma, Fadwa B; Nawaya, Fehmieh R

2016-07-01

The aim of this randomized controlled trial was to compare the skeletal and dentoalveolar effects of the modified tandem appliance (MTA) vs the facemask (FM) with rapid maxillary expansion. Thirty-two patients, aged 7 to 9 years were recruited. Eligibility criteria included skeletal class III malocclusion that resulted from the retrusion of the maxilla. Randomization was accomplished to divide the sample into two equal groups to be treated with either MTA or FM. Lateral cephalometric radiographs were obtained before treatment and after 2 mm positive overjet was achieved. Intragroup comparisons were performed using paired-sample t-test, and intergroup comparisons were performed using two-sample t-test at the p ≤ 0.05 level. Thirty-two patients (16 in each group) were available for statistical analysis. The pretreatment variables of both groups were similar. Both treatment therapies showed similar significant increase in the SNA and ANB angles, accompanied by slight decrease in the SNB angle. The increase in the SN:GoMe angle, Bjork's sum, and the overjet were significantly greater in the FM group. The forward movement of upper dentition was similar in both groups. Although the lower incisors retrusion was significantly greater in the FM group than in the MTA group, the uprighting of the lower molars was significantly greater in the MTA group. Both appliances showed similar effects apart from less clockwise rotation of the mandible, less retrusion of the lower incisors, and greater uprighting of the lower molars in the MTA group. Both the MTA and the FM groups are effective in treating class III malocclusion. The MTA group is more efficient in controlling the clockwise rotation and gaining some space in the lower arch.

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

PubMed Central

de Almeida Cardoso, Mauricio; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo

2016-01-01

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects. PMID:26877982

Complications of misdiagnosis of maxillary canine ectopic eruption.

PubMed

Garib, Daniela Gamba; Janson, Guilherme; Baldo, Taiana de Oliveira; dos Santos, Patrícia Bittencourt Dutra

2012-08-01

Ectopic eruption of maxillary canines can be associated with root resorption of adjacent teeth. This case report describes and discusses an interesting case of a 15-year-old girl with a Class III malocclusion and an impacted maxillary canine. Because of the unfavorable position of the ectopic canine and the severe root resorption of the maxillary left central and lateral incisors, the treatment options included extraction of the maxillary permanent canines. The mandibular first premolars were extracted to compensate for the Class III malocclusion. A panoramic radiograph taken earlier in the mixed dentition already indicated a possible eruption disturbance of the maxillary left permanent canine. The importance of early diagnosis of maxillary canine ectopic eruption is highlighted in this case report. The early identification of radiographic signs of an ectopic pathway of eruption should be followed by deciduous canine extraction to prevent canine retention and maxillary incisor root resorption. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Use of body plethysmography to measure effect of bimaxillary orthognathic surgery on airway resistance and lung volumes.

PubMed

Rezaeetalab, Fariba; Kazemian, Mozhgan; Vaezi, Touraj; Shaban, Barratollah

2015-12-01

Bimaxillary orthognathic surgery can cause changes to respiration and the airways. We used body plethysmography to evaluate its effect on airway resistance and lung volumes in 20 patients with class III malocclusions (8 men and 12 women, aged 17 - 32 years). Lung volumes (forced vital capacity; forced inspiratory volume/one second; forced expiratory volume/one second: forced vital capacity; peak expiratory flow; maximum expiratory flow 25-75; maximum inspiratory flow; total lung capacity; residual volume; residual volume:total lung capacity), and airway resistance were evaluated one week before, and six months after, operation. Bimaxillary operations to correct class III malocclusions significantly increased airway resistance, residual volume, total lung capacity, and residual volume:total lung capacity. Other variables also changed after operation but not significantly so. Orthognathic operations should be done with caution in patients who have pre-existing respiratory diseases. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Correlation of Beta Angle with Antero-Posterior Dysplasia Indicators and FMA: An Institution Based Cephalometric Study.

PubMed

Singh, Gurinder; Verma, Sanjeev; Singh, Devinder Preet; Yadav, Sumit Kumar; Yadav, Achla Bharti

2016-11-01

Beta angle utilizes three skeletal landmarks - point A, point B, and point C (the apparent axis of the condyle). It is formed between A-B line and point A perpendicular to C-B line. Further this angle indicates the severity and the type of skeletal dysplasia in the sagittal dimension and it changes with the growth pattern of the patient. Hence, it is important to study the dependence of beta angle on the growth pattern. The present study was designed to evaluate the correlation of Beta angle with point A-Nasion-point B (ANB) angle, points A and B to palatal plane (App-Bpp), Wit's appraisal and Maxillary-Mandibular plane angle Bisector (MMB) and Frankfort-Mandibular plane Angle (FMA) in Skeletal Class I, Class II and Class III malocclusion groups. Pre-treatment lateral head cephalo-grams of 120 subjects in age group of 15-25 years were obtained. Three skeletal Class I, Class II and Class III malocclusion groups (40 each) were assorted on the basis of ANB, MMB, App-Bpp, Wit's appraisal and FMA. Analysis of variance (ANOVA) and mean differences were calculated to compare the study groups. Bivariate correlations among different parameters of these groups were obtained. Normal values of beta angle in skeletal Class I group, skeletal Class II group and skeletal Class III group was 31.33±3.25, 25.28±4.28 and 40.93±4.55 respectively. Overall beta angle showed a strong correlation with all parameters of anterio-posterior dysplasia indicators except FMA. Beta angle shows weak correlation with FMA and is not affected by growth pattern/jaw rotation. The normal values are in same range irrespective of the differences in craniofacial morphology.

Correlation of Beta Angle with Antero-Posterior Dysplasia Indicators and FMA: An Institution Based Cephalometric Study

PubMed Central

Singh, Gurinder; Verma, Sanjeev; Singh, Devinder Preet; Yadav, Achla Bharti

2016-01-01

Introduction Beta angle utilizes three skeletal landmarks – point A, point B, and point C (the apparent axis of the condyle). It is formed between A-B line and point A perpendicular to C-B line. Further this angle indicates the severity and the type of skeletal dysplasia in the sagittal dimension and it changes with the growth pattern of the patient. Hence, it is important to study the dependence of beta angle on the growth pattern. Aim The present study was designed to evaluate the correlation of Beta angle with point A–Nasion–point B (ANB) angle, points A and B to palatal plane (App-Bpp), Wit’s appraisal and Maxillary-Mandibular plane angle Bisector (MMB) and Frankfort-Mandibular plane Angle (FMA) in Skeletal Class I, Class II and Class III malocclusion groups. Materials and Methods Pre-treatment lateral head cephalo-grams of 120 subjects in age group of 15-25 years were obtained. Three skeletal Class I, Class II and Class III malocclusion groups (40 each) were assorted on the basis of ANB, MMB, App-Bpp, Wit’s appraisal and FMA. Analysis of variance (ANOVA) and mean differences were calculated to compare the study groups. Bivariate correlations among different parameters of these groups were obtained. Results Normal values of beta angle in skeletal Class I group, skeletal Class II group and skeletal Class III group was 31.33±3.25, 25.28±4.28 and 40.93±4.55 respectively. Overall beta angle showed a strong correlation with all parameters of anterio-posterior dysplasia indicators except FMA. Conclusion Beta angle shows weak correlation with FMA and is not affected by growth pattern/jaw rotation. The normal values are in same range irrespective of the differences in craniofacial morphology. PMID:28050509

[Evaluation of the correction of the skeletal class III malocclusion by distalization of the whole mandible dentition with micro-implant anchorage].

PubMed

2017-06-18

To evaluate the clinical effect of distalizing mandibular dentition with micro-implant in patients with skeletal class III malocclusion. In the study, 20 patients with skeletal class IIImalocclusion were selected. They are consist of 8 males and 12 female with an age range from 16 to 38 years old and an average age of (21.5±5.6) years.They were treated with straight wire technique and the implant were inserted into the mandibular external oblique line to distlize the lower dentition to a class I molar relationships. Cephalometrics films were taken before and after treatment. The changes of hard tissue and soft tissue were analyzed by evaluating 26 measurement measurements. Class I molar relationships were achieved, and the profile were improved after treatment. ANB increased by (0.80±1.02) °,Wits increased by (1.67±1.74) mm,after treatment (P<0.05). The lower dentition were significantly retracted after treatment with L1-NB distance decreased by(2.64±1.50) mm, P<0.05; the mesial buccal cusp and mesial root of the lower first molars were retracted by (3.26±1.95) mm and (0.79±1.27) mm respectively (P<0.05); the mesial buccal cusp of the lower second molars were retracted by (3.06±1.80) mm (P<0.05). After treatment, mandibular teeth got up-righted distally. From incisors to molar, L1/MP, L5/MP, L6/MP, L7/MP angle decreased by (6.37±8.53)°, (10.59±8.50)°, (11.48±7.22)°, (15.72±7.16)°on average respectively (P<0.05), all of those changes had the statically significant effects. Soft tissue change after treatment, the distance from lower lip to esthetic plane were decreased by (1.70±1.59) mm on average (P<0.05). Distalizing mandibular dentition with micro-implant can get an satisfying result in patients with skeletal class III malocclusion, the lower teeth were retracted by controlled tipping movement.

Maternal breastfeeding, parafunctional oral habits and malocclusion in adolescents: a multivariate analysis.

PubMed

Thomaz, Erika Bárbara Abreu Fonseca; Cangussu, Maria Cristina Teixeira; Assis, Ana Marlúcia Oliveira

2012-04-01

Malocclusion may result in esthetic impairment and functional disorders such as bad chewing, speech and swallowing, with a negative impact on quality of life. There is uncertainty regarding the effects of breastfeeding on dentofacial malocclusions. The purpose of the study was to evaluate the relationship between maternal breastfeeding and dental malocclusions and facial characteristics in adolescents with permanent dentition. Probabilistic sampling of 2060 12- to 15-year-old students in a cross-sectional study was used. Malocclusion, as defined by Angle, and facial characteristics were the dependent variables. The duration of breastfeeding was the main independent variable. Other covariates were tested as effect modifiers or confounders. The associations were estimated using the odds ratio (OR) in multinomial logistic regression analysis (α=5%). There was an association between a short duration of breastfeeding (less than 6 months) and Angle class II (OR=3.14; 95% CI: 1.28-7.66) and class III (OR=2.78; 95% CI: 1.21-6.36) malocclusion only in students with a prolonged history of bruxism. A higher occurrence of severe convex profile (OR=3.4; 95% CI: 0.63-18.26) and a lower occurrence of cancave profile (OR=0.43; 95% CI: 0.21-0.88) were also observed only among adolescents who had been breastfed for a short period and exposed to a long periods of mouth breathing. These findings support the hypothesis that breastfeeding alone seems not to be directly associated with malocclusions, but it may have a synergetic effect with parafunctional oral habits on the development of occlusofacial problems. It is recommended that deleterious oral habits be avoided, especially by children who were breast-fed for less than 6 months. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Candidate gene analyses of 3-dimensional dentoalveolar phenotypes in subjects with malocclusion

PubMed Central

Weaver, Cole A.; Miller, Steven F.; da Fontoura, Clarissa S. G.; Wehby, George L.; Amendt, Brad A.; Holton, Nathan E.; Allareddy, Veeratrishul; Southard, Thomas E.; Moreno Uribe, Lina M.

2017-01-01

Introduction Genetic studies of malocclusion etiology have identified 4 deleterious mutations in genes, DUSP6, ARHGAP21, FGF23, and ADAMTS1 in familial Class III cases. Although these variants may have large impacts on Class III phenotypic expression, their low frequency (<1%) makes them unlikely to explain most malocclusions. Thus, much of the genetic variation underlying the dentofacial phenotypic variation associated with malocclusion remains unknown. In this study, we evaluated associations between common genetic variations in craniofacial candidate genes and 3-dimensional dentoalveolar phenotypes in patients with malocclusion. Methods Pretreatment dental casts or cone-beam computed tomographic images from 300 healthy subjects were digitized with 48 landmarks. The 3-dimensional coordinate data were submitted to a geometric morphometric approach along with principal component analysis to generate continuous phenotypes including symmetric and asymmetric components of dentoalveolar shape variation, fluctuating asymmetry, and size. The subjects were genotyped for 222 single-nucleotide polymorphisms in 82 genes/loci, and phenotpye-genotype associations were tested via multivariate linear regression. Results Principal component analysis of symmetric variation identified 4 components that explained 68% of the total variance and depicted anteroposterior, vertical, and transverse dentoalveolar discrepancies. Suggestive associations (P < 0.05) were identified with PITX2, SNAI3, 11q22.2-q22.3, 4p16.1, ISL1, and FGF8. Principal component analysis for asymmetric variations identified 4 components that explained 51% of the total variations and captured left-to-right discrepancies resulting in midline deviations, unilateral crossbites, and ectopic eruptions. Suggestive associations were found with TBX1 AJUBA, SNAI3 SATB2, TP63, and 1p22.1. Fluctuating asymmetry was associated with BMP3 and LATS1. Associations for SATB2 and BMP3 with asymmetric variations remained significant after the Bonferroni correction (P <0.00022). Suggestive associations were found for centroid size, a proxy for dentoalveolar size variation with 4p16.1 and SNAI1. Conclusions Specific genetic pathways associated with 3-dimensional dentoalveolar phenotypic variation in malocclusions were identified. PMID:28257739

[Pre- and post-surgical orthodontic treatment for skeletal open bite].

PubMed

Zhou, Y; Hu, W; Sun, Y

2001-05-01

To Study the principles and rules of pre- and post-surgical orthodontic treatment for skeletal open bite patients. Thirty-two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8.5 mm, average was 4 mm. 31 patients were Class III malocclusion, while 1 patient was Class II malocclusion. 1. Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre-surgical orthodontics only, and other 3 had post-surgical orthodontics only. The duration for pre-surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post-surgical orthodontics was from 3 to 17 months, average was 8.5 months. 2. Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. 3. Post-surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class II or III intermaxillary elastics. Skeletal open bites require combined orthodontic-orthognathic surgery for optimal and esthetical pleasing results.

Validity of the American Board of Orthodontics Discrepancy Index and the Peer Assessment Rating Index for comprehensive evaluation of malocclusion severity.

PubMed

Liu, S; Oh, H; Chambers, D W; Baumrind, S; Xu, T

2017-08-01

To assess the validity of the American Board of Orthodontics Discrepancy Index (ABO-DI) and Peer Assessment Rating (PAR) Index in evaluating malocclusion severity in Chinese orthodontic patients. A stratified random sample of 120 orthodontic patients based on Angle classification was collected from six university orthodontic centres. Sixty-nine orthodontists rated malocclusion severity on a five-point scale by assessing a full set of pre-treatment records for each case and listed reasons for their decision. Their judgement was then compared with ABO-DI and PAR scores determined by three calibrated examiners. Excellent interexaminer reliability of clinician judgement, ABO-DI and PAR index was demonstrated by the Intraclass Correlation Coefficient (rho= 0.995, 0.990 and 0.964, respectively). Both the ABO-DI and US-PAR index showed good correlation with clinician judgement (r=.700 and r=.707, respectively). There was variability among the different Angle classifications: the ABO-DI showed the highest correlation with clinician judgement in Class II patients (r=.780), whereas the US-PAR index showed the highest correlation with clinician judgement in Class III patients (r=.710). Both indices demonstrated the lowest correlations with clinician judgement in Class I patients. With strong interexaminer agreement, the panel consensus was used for validating the ABO-DI and US-PAR index for malocclusion severity. Overall, the ABO-DI and US-PAR index were reliable for measuring malocclusion severity with significantly variable weightings for different Angle classifications. Further modification of the indices for different Angle classification may be indicated. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparison of second molar eruption patterns in patients with skeletal Class II and skeletal Class I malocclusions.

PubMed

Brin, Ilana; Camasuvi, Semin; Dali, Nasser; Aizenbud, Dror

2006-12-01

The eruptive positions of the second molars in Class I and Class II malocclusions were studied. Pretreatment records of 221 patients with a mean age of 11.3 years were evaluated. About 19% of them had skeletal Class I, 31% had skeletal maxillary Class II, and 50% had skeletal mandibular Class II malocclusions. The mean values of the dental and chronologic ages of the subjects were similar. The eruptive positions in relation to a reference line, the developmental stages of the patients' second molars and dental ages were recorded from the panoramic roentgenograms. The distribution of the various developmental stages in each malocclusion group was similar, and no association between skeletal malocclusion and dental developmental stage of the second molars was encountered. The eruptive position of the maxillary second molars was more occlusal only in the oldest maxillary Class II group, above 12 years of age (P = .02). These results support, in part, previous reports suggesting that the maxillary second molars may erupt earlier in patients with skeletal maxillary Class II malocclusions.

Occlusal and facial features in Amazon indigenous: An insight into the role of genetics and environment in the etiology dental malocclusion.

PubMed

de Souza, Bento Sousa; Bichara, Livia Monteiro; Guerreiro, João Farias; Quintão, Cátia Cardoso Abdo; Normando, David

2015-09-01

Indigenous people of the Xingu river present a similar tooth wear pattern, practise exclusive breast-feeding, no pacifier use, and have a large intertribal genetic distance. To revisit the etiology of dental malocclusion features considering these population characteristics. Occlusion and facial features of five semi-isolated Amazon indigenous populations (n=351) were evaluated and compared to previously published data from urban Amazon people. Malocclusion prevalence ranged from 33.8% to 66.7%. Overall this prevalence is lower when compared to urban people mainly regarding posterior crossbite. A high intertribal diversity was found. The Arara-Laranjal village had a population with a normal face profile (98%) and a high rate of normal occlusion (66.2%), while another group from the same ethnicity presented a high prevalence of malocclusion, the highest occurrence of Class III malocclusion (32.6%) and long face (34.8%). In Pat-Krô village the population had the highest prevalence of Class II malocclusion (43.9%), convex profile (38.6%), increased overjet (36.8%) and deep bite (15.8%). Another village's population, from the same ethnicity, had a high frequency of anterior open bite (22.6%) and anterior crossbite (12.9%). The highest occurrence of bi-protrusion was found in the group with the lowest prevalence of dental crowding, and vice versa. Supported by previous genetic studies and given their similar environmental conditions, the high intertribal diversity of occlusal and facial features suggests that genetic factors contribute substantially to the morphology of occlusal and facial features in the indigenous groups studied. The low prevalence of posterior crossbite in the remote indigenous populations compared with urban populations may relate to prolonged breastfeeding and an absence of pacifiers in the indigenous groups. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Surgical Management of Skeletal Disproportion with Lingual Orthodontics and Three-dimensional Planning

PubMed Central

Patel, Krutiben; Kau, Chung How; Waite, Peter D; Celebi, Ahmet Arif

2017-01-01

This case report describes the successful treatment of a 26-year-old Caucasian male with skeletal and dental Class III malocclusion associated with mild maxillary and mandibular crowding. The patient had anteroposterior and transverse discrepancies with a reverse overjet and bilateral posterior crossbites. The nonextraction treatment plan included aligning and leveling of the teeth in both arches, Le Fort I and bilateral sagittal split osteotomies, and postsurgical correction of the malocclusion. Orthodontic treatment was initiated with custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Treatment was concluded with detailed orthodontic finishing, achieving optimum esthetics and function. PMID:28713747

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia.

PubMed

Ağlarcı, Cahide; Esenlik, Elçin; Fındık, Yavuz

2016-06-01

The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P < 0.05). The undesired dentoalveolar effects of the FM treatment were eliminated with SA treatment, except with regard to lower incisor inclination. Favourable skeletal outcomes can be achieved by SA therapies, which could be an alternative to the extraoral appliances frequently applied to treat skeletal Class III patients with maxillary deficiency. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization.

PubMed

Jing, Yan; Han, Xianglong; Guo, Yongwen; Li, Jingyu; Bai, Ding

2013-06-01

This article reports the successful use of miniscrews in the mandible to treat a 20-year-old Mongolian woman with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a mildly protrusive mandible, an anterior crossbite, and a deviated midline. In light of the advantages for reconstruction of the occlusal plane and distal en-masse movement of the mandibular arch, we used a multiloop edgewise archwire in the initial stage. However, the maxillary incisors were in excessive labioversion accompanied by little retraction of the mandibular incisors; these results were obviously not satisfying after 4 months of multiloop edgewise archwire treatment. Two miniscrews were subsequently implanted vertically in the external oblique ridge areas of the bilateral mandibular ramus as skeletal anchorage for en-masse distalization of the mandibular dentition. During treatment, the mandibular anterior teeth were retracted about 4.0 mm without negative lingual inclinations. The movement of the mandibular first molar was almost bodily translation. The maxillary incisors maintained good inclinations by rotating their brackets 180° along with the outstanding performance of the beta-titanium wire. The patient received a harmonious facial balance, an attractive smile, and ideal occlusal relationships. The outcome was stable after 1 year of retention. Our results suggest that the application of miniscrews in the posterior area of the mandible is an effective approach for Class III camouflage treatment. This technique requires minimal compliance and is particularly useful for correcting Class III patients with mild mandibular protrusion and minor crowding. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern.

PubMed

Farret, Marcel Marchiori

2016-06-01

This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as one of the requirements to become diplomate by the BBO.

Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern

PubMed Central

Farret, Marcel Marchiori

2016-01-01

ABSTRACT This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as one of the requirements to become diplomate by the BBO. PMID:27409659

North Cork HSE orthodontic treatment waiting list 2009-2010: retrospective audit of patient records.

PubMed

McSwiney, Timothy P; Millett, Declan T

2013-01-01

To evaluate the case profile and verify the treatment eligibility (based on the modified IOTN) from written case records, of patients accepted for orthodontic treatment from the North Cork area of HSE South. A data collection form was designed and applied to the written case records of 200 consecutive patients accepted for orthodontic treatment in 2009/2010. Data relating to the IOTN (DHC and AC, where relevant) were provided by a calibrated examiner. Based on the written case records, most (57%) of the treatment cohort were female and had an average age of 14 years and two months. The predominant malocclusion was Class II division 1 (40%). The prevalence of Class III malocclusion was high at 18%. A total of 61% of patients were in grade 5 and 36% in grade 4. The majority of patients in each of these grades fell into DHC 5a (32%), followed by 5i (24%) and 4d AC > 8 (16%). Written case records conclude that patients accepted for orthodontic treatment from the North Cork area of HSE South were predominantly female. Class II division 1 malocclusion was the most common accepted for treatment. These records verify that those patients accepted for orthodontic treatment satisfy the eligibility criteria for HSE treatment.

Treatment of skeletal Class III malocclusions: orthognathic surgery or orthodontic camouflage? How to decide.

PubMed

Benyahia, Hicham; Azaroual, Mohamed Faouzi; Garcia, Claude; Hamou, Edith; Abouqal, Redouane; Zaoui, Fatima

2011-06-01

The choice of treatment in adult skeletal Class III occlusions often poses a particularly tricky problem for the orthodontist. Faced with the option of either orthodontic camouflage or orthognathic surgery, the clinician's clinical experience is of paramount importance, especially in borderline cases. The aim of our study was to uncover a guide model enabling the practitioner to distinguish between skeletal Class III cases which can be suitably treated with orthodontics and those requiring orthognathic surgery. The lateral headfilms of 47 adult patients exhibiting skeletal Class III occlusions were analyzed. The orthodontic group comprised 22 patients and the surgical group 25. Twenty-seven linear, proportional and angular measurements were scrutinized. Stepwise discriminant analysis was used to identify the dentoskeletal and esthetic variables which most distinguished the two groups. The Holdaway angle was chosen to differentiate between patients prior to treatment. This model enables us to classify 87.2% of patients correctly. Copyright © 2011 CEO. Published by Elsevier Masson SAS. All rights reserved.

Skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances and lower premolar extractions.

PubMed

Abu Alhaija, Elham S J; Al-Khateeb, Susan N

2011-05-01

Mild Class III malocciusions can be treated by upper incisor proclination and lower incisor retroclination following extraction of the lower first premolars. To compare the skeletal, dental and soft tissue changes in Class III patients treated with fixed appliances, Class III traction and lower first premolar extractions with the changes in a group of untreated Class III patients. The Treatment group consisted of 30 Class III patients (Mean age 13.69 +/- 1.48 years) who were treated by upper and lower fixed appliances, Class III intermaxillary traction and lower first premolar extractions for 2.88 +/- 1.12 years. The Control group consisted of 20 untreated Class III patients (Mean age 13.51 +/- 0.95) matched for age and gender. The T1 to T2 changes in the treated and untreated groups were compared using a paired t-test while differences between the two groups were compared with an independent t-test. During treatment, the upper incisors were proclined about 1 degree and the lower incisors were retroclined 8 degrees. Small, but statistically significant changes in SNB, Wits and the overlying soft tissues accompanied the changes in incisor inclination. At the end of treatment a positive overbite and overjet were achieved. The increase in lower facial height in the Treatment group was comparable with the change in the Control group. A range of mild to moderate Class III malocclusions can be treated by dentoalveolar compensation.

Alteration of Occlusal Plane in Orthognathic Surgery: Clinical Features to Help Treatment Planning on Class III Patients

PubMed Central

Costa, Tony Eduardo; Barbosa, Saulo de Matos; Pereira, Rodrigo Alvitos; Chaves Netto, Henrique Duque de Miranda

2018-01-01

Dentofacial deformities (DFD) presenting mainly as Class III malocclusions that require orthognathic surgery as a part of definitive treatment. Class III patients can have obvious signs such as increasing the chin projection and chin throat length, nasolabial folds, reverse overjet, and lack of upper lip support. However, Class III patients can present different facial patterns depending on the angulation of occlusal plane (OP), and only bite correction does not always lead to the improvement of the facial esthetic. We described two Class III patients with different clinical features and inclination of OP and had undergone different treatment planning based on 6 clinical features: (I) facial type; (II) upper incisor display at rest; (III) dental and gingival display on smile; (IV) soft tissue support; (V) chin projection; and (VI) lower lip projection. These patients were submitted to orthognathic surgery with different treatment plannings: a clockwise rotation and counterclockwise rotation of OP according to their facial features. The clinical features and OP inclination helped to define treatment planning by clockwise and counterclockwise rotations of the maxillomandibular complex, and two patients undergone to bimaxillary orthognathic surgery showed harmonic outcomes and stables after 2 years of follow-up. PMID:29854480

Two-Step Extraction of the Lower First Molar for Class III Treatment in Adult Patient.

PubMed

Almeida, Kélei Cristina de Mathias; Paulin, Ricardo Fabris; Raveli, Taísa Barnabé; Raveli, Dirceu Barnabé; Santos-Pinto, Ary

2016-01-01

The aim of this article is to describe a case report of Class III malocclusion treatment with lower first molar extraction. The 27-year-old Caucasian male patient presented a symmetric face with a straight profile, hyperdivergent growth pattern, molar and cuspid Class III relation, and an anterior crossbite as well as a mild crowding on cuspids area, in both upper and lower arches and a tendency to posterior crossbite. The treatment was performed by the use of Haas expansion appliance followed by an initial alignment and leveling of the upper and lower arches with a fixed edgewise appliance, extraction of lower teeth aiming the correction of the incisors proclination and end the treatment with a Class I molar relationship. It resulted in a significant change in the patient's profile, dentoalveolar Class III correction, upper arch expansion, leveling and alignment of the upper and lower arches, and improvement of tipping of the upper and lowers incisors. In cases of a dentoalveolar compensation in well positioned bone bases the treatment with fixed appliances is an alternative and extraction of lower teeth is considered.

Correlation between occlusion and cervical posture in patients with bruxism.

PubMed

Cesar, Guilherme Manna; Tosato, Juliana de Paiva; Biasotto-Gonzalez, Daniela Ap

2006-08-01

The goal of this study was to evaluate head and neck posture in the rest position of patients with bruxism and patients without temporomandibular disorder signs or symptoms to further relate them with Angle's class of malocclusion. Fifty-six volunteers participated in this study, ages 18 to 27 years with an average age of 22.5 years. They were divided into 2 groups: Group B--28 subjects with parafunctions (teeth grinding or clenching); and Group C--28 subjects without parafunctional habits (control group). All participants were photographed, and their pictures were analyzed and compared with the software Alcimagem (Instrumental Concept and Movement Analysis Laboratory, Uberlândia, Minas Gerais, Brazil). The results demonstrated that variation of angular values did not present statistical difference for the studied groups. Regarding Angle's class of malocclusion, class I was predominant in Group C, and classes II and III were predominant in Group B. The mental-sternal angle calculated did not present statistical significance between the groups; however, there was a greater variation between the smaller angle and the higher angle in Group B, contrary to Group C.

Changes in anteroposterior position and inclination of the maxillary incisors after surgical-orthodontic treatment of skeletal class III malocclusions.

PubMed

Zou, Bingshuang; Zhou, Yang; Lowe, Alan A; Li, Huiqi; Pliska, Benjamin

2015-12-01

The purpose of this study was to evaluate and compare the anteroposterior (AP) position and inclination of the maxillary incisors in subjects with class I normal occlusion and a harmonious profile with patients with skeletal class III malocclusions, and to investigate the changes in maxillary incisor inclination and AP position after surgical-orthodontic treatment in class III patients. Sixty-five subjects (35 female and 30 male; mean age: 21.8 ± 3.89 years) with normal profiles and class I skeletal and dental patterns were selected as a control sample. Sixty-seven patients (38 female and 29 male; mean age: 21.3 ± 3.31 years) with skeletal and dental class III malocclusions who sought surgical-orthodontic treatment were used as the study sample. Subjects were asked to smile and profile photographs were taken with the head in a natural position and the maxillary central incisors and the forehead in full view; cephalograms were taken and superimposed on the profile pictures according to the outline of the forehead and nose. Forehead inclination, maxillary incisor facial inclination and the AP position of the maxillary central incisor relative to the forehead (FAFFA) were measured on the integrated images and statistical analyses were performed. In both groups, there were no significant male/female differences in either the maxillary central incisor inclination or AP position. Female subjects had a significantly steeper forehead inclination compared with males (P < 0.001) in both groups. After combined surgical-orthodontic treatment, the significant labial inclination (P < 0.001) and posterior positioning (P < 0.001) of the maxillary central incisors had been corrected to close to normal range (P > 0.05). In the control group, 84.6% had the facial axial point (FA) of their maxillary central incisors positioned between lines through the forehead facial axis (FFA) point and the glabella. In the study group, however, 79.1% had the maxillary central incisors positioned posterior to the line through the FFA point and the difference with the control group was statistically significant (P < 0.001). The position of the maxillary central incisors was strongly correlated with forehead inclination in the control sample (r(2) = 0.456; P < 0.01), but only a poor correlation was detected in the class III group (r(2) = 0.177; P > 0.05). With the integrated radiograph-photograph method, the lateral cephalogram was reoriented, which makes it possible to accurately measure the variables on profile photographs. The AP position and inclination of the maxillary central incisors relative to the forehead plays an important role in the esthetics of the profile during smiling and could be an important variable to be considered during diagnosis and treatment planning. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Assessment of Temporary Crown Extensions to Correct Linguoverted Mandibular Canine Teeth in 72 Client-Owned Dogs (2012-2016).

PubMed

Storli, Sigbjørn H; Menzies, Robert A; Reiter, Alexander M

2018-06-01

A search of the medical and dental records at Evidensia Lørenskog Dyreklinikk, in Lørenskog, Norway, was conducted to identify dogs that received temporary crown extensions (TCEs) to correct linguoverted mandibular canine (LMC) teeth over a 54-month investigation period (2012-2016). Criteria for inclusion into the study were the presence of complete medical and dental records, pre- and postoperative clinical photographs and intraoral radiographs of the affected canine teeth, adequate information pertaining to the procedures performed, and at least 1 follow-up >3 months after appliance removal. Seventy-two dogs with LMC teeth were treated with TCE. Thirty-nine breeds were represented in this study. Mean age at the time of appliance installation was 6.4 (range, 4.7-13.4 months [median, 5.9 months] months). Fifty-three (73.6%) dogs presented with class I malocclusion, 14 (19.5%) dogs with class II malocclusion, and 5 (6.9%) dogs with class III malocclusion. Twenty-five (34.7%) dogs were considered to have mild, 32 (44.4%) dogs to have moderate, and 15 (20.8%) dogs to have severe mandibular canine malocclusion. The TCE was combined with other treatment modalities (active orthodontics, extraction of nonstrategic teeth, gingivectomy, and inclined bite plane and ball therapy) to correct mandibular canine tooth malocclusions in 19 (26.4%) dogs. Fractured or detached crown extensions were seen in 9 (12.5%) dogs. Soft tissue ulceration or inflammation was seen in 7 (9.7%) dogs. The mandibular canine teeth occlusion resolved completely with self-retaining, functional, nontraumatic occlusion in 56 (77.8%) dogs. Fifteen dogs (20.8%) resolved with functional, nontraumatic occlusion, but the mandibular canine teeth were too short to be perfectly self-retained, thus left with 1- to 2-mm crown extensions for permanent retention. In 1 (1.4%) dog, both mandibular canine teeth relapsed almost back to original position. The results show that TCE is a viable treatment option to correct LMC teeth in young dogs.

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Perceptual Outcomes of Velopharyngeal Function

ERIC Educational Resources Information Center

Pereira, Valerie J.; Sell, Debbie; Tuomainen, Jyrki

2013-01-01

Background: Abnormal facial growth is a well-known sequelae of cleft lip and palate (CLP) resulting in maxillary retrusion and a class III malocclusion. In 10-50% of cases, surgical correction involving advancement of the maxilla typically by osteotomy methods is required and normally undertaken in adolescence when facial growth is complete.…

Thin-plate spline graphical analysis of the mandible in mandibular prognathism.

PubMed

Chang, Hsin-Fu; Chang, Hong-Po; Liu, Pao-Hsin; Chang, Chih-Han

2002-11-01

The chin cup has been used to treat skeletal mandibular prognathism in growing patients for 200 years. The pull on the orthopedic-force chin cup is oriented along a line from the mandibular symphysis to the mandibular condyle. Various levels of success have been reported with this restraining device. The vertical chin cup produces strong vertical compression stress on the maxillary molar regions when the direction of traction is 20 degrees more vertical than the chin-condyle line. This treatment strategy may prevent relapse due to counter-clockwise rotation of the mandible. In this report, we describe a new strategy for using chin-cup therapy involving thin-plate spline (TPS) analysis of lateral cephalometric roentgenograms to visualize transformation of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. A case of mandibular prognathism treated with a chin cup and a case of dental Class III malocclusion without orthodontic treatment are described. The case analysis illustrates that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopedic therapy, and that visualization of these deformations is feasible using TPS graphical analysis.

Pathognomonic features of Angle's Class II division 2 malocclusion: A comparative cephalometric and arch width study

PubMed Central

Prasad, Singamsetty E.R.V.; Indukuri, Ravikishore Reddy; Singh, Rupesh; Nooney, Anitha; Palagiri, Firoz Babu; Narayana, Veera

2014-01-01

Background: A thorough knowledge of the salient features of malocclusion helps the clinician in arriving at a proper diagnosis and treatment plan, and also to predict the prognosis, prior to the onset of treatment process. Among the four classes of Angle's classification of malocclusion, Class II division 2 occurs with the least frequency. There is still continuing debate in the literature whether the Class II division 2 patients ascribe the pathognomonic skeletal and dental features. Aim of the study: The aim of this study is to describe the unique features of Angle's Class II division 2 malocclusion to differentiate it from Angle's Class II division 1 malocclusion. Materials and Methods: A total of 582 pre-treatment records (study models and cephalograms), with the age of patients ranging from 15 to 22 years, were obtained from the hospital records of Vishnu Dental College, Bhimavaram and Geetam's Dental College, Visakhapatnam. Out of these, 11 pre-treatment records were excluded because of lack of clarity. In the rest of the sample, 283 were Class II division 1 and 288 were Class II division 2. The lateral cephalograms were analyzed by using digiceph and the arch width analysis was done based on the anatomical points described by Staley et al. and Sergl et al. Results: An intergroup evaluation was done by using unpaired Student's “t” test. The skeletal vertical parameters, dental parameters, and the maxillary arch width parameters revealed a statistically significant difference between the two groups of malocclusion. Conclusion: Angle's Class II division 2 malocclusion has a pronounced horizontal growth pattern with decreased lower anterior facial height, retroclined upper anteriors, and significantly increased maxillary arch width parameters. PMID:25558449

Skeletal class III malocclusion treated using a non-surgical approach supplemented with mini-implants: a case report.

PubMed

Farret, Marcel Marchiori; Benitez Farret, Milton M

2013-09-01

We describe a 28-year-old man who sought orthodontic treatment complaining about the esthetics of his smile and difficulties associated with masticatory function. The patient had a straight facial profile, skeletal and dental class III relationship, anterior open bite and posterior crossbite. He refused orthognathic surgery and was therefore treated with camouflage orthodontics supplemented with the placement of one mini-implant in each side of the mandible to facilitate movement of the lower dentition distally, tooth-by-tooth. At the end of treatment, a class I molar relationship was obtained, with an ideal overjet and overbite and excellent intercuspation. Furthermore, the open bite and crossbite were corrected. Analysis 2 years after treatment revealed good stability of treatment outcome.

Biology of biomechanics: Finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion.

PubMed

Roberts, W Eugene; Viecilli, Rodrigo F; Chang, Chris; Katona, Thomas R; Paydar, Nasser H

2015-12-01

In the absence of adequate animal or in-vitro models, the biomechanics of human malocclusion must be studied indirectly. Finite element analysis (FEA) is emerging as a clinical technology to assist in diagnosis, treatment planning, and retrospective analysis. The hypothesis tested is that instantaneous FEA can retrospectively simulate long-term mandibular arch retraction and occlusal plane rotation for the correction of a skeletal Class III malocclusion. Seventeen published case reports were selected of patients treated with statically determinate mechanics using posterior mandible or infrazygomatic crest bone screw anchorage to retract the mandibular arch. Two-dimensional measurements were made for incisor and molar movements, mandibular arch rotation, and retraction relative to the maxillary arch. A patient with cone-beam computed tomography imaging was selected for a retrospective FEA. The mean age for the sample was 23.3 ± 3.3 years; there were 7 men and 10 women. Mean incisor movements were 3.35 ± 1.55 mm of retraction and 2.18 ± 2.51 mm of extrusion. Corresponding molar movements were retractions of 4.85 ± 1.78 mm and intrusions of 0.85 ± 2.22 mm. Retraction of the mandibular arch relative to the maxillary arch was 4.88 ± 1.41 mm. Mean posterior rotation of the mandibular arch was -5.76° ± 4.77° (counterclockwise). The mean treatment time (n = 16) was 36.2 ± 15.3 months. Bone screws in the posterior mandibular region were more efficient for intruding molars and decreasing the vertical dimension of the occlusion to close an open bite. The full-cusp, skeletal Class III patient selected for FEA was treated to an American Board of Orthodontics Cast-Radiograph Evaluation score of 24 points in about 36 months by en-masse retraction and posterior rotation of the mandibular arch: the bilateral load on the mandibular segment was about 200 cN. The mandibular arch was retracted by about 5 mm, posterior rotation was about 16.5°, and molar intrusion was about 3 mm. There was a 4° decrease in the mandibular plane angle to close the skeletal open bite. Retrospective sequential iterations (FEA animation) simulated the clinical response, as documented with longitudinal cephalometrics. The level of periodontal ligament stress was relatively uniform (<5 kPa) for all teeth in the mandibular arch segment. En-masse retraction of the mandibular arch is efficient for conservatively treating a skeletal Class III malocclusion. Posterior mandibular anchorage causes intrusion of the molars to close the vertical dimension of the occlusion and the mandibular plane angle. Instantaneous FEA as modeled here could be used to reasonably predict the clinical results of an applied load. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Three-dimensional assessment of maxillary changes associated with bone anchored maxillary protraction

PubMed Central

Nguyen, Tung; Cevidanes, Lucia; Cornelis, Marie A.; Heymann, Gavin; de Paula, Leonardo K.; De Clerck, Hugo

2013-01-01

Introduction Bone-anchored maxillary protraction has been shown to be an effective treatment modality for the correction of Class III malocclusions. The purpose of this study was to evaluate 3-dimensional changes in the maxilla, the surrounding hard and soft tissues, and the circummaxillary sutures after bone-anchored maxillary protraction treatment. Methods Twenty-five consecutive skeletal Class III patients between the ages of 9 and 13 years (mean, 11.10 ± 1.1 years) were treated with Class III intermaxillary elastics and bilateral miniplates (2 in the infrazygomatic crests of the maxilla and 2 in the anterior mandible). Cone-beam computed tomographs were taken before initial loading and 1 year out. Three-dimensional models were generated from the tomographs, registered on the anterior cranial base, superimposed, and analyzed by using color maps. Results The maxilla showed a mean forward displacement of 3.7 mm, and the zygomas and the maxillary incisors came forward 3.7 and 4.3 mm, respectively. Conclusions This treatment approach produced significant orthopedic changes in the maxilla and the zygomas in growing Class III patients. PMID:22133943

Pattern of clefts and dental anomalies in six-year-old children: a retrospective observational study in western Norway.

PubMed

Sæle, Paul; Østhus, Eirik; Ådalen, Sondre; Nasir, Elwalid F; Mustafa, Manal

2017-03-01

Clefts of the lip and/or palate (CL/P) are the most common congenital disorders of the head and neck. In Norway, the incidence is 1.9/1000 live births. The aim of this study was to investigate the frequency and distribution of various types of clefts and dental anomalies in patients treated by the cleft lip and palate (CLP) team in Bergen, Norway. The material comprised the records of patients 6 years of age, examined by the CLP team in Bergen from spring 1993 to autumn 2012, incomplete records were excluded. The records of 989 patients were analysed, using frequencies and Chi-square test to compare differences in percentages between groups. The gender distribution was 58.8% male and 41.2% female. Isolated cleft palate (CP) was the most common condition (39.5%). Clefts of the lip, jaw and palate (CLP) constituted (30%) of cases and (30.5%) had isolated cleft lip (CL). The frequencies of agenesis, supernumerary and peg-shaped teeth were (36.5%), (17.8%) and (7.5%), respectively. Over 50% of the study population were diagnosed with one or more malocclusion. Of the CLP patients, 61.4% had Angle Class III occlusion. Statistical analysis disclosed a positive association of agenesis with Class III occlusion (OR =1.8, p≤ 0.001). The findings supported the hypothesis that the distribution of dental anomalies and occlusal disorders varied among patients with CL, CP and CLP. In patients with cleft, there is a twofold chance to get Class III malocclusion in the presence of agenesis.

Posterior open occlusion management by registration of overlay removable partial denture: A clinical report

PubMed Central

Nosouhian, Saeid; Davoudi, Amin; Derhami, Mohammad

2015-01-01

This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions. PMID:26929544

Posterior open occlusion management by registration of overlay removable partial denture: A clinical report.

PubMed

Nosouhian, Saeid; Davoudi, Amin; Derhami, Mohammad

2015-01-01

This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.

Dentoskeletal modifications in Class II deep bite malocclusion treatment with anterior bite plane functional appliance

PubMed Central

Ciavarella, Domenico; Laurenziello, Michele; Guida, Laura; Montaruli, Graziano; Gallo, Crescenzio; Lo Muzio, Lorenzo

2017-01-01

Background A treatment modality for Class II division 1 malocclusion is discussed. Orthodontic treatment of patients with deep bite and Class II malocclusion is an important challenge in clinical practice. The aim of this work is to compare the efficacy of anterior bite plane functional appliance (ABPFA) by assessing the changes in different times with untreated patients by literature. Material and Methods The study group comprised 22 subjects with Class II division 1 malocclusion and hypo-divergent. Eligibility criteria for this study were: dental Class II division 1 malocclusion, hypo-divergent skeletal pattern, late mixed or permanent dentition. We analyzed with the use of stable bone structure (ASCB) at two different times: pre-treatment (T0) and post-treatment (T1) after 24 months. Inter-group differences were evaluated with paired samples t-test at the P<0.05 level. Results No statistical significant differences were found in cephalometric skeletal measurements, whereas dental parameters showed a significant different overjet, which was significantly reduced (6 mm at T0 vs. 5 mm at T1) in our series. Conclusions In ABPFA group, the treatment effects were reduce mainly Class II malocclusion, overjet and overbite alteration. This appliance seems to suggest a significant beneficial effect in mandible displacement by reducing the counter clockwise rotation of the mandible, which is further confirmed by the almost absence of modifications of ArGoMe and SNGoMe angles. The ABPFA is particularly suitable to reduce the non-desirable dental effects represented by lower incisors pro inclination, and upper incisors retro-inclination. Key words:Orthodontics, Functional orthodontics, Class II malocclusion, Anterior bite plane functional appliance. PMID:28936295

Duration of the peak of adolescent growth spurt in class i and ii malocclusion subjects using a cervical vertebrae maturation analysis.

PubMed

Salazar-Lazo, Rodrigo; Arriola-Guillén, Luis E; Flores-Mir, Carlos

2014-01-01

The aim of the present work was to determine the duration of the adolescent peak growth spurt using cervical vertebral maturation analysis in class I and II malocclusion subjects. The study was conducted on a sample which consisted of 154 lateral cephalograms of children and adolescents aged 9-15 years (84 females and 70 males). The evaluation of skeletal maturation stage was performed using a visual morphological analysis of CS3 and CS4 cervical vertebrae. The sagittal skeletal relation was evaluated according to Steiner analysis. Descriptive statistics were used to summarize chronological age in each malocclusion group and for each CS3 and CS4 skeletal maturation stage. Due to a lack of normal distribution, comparisons of CS3 and CS4 age intervals on class I and II subjects were compared using the Mann-Whitney U test for independent samples. The results show that the mean duration of the adolescent peak growth spurt was 10 months between CS3 and CS4 stages in class I malocclusion subjects, whereas in class II malocclusion patients the duration was 6 months. This difference of 4 months was statistically significant (p<0.001). Finally, a clinically significant difference of 4 months in the duration of the adolescent peak growth spurt for class I and II malocclusion subjects was identified.

A Cephalometric Comparison of Twin Block and Bionator Appliances in Treatment of Class II Malocclusion

PubMed Central

Ahmadian-Babaki, Fatemeh; Araghbidi-Kashani, S. Mehdi

2017-01-01

Background Class II malocclusion is one of the most common orthodontic problems. In cases of class II malocclusion with mandibular deficiency, functional appliances often are used with the intent of stimulating mandibular growth. Bionator and twin block are two of the more popular functional appliances. The aim of this study was to compare the treatment outcomes of these two appliances using cephalometric radiographs. Material and Methods Cephalometric radiographs of 33 patients who had class II division I malocclusion, before and after treatment were digitalized. The mean changes in twin block and bionator groups were compared using independent t test. Results Twin block and bionator showed no statistically significant differences in cephalometric parameters except for ANB, NA-Pog, Basal and Ar-Go-Me angles. Conclusions There were no statistically significant differences in dentoalveolar and mandibular position between twin block and bionator (p>0.1). Twin block was more efficient in inhibition of forward movement of maxilla (p<0.1). Key words:Functional, Class II malocclusion, Cephalometrics, Twin block, Bionator, Treatment. PMID:28149473

Quantitative validation of a computer-aided maxillofacial planning system, focusing on soft tissue deformations.

PubMed

Nadjmi, Nasser; Defrancq, Ellen; Mollemans, Wouter; Hemelen, Geert Van; Bergé, Stefaan

2014-01-01

The aim of this study was to evaluate the accuracy of 3D soft tissue predictions generated by a computer-aided maxillofacial planning system in patients undergoing orthognathic surgery. Twenty patients with dentofacial dysmorphosis were treated with orthognathic surgery after a preoperative orthodontic treatment. Fourteen patients had an Angle Class II malocclusion; three patients had an Angle class III malocclusion, and three patients had an Angle Class I malocclusion. Skeletal asymmetry was observed in six patient. The surgeries were planned using the Maxilim software. Computer assisted surgical planning was transferred to the patient by digitally generated splints. The validation procedures were performed in the following steps: (1) Standardized registration of the pre- and postoperative Cone Beam CT volumes; (2) Automated adjustment of the bone-related planning to the actual operative bony displacement; (3) Simulation of soft tissue changes; (4) Calculation of the soft tissue differences between the predicted and the postoperative results by distance mapping. Eighty four percent of the mapped distances between the predicted and actual postoperative results measured between -2 mm and +2 mm. The mean absolute linear measurements between the predicted and actual postoperative surface was 1.18. Our study shows the overall prediction was dependent on neither the surgical procedures nor the dentofacial deformity type. Despite some shortcomings in the prediction of the final position of the lower lip and cheek area, this software promises a clinically acceptable soft tissue prediction for orthognathic surgical procedures.

The Use of Invisalign® System in the Management of the Orthodontic Treatment before and after Class III Surgical Approach

PubMed Central

2016-01-01

The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time. PMID:27429811

Orthodontic decompensation in class III patients by means of distalization of upper molars.

PubMed

Carlos, Villegas B; Giovanni, Oberti; Diego, Rey; Angela, Sierra; Baccetti, Tiziano

2009-01-01

Pre-surgical orthodontic treatments have the objective of establishing harmony between the dental arches by moving the teeth to ideal positions in relation to their bony bases, in order to achieve adequate antero-posterior occlusal and transverse relationships at the moment of surgery. Among the typical requirements in terms of dental compensations presented by Class III patients that require surgery, the inclination of anterior teeth must be changed in most cases by proclination of the lower incisors and retroclination of upper incisors. To achieve the inclination of the upper incisors, many different alternatives have been proposed, such as inter-proximal reduction, extractions, or distalization of upper molars, which has not been widely reported in the literature as a means to decompensate Class III malocclusion prior to surgery. This article describes the Bone Supported Pendulum (BSP) as an efficient therapeutic option to distalize molars through the use of an appliance stabilized to the palate by mini-implants, thus avoiding extractions and providing good interdigitation and coordination of the dental arches.

Modified protrusion arch for anterior crossbite correction - a case report.

PubMed

Roy, Abhishek Singha; Singh, Gulshan Kr; Tandon, Pradeep; Chaudhary, Ramsukh

2013-01-01

Borderline and mild skeletal Class III relationships in adult patients are usually treated by orthodontic camouflage. Reasonably rood results have been achieved with nonsurgical teatment of anterior crossbite. Class III malocclusion may be associated with mandibular prognathism, maxillary retrognathism, or both. Class III maxillary retrognathism generally involves anterior crossbite, which must be opened if upper labial brackets are to be bonded. If multiple teeth are in crossbite, after opening the bite usual step is to ligate forward or advancement arch made of 0.018" or 0.020" stainless steel or NiTi wire main arch that must be kept separated 2 mm from the slot ofupper incisor braces. Two stops or omegas are made 1 mm mesial to the tubes of the molar bands that will impede main arch from slipping,and in this manner the arch will push the anterior teeth forward Here we have fabricated a modified multiple loop protrusion arch to correct an anterior crossbite with severe crowding that was not amenable to correct by advancement arches.

Orthodontic camouflage in the case of a skeletal class III malocclusion.

PubMed

Costa Pinho, Teresa M; Ustrell Torrent, Josep M; Correia Pinto, João G R

2004-01-01

To describe the clinical problem of a male patient, 15 years of age, who had a dolichofacial biotype and a Class III skeletal type at the beginning of treatment, manifesting itself at the dental level. To resolve the dental problems, orthodontic camouflage (dentoalveolar compensation) with the extraction of two mandibular premolars was performed. This procedure allowed a more harmonious occlusal relationship at the canine level and provided better occlusal stability of the final result. The procedure choice was based on the fact that some cephalometric values were favorable to attenuation of the skeletal Class III. For example, according to the analyses of Björk and Jarabak, these values are the total sum of 1, 2, 3 (sella angle, articular angle, and gonial angles) and the anterior/posterior facial height (S-Go/Na-Me). However, the same cephalometric data indicate a possible worsening of the existing open bite, which might be corrected with dental extractions and the use of intermaxillary elastics.

Class III dento-skeletal anomalies: rotational growth and treatment timing.

PubMed

Mosca, G; Grippaudo, C; Marchionni, P; Deli, R

2006-03-01

The interception of a Class III malocclusion requires a long-term growth prediction in order to estimate the subject's evolution from the prepubertal phase to adulthood. The aim of this retrospective longitudinal study was to highlight the differences in facial morphology in relation to the direction of mandibular growth in a sample of subjects with Class III skeletal anomalies divided on the basis of their Petrovic's auxological categories and rotational types. The study involved 20 patients (11 females and 9 males) who started therapy before reaching their pubertal peak and were followed up for a mean of 4.3 years (range: 3.9-5.5 years). Despite the small sample size, the definition of the rotational type of growth was the main diagnostic element for setting the correct individualised therapy. We therefore believe that the observation of a larger sample would reinforce the diagnostic-therapeutic validity of Petrovic's auxological categories, allow an evaluation off all rotational types, and improve the statistical significance of the results obtained.

Orthodontic Camouflage: A Treatment Option - A Clinical Case Report.

PubMed

Mazzini, William Ubilla; Torres, Fátima Mazzini

2017-01-01

Orthodontic camouflage provides an alternative treatment for angle III malocclusion since patients with limited economic resources cannot opt for orthognathic surgery, it being clear that correction will be achieved at the dental level and not at the bone complex. To determine an alternative treatment for patients who do not have the possibility of having orthognathic surgery. A 13-year-old female patient, dolico facial biotype with slightly concave profile, with Class III Skeletal by mandibular prognathism, anterior crossbite, anterior diastema, and large mandibular body, molar class, and canine III. Alexander technique brackets were placed; premolar extraction was not planned. Once the case was completed, the correction of the anterior crossbite was achieved, thanks to the use of the spaces that existed at the beginning of the treatment and also that a correct distalization of canines and retraction of the lower anterior segment were performed.

Orthodontic Camouflage: A Treatment Option – A Clinical Case Report

PubMed Central

Mazzini, William Ubilla; Torres, Fátima Mazzini

2017-01-01

Orthodontic camouflage provides an alternative treatment for angle III malocclusion since patients with limited economic resources cannot opt for orthognathic surgery, it being clear that correction will be achieved at the dental level and not at the bone complex. Objective: To determine an alternative treatment for patients who do not have the possibility of having orthognathic surgery. Clinical case: A 13-year-old female patient, dolico facial biotype with slightly concave profile, with Class III Skeletal by mandibular prognathism, anterior crossbite, anterior diastema, and large mandibular body, molar class, and canine III. Alexander technique brackets were placed; premolar extraction was not planned. Once the case was completed, the correction of the anterior crossbite was achieved, thanks to the use of the spaces that existed at the beginning of the treatment and also that a correct distalization of canines and retraction of the lower anterior segment were performed. PMID:29326524

Dentoalveolar class III treatment using retromolar miniscrew anchorage.

PubMed

Poletti, Laura; Silvera, Aimara A; Ghislanzoni, Luis T Huanca

2013-05-23

In this article, we report the successful use of miniscrews in the distalization of the lower dentition to correct an Angle class III malocclusion with lower anterior crowding in a dolichofacial adult patient. Conventional intraoral and extraoral appliances have many disadvantages, including the need for patient cooperation, potential for anchorage loss, and vertical extrusion of upper molars and lower incisors. Extrusion should be prevented or minimized when treating long-faced patients with reduced overbite. After third molar extractions, miniscrews were placed in the retromolar area. A sliding jig was applied to distalize the lower molars, while the anterior teeth were bonded and retracted secondarily to avoid round tripping. After 18 months of treatment, molar and canine class I relationship with normal overjet and overbite were achieved. In addition, there was an esthetic improvement in the profile with only a small increase of the lower anterior facial height. These results remained stable at a 12-month follow-up.

Therapeutic approach to Class II, Division 1 malocclusion with maxillary functional orthopedics

PubMed Central

de Bittencourt, Aristeu Corrêa; Saga, Armando Yukio; Pacheco, Ariel Adriano Reyes; Tanaka, Orlando

2015-01-01

INTRODUCTION: Interceptive treatment of Class II, Division 1 malocclusion is a challenge orthodontists commonly face due to the different growth patterns they come across and the different treatment strategies they have available. OBJECTIVE: To report five cases of interceptive orthodontics performed with the aid of Klammt's elastic open activator (KEOA) to treat Class II, Division 1 malocclusion. METHODS: Treatment comprehends one or two phases; and the use of functional orthopedic appliances, whenever properly recommended, is able to minimize dentoskeletal discrepancies with consequent improvement in facial esthetics during the first stage of mixed dentition. The triad of diagnosis, correct appliance manufacture and patient's compliance is imperative to allow KEOA to contribute to Class II malocclusion treatment. RESULTS: Cases reported herein showed significant improvement in skeletal, dental and profile aspects, as evinced by cephalometric analysis and clinical photographs taken before, during and after interceptive orthodontics. PMID:26352852

Orthodontic Camouflage Treatment in an Adult Patient with a Class II, Division 1 Malocclusion – A Case Report

PubMed Central

Naragond, Appasaheb; Kenganal, Smitha; Sagarkar, Roshan; Sugaradday

2013-01-01

Since so many decades, various treatment modalities have been presented for the treatment for the class II, div 1 malocclusions. In recent times, we have seen enormously increasing numbers of young adults who desire the shortest, cost effective and a non surgical correction of Class II malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy. This case report presents one such case of a 22 year old non-growing female who had a skeletal Class II, division 1 malocclusion with an orthognathic maxilla, a retrognathic mandible, a negative VTO and an overjet of 12mm, who did not want a surgical treatment. We considered the camouflage treatment by extracting the upper first premolars. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, smile and lip competence and stability of the treatment results. PMID:23543878

Prevalence of dental anomalies in Saudi orthodontic patients.

PubMed

Al-Jabaa, Aljazi H; Aldrees, Abdullah M

2013-07-01

This study aimed to investigate the prevalence of dental anomalies and study the association of these anomalies with different types of malocclusion in a random sample of Saudi orthodontic patients. Six hundred and two randomly selected pretreatment records including orthopantomographs (OPG), and study models were evaluated. The molar relationship was determined using pretreatment study models, and OPG were examined to investigate the prevalence of dental anomalies among the sample. The most common types of the investigated anomalies were: impaction followed by hypodontia, microdontia, macrodontia, ectopic eruption and supernumerary. No statistical significant correlations were observed between sex and dental anomalies. Dental anomalies were more commonly found in class I followed by asymmetric molar relation, then class II and finally class III molar relation. No malocclusion group had a statistically significant relation with any individual dental anomaly. The prevalence of dental anomalies among Saudi orthodontic patients was higher than the general population. Although, orthodontic patients have been reported to have high rates of dental anomalies, orthodontists often fail to consider this. If not detected, dental anomalies can complicate dental and orthodontic treatment; therefore, their presence should be carefully investigated during orthodontic diagnosis and considered during treatment planning.

Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren.

PubMed

Lux, Christopher J; Dücker, Britta; Pritsch, Maria; Komposch, Gerda; Niekusch, Uwe

2009-06-01

The aim of this study was to provide detailed information concerning clinically relevant occlusal traits and the prevalence of occlusal anomalies in an orthodontically relevant period of dental development. Four hundred and ninety-four German schoolchildren (237 males and 257 females), median age 9 years, were orthodontically examined. Overjet and overbite were measured to the nearest 0.5 mm, and sagittal molar relationships were registered clinically to the nearest quarter unit. In addition, crossbites, scissor bites, and midline displacements were evaluated. Descriptive statistics was complemented by testing gender differences and differences between groups with Class I and Class II anomalies (Mann-Whitney U-test) as well as a statistical evaluation of differences between the three dental stages (Kruskal-Wallis test). Overjet exhibited an extreme range between -2 and 12 mm (median values 3-3.5 mm). An increased overjet was more prevalent than a reduced or reverse overjet, and a severely increased overjet greater than 6 mm was a common finding affecting around 5-10 per cent of the children. Similarly, overbite showed considerable variations of between -1 and 9 mm (medians 3-3.5 mm) and males exhibited a significantly larger overbite than females. In Class II malocclusion subjects, overbite was significantly enlarged (on average between 0.5 and 1 mm) when compared with those with a Class I malocclusion. Traumatic contact of the gingiva affected every 14th child. A Class II molar relationship of three-quarter units or more was a frequent finding affecting more than one child in five. In addition, at 9 years of age, 3 per cent of the children exhibited a Class III molar relationship of at least a half unit. The wide range of orthodontically relevant occlusal traits found in the present study underlines the need for orthodontic screening at 9 years of age (or earlier).

Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh

PubMed Central

Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

2016-01-01

Objective To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. Materials and methods This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13–21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Results Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics (P=0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics (P<0.0001). Conclusion Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics. PMID:27843351

Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh.

PubMed

Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

2016-01-01

To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13-21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics ( P =0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics ( P <0.0001). Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics.

Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

PubMed

Rizkallah, Jean; Schwartz, Stephane; Rauch, Frank; Glorieux, Francis; Vu, Duy-Dat; Muller, Katia; Retrouvey, Jean-Marc

2013-03-01

Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P <0.05). The mean United States weighted PAR scores were 32.2 (SD, 15.0) for patients with osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P <0.05). The average modified DI scores were 29.8 (SD, 20.2) for the osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P <0.05). Group differences were greatest for lateral open bite (osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Hard- and soft-tissue profiles of the midface region in patients with skeletal Class III malocclusion using cone-beam computed tomography multiplanar-reconstructed image analysis.

PubMed

Kim, Bomi; Lee, Hyung-Chul; Kim, Seong-Hun; Kim, Yongil; Son, Woosung; Kim, Seong Sik

2018-05-01

This study examined cone-beam computed tomography (CBCT)-derived multiplanar-reconstructed (MPR) cross-sections to clarify the salient characteristics of patients with skeletal class III malocclusion with midface deficiency (MD). The horizontal and sagittal plane intersection points were identified for middle-third facial analysis in 40 patients in the MD or normal (N) groups. MPR images acquired parallel to each horizontal plane were used for length and angular measurements. A comparison of the MD and N groups revealed significant differences in the zygoma prominence among female patients. The convex zygomatic area in the N group was larger than that in the MD group, and the inferior part of the midface in the N group was smaller than that in the MD group for both male and female patients. A significant difference was observed in the concave middle maxillary area among male patients. This study was conducted to demonstrate the difference between MD and normal face through MPR images derived from CBCT. Male patients in the MD group had a more flattened face than did those in the N group. Female patients in the MD group showed a concave-shaped lower section of the zygoma, which tended to have more severe MD. These findings indicate that orthognathic surgery to improve skeletal discrepancy requires different approaches in male and female patients.

Correlation Between Cephalometric Measures and End-of-Treatment Facial Attractiveness.

PubMed

Yu, Xiao-nan; Bai, Ding; Feng, Xue; Liu, Yue-hua; Chen, Wen-jing; Li, Song; Han, Guang-li; Jiang, Ruo-ping; Xu, Tian-min

2016-03-01

Sixty-nine experienced Chinese orthodontists evaluated 108 Chinese patients' facial attractiveness from set of photographs (frontal, lateral, and frontal smiling photos) taken at the end of orthodontic treatment. These 108 patients, which contained an equal number of patients with Class I, II, and III malocclusion, were randomly selected from 6 orthodontic treatment centers throughout China. Spearman rank-order correlation coefficients (rs) analyses were performed to examine agreement in ranking between all judge pairs. Pearson correlation and multivariate regression were performed to examine the correlation between cephalometric measures and end-of-treatment Photo Attractiveness Rank.96.68% judge pairs showed moderate correlated (+0.4 ≤ rs < +0.7) subjective rankings. Cephalometric measures significantly correlated with end-of-treatment Photo Attractiveness Rank included interincisal angle (r = 0.330, P < 0.05), L1/MP° (r = 0.386, P < 0.05), L1-NBmm (r = 0.451, P < 0.01), L1/NB° (r = 0.374, P < 0.05), and profile angle (r = 0.353, P < 0.05) in Class I patients with an explained variance of 32.8%, and ANB angle (r = 0.432, P < 0.01), angle of convexity (r = 0.448, P < 0.01), profile angle (r = 0.488, P < 0.01), Li to E-line (r = 0.374, P < 0.05), Li to B-line (r = 0.543, P < 0.01), and Z angle (r = 0.543, P < 0.01) in Class II patient with an explained variance of 43.3%.There was less association than expected between objective measurements on the lateral cephalograms and clinicians' rankings of facial attractiveness on clinical photography in Chinese patients. Straight-stand lower incisor was desired for facial attractiveness of Class I malocclusion; and sagittal relationship and lip prominence influence the esthetics of Class II malocclusion in Chinese population.

Perceived relative attractiveness of facial profiles with varying degrees of skeletal anomalies.

PubMed

Hönn, Mirjam; Dietz, Klaus; Godt, Arnim; Göz, Gernot

2005-05-01

The objective of this study was to answer the following questions: Are profiles of Class I patients perceived as more attractive than profiles of Class II or Class III patients in Germany today? How pronounced must a skeletal malocclusion be to be perceived as less attractive? Are there differences in perception between dentists and laypersons? For the present study we examined seven patients with skeletal Class I, orthognathic maxillae and mandibles, and straight average faces (ideal biometric face as defined by A. M. Schwarz). Using the Onyx Ceph software, their profile lines were modified to reflect three different Class II profile variants and three different Class III profile variants. The 49 profiles thus obtained were assigned to two groups. Group 1 comprised the seven straight average faces and the first part of the retrognathic and prognathic profile variants. Group 2 comprised the same seven straight average faces and the remaining retrognathic and prognathic profile variants. Both groups of faces were scored by 130 laypersons and 126 dentists. Both groups of observers perceived the seven straight average faces similarly both in the first and second (subsequent) scoring rounds. The straight average face was perceived as most attractive by laypersons (mean, 5.48; 95% confidence interval (CI:) 5.33-5.60) and dentists (mean, 5.44; 95% CI, 5.28-5.50) alike, followed by the mildest variant of the retrognathic face (laypersons, mean, 4.85; 95% CI, 4.68-5.01; dentists, mean, 4.98; 95% CI, 4.81-5.10). Dentists differentiated more clearly by degree of skeletal malocclusion than did laypersons. Both groups alike perceived the extreme variant of the prognathic and retrognathic profile lines as the least attractive. Grouping the subjects by gender yielded only minor differences in perception. The straight average face is perceived as most attractive by representative German populations today. Dentists make clearer gradual distinctions in their perceptions than do laypersons.

To Evaluate the Correlation Between Skeletal and Dental Parameters to the Amount of Crowding in Class II Div. 1 Malocclusions.

PubMed

Singh, Shivani; Shivaprakash, G

2017-09-01

Crowding of teeth is one of the most common problem that motivates the patient to seek orthodontic treatment. Determination of etiology of crowding could have a significant effect on treatment planning and prognosis of Class II malocclusion. Aim of this study was to evaluate the relationship of skeletal and dental parameters to amount of dental crowding in patients with Class II Divison 1 (div.1) malocclusion. Pretreatment lateral cephalograms and dental casts of 60 patients with skeletal Class II malocclusion were collected for the study. The sample was divided into two groups according to severity of pretreatment mandibular crowding. Group I consisted of cases with crowding ≥3 mm and Group II with crowding <3 mm. Lateral cephalograms for each patient was manually traced and skeletal parameters (effective maxillary and mandibular length, mandibular plane angle, Y Axis, lower anterior face height) and dental parameters (axial inclination of lower incisor, inclination of lower incisor to mandibular plane, interincisal angle) were measured. Unpaired t-test was used for intergroup comparison and relationship between different measurements was investigated using Pearson correlation coefficient. Among the skeletal parameters measured, only effective mandibular length exhibited statistically significant difference between the two groups. No statistically significant difference was found between the two groups for any of the dental parameters. Significant inverse correlation was found between mandibular crowding and effective mandibular length. Subjects with Class II div.1 malocclusion and moderate to severe mandibular crowding have significantly smaller effective mandibular base length than subjects with the same malocclusion and slight mandibular crowding.

Class III camouflage using skeletal anchorage and Pendex appliance.

PubMed

Miguel, José Augusto M; Zanardi, Gustavo

2011-01-01

This case report describes the orthodontic treatment for a young female, aged 18 years 4 months, with a Class III malocclusion on the right side, with a combination of a posterior and anterior crossbite. Two rigid orthodontic mini-implants were placed in the retromolar region in order to move the entire lower arch distally with nickel-titanium coil springs. In addition, a Pendex appliance was used to create space and to improve the arch form and the transverse relationship. The active treatment period was 17 months. Normal overjet and overbite were obtained, and facial balance was improved. Although the cephalometric superimposition has demonstrated the effects of dental compensation, the final dental and facial results were satisfactory and stable after the second year in retention. Copyright © 2011 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

Bibliometric study of articles on skeletal Class II malocclusions published in four high impact factor journals.

PubMed

Ousehal, Lahcen; El Aouame, Amal; Fatene, Nassiba; Lazrak, Laila; Traiba, Loubna; N'Gom, Papa Ibrahima

2018-04-11

Perform a bibliometric analysis of the orthodontic literature on skeletal Class II malocclusions during the first decade of the 21st century. A retrospective, observational, and comprehensive study ranging from January the first 2001 to December 31 2010, based on the articles published in four high impact factor orthodontic journals: Angle Orthod, OCR, EJO, and AJODO (Quotation Report Newspaper of the Scientific Information Institute). In the 4565 reviewed articles, only 338 were published on Class II malocclusions. Brazil, the United States, Turkey, and Germany are the nationalities, which have published the most. The cross-sectional descriptive studies represent 33%, randomized clinical trials (RCTs) 10.5%, meta-analyses 0.3%. Kanavakis et al. (2006) reported 72.34% of original articles, 2.83% of synthetic reviews, 8.89% of case reports, and 15.75% of unclassifiable articles. In conclusion, searchers in Orthodontics are invited to publish more clinical trials on skeletal Class II malocclusions. Copyright © 2018. Published by Elsevier Masson SAS.

Changes in Cranial Base Morphology in Class I and Class II Division 1 Malocclusions

PubMed Central

Agarwal, Anirudh; Pandey, Harsh; Bajaj, Kamal; Pandey, Lavesh

2013-01-01

Introduction: The cranial base plays a key role in craniofacial growth; it helps to integrate spatially and functionally different patterns of growth in various adjoining regions of the skull such as components of the brain, the nasal and oral cavity and the pharynx. The aim of this study was to evaluate the difference in cranial base flexure between skeletal and dental Class I and Class II division 1. Materials & Methods: Lateral cephalometric radiograph, of Class I and Class II with an average growth pattern were analyzed and compared. A total of 103 patients having class I (n=52) and class II (n=51) malocclusion, were taken from Department of Orthodontics, Rajasthan Dental College & Hospital, Jaipur. Cranial base angle (N-S-Ar) and ANB were measured on pre treatment lateral cephalograms. Results: In this study cranial base angle did not show statistically significant difference between the two groups studied. Conclusion: In the assessment of orthodontic problems involving anteroposterior malrelationships of the jaws, the problem is usually the result of size, form and position of the jaw. The present study failed to find any differences in cranial base angle between sagittal malocclusions. How to cite this article: Agarwal A, Pandey H, Bajaj K, Pandey L. Changes in Cranial Base Morphology in Class I and Class II Division 1 Malocclusion. J Int Oral Health 2013; 5(1):39-42. PMID:24155576

Interceptive management of eruption disturbances: case report.

PubMed

Cozza, Paola; Marino, Alessandra; Lagana, Giuseppina

2004-01-01

The aim of the present report is to describe a case of a patient with eruption disturbances of an ankylosed lower primary second molar, delayed development of a maxillary permanent canine associated with an odontoma and a class III dental malocclusion. In such a case the objectives of treatment are: to prevent impaction of the lower second premolar and tipping of the lower first molar; to establish correct anterior overbite and overjet and to control the development of the permanent upper canine.

A simple technique for correction of relapsed overjet.

PubMed

Kakkirala, Neelima; Saxena, Ruchi

2014-01-01

Class III malocclusions are usually growth related discrepancies, which often become more severe when growth is completed Orthognathic surgery can be a part of the treatment plan, although a good number of cases can be treated non-surgically by camouflage treatment. The purpose of this report is to review the relapse tendency in patients treated non-surgically. A simple technique is described to combat one such post-treatment relapse condition in an adult patient who had undergone orthodontic treatment by extraction of a single lower incisor.

The prevalence of malocclusion and orthodontic treatment needs in school going children of Nalagarh, Himachal Pradesh, India.

PubMed

Singh, Sarabjeet; Sharma, Abhishek; Sandhu, Navreet; Mehta, Kavita

2016-01-01

The aim of this study was to determine the prevalence of malocclusion and orthodontic treatment need in 13-18-year-old schoolchildren of Nalagarh, Himachal Pradesh, India using the Index of Orthodontic Treatment need (IOTN) and to analyze the treatment needs between males and females and correlation between the esthetic component (AC) and dental health component (DHC) of IOTN. The sample comprised 2000 school children (1125 females and 875 males) who had not undergone orthodontic treatment. No radiographs, study casts, were used; IOTN was calculated from clinical examination. DHC results showed that little need for orthodontic treatment was found in 31.6% and moderate need in 30.85%. A great need was estimated at 37.55%. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by increased overjet, impeded eruption of teeth, and anterior or posterior cross bite. AC results showed that little need for orthodontic treatment was in 86.15%, moderate need in 8.90%, and great need in 4.95%. Index does not consider midline discrepancy, soft tissue abnormalities, and AC does not include Class III and Class II div 2 malocclusion photographs. There seems a discrepancy in the proportion of children needing orthodontic treatment on esthetic and dental health grounds. This study provides baseline data on the need and demand for orthodontic treatment among the sample which is important for planning public orthodontic and dental services.

Prevalence of malocclusion among mouth breathing children: do expectations meet reality?

PubMed

Souki, Bernardo Q; Pimenta, Giovana B; Souki, Marcelo Q; Franco, Leticia P; Becker, Helena M G; Pinto, Jorge A

2009-05-01

The aim of this study was to report epidemiological data on the prevalence of malocclusion among a group of children, consecutively admitted at a referral mouth breathing otorhinolaryngological (ENT) center. We assessed the association between the severity of the obstruction by adenoids/tonsils hyperplasia or the presence of allergic rhinitis and the prevalence of class II malocclusion, anterior open bite and posterior crossbite. Cross-sectional, descriptive study, carried out at an Outpatient Clinic for Mouth-Breathers. Dental inter-arch relationship and nasal obstructive variables were diagnosed and the appropriate cross-tabulations were done. Four hundred and one patients were included. Mean age was 6 years and 6 months (S.D.: 2 years and 7 months), ranging from 2 to 12 years. All subjects were evaluated by otorhinolaryngologists to confirm mouth breathing. Adenoid/tonsil obstruction was detected in 71.8% of this sample, regardless of the presence of rhinitis. Allergic rhinitis alone was found in 18.7% of the children. Non-obstructive mouth breathing was diagnosed in 9.5% of this sample. Posterior crossbite was detected in almost 30% of the children during primary and mixed dentitions and 48% in permanent dentition. During mixed and permanent dentitions, anterior open bite and class II malocclusion were highly prevalent. More than 50% of the mouth breathing children carried a normal inter-arch relationship in the sagital, transversal and vertical planes. Univariate analysis showed no significant association between the type of the obstruction (adenoids/tonsils obstructive hyperplasia or the presence of allergic rhinitis) and malocclusions (class II, anterior open bite and posterior crossbite). The prevalence of posterior crossbite is higher in mouth breathing children than in the general population. During mixed and permanent dentitions, anterior open bite and class II malocclusion were more likely to be present in mouth breathers. Although more children showed these malocclusions, most mouth breathing children evaluated in this study did not match the expected "mouth breathing dental stereotype". In this population of mouth breathing children, the obstructive size of adenoids or tonsils and the presence of rhinitis were not risk factors to the development of class II malocclusion, anterior open bite or posterior crossbite.

Correction of malocclusion and oral rehabilitation in a case of amelogenesis imperfecta by insertion of dental implants followed by Le Fort I distraction osteogenesis of the edentulous atrophic maxilla.

PubMed

Apaydin, Aysegul; Sermet, Bulent; Ureturk, Sevin; Kundakcioglu, Abdulsamet

2014-09-17

Amelogenesis imperfecta refers a group of hereditary diseases affecting the teeth and can present a variety of clinical forms and appearances, compromising esthetic appearance. Amelogenesis imperfecta variably reduces oral health quality and can result in severe psychological problems. We present the management of an amelogenesis imperfecta Angle class III malocclusion case with speech, esthetics and functional problems. This is an example of the rarely presented delayed eruption with multiple morphologic dental alterations and edentulous maxilla.There are only a few available reports in which this method is used method to correct sagittal discrepancies in edentulous patients.Our treatment plan consisted of a preoperative diagnostic and prosthodontics phase (including preparation of guiding prosthesis), followed by a surgical phase of Le Fort I osteotomy, distraction osteogenesis to correct the malocclusion, implant insertion and a follow up final restorative phase. Our treatment strategy attempts to serve patient needs, achieving function and esthetics while also minimizing the risk of reconstruction failure. Treatment not only restored function and esthetics, but also showed a positive psychological impact and thereby improved perceived quality of life.

Evaluation of facial attractiveness for patients with malocclusion: a machine-learning technique employing Procrustes.

PubMed

Yu, Xiaonan; Liu, Bin; Pei, Yuru; Xu, Tianmin

2014-05-01

To establish an objective method for evaluating facial attractiveness from a set of orthodontic photographs. One hundred eight malocclusion patients randomly selected from six universities in China were randomly divided into nine groups, with each group containing an equal number of patients with Class I, II, and III malocclusions. Sixty-nine expert Chinese orthodontists ranked photographs of the patients (frontal, lateral, and frontal smiling photos) before and after orthodontic treatment from "most attractive" to "least attractive" in each group. A weighted mean ranking was then calculated for each patient, based on which a three-point scale was created. Procrustes superimposition was conducted on 101 landmarks identified on the photographs. A support vector regression (SVR) function was set up according to the coordinate values of identified landmarks of each photographic set and its corresponding grading. Its predictive ability was tested for each group in turn. The average coincidence rate obtained for comparisons of the subjective ratings with the SVR evaluation was 71.8% according to 18 verification tests. Geometric morphometrics combined with SVR may be a prospective method for objective comprehensive evaluation of facial attractiveness in the near future.

Cone-beam computed tomographic evaluation of the temporomandibular joint and dental characteristics of patients with Class II subdivision malocclusion and asymmetry

PubMed Central

Huang, Mingna; Hu, Yun; Yu, Jinfeng; Sun, Jicheng; Ming, Ye

2017-01-01

Objective Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. Methods Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. Results The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. Conclusions Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar. PMID:28861389

Age, extraction rate and jaw surgery rate in Korean orthodontic clinics and small dental hospitals

PubMed Central

2012-01-01

Objective This study aimed to investigate the current data regarding age, sex, and Angle Classification of Korean orthodontic patients and influence of these factors on the tendency to undergo extraction and orthognathic surgery. Methods The recent trends of Korean orthodontic patients were assessed using questionnaire survey. The questionnaires were e-mailed to orthodontists who met the study criteria; 58% of the orthodontists opened the e-mails, and 27.7% replied to the e-mails. In all, the medical records of 11,340 patients who underwent orthodontic treatment at private clinics and small dental hospitals in Korea were analyzed. Results The percentage of female patients in the study sample was 69.6%, and the average age of the patients was 19.87 years. The percentage of patients who were older than 19 years was 50.2%. Class II and Class III malocclusions were noted in 33.6% and 23.6% of patients, respectively. Extraction and orthognathic surgery were performed in 60.4% and 6.9% of patients, respectively. Conclusions The results showed that there were a high percentage of adult, Class II malocclusion and extraction patients in private practices and small dental hospitals during the study period. Further, a relatively high proportion of adult patients opted to undergo orthognathic surgery. PMID:23112936

Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies.

PubMed

Perinetti, Giuseppe; Contardo, Luca

2017-01-01

Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion.

Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

PubMed Central

2017-01-01

Current evidence on the reliability of growth indicators in the identification of the pubertal growth spurt and efficiency of functional treatment for skeletal Class II malocclusion, the timing of which relies on such indicators, is highly controversial. Regarding growth indicators, the hand and wrist (including the sole middle phalanx of the third finger) maturation method and the standing height recording appear to be most reliable. Other methods are subjected to controversies or were showed to be unreliable. Main sources of controversies include use of single stages instead of ossification events and diagnostic reliability conjecturally based on correlation analyses. Regarding evidence on the efficiency of functional treatment, when treated during the pubertal growth spurt, more favorable response is seen in skeletal Class II patients even though large individual responsiveness remains. Main sources of controversies include design of clinical trials, definition of Class II malocclusion, and lack of inclusion of skeletal maturity among the prognostic factors. While no growth indicator may be considered to have a full diagnostic reliability in the identification of the pubertal growth spurt, their use may still be recommended for increasing efficiency of functional treatment for skeletal Class II malocclusion. PMID:28168195

Combined Orthodontic-surgical Treatment for Skeletal Class III Malocclusion with Multiple Impacted Permanent and Supernumerary Teeth: Case Report.

PubMed

Xue, Dai Juan And Feng

2014-01-01

In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.

Treatment of Severe Maxillary Hypoplasia With Combined Orthodontics and Distraction Osteogenesis.

PubMed

Lucchese, Alessandra; Albertini, Paolo; Asperio, Paolo; Manuelli, Maurizio; Gastaldi, Giorgio

2018-01-05

Distraction osteogenesis (DO) is a technique that allows the generation of new bone in a gap between 2 vascularized bone surfaces in response to the application of graduated tensile stress across the bone gap.Distraction osteogenesis has become a routine treatment of choice to correct skeletal deformities and severe bone defects in the craniofacial complex over the past decade. Distraction osteogenesis has been successfully chosen in lengthening the maxilla and the mandible; in the maxilla and recently in the mandible, the jawbones have been distracted and widened transversely to relieve severe anterior dental crowding and transverse discrepancies between the dental arches.Distraction osteogenesis for maxillary advancement started in 1993 and is now widely used, especially in patients with skeletal Class III malocclusion caused by maxillary hypoplasia.The aim of this study was to present the efficiency of combined orthodontic and DO in the severe maxillary hypoplasia.A 35-year-old Italian man presented to our clinical practice with the chief complaint of esthetic and functionally problems because of skeletal Class III malocclusion with anterior crossbite.Considering that the severity of the skeletal discrepancy is remarkable but compensated by the DO potential, the combined orthodontic and DO treatment was considered adequate, like less invasive and equally effective.It was obtained a good alignment with the upper and lower arch dental alveolar maxillary advancement that allowed to correct the sagittal relationships.The patient was satisfied for the treatment results and had considerable improvement in his self-esteem.

Relationship between crown-root angulation (collum angle) of maxillary central incisors in Class II, division 2 malocclusion and lower lip line.

PubMed

Srinivasan, Bhadrinath; Kailasam, Vignesh; Chitharanjan, Arun; Ramalingam, Arthi

2013-01-01

The present study aimed to measure the magnitude of the collum angle (crown-root angulation) of maxillary central incisors present in Class II, division 2 malocclusion and to relate the changes in its magnitude with variations in the lower lip line. A set of 120 conventional lateral cephalograms were selected and divided into three groups of 40 each based on the type of malocclusion presented: Class II, division 2 (group 1); Class II, division 1 (group 2); and Class I (group 3). The collum angle of the maxillary central incisor was measured, and the lower lip line was recorded. Analysis of variance (ANOVA) revealed that the mean collum angle was statistically significantly different in the three groups. The mean collum angle was greatest in Class II, division 2 malocclusion (group 1). The mean collum angles were 3.24 ± 4.69 degrees, 0.95 ± 1.06 degrees, and 1.05 ± 1.50 degrees in groups 1, 2, and 3 respectively. In χ ² test comparison of the location of the lower lip line (incisal, middle, or apical third of the central incisor) among the three groups, the lower lip line was found to contact the middle third of the central incisor most frequently in Class II, division 2 malocclusion. ANOVA followed by Tukey honestly significant difference (HSD) test showed that the mean collum angle is significantly increased when the lower lip is in the middle third (P < .05) of the central incisor. Variations in magnitude of the collum angle with the change in the lower lip line suggest a probable etiologic role of the lower lip line in the development of the collum angle.

An evaluation of self-esteem and quality of life in orthodontic patients: effects of crowding and protrusion.

PubMed

Jung, Min-Ho

2015-09-01

To evaluate the effect of dental crowding and lip protrusion on self-esteem and quality of life (QOL) in female orthodontic patients with Class I malocclusion. The study sample consisted of 201 patients (mean age 22.6 ± 3.0 years) who sought orthodontic treatment. All the patients were evaluated before treatment in terms of their degree of dental crowding and lip protrusion. Rosenberg's Self-Esteem Scale and the Orthognathic Quality of Life Questionnaire (OQLQ) were used to determine self-esteem and QOL and to evaluate whether these values were related to malocclusion severity. The results indicated that severe crowding and severe protrusion can result in lower self-esteem and poorer QOL (P < .05) than mild crowding and protrusion in Class I malocclusion. In the oral function component of the OQLQ, the severity of protrusion did not have significant effect. In Class I malocclusion, patients with mild crowding or protrusion had significantly better self-esteem and QOL scores than severe crowding or protrusion patients.

Mini-implant-borne Pendulum B appliance for maxillary molar distalisation: design and clinical procedure.

PubMed

Wilmes, Benedict; Katyal, Vandana; Drescher, Dieter

2014-11-01

A treatment objective of upper molar distalisation may often be required during the correction of a malocclusion. Distalisation is not only indicated for the management of Class II patients, but also for Class III surgery patients who require decompensation in the upper arch if upper incisor retrusion is needed. Unfortunately, most conventional intra-oral devices for non-compliance maxillary molar distalisation experience anchorage loss. A Pendulum type of appliance and a mini-implant-borne distalisation mechanism have been designed which can be inserted at chair-side, without a prior laboratory procedure and immediately after mini-implant placement. For re-activation purposes, a distal screw may be added to the Pendulum B appliance.

[Prevention and treatment after age 10 with the edgewise technique].

PubMed

Horn, A J; Thiers-Jégou, I

2006-06-01

The success of therapy for Class II malocclusions depends on the choice orthodontists make on when to intervene. Usually they begin a two-stage treatment, first orthopedic, then orthodontic, in the mixed dentition. If they want to their non-extraction therapy to coincide with and benefit from growth, they need to diagnose the malocclusion as early as possible. Treatment of Class II malocclusions works best when it is undertaken before the second molars erupt. By correcting the malrelationship between the jaws with an orthopedic appliance, they facilitate the second, full-banded stage of treatment.

Dermatoglyphics--a marker for malocclusion?

PubMed

Tikare, S; Rajesh, G; Prasad, K W; Thippeswamy, V; Javali, S B

2010-08-01

Dermatoglyphics is the study of dermal ridge configurations on palmar and plantar surfaces of hands and feet. Dermal ridges and craniofacial structures are both formed during 6-7th week of intra-uterine life. It is believed that hereditary and environmental factors leading to malocclusion may also cause peculiarities in fingerprint patterns. To study and assess the relationship between fingerprints and malocclusion among a group of high school children aged 12-16 years in Dharwad, Karnataka, India. A total of 696 high school children aged 12-16 years were randomly selected. Their fingerprints were recorded using duplicating ink and malocclusion status was clinically assessed using Angle's classification. Chi-square analysis revealed statistical association between whorl patterns and classes 1 and 2 malocclusion (p < 0.05). However, no overall statistical association was observed between fingerprint patterns and malocclusion (p > 0.05). Dermatoglyphics might be an appropriate marker for malocclusion and further studies are required to elucidate an association between fingerprint patterns and malocclusion.

Orthognathic Surgery and Rhinoplasty to Address Nasomaxillary Hypoplasia.

PubMed

Veeramani, Anamika; Sawh, Raj; Steinbacher, Derek M

2017-11-01

The treatment of nasomaxillary hypoplasia is challenging. The phenotype of Binder "syndrome" includes the following: midfacial hypoplasia, class III malocclusion, small or absent anterior nasal spine, flattened nose, horizontal nostrils, short columella, acute nasolabial angle, and a flat frontonasal angle. A staged approach is used, with orthognathic surgery to achieve vertical maxillary length and sagittal advancement, followed by rhinoplasty aimed to increase nasal tip projection, rotation, and columellar length. This article details the diagnosis and treatment of nasomaxillary hypoplasia, demonstrating the senior author's (D.M.S.) preferred approach and technical steps. Therapeutic, V.

Multivariate Analysis of Factors Affecting Presence and/or Agenesis of Third Molar Tooth

PubMed Central

Alam, Mohammad Khursheed; Hamza, Muhammad Asyraf; Khafiz, Muhammad Aizuddin; Rahman, Shaifulizan Abdul; Shaari, Ramizu; Hassan, Akram

2014-01-01

To investigate the presence and/or agenesis of third molar (M3) tooth germs in orthodontics patients in Malaysian Malay and Chinese population and evaluate the relationship between presence and/or agenesis of M3 with different skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. Pretreatment records of 300 orthodontic patients (140 males and 160 females, 219 Malaysian Malay and 81 Chinese, average age was 16.27±4.59) were used. Third-molar agenesis was calculated with respect to race, genders, number of missing teeth, jaws, skeletal malocclusion patterns and sagittal maxillomandibular jaw dimensions. The Pearson chi-square test and ANOVA was performed to determine potential differences. Associations between various factors and M3 presence/agenesis groups were assessed using logistic regression analysis. The percentages of subjects with 1 or more M3 agenesis were 30%, 33% and 31% in the Malaysian Malay, Chinese and total population, respectively. Overall prevalence of M3 agenesis in male and female was equal (P>0.05). The frequency of the agenesis of M3s is greater in maxilla as well in the right side (P>0.05). The prevalence of M3 agenesis in those with a Class III and Class II malocclusion was relatively higher in Malaysian Malay and Malaysian Chinese population respectively. Using stepwise regression analyses, significant associations were found between Mx (P<0.05) and ANB (P<0.05) and M3 agenesis. This multivariate analysis suggested that Mx and ANB were significantly correlated with the M3 presence/agenesis. PMID:24967595

Resting position of the head and malocclusion in a group of patients with cerebral palsy

PubMed Central

Martinez-Mihi, Victoria; Orellana, Lorena M.; Silvestre-Rangil, Javier

2014-01-01

Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients. PMID:24596627

Malocclusion Class II division 1 skeletal and dental relationships measured by cone-beam computed tomography.

PubMed

Xu, Yiling; Oh, Heesoo; Lagravère, Manuel O

2017-09-01

The purpose of this study was to locate traditionally-used landmarks in two-dimensional (2D) images and newly-suggested ones in three-dimensional (3D) images (cone-beam computer tomographies [CBCTs]) and determine possible relationships between them to categorize patients with Class II-1 malocclusion. CBCTs from 30 patients diagnosed with Class II-1 malocclusion were obtained from the University of Alberta Graduate Orthodontic Program database. The reconstructed images were downloaded and visualized using the software platform AVIZO ® . Forty-two landmarks were chosen and the coordinates were then obtained and analyzed using linear and angular measurements. Ten images were analyzed three times to determine the reliability and measurement error of each landmark using Intra-Class Correlation coefficient (ICC). Descriptive statistics were done using the SPSS statistical package to determine any relationships. ICC values were excellent for all landmarks in all axes, with the highest measurement error of 2mm in the y-axis for the Gonion Left landmark. Linear and angular measurements were calculated using the coordinates of each landmark. Descriptive statistics showed that the linear and angular measurements used in the 2D images did not correlate well with the 3D images. The lowest standard deviation obtained was 0.6709 for S-GoR/N-Me, with a mean of 0.8016. The highest standard deviation was 20.20704 for ANS-InfraL, with a mean of 41.006. The traditional landmarks used for 2D malocclusion analysis show good reliability when transferred to 3D images. However, they did not reveal specific skeletal or dental patterns when trying to analyze 3D images for malocclusion. Thus, another technique should be considered when classifying 3D CBCT images for Class II-1malocclusion. Copyright © 2017 CEO. Published by Elsevier Masson SAS. All rights reserved.

The origin and development of malocclusions. When, where and how dental malocclusions develop.

PubMed

Loudon, Merle E

2013-01-01

This article describes the forces of the muscles from the stomatonathic system and how they interact in many children to change the normal forces of growth. Because of this change in muscle forces there is a change from normal teeth and bone growth positions to abnormal positions. These normal and/or abnormal changes in muscle forces are the basis for development into class one, class two and class three occlusions. This is very valuable information for the orthodontic clinician because these muscle forces are the fundamental basis for all orthodontic treatment. By knowing this an orthodontic clinician will be more able to diagnose and treat a malocclusion. This is exceptionally important for the dentist who is just starting to learn diagnosis, treatment planning, functional and fixed orthodontic treatment.

Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator.

PubMed

Bigliazzi, Renato; Franchi, Lorenzo; Bertoz, André Pinheiro de Magalhães; McNamara, James A; Faltin, Kurt; Bertoz, Francisco Antonio

2015-09-01

To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography

PubMed Central

Ucar, Faruk Izzet; Buyuk, Suleyman Kutalmis; Ozer, Torun; Uysal, Tancan

2013-01-01

Objective To evaluate lower incisor position and bony support between patients with Class II average- and high-angle malocclusions and compare with the patients presenting Class I malocclusions. Methods CBCT records of 79 patients were divided into 2 groups according to sagittal jaw relationships: Class I and II. Each group was further divided into average- and high-angle subgroups. Six angular and 6 linear measurements were performed. Independent samples t-test, Kruskal-Wallis, and Dunn post-hoc tests were performed for statistical comparisons. Results Labial alveolar bone thickness was significantly higher in Class I group compared to Class II group (p = 0.003). Lingual alveolar bone angle (p = 0.004), lower incisor protrusion (p = 0.007) and proclination (p = 0.046) were greatest in Class II average-angle patients. Spongious bone was thinner (p = 0.016) and root apex was closer to the labial cortex in high-angle subgroups when compared to the Class II average-angle subgroup (p = 0.004). Conclusions Mandibular anterior bony support and lower incisor position were different between average- and high-angle Class II patients. Clinicians should be aware that the range of lower incisor movement in high-angle Class II patients is limited compared to average- angle Class II patients. PMID:23814708

Alveolar bone thickness and lower incisor position in skeletal Class I and Class II malocclusions assessed with cone-beam computed tomography.

PubMed

Baysal, Asli; Ucar, Faruk Izzet; Buyuk, Suleyman Kutalmis; Ozer, Torun; Uysal, Tancan

2013-06-01

To evaluate lower incisor position and bony support between patients with Class II average- and high-angle malocclusions and compare with the patients presenting Class I malocclusions. CBCT records of 79 patients were divided into 2 groups according to sagittal jaw relationships: Class I and II. Each group was further divided into average- and high-angle subgroups. Six angular and 6 linear measurements were performed. Independent samples t-test, Kruskal-Wallis, and Dunn post-hoc tests were performed for statistical comparisons. Labial alveolar bone thickness was significantly higher in Class I group compared to Class II group (p = 0.003). Lingual alveolar bone angle (p = 0.004), lower incisor protrusion (p = 0.007) and proclination (p = 0.046) were greatest in Class II average-angle patients. Spongious bone was thinner (p = 0.016) and root apex was closer to the labial cortex in high-angle subgroups when compared to the Class II average-angle subgroup (p = 0.004). Mandibular anterior bony support and lower incisor position were different between average- and high-angle Class II patients. Clinicians should be aware that the range of lower incisor movement in high-angle Class II patients is limited compared to average- angle Class II patients.

An evaluation of self-esteem and quality of life in orthodontic patients: Effects of crowding and protrusion.

PubMed

Jung, Min-Ho

2014-12-31

Objective: To evaluate the effect of dental crowding and lip protrusion on self-esteem and quality of life (QOL) in female orthodontic patients with Class I malocclusion. Materials and Methods: The study sample consisted of 201 patients (mean age 22.6 ± 3.0 years) who sought orthodontic treatment. All the patients were evaluated before treatment in terms of their degree of dental crowding and lip protrusion. Rosenberg's Self-Esteem Scale and the Orthognathic Quality of Life Questionnaire (OQLQ) were used to determine self-esteem and QOL and to evaluate whether these values were related to malocclusion severity. Results: The results indicated that severe crowding and severe protrusion can result in lower self-esteem and poorer QOL (P < .05) than mild crowding and protrusion in Class I malocclusion. In the oral function component of the OQLQ, the severity of protrusion did not have significant effect. Conclusions: In Class I malocclusion, patients with mild crowding or protrusion had significantly better self-esteem and QOL scores than severe crowding or protrusion patients.

Asymmetric molar distalization with miniscrews to correct a severe unilateral Class III malocclusion.

PubMed

Ma, Qiao Ling; Conley, R Scott; Wu, Tuojiang; Li, Huang

2016-05-01

Asymmetries are among the most challenging problems in orthodontics. Proper diagnosis is critical to discern first whether the asymmetry is dental or skeletal. If it is dental, one must then determine whether one dental arch or both are at fault. Once diagnosed, the next challenge is determining not only an appropriate treatment plan, but also the appropriate mechanics plan. This aim of this article is to present a patient with a severe asymmetry to emphasize the importance of a problem-based differential diagnosis to develop both a sound treatment plan and a mechanics plan that successfully integrates miniscrews from the start of the process. An 18-year-old woman had a Class III subdivision left malocclusion, an asymmetric lower facial third, and a deviated midline. The treatment plan consisted of asymmetric distalization of the maxillary right and mandibular left posterior dentitions to create space to resolve the deviated midlines, correct the canted occlusal plane, and obtain an ideal occlusion. Active treatment with Clarity ceramic 0.022 × 0.028-in appliances (3M Unitek, Monrovia, Calif), temporary anchorage devices, and a pendulum appliance lasted 22 months. The final result and the 2-year retention records demonstrate that a harmonious facial balance, an attractive smile, ideal occlusal relationships, and a stable outcome were achieved. This case report shows that with proper planning, asymmetric use of temporary anchorage devices in multiple posterior quadrants can be used to obtain molar distalization, and this approach is an effective alternative to dental extraction therapy. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Nasal changes after orthognathic surgery for patients with prognathism and Class III malocclusion: analysis using three-dimensional photogrammetry.

PubMed

Worasakwutiphong, Saran; Chuang, Ya-Fang; Chang, Hsin-Wen; Lin, Hsiu-Hsia; Lin, Pei-Ju; Lo, Lun-Jou

2015-02-01

Orthognathic surgery alters the position of maxilla and mandible, and consequently changes the nasal shape. The nasal change remains a concern to Asian patients. The aim of this study was to measure the nasal changes using a novel three-dimensional photographic imaging method. A total of 38 patients with Class III malocclusion and prognathism were enrolled. All patients underwent two-jaw surgery with the standard technique. A nasal alar cinching suture was included at the end of procedure. Facial landmarks and nasal morphology were defined and measured from pre- and postoperative three-dimensional photographic images. Intra-rater errors on landmark identification were controlled. Patient's reports of perceptual nasal changes were recorded. The average width of the alar base and subalare remained similar after surgery. Alar width was increased by 0.74 mm. Nasal height and length remained the same. Nasolabial angle increased significantly. The area of nostril show revealed a significant increase and was correlated with a decrease of columella inclination. Nasal tip projection decreased significantly, by 1.99 mm. Preoperative nasal morphology was different between patients with and without cleft lip/palate, but most nasal changes were concordant. In the self-perception, 37% of patients reported improved nasal appearance, 58% reported no change, and 5% were not satisfied with the nasal changes. After the surgery, characteristic nasal changes occurred with an increase of nasolabial angle and nostril show, but a preserved nasal width. The majority of patients did not perceive adverse nasal changes. Copyright © 2014. Published by Elsevier B.V.

Comparison of incisor inclination in patients with Class III malocclusion treated with orthognathic surgery or orthodontic camouflage.

PubMed

Troy, Beth A; Shanker, Shiva; Fields, Henry W; Vig, Katherine; Johnston, William

2009-02-01

Reports comparing Class III patients treated by camouflage and those treated by orthognathic surgery are not numerous. The purpose of this study was to compare the dental and skeletal values of Class III patients treated with these methods against normative data and over the course of treatment. Thirty-three surgical and 39 camouflage Class III patients were selected from a graduate orthodontic clinic and regional private practices, and lateral cephalograms were digitized. Skeletal and dental values were obtained, and mean and efficacy evaluations referenced to ethnic norms were calculated. At pretreatment, the surgery patients had more severe skeletal discrepancies and more compensated incisors. During presurgical orthodontic treatment, most of the surgery group's mandibular incisors were significantly decompensated, although half of the maxillary incisors remained compensated. The surgical move improved 90% of these patients but to only 60% to 65% of the norm. The camouflage group was compensated at pretreatment, and they became more compensated in the end. After treatment, there were no differences between the incisor positions of the 2 groups. There was no statistical difference in incisor inclination and position between the Class III surgical and camouflage groups after treatment; there was a significant difference in the pretreatment and posttreatment incisor inclination and position compared with normative values for both the surgical and the camouflage groups; the maxillary and mandibular incisors were not adequately decompensated in the surgical group, but significant improvement in mandibular incisor position and axial inclination was achieved presurgically. The outcome of the surgical correction was limited by the inadequate presurgical orthodontic incisor decompensation, and orthodontic compensation of incisors occurred postsurgically to achieve an optimal occlusal result.

ACTN3 R577X Genotypes Associate with Class II and Deep Bite Malocclusions

PubMed Central

Zebrick, Brian; Teeramongkolgul, Teesit; Nicot, Romain; Horton, Michael J.; Raoul, Gwenael; Ferri, Joel; Vieira, Alexandre R.; Sciote, James J.

2014-01-01

Introduction α-actinins are myofibril anchor proteins which influence contractile properties of skeletal muscle. ACTN2 is expressed in slow type I and fast type II fibers whereas ACTN3 is expressed only in fast fibers. ACTN3 homozygosity for the 577X stop codon (i.e. changing 577RR to 577XX - the R577X polymorphism) results in the absence of α-actinin-3 in about 18% of Europeans, diminished fast contractile ability, enhanced endurance performance and reduced bone mass or bone mineral density. We have examined ACTN3 expression and genetic variation in masseter muscle of orthognathic surgery patients to determine genotype associations with malocclusion. Methods Clinical information, masseter muscle biopsies and saliva samples were obtained from 60 subjects. Genotyping for ACTN3 SNPs, RT-PCR quantitation of muscle gene message and muscle morphometric fiber type properties were compared to determine statistical differences between genotype and phenotype. Results Muscle mRNA expression level was significantly different for ACTN3 SNP genotypes (p<0.01). The frequency of ACTN3 genotypes was significantly different for sagittal and vertical classifications of malocclusion with the clearest association being elevated 577XX genotype in skeletal class II malocclusion (p = 0.003). This genotype also resulted in significantly smaller diameter of fast type II fibers in masseter muscle (p = 0.002). Conclusion ACTN3 577XX is overrepresented in skeletal class II malocclusion, suggesting a biologic influence during bone growth. ACTN3 577XX is underrepresented in deep bite malocclusion, suggesting muscle differences contribute to variations in vertical facial dimensions. PMID:25439211

The Influence of Class II Division 2 Malocclusions on the Harmony of the Human Face Profile.

PubMed

Perović, Tatjana

2017-11-24

BACKGROUND Persons with class II division 2 malocclusion are characterized by a very specific dento-skeletal and soft-tissue profile (a profile in which a protruding nose and chin, retruding lips, concave and shortened lower third of the face, and gummy smile are dominant), which is the opposite of the currently modern profiles (convex profile of protruding lips and small chin). The aim of this research was to determine the differences in parameters of harmonies of facial profiles between persons with class II division 2 malocclusions and class I, and to establish the significance of those differences. MATERIAL AND METHODS For this study, 50 patients with class II division 2 malocclusions and 50 patients with class I were selected; profile photos were recorded and a photometric analysis was done: a type of profile according to Schwarz, the shape of a nose, the prominence of chin, biometrical field, the position of lips in relation to the tangent Sn-Pg, S-line (Steiner), E-line (Riketts) and a facial angle according to Arnett. RESULTS The significant differences in profiles of persons with class II division 2 compared to class I were: position and prominence of the chin, the position of the lower and upper lip in relation to the S-line, and smaller value of a facial angle in relation to persons with class I. CONCLUSIONS The differences seen in skeletal profiles were not associated with significant differences in the profiled facial contours of the examined groups. The compensatory role of the fullness of soft tissues of the lips is probably the reason why there were not significant deviations in all the examined parameters.

Skeletal effects in Angle Class II/1 patients treated with the functional regulator type II : Cephalometric and tensor analysis.

PubMed

Schulz, Simone; Koos, Bernd; Duske, Kathrin; Stahl, Franka

2016-11-01

The purpose of this work was to employ both cephalometric and tensor analysis in characterizing the skeletal changes experienced by patients with Angle Class II/1 malocclusion during functional orthodontic treatment with the functional regulator type II. A total of 23 patients with Class II/1 malocclusion based on lateral cephalograms obtained before and after treatment with the functional regulator type II were analyzed. Another 23 patients with Angle Class II/1 malocclusion who had not undergone treatment were included as controls. Our cephalometric data attest to significant therapeutic effects of the functional regulator type II on the skeletal mandibular system, including significant advancement of the mandible, increases in effective mandibular length with enhancement of the chin profile, and reduction of growth-related bite deepening. No treatment-related effects were observed at the cranial-base and midface levels. In addition, tensor analysis revealed significant stimulation of mandibular growth in sagittal directions, without indications of growth effects on the maxilla. Its growth-pattern findings differed from those of cephalometric analysis by indicating that the appliance did promote horizontal development, which supports the functional orthodontic treatment effect in Angle Class II/1 cases. Tensor analysis yielded additional insights into sagittal and vertical growth changes not identifiable by strictly cephalometric means. The functional regulator type II was an effective treatment modality for Angle Class II/1 malocclusion and influenced the skeletal development of these patients in favorable ways.

Thin-plate spline analysis of craniofacial growth in Class I and Class II subjects.

PubMed

Franchi, Lorenzo; Baccetti, Tiziano; Stahl, Franka; McNamara, James A

2007-07-01

To compare the craniofacial growth characteristics of untreated subjects with Class II division 1 malocclusion with those of subjects with normal (Class I) occlusion from the prepubertal through the postpubertal stages of development. The Class II division 1 sample consisted of 17 subjects (11 boys and six girls). The Class I sample also consisted of 17 subjects (13 boys and four girls). Three craniofacial regions (cranial base, maxilla, and mandible) were analyzed on the lateral cephalograms of the subjects in both groups by means of thin-plate spline analysis at T1 (prepubertal) and T2 (postpubertal). Both cross-sectional and longitudinal comparisons were performed on both size and shape differences between the two groups. The results showed an increased cranial base angulation as a morphological feature of Class II malocclusion at the prepubertal developmental phase. Maxillary changes in either shape or size were not significant. Subjects with Class II malocclusion exhibited a significant deficiency in the size of the mandible at the completion of active craniofacial growth as compared with Class I subjects. A significant deficiency in the size of the mandible became apparent in Class II subjects during the circumpubertal period and it was still present at the completion of active craniofacial growth.

Image Processing Techniques for Assessment of Dental Trays

DTIC Science & Technology

2001-10-25

170 patients having Angle Class I molar relationships with minor malocclusions and teeth including second molars fully erupted without loss of tooth...Abstract-A tray selected for the dental patient must adapt to the curvature of the teeth and allow the impression material to be in appropriate...brands of perforated metal trays with 170 lower arch cast models collected from patients having Angle Class 1 type occlusion with minor malocclusions

Thin-plate spline analysis of mandibular shape changes induced by functional appliances in Class II malocclusion : A long-term evaluation.

PubMed

Franchi, Lorenzo; Pavoni, Chiara; Faltin, Kurt; Bigliazzi, Renato; Gazzani, Francesca; Cozza, Paola

2016-09-01

The purpose of this work was to evaluate the long-term morphological mandibular changes induced by functional treatment of Class II malocclusion with mandibular retrusion. Forty patients (20 females, 20 males) with Class II malocclusion consecutively treated with either a Bionator or an Activator followed by fixed appliances were compared with a control group of 40 subjects (19 females, 21 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (T1, mean age 9.9 years), at the end of treatment with functional appliances (T2, mean age 12.2 years), and for long-term follow-up (T3, mean age 18.3 years). Mandibular shape changes were analyzed on lateral cephalograms of the subjects in both groups via thin-plate spline (TPS) analysis. Shape differences were statistically analyzed by conducting permutation tests on Goodall F statistics. In the long term, both the treated and control groups exhibited significant longitudinal mandibular shape changes characterized by upward and forward dislocation of point Co associated with a vertical extension in the gonial region and backward dislocation of point B. Functional appliances induced mandible's significant posterior morphogenetic rotation over the short term. The treated and control groups demonstrated similar mandibular shape over the long term.

Complex networks for data-driven medicine: the case of Class III dentoskeletal disharmony

NASA Astrophysics Data System (ADS)

Scala, A.; Auconi, P.; Scazzocchio, M.; Caldarelli, G.; McNamara, JA; Franchi, L.

2014-11-01

In the last decade, the availability of innovative algorithms derived from complexity theory has inspired the development of highly detailed models in various fields, including physics, biology, ecology, economy, and medicine. Due to the availability of novel and ever more sophisticated diagnostic procedures, all biomedical disciplines face the problem of using the increasing amount of information concerning each patient to improve diagnosis and prevention. In particular, in the discipline of orthodontics the current diagnostic approach based on clinical and radiographic data is problematic due to the complexity of craniofacial features and to the numerous interacting co-dependent skeletal and dentoalveolar components. In this study, we demonstrate the capability of computational methods such as network analysis and module detection to extract organizing principles in 70 patients with excessive mandibular skeletal protrusion with underbite, a condition known in orthodontics as Class III malocclusion. Our results could possibly constitute a template framework for organising the increasing amount of medical data available for patients’ diagnosis.

Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique

PubMed Central

Freitas, Heloiza; dos Santos, Pedro César F; Janson, Guilherme

2014-01-01

A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery. PMID:25309867

Maxillary advancement using distraction osteogenesis with intraoral device.

PubMed

Takigawa, Yoko; Uematsu, Setsuko; Takada, Kenji

2010-11-01

This article describes the surgical orthodontic treatment of maxillary hypoplasia in a patient with cleft lip and palate using maxillary distraction osteogenesis with internal maxillary distractors. Maxillary advancement was performed to correct the retrusive maxillary facial profile and Class III malocclusion. Rotational movement of the distraction segment was made to correct the upper dental midline. Although maxillary advancement was insufficient because of unexpected breakage of the intraoral distractor after completion of the distraction, skeletal traction with a face mask compensated for the shortage. Successful esthetic improvement and posttreatment occlusal stability were achieved with no discernible relapse after 2 years of retention.

Maxillary and mandibular contribution to the establishment of class II malocclusion in an adult Lebanese population.

PubMed

El Hajj, Nadine; Bassil-Nassif, Nayla; Tauk, Alain; Mouhanna-Fattal, Carole; Bouserhal, Joseph P

2017-12-01

The main aim of this study was to describe the contribution of the maxilla and the mandible to the establishment of a Class II skeletal malocclusion in an adult Lebanese population. Secondary aims were to detect the presence of sex-based dimorphism and to study the influence of the vertical dimension on the Class II skeletal pattern. A sample of 90 adults in skeletal Class II was recruited and equally distributed according to sex and vertical typology. The study describes the skeletal and dentoalveolar cephalometric characteristics of the Class II sample, essentially according to Coben's cephalometric analysis. The total effective depth of the cranial base and the anterior cranial base angle (SN-BaH) were both greater in the Class II sample. In females, the effective depth of the maxilla (Ptm-A) was larger than normal while SNB was smaller. The parameters describing the size and shape of the body of the mandible were significantly different from those of normal subjects. The upper incisors were in a retrusive position, while the axis of the lower incisors was located normally. The mandibular molars had a more distal sagittal position. Hyperdivergent subjects had more significant posterior alveolar growth, a more retrusive mandibular position and smaller mandibular dimensions than the other two vertical sub-groups. The cranial base contributes to the establishment of a Class II malocclusion, and mandibular retrusion cannot be considered as a characteristic shared by all skeletal Class II subjects. Lessening of the absolute length of the mandibular body is the second most frequent etiological factor noted in the Class II sample studied. Most individuals in skeletal Class II have an associated dental Class II malocclusion, and the vertical dimension has an influence on the Class II skeletal pattern. Copyright © 2017 CEO. Published by Elsevier Masson SAS. All rights reserved.

Relationship between formation/eruption of maxillary teeth and skeletal pattern of maxilla.

PubMed

Suda, Naoto; Hiyama, Shigetoshi; Kuroda, Takayuki

2002-01-01

Previous reports have indicated that formation and eruption of the maxillary teeth, especially the molars, are delayed in skeletal Class III patients compared with Class I and Class II patients. However, the relationship between the formation/eruption of maxillary teeth and the skeletal pattern of the maxilla is not yet clear. To examine this relationship, we studied 81 skeletal Class III Japanese patients (mean age, 8.8 years). The sample was divided into 2 groups: a maxillary retrusion (MR) group, characterized by a small SNA angle and a short palatal length, and a control group in which those values were in the normal range for patients of Japanese descent. There was no significant difference in the rate of formation for the maxillary and mandibular teeth between the 2 groups. The eruption of the maxillary second molars was delayed in the MR group compared with the control group. There were no significant differences between the 2 groups for any other teeth. A multiple-regression analysis was carried out to examine whether the skeletal pattern of the maxilla is a useful indicator for predicting the eruption of the maxillary teeth. The results showed that palatal length and chronologic age were significant independent (explanatory) variables for predicting eruption of the maxillary second molars. These findings indicated that the skeletal pattern of the maxilla is a useful indicator for predicting the timing of maxillary molar eruption when considering treatment of skeletal Class III malocclusions.

Comparison of Forsus FRD EZ and Andresen activator in the treatment of class II, division 1 malocclusions.

PubMed

Bilgiç, Fundagül; Başaran, Güvenç; Hamamci, Orhan

2015-03-01

Purpose of this study is to evaluate the effects of Forsus Fatigue-Resistant Device (FRD) EZ and Andresen activator in terms of skeletal, dental, and soft tissue changes in actively growing patients presenting with class II, division 1 malocclusion. Study sample included 60 subjects. Inclusion criteria were as follows: class II division 1 malocclusion, retrognathic mandible, normal or low-angle growth pattern, and peak growth period. The first study group consisted of 20 patients who were treated with Forsus appliance, and the second group of 20 patients received treatment with Andresen activator. Control group received no treatment. Our results revealed that both appliances enhanced mandibular growth, helped increase the length of the mandible, and had a restraining growth effect on the maxilla. Anterior face height increased in both of treatment groups, whereas posterior face height had a significant increase in the activator group only. More mandibular incisors protrusion and intrusion were seen with the Forsus appliance. Moreover, occlusal plane and palatal plane rotated significantly in clockwise direction as a result of dentoalveolar changes only in the Forsus group. As well as the Forsus appliances corrected class II discrepancies mostly through dentoalveolar changes as compared to the activator group, both appliances proved effective in the treatment of growing individuals having class II malocclusions with mandibular retrognathia. By this investigation, two treatment methods, which are currently used in clinical practice, will be evaluated, and the results will be useful for clinicians.

Evaluation of skeletal and dental asymmetries in Angle Class II subdivision malocclusions with cone-beam computed tomography.

PubMed

Minich, Craig M; Araújo, Eustáquio A; Behrents, Rolf G; Buschang, Peter H; Tanaka, Orlando M; Kim, Ki Beom

2013-07-01

The purpose of this study was to determine whether Angle Class II subdivision malocclusions have skeletal or dental asymmetries between the Class II and Class I sides. A sample of 54 untreated Angle Class II subdivision patients with pretreatment photos and cone-beam computed tomography (CBCT) scans was used. The photos were used to identify the Class II subdivision malocclusion and to record the amount of crowding per quadrant. Landmarks were plotted on each CBCT volume so that direct 3-dimensional measurements could be made to compare the positions and dimensions of the skeletal and dental structures on the Class II side vs the Class I side. Significant differences were found for 2 skeletal measurements: the position of the maxilla relative to the cranial base, and the mandibular dimension from the mandibular foramen to the mental foramen. Statistically significant dental differences were found for the position of the mandibular first molars and canines in relation to the maxilla and the mandible. Statistically significant differences were found for the maxillary first molars and canines in relation to the mandible. There were significant skeletal and dental differences between the Class I and Class II sides. The dental asymmetries accounted for about two thirds of the total asymmetry. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Dentoskeletal and Soft Tissue Effects in the Treatment of Class II Malocclusion with Klammt's Elastic Open Activator.

PubMed

Inamassu-Lemes, Sheila Marques; Fuziy, Acácio; Costa, André Luiz Ferreira; Carvalho, Paulo Eduardo Guedes; Nahás-Scocate, Ana Carla Raphaelli

2016-01-01

The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors.

Endoscopically assisted intraoral modified Le Fort II type midfacial advancement using piezoelectric surgery and an intraoperative RED system.

PubMed

Hara, Shingo; Mitsugi, Masaharu; Kanno, Takahiro; Nomachi, Akihiko; Kawakami, Seiichi; Tatemoto, Yukihiro

2013-02-01

The Le Fort II midfacial advancement appears to be an effective surgical method for the treatment of severe midfacial-nose hypoplasia with a skeletal class III malocclusion, which is usually combined with syndromic midfacial anomalies. However, the conventional surgical method requires the coronal approach, including a coronal incision, together with other surgical approaches, such as an intraoral incision. Therefore, surgeons often hesitate to propose this type of osteotomy, even for patients who develop severe nonsyndromic midfacial-nose hypoplasia. This report presents a new surgical approach for performing a safe Le Fort II osteotomy for nasomaxillary, midfacial corrective advancement via a solely intraoral approach. Surgery was performed with endoscopically assisted piezoelectric surgery. The osteotomized nasomaxillary Le Fort II segment was successfully protracted without aggressive down-fracture procedures with the sole intraoperative use of a rigid external distraction (RED) system, followed by internal rigid fixation, and the subsequent removal of the RED system. Seven patients (all patients were nonsyndromic, but 2 had cleft lip and palate, and an average age of 19.9 years) were included in this study. The degrees of midfacial advancement at the base of nasal bone (the top edge of the modified Le Fort II segment) that was osteotomized and at maxillary point A was 8.3 mm (range 5.8 mm to 10.5mm) and 8.5 mm (range 5.9 mm to 9.8 mm), respectively. This new method less invasively facilitates safe, secure, and ideal nasomaxillary midfacial protraction to yield a satisfactory resultant facial profile and favorable occlusion in patients with severe midfacial-nose hypoplasia and skeletal class III malocclusions. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Combined orthodontic and surgical correction of adult skeletal class II with hyperdivergent jaws.

PubMed

Abraham, Jiku; Bagchi, Paulami; Gupta, Swati; Gupta, Hemant; Autar, Ram

2012-01-01

A case of severe Class II skeletal malocclusion with anterior open bite having vertical growth pattern and matching soft tissue profile is presented. Considering age of the patient and the severity of the malocclusion, it was decided to combine orthodontic treatment with surgery. A 0.022 Roth Pre-adjusted Edgewise Appliance was chosen for the orthodontic correction and Le-Fort 1 differential vertical impaction of maxilla with mandibular autorotation and augmentation genioplasty was considered as the treatment plan. The main aim was to reduce the gummy smile and correct the class II profile.

A Comparison of Arch Width with Angle Classification and Wits Appraisal in Class 2 Division 1 and Class 1 Individuals.

DTIC Science & Technology

1983-05-01

longitudinal changes in arch width between lateral incisors, canines and second premolars or deciduous second molars at four stages of dental eruption in 22 male... dental arch or skeletal widths. Also, he made no attempt to divide his sample into normal and malocclusion groups. -J 7 Warren (1959) studying twenty...buccal crossbite of the posterior teeth Many clinicians believe that this problem is highly correlated with tfte type or classification of malocclusion

Malocclusion and dental caries experience among 8–9-year-old children in a city of South Indian region: A cross-sectional survey

PubMed Central

Disha, Patil; Poornima, P.; Pai, Suryakanth M.; Nagaveni, N. B.; Roshan, N. M.; Manoharan, M.

2017-01-01

BACKGROUND: Although numerous studies have documented malocclusion in various age groups in India, the literature on the prevalence of malocclusion in mixed dentition is scanty. Dental caries is another most common condition affecting the general health. However, its association with malocclusion in mixed dentition is not well known. AIM: The purpose of this study was to establish the prevalence of malocclusion and its association with caries experience in 8–9-year-old children of Davangere city, South Indian region. SETTING AND DESIGN: The study design was a cross-sectional survey. MATERIALS AND METHODS: A total of 800 children from 350 schools (both males and females) were randomly selected for the study. t-test and Chi-square test were used for statistical analysis. RESULTS: The overall prevalence of malocclusion among 8–9-year-old children was 40.9%. The most prevalent malocclusion was crowding (11.5%), followed by excessive overjet (9.4%), deep bite (6.8%), spacing (6.5%), crossbite (4.5%), and open bite (3.2%). Class I molar relationship prevailed in 95.5% of children. CONCLUSION: The prevalence of malocclusion in our study was in accordance with the other studies reported in India, which ranged from 19.6% to 90%. Furthermore, correlation of malocclusion and dental caries in the primary dentition, although nonsignificant, presented children with malocclusion to have a higher caries experience than children without malocclusion. PMID:29296599

A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions

PubMed Central

Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

2014-01-01

Objectives We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. Materials and methods This retrospective study included three groups: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (−12.42°), whereas only −4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Conclusion Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy. PMID:25114591

A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions.

PubMed

Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

2014-01-01

We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. THIS RETROSPECTIVE STUDY INCLUDED THREE GROUPS: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (-12.42°), whereas only -4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy.

Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion.

PubMed

Franchi, Lorenzo; Pavoni, Chiara; Faltin, Kurt; McNamara, James A; Cozza, Paola

2013-03-01

To analyze the long-term skeletal and dentoalveolar effects and to evaluate treatment timing of Class II treatment with functional appliances followed by fixed appliances. A group of 40 patients (22 females and 18 males) with Class II malocclusion consecutively treated either with a Bionator or an Activator followed by fixed appliances was compared with a control group of 20 subjects (9 females and 11 males) with untreated Class II malocclusion. Lateral cephalograms were available at the start of treatment (mean age 10 years), end of treatment with functional appliances (mean age 12 years), and long-term observation (mean age 18.6 years). The treated sample also was divided into two groups according to skeletal maturity. The early-treatment group was composed of 20 subjects (12 females and 8 males) treated before puberty, while the late-treatment group included 20 subjects (10 females and 10 males) treated at puberty. Statistical comparisons were performed with analysis of variance followed by Tukey's post hoc tests. Significant long-term mandibular changes (Co-Gn) in the treated group (3.6 mm over the controls) were associated with improvements in the skeletal sagittal intermaxillary relationship, overjet, and molar relationship (∼3.0-3.5 mm). Treatment during the pubertal peak was able to produce significantly greater increases in total mandibular length (4.3 mm) and mandibular ramus height (3.1 mm) associated with a significant advancement of the bony chin (3.9 mm) when compared with treatment before puberty. Treatment of Class II malocclusion with functional appliances appears to be more effective at puberty.

Orthognathic bimaxillary surgery in two patients with osteogenesis imperfecta and a review of the literature.

PubMed

Rosén, A; Modig, M; Larson, O

2011-08-01

Orthognathic surgery in patients with osteogenesis imperfecta is rare. Most cases result in a successful outcome with stable and good occlusion. Two patients with, probably severe types III and IV, and malocclusion class III with retrognathic maxilla and prognathic mandible, were treated with orthodontic treatment and bimaxillary surgical correction. The surgical outcome and follow up are presented together with a review of published cases of orthognathic surgery in patients with different types of osteogenesis imperfecta. The authors conclude that it is possible to perform combined orthodontic and orthognathic surgery in patients with osteogenesis imperfecta despite the greater risk of complications. The treatments were successful with follow up times of 5-6 years. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Treatment of hyperdivergent growth pattern and anterior open bite with posterior metallic bite planes.

PubMed

Ciavarella, Domenico; Lo Russo, Lucio; Nichelini, Jeffrey; Mastrovincenzo, Mario; Barbato, Ersilia; Laurenziello, Michele; Montaruli, Graziano; Lo Muzio, Lorenzo

2017-12-01

In the present paper, the authors analyze the effect of the "Swallowing Occlusal Contact Intercept Appliance" (SOCIA) in treatment of children with hyperdivergent Class II malocclusion. This functional appliance has no intra-oral anchorage, but induces a continuous periodontal, muscular, and articular stimulation. Twenty-six patients with hyperdivergent growth and class II malocclusion were selected and treated with SOCIA appliance. Cephalometric analysis was performed before treatment (T1) and immediately after the treatment (T2). After 24 months treatment authors observed a modification of maxillary growth with a reduction of the divergence with an increase of the posterior facial height, a modification of condylar inclination and forward position of the a hyoid. No modifications was observed about the ANB angle. After treatment the open bite was resolved with a reduction of the inclination of the upper incisors. SOCIA is a reliable functional appliance in growing age patients with a hyperdivergent pattern growth, anterior open bite and class II molar malocclusion.

Radiologically determined orthodontically induced external apical root resorption in incisors after non-surgical orthodontic treatment of class II division 1 malocclusion: a systematic review.

PubMed

Tieu, Long D; Saltaji, Humam; Normando, David; Flores-Mir, Carlos

2014-07-23

This study aims to critically evaluate orthodontically induced external apical root resorption (OIEARR) in incisors of patients undergoing non-surgical orthodontic treatment of class II division 1 malocclusion by a systematic review of the published data. An electronic search of two databases was performed; the bibliographies of relevant articles were also reviewed. Studies were included if they examined the amount of OIEARR in incisors produced during non-surgical orthodontic treatment of individuals with class II division I malocclusion in the permanent dentition. Individuals had no previous history of OIEARR, syndromes, pathologies, or general diseases. Study selections, risk of bias assessment, and data extraction were performed in duplicate. Eight studies of moderate methodological quality were finally included. An increased prevalence (65.6% to 98.1%) and mild to moderate severity of OIEARR (<4 mm and <1/3 original root) were reported. No sex difference in root resorption was found. For the maxillary incisors, there was no evidence that either the central or lateral incisor was more susceptible to OIEARR. A weak to moderate positive correlation between treatment duration and root resorption, and anteroposterior apical displacement and root resorption was found. Current limited evidence suggests that non-surgical comprehensive orthodontic treatment to correct class II division 1 malocclusions causes increased prevalence and severity of OIEARR the more the incisor roots are displaced and the longer this movement takes.

Cephalometric skeletal evaluation of patients with Incontinentia Pigmenti

PubMed Central

Maahs, Marcia Angelica Peter; Kiszewski, Ana Elisa; Rosa, Rafael Fabiano Machado; Maria, Fernanda Diffini Santa; Prates, Frederico Ballvé; Zen, Paulo Ricardo Gazzola

2014-01-01

Purpose The aim of this study was to evaluate the skeletal characteristics of patients with the rare genetic disease of Incontinentia Pigmenti, by lateral cephalometric analysis on the antero-posterior plane and by frontal cephalometric analysis on the horizontal plane. Methods Lateral skeletal cephalometric analyses were performed according to Steiner for evaluation of antero-posterior direction, and frontal skeletal cephalometric analyses according to Ricketts for evaluation of horizontal direction in 9 patients with IP. Left and right facial widths at the level of the zygomatic arch were also evaluated. The Student t-test was used for paired to a 5% level of significance data. Results The lateral skeletal cephalometric findings were not statistically significant, but the Class II was the most frequent finding (44.4%), followed by Class III (33.3%) and Class I (22.2%). The right maxillo-mandibular width was significantly lower than normal values, and the right facial width was significantly higher than the left, at the level of the zygomatic arch. Conclusions Patients with IP showed more skeletal discrepancies of Class II and III than Class I malocclusion, and had significant horizontal facial skeletal asymmetries. This should alert health professionals to route these patients for orthodontic assessment and possible therapeutic interventions. However, larger samples are needed to better elucidate if these cephalometric findings can be specifically related to IP. PMID:25737924

Successful and stable orthodontic camouflage of a mandibular asymmetry with sliding jigs.

PubMed

Oliveira, Dauro Douglas; Oliveira, Bruno Franco de; Mordente, Carolina Morsani; Godoy, Gabriela Martins; Soares, Rodrigo Villamarim; Seraidarian, Paulo Isaías

2018-03-12

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.

The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander (MARPE) and the novel N2 mini-implant-a finite element study.

PubMed

Moon, Won; Wu, Kimberley W; MacGinnis, Matthew; Sung, Jay; Chu, Howard; Youssef, George; Machado, Andre

2015-01-01

Maxillary protraction with the novel N2 mini-implant- and micro-implant-assisted rapid palatal expander (MARPE) can potentially provide significant skeletal effects without surgery, even in older patients where conventional facemask therapy has limited skeletal effects. However, the skeletal effects of altering the location and direction of force from mini-implant-assisted maxillary protraction have not been extensively analyzed. In this study, the application of the novel N2 mini-implant as an orthopedic anchorage device is explored in its ability to treat patients with class III malocclusions. A 3D cranial mesh model with associated sutures was developed from CT images and Mimics modeling software. Utilizing ANSYS simulation software, protraction forces were applied at different locations and directions to simulate conventional facemask therapy and seven maxillary protraction protocols utilizing the novel N2 mini-implant. Stress distribution and displacement were analyzed. Video animations and superimpositions were created. By changing the vector of force and location of N2 mini-implant, the maxilla was displaced differentially. Varying degrees of forward, downward, and rotational movements were observed in each case. For brachyfacial patients, anterior micro-implant-supported protraction at -45° or intermaxillary class III elastics at -45° are recommended. For dolicofacial patients, either anterior micro-implants at -15° or an intermaxillary spring at +30° is recommended. For mesofacial patients with favorable vertical maxillary position, palatal micro-implants at -30° are recommended; anterior micro-implants at -30° are preferred for shallow bites. For patients with a severe mid-facial deficiency, intermaxillary class III elastics at -30° are most effective in promoting anterior growth of the maxilla. By varying the location of N2 mini-implants and vector of class III mechanics, clinicians can differentially alter the magnitude of forward, downward, and rotational movement of the maxilla. As a result, treatment protocol can be customized for each unique class III patient.

Correction of complete maxillary crossbite with severe crowding using Hyrax expansion and fixed appliance.

PubMed

Wangsrimongkol, Tasanee; Manosudprasit, Montian; Pisek, Poonsak; Leelasinjaroen, Pornnapha

2013-09-01

An 18-year-old Thai man who presented with a secondary cleft palate, maxillary hypoplasia and severe crowding was treated by rapid maxillary expansion and fixed orthodontic appliances. Initial assessment found skeletal Class III malrelationship and dental Class II malocclusion with anterior and bilateral posterior crossbites. Camouflage orthodontic treatment was planned using a rapid maxillary expansion appliance and correcting crowding with extraction all four premolar teeth. A Hyrax appliance and vertical loop arch wire were placed for maxillary arch expansion of 9.5 mms at first molars and canines, and 5.5 mms at the premolars and obtained positive overjet. Both acceptable skeletal and soft tissue relationships and satisfactory occlusion were produced. After 14 months of postoperative follow-up, the occlusal result was stable and no skeletal reversals could be detected.

Camouflage of a high-angle skeletal Class II open-bite malocclusion in an adult after mini-implant failure during treatment.

PubMed

Franzotti Sant'Anna, Eduardo; Carneiro da Cunha, Amanda; Paludo Brunetto, Daniel; Franzotti Sant'Anna, Claudia

2017-03-01

The treatment of skeletal anterior open-bite malocclusion requires complex orthodontic planning that considers its multifactorial etiology, treatment limitations, and high relapse rates. This case report illustrates a successful treatment approach for a skeletal high-angle Class II malocclusion in an adult with a severe open bite. The treatment consisted of a high-pull headgear therapy after mini-implants failure during fixed orthodontic therapy. Adequate esthetics and function were achieved. Despite its low probability, the unexpected event of mini-implant loosening during complex treatments should be considered. Therefore, classic orthodontic mechanics should be established, especially when treating patients for whom invasive procedures such as miniplates or orthognathic surgery are not available options. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Cephalometric analysis in cases with Class III malocclusions].

PubMed

Rak, D

1989-01-01

Various orthodontic class III anomalies, classified into several experimental groups, and eugnathic occlusions serving as controls were studied by roentgencephalometry. The objective of the study was to detect possible distinctions in the quantitative values of two variables chosen and to select the variables which most significantly discriminate the group of class III orthodontic anomalies. Attempts were made to ascertain whether or not there were sex-related differences. The teleroentgenograms of 269 examines, aged 10-18 years, of both sexes were analyzed. The experimental group consisted of 89 examinees class III orthodontic anomalies. The control group consisted of 180 examines with eugnathic occlusion. Latero-lateral skull roentgenograms were taken observing the rules of roentgenocephalometry. Using acetate paper, the drawings of profile teleroentgenograms were elaborated and the reference points and lines were entered. A total of 38 variables were analyzed, of which there were 10 linear, 19 angular, and 8 variables were obtained by mathematical calculation; the age variable was also analyzed. In statistical analyses an electronic computer was used. The results are presented in tables and graphs. The results obtained showed that: --compared to the findings in the control group, the subjects in the experimental group displayed significant changes in the following craniofacial characteristics a negative difference in the position of the apical base of the jaw, manifest concavity of the osseous profile and diminished convexity of the profile of soft parts, retroinclination of the lower incisors, mandibular prognathism, increased mandibular angle and increased mandibular proportion compared to maxillary and the anterior cranial base; --with regard to the sex of the examinees, only four linear variables of significantly discriminating character were selected, so that in can be concluded that there were no significant sex differences among the morphological characteristics of the viscerocranium.

A novel approach for treatment of skeletal Class II malocclusion: Miniplates-based skeletal anchorage.

PubMed

Al-Dumaini, Abdullsalam Abdulqawi; Halboub, Esam; Alhammadi, Maged Sultan; Ishaq, Ramy Abdul Rahman; Youssef, Mohamed

2018-02-01

The objective of this study was to evaluate the effect of a new approach-bimaxillary miniplates-based skeletal anchorage-in the treatment of skeletal Class II malocclusion compared with untreated subjects. The study (miniplates) group comprised 28 patients (14 boys, 14 girls) with skeletal Class II malocclusion due to mandibular retrusion, with a mean age of 11.83 years. After 0.017 × 0.025-in stainless steel archwires were placed in both arches, 4 miniplates were fixed bilaterally, 2 in the maxillary anterior areas and 2 in the mandibular posterior areas, and used for skeletal treatment with elastics. Twenty-four Class II untreated subjects (11 boys, 13 girls), with a mean age of 11.75 years, were included as controls. Skeletal and dental changes were evaluated using pretreatment and posttreatment or observational lateral cephalometric radiographs. The treatment changes were compared with the growth changes observed in the control group using independent t tests. Compared with the minimal changes induced by growth in the control group, the skeletal changes induced by miniplates were more obvious. The mandibular length increased significantly (3 mm), and the mandible moved forward, with a significant restraint in the sagittal position of the maxilla (P <0.001). The overjet correction (-4.26 mm) was found to be a net result of skeletal changes (A-Y-axis = -1.18 mm and B-Y-axis = 3.83 mm). The mandibular plane was significantly decreased by 2.75° (P <0.001). This new technique, bimaxillary miniplates-based skeletal anchorage, is an effective method for treating patients with skeletal Class II malocclusions through obvious skeletal, but minimal dentoalveolar, changes. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Three-dimensional evaluation of tooth movement in Class II malocclusions treated without extraction by orthodontic mini-implant anchorage.

PubMed

Ali, Dler; Mohammed, Hnd; Koo, Seung-Hwan; Kang, Kyung-Hwa; Kim, Sang-Cheol

2016-09-01

The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t-test. All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in (4.5°, p < 0.001; 3.0°, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.

Three-dimensional evaluation of tooth movement in Class II malocclusions treated without extraction by orthodontic mini-implant anchorage

PubMed Central

Ali, Dler; Mohammed, Hnd; Koo, Seung-Hwan; Kang, Kyung-Hwa

2016-01-01

Objective The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. Methods Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t-test. Results All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in (4.5°, p < 0.001; 3.0°, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). Conclusions Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars. PMID:27668191

[Size of lower jaw as an early indicator of skeletal class III development].

PubMed

Stojanović, Zdenka; Nikodijević, Angelina; Udovicić, Bozidar; Milić, Jasmina; Nikolić, Predrag

2008-08-01

Malocclusion of skeletal class III is a complex abnormality, with a characteristic sagital position of the lower jaw in front of the upper one. A higher level of prognatism of the lower jaw in relation to the upper one can be the consequence of its excessive length. The aim of this study was to find the differences in the length of the lower jaw in the children with skeletal class III and the children with normal sagital interjaw relation (skeletal class I) in the period of mixed dentition. After clinical and x-ray diagnostics, profile tele-x-rays of the head were analyzed in 60 examinees with mixed dentition, aged from 6 to 12 years. The examinees were divided into two groups: group 1--the children with skeletal class III and group 2--the children with skeletal class I. The length of the lower jaw, upper jaw and cranial base were measured. The proportional relations between the lengths measured within each group were established and the level of difference in the lengths measured and their proportions between the groups were estimated. No significant difference between the groups was found in the body length, ramus and the total length of the lower jaw. Proportional relation between the body length and the length of the lower jaw ramus and proportional relation between the forward cranial base and the lower jaw body were not significantly different. A significant difference was found in proportional relations of the total length of the lower jaw with the total lengths of cranial base and the upper jaw and proportional relation of the length of the lower and upper jaw body. Of all the analyzed parameters, the following were selected as the early indicators of the development of skeletal class III on the lower jaw: greater total length of the lower jaw, proportional to the total lengths of cranial base and theupper jaw, as well as greater length of the lower jaw body, proportional to the length of the upper jaw body.

Bone-anchored intermaxillary elastics in an asymmetric Class II malocclusion: A case report.

PubMed

Manni, Antonio; Lupini, Daniela; Cozzani, Mauro

2017-06-01

A 13-year-old male patient, presenting a Class II, division 1 malocclusion and crowding was treated by an innovative technique. After rapid palatal expansion by a Hyrax appliance, the teeth were bonded with straightwire brackets. Two miniscrews were inserted, one per side, in the mandibular buccal bone between the roots of the mandibular first molar and the second premolar. On the right side, the miniscrew implant was connected to the hook clamped on a 0.021×0.028″ SS wire with a twisted SS ligature in order to maintain the inclination of the frontal incisors during the Class II mechanics. On the left side, where the Class II relationship was more marked, intermaxillary elastics were applied from the upper left hook clamped on the archwire to the lower first molar and a power chain (100g) was stretched from the lower left hook to the miniscrew implant. Class II correction was accomplished using sequential Class II elastics of progressive strength coupled with rectangular stainless steel wires. After 22 months of active treatment, the results were balanced facial esthetics and a good occlusion. This dual anchorage set-up of Class II elastics reinforced with TADs produced protrusive action on the mandible with minimal side effects and with no significant change in the vertical dimension during the sagittal correction of the Class II malocclusion. Copyright © 2017 CEO. Published by Elsevier Masson SAS. All rights reserved.

Second Class Resolver: a retrospective analysis.

PubMed

D'Attilio, M; Rodolfino, D; Filippakos, A; Saccucci, M; Festa, F; Tripodi, D

2014-03-01

To evaluate the use of Second Class Resolver (SCR), a new fixed orthopaedic appliance, for the treatment of skeletal Class II malocclusion in growing subjects. Design Retrospective analysis. Forty subjects were treated with Second Class Resolver (SCR). The mean age was 8 years at the beginning of treatment and 10 years at the end of treatment. Digital cephalometric superimpositions on lateral radiographs taken at start and end of treatment were assessed. The cephalometric values were statistically analysed. Cephalometric analysis of changes during treatment shows reduction of ANB angle (mean 2°); reduction of Witts Index (mean 3 mm); reduction of Maxillo-Mandibular angle (MM) (mean 1°); reduction of SNA (angle mean 3°); reduction of gonial angle (mean 1.8°); increase of the mandibular branch length (mean 5 mm); increase of mandibular body (mean 2.9°). The Second Class Resolver can be beneficially used for the treatment of Class II malocclusion.

Soft tissue effects of three different Class II/1-camouflage treatment strategies.

PubMed

Atik, Ezgi; Akarsu-Guven, Bengisu; Kocadereli, Ilken

2017-03-01

Aim of this retrospective study was to compare soft tissue effects of Class II treatments with the forsus fatigue resistant device (FRD), the pendulum appliance, and the extraction of two maxillary premolars, all of which were combined with pre-adjusted fixed appliances. The sample of 54 patients with Class II malocclusions was divided in three groups: group I patients (mean age = 15.91 years) were treated with the FRD concurrently used with fixed appliances; group II patients (mean age = 16.08 years) were treated with the pendulum appliance combined with a Nance and headgear followed by fixed appliances; and group III patients (mean age = 19.04 years) were treated with the extraction of two maxillary premolars with miniscrew anchorage. Soft tissue and dentoskeletal parameters were measured on pretreatment (T1) and posttreatment (T2) lateral cephalograms. The changes from T1 to T2 were compared between the groups using Kruskal-Wallis test, and treatment differences were evaluated with the Wilcoxon test at p < 0.05. Soft tissue measurement changes related to the upper and lower lips were significantly greater in group II than in group III (p < 0.05). Upper incisor measurement changes were significantly different between groups II and III. Lower incisor measurement changes were significantly different between groups I and III and groups II and III (p < 0.05). Pendulum and extraction treatment groups showed significant differences in relation with the upper and lower lip positional changes, which were significantly greater in the pendulum group. Treatment time with the extraction treatment was statistically shorter than with the nonextraction protocols.

Evaluation of the effects of skeletal anchoraged Forsus FRD using miniplates inserted on mandibular symphysis: A new approach for the treatment of Class II malocclusion.

PubMed

Unal, Tuba; Celikoglu, Mevlut; Candirli, Celal

2015-05-01

To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus Fatigue Resistant Device (FRD) appliance with miniplate anchorage for the treatment of skeletal Class II malocclusion. The prospective clinical study group included 17 patients (11 girls and 6 boys; mean age 12.96 ± 1.23 years) with Class II malocclusion due to mandibular retrusion and treated with skeletal anchoraged Forsus FRD. After 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back in the maxillary arch, two miniplates were placed bilaterally on the mandibular symphysis. Then, the Forsus FRD EZ2 appliance was adjusted to the miniplates without leveling the mandibular arch. The changes in the leveling and skeletal anchoraged Forsus FRD phases were evaluated by means of the Paired and Student's t-tests using the cephalometric lateral films. The success rate of the miniplates was found to be 91.5% (38 of 42 miniplates). The mandible significantly moved forward (P < .001) and caused a significant restraint in the sagittal position of the maxilla (P < .001). The overjet correction (-5.11 mm) was found to be mainly by skeletal changes (A-VRL, -1.16 mm and Pog-VRL, 2.62 mm; approximately 74%); the remaining changes were due to the dentoalveolar contributions. The maxillary and mandibular incisors were significantly retruded (P < .001). This new approach was an effective method for treating skeletal Class II malocclusion due to the mandibular retrusion via a combination of skeletal and dentoalveolar changes.

Maxillary molar distalization with first class appliance

PubMed Central

Ramesh, Namitha; Palukunnu, Biswas; Ravindran, Nidhi; Nair, Preeti P

2014-01-01

Non-extraction treatment has gained popularity for corrections of mild-to-moderate class II malocclusion over the past few decades. The distalization of maxillary molars is of significant value for treatment of cases with minimal arch discrepancy and mild class II molar relation associated with a normal mandibular arch and acceptable profile. This paper describes our experience with a 16-year-old female patient who reported with irregularly placed upper front teeth and unpleasant smile. The patient was diagnosed to have angles class II malocclusion with moderate maxillary anterior crowding, deep bite of 4 mm on a skeletal class II base with an orthognathic maxilla and retrognathic mandible and normal growth pattern. She presented an ideal profile and so molar distalization was planned with the first-class appliance. Molars were distalised by 8 mm on the right and left quadrants and class I molar relation achieved within 4 months. The space gained was utilised effectively to align the arch and establish a class I molar and canine relation. PMID:24577171

Extreme skeletal open bite correction with vertical elastics.

PubMed

Cruz-Escalante, Marco Antonio; Aliaga-Del Castillo, Aron; Soldevilla, Luciano; Janson, Guilherme; Yatabe, Marilia; Zuazola, Ricardo Voss

2017-11-01

Severe skeletal open bites may be ideally treated with a combined surgical-orthodontic approach. Alternatively, compensations may be planned to camouflage the malocclusion with orthodontics alone. This case report describes the treatment of an 18-year-old man who presented with a severe open bite involving the anterior and posterior teeth up to the first molars, increased vertical dimension, bilateral Class III molar relationship, bilateral posterior crossbite, dental midline deviation, and absence of the maxillary right canine and the mandibular left first premolar. A treatment plan including the extraction of the mandibular right first premolar and based on uprighting and vertical control of the posterior teeth, combined with extrusion of the anterior teeth using multiloop edgewise archwire mechanics and elastics was chosen. After 6 months of alignment and 2 months of multiloop edgewise archwire mechanics, the open bite was significantly reduced. After 24 months of treatment, anterior teeth extrusion, posterior teeth intrusion, and counterclockwise mandibular rotation were accomplished. Satisfactory improvement of the overbite, overjet, sagittal malocclusion, and facial appearance were achieved. The mechanics used in this clinical case demonstrated good and stable results for open-bite correction at the 2-year posttreatment follow-up.

Numbers of Beauty: An Innovative Aesthetic Analysis for Orthognathic Surgery Treatment Planning.

PubMed

Marianetti, Tito Matteo; Gasparini, Giulio; Midulla, Giulia; Grippaudo, Cristina; Deli, Roberto; Cervelli, Daniele; Pelo, Sandro; Moro, Alessandro

2016-01-01

The aim of this study was to validate a new aesthetic analysis and establish the sagittal position of the maxilla on an ideal group of reference. We want to demonstrate the usefulness of these findings in the treatment planning of patients undergoing orthognathic surgery. We took a reference group of 81 Italian women participating in a national beauty contest in 2011 on which we performed Arnett's soft tissues cephalometric analysis and our new "Vertical Planning Line" analysis. We used the ideal values to elaborate the surgical treatment planning of a second group of 60 consecutive female patients affected by skeletal class III malocclusion. Finally we compared both pre- and postoperative pictures with the reference values of the ideal group. The ideal group of reference does not perfectly fit in Arnett's proposed norms. From the descriptive statistical comparison of the patients' values before and after orthognathic surgery with the reference values we observed how all parameters considered got closer to the ideal population. We consider our "Vertical Planning Line" a useful help for orthodontist and surgeon in the treatment planning of patients with skeletal malocclusions, in combination with the clinical facial examination and the classical cephalometric analysis of bone structures.

Malocclusions in young children: Does breast-feeding really reduce the risk? A systematic review and meta-analysis.

PubMed

Doğramacı, Esma J; Rossi-Fedele, Giampiero; Dreyer, Craig W

2017-08-01

Researchers have purported that breast-feeding can decrease the risk of malocclusions. The authors studied the relationship of breast-feeding on malocclusions in young children by means of conducting a systematic review of association (etiology). The authors used a 3-step search strategy, including electronic searches. They considered studies whose investigators included healthy children with primary dentition with a history of breast-feeding and in which the study investigators had assessed specific malocclusion outcomes to be eligible for inclusion in this review. The authors considered prospective and retrospective (longitudinal) studies, case-control studies, and analytical cross-sectional studies. Two of the authors, using standardized instruments, independently assessed the methodological quality and extracted data from the included studies. For situations for which there were a sufficient number of studies, the authors conducted meta-analyses using the random-effects model, supplemented with the fixed-effects model in situations for which statistical heterogeneity was 50% or less, assessed using the I 2 statistic. The authors identified 7 studies that were included in the review. They found that children who had breast-fed suboptimally had an increased risk of developing malocclusions and that a strong and significant association existed between a shorter duration of breast-feeding (less than 12 months) and the development of an anterior open bite (n = 1,875; risk ratio, 3.58; 95% confidence interval, 2.55 to 5.03; P < .00001) and a class II canine relationship (n = 1,203; risk ratio, 1.65; 95% confidence interval, 1.38 to 1.97; P < .00001). Young children with a history of suboptimal breast-feeding have a higher prevalence and risk ratio for malocclusions. These children have an increased risk of developing a class II canine relationship, posterior crossbite, and anterior open bite. Dental health care professionals should continue to encourage and promote breast-feeding; however, patients should be aware that children still can develop malocclusions, despite having received optimal breast-feeding, owing to the multifactorial etiology of malocclusions. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

Interpreting weightings of the peer assessment rating index and the discrepancy index across contexts on Chinese patients.

PubMed

Liu, Siqi; Oh, Heesoo; Chambers, David William; Xu, Tianmin; Baumrind, Sheldon

2018-04-06

Determine optimal weightings of Peer Assessment Rating (PAR) index and Discrepancy Index (DI) for malocclusion severity assessment in Chinese orthodontic patients. Sixty-nine Chinese orthodontists assessed a full set of pre-treatment records from a stratified random sample of 120 subjects gathered from six university orthodontic centres. Using professional judgment as the outcome variable, multiple regression analyses were performed to derive customized weighting systems for the PAR index and DI, for all subjects and each Angle classification subgroup. Professional judgment was consistent, with an Intraclass Correlation Coefficient (ICC) of 0.995. The PAR index or DI can be reliably measured, with ICC = 0.959 and 0.990, respectively. The predictive accuracy of PAR index was greatly improved by the Chinese weighting process (from r = 0.431 to r = 0.788) with almost equal distribution in each Angle classification subgroup. The Chinese-weighted DI showed a higher predictive accuracy, at P = 0.01, compared with the PAR index (r = 0.851 versus r = 0.788). A better performance was found in the Class II group (r = 0.890) when compared to Class I (r = 0.736) and III (r = 0.785) groups. The Chinese-weighted PAR index and DI were capable of predicting 62 per cent and 73 per cent of total variance in the professional judgment of malocclusion severity in Chinese patients. Differential prediction across Angle classifications merits attention since different weighting formulas were found.

Correlation between the frequency of eruption disorders for first permanent molars and the occurrence of malocclusions in early mixed dentition.

PubMed

Salbach, Anja; Schremmer, Britt; Grabowski, Rosemarie; Stahl de Castrillon, Franka

2012-08-01

We analyzed the incidence of eruption disorders in 6-year molars during the first phase of mixed dentition, and then determined the risks for later dental arch development according to specific combinations of orthodontic malocclusions. We, thus, aimed to derive potential conclusions for preventative orthodontics. In this cross-sectional study, 8,041 kindergarten and school children with early mixed dentition were randomly selected and clinically examined. Examinations were performed in two consecutive years during the standard dental screening that school children undergo. The average age was 6.9 years. We defined an eruption of the 6-year molars as being disturbed when (1) the distal cusps had erupted further than the mesial cusps, (2) the mesial inclination of the occlusal surface revealed disturbed eruption, and (3) the 6-year molar had erupted below the second primary molar. Disturbed eruption of the first permanent molars was observed in 102 of these children. The upper 6-year molars were affected more often (88.5%) than the lower molars. Bilateral disturbed eruption of the upper molars was the most frequent combination of symptoms found. Although disturbed eruption was diagnosed most often in 6- and 7-year-old children, the 8-year-old children presented 20% of the eruption disorders. Moreover, 72.6% of the children with disturbed eruption presented at least one additional orthodontic malocclusion. Crowding (p ≤ 0.001), lateral malocclusions (p ≤ 0.001), and mandibular prognathism (p = 0.009) were present significantly more often in children with disturbed eruption of 6-year molars. Delayed eruption and false direction of eruption of the upper 6-year molars may-already at an early stage-raise the likelihood of problems during later dental arch development, such as crowding in the sagittal and transverse directions or Class III developments.

Combined orthodontic-restorative management of maxillary central incisors lost following traumatic injury: a case report.

PubMed

Fleming, Padhraig S; Seehra, Jadbinder; Dibiase, Andrew T

2011-01-01

A history of traumatic dental injury to the maxillary central incisors during preadolescence or adolescence is common and may result in premature loss. Treatment options include prosthetic implant replacement, autotransplantation, and orthodontic space closure with direct composite recontouring. This case report describes the treatment of an adolescent girl who presented with a crowded Class I malocclusion complicated by a history of trauma to the maxillary central incisors. The treatment plan consisted of orthodontic space closure following loss of both maxillary central incisors and mandibular premolars. This case highlights that orthodontic space closure can be a valuable treatment option in selected Class I crowded and Class II uncrowded malocclusions, producing predictable and efficient results.

Surgical treatment of class II malocclusion in the orthodontic boundaries: a case report.

PubMed

Bandeca, Matheus Coelho; Porto, Alessandra Nogueira; Valieri, Sidnei; Valieri, Matheus; Borges, Alvaro H; Mattos, Fernanda Zanol

2014-01-01

The aim of this study was to report a clinical case of treatment of Class II division I malocclusion with facial aesthetic impairment, whose therapeutic approach comprised the association of orthodontic treatment with orthognathic surgery. The treatment for the present case consisted of decompensation oflower incisors and extraction oftwo lower premolars, in order to obtain horizontal discrepancy allowing the surgery for mandibular advancement. At the end of treatment, we could clinically observe a Class I molar/canine relationship, normal overbite and overjet, presence of lip seal, type I facial profile with considerable aesthetic improvement. We can conclude that the ortho-surgical treatment is a therapeutic alternative providing the best prognosis in terms of aesthetic correction in patients with unpleasant facial profile.

Treatment and posttreatment effects induced by the Forsus appliance: A controlled clinical study.

PubMed

Cacciatore, Giorgio; Ghislanzoni, Luis Tomas Huanca; Alvetro, Lisa; Giuntini, Veronica; Franchi, Lorenzo

2014-11-01

To evaluate treatment and posttreatment dentoskeletal effects induced by the Forsus device (FRD) in growing patients with Class II malocclusion in a retrospective controlled clinical study. Thirty-six Class II patients (mean [SD] age 12.3 [1.2] years) were treated consecutively with the FRD protocol and compared with a sample of 20 subjects with untreated Class II malocclusion (mean [SD] age 12.2 [0.9] years). Lateral cephalograms were taken at the beginning of treatment, at the end of comprehensive treatment (after 2.3 ± 0.4 years), and at a postretention period (after 2.3 ± 1.1 years from the end of comprehensive treatment). Statistical comparisons were carried out with the unpaired t-test and Benjamini-Hochberg correction (P < .05). After comprehensive treatment, the FRD sample showed a significant restriction of the sagittal maxillary growth together with a significant correction in overjet, overbite, and molar relationship. During the overall observation interval, the FRD group exhibited no significant sagittal or vertical skeletal changes, while significant improvements were recorded in overjet (-3.8 mm), overbite (-1.5 mm), and molar relationship (+3.7 mm). The FRD protocol was effective in correcting Class II malocclusion mainly at the dentoalveolar level when evaluated 2 years after the end of comprehensive treatment.

Evaluation of treatment modality for skeletal Class III malocclusion with labioversed upper incisors and/or protrusive maxilla: surgical movement and stability of rotational maxillary setback procedure.

PubMed

Baek, Seung-Hak; Kim, Keunwoo; Choi, Jin-Young

2009-11-01

The purpose of this study was to evaluate the range of surgical movement and stability of rotational maxillary setback (MXS) procedure as treatment modality for skeletal class III malocclusion with labioversed upper incisors and/or protrusive maxilla (CIII/LUI-PM). The samples consisted of 20 adult patients (mean [SD] age, 23.55 [4.30] y) who had CIII/LUI-PM and were treated with rotational MXS and mandibular setback using LeFort I osteotomy and bilateral sagittal split ramus osteotomy. The lateral cephalograms were obtained 1 week before (T0), 1 week after (T1), and 1 year after surgery (T2). The amounts of surgical movement, relapse, and stability rate of the upper central incisor (UIE), upper first molar (U6MBC), point A (A), incisive canal point, and posterior nasal spine (PNS) in relation to the reference planes were statistically analyzed. During T1 - T0, there were backward and downward movements of UIE and A, backward and upward movements of U6MBC, and upward and slight forward movements of PNS due to rotational MXS. The center of rotation of the maxilla was placed between A and the upper premolar area. During T2 - T1, skeletal landmarks showed clinically insignificant counterclockwise rotational relapse (<0.5 mm). The anteroposterior (AP) and vertical positions of skeletal landmarks were more stable than dental landmarks. The U6MBC was more stable in the vertical aspect than UIE (P < 0.01). Posterior nasal spine showed significantly higher stability rate in both vertical and AP aspects (P < 0.01, respectively), whereas UIE showed a lower value in the vertical aspect (P < 0.05). Rotational MXS procedure in cases with CIII/LUI-PM can be regarded as a stable one, especially in the vertical and AP positions of PNS. Vertical relapse in UIE should be managed with postoperative orthodontic treatment.

Protocols for Late Maxillary Protraction in Cleft Lip and Palate Patients at Childrens Hospital Los Angeles

PubMed Central

Yen, Stephen L-K

2011-01-01

This paper describes the protocols used at Childrens Hospital Los Angeles (CHLA) to protract the maxilla during early adolescence. It is a modification of techniques introduced by Eric Liou with his Alternate Rapid Maxillary Expansion and Constriction (ALT-RAMEC) technique. The main differences between the CHLA protocol and previous maxillary protraction protocols are the age the protraction is attempted, the sutural loosening by alternating weekly expansion with constriction and the use of Class III elastics to support and redirect the protraction by nightly facemask wear. The CHLA protocol entirely depends on patient compliance and must be carefully taught and monitored. In a cooperative patient, the technique can correct a Class III malocclusion that previously would have been treated with LeFort 1 maxillary advancement surgery. Thus, it is not appropriate for patients requiring 2 jaw surgeries to correct mandibular prognathism, occlusal cants or facial asymmetry. The maxillary protraction appears to work by a combination of skeletal advancement, dental compensation and rotation of the occlusal planes. Microscrew/microimplant/temporary anchorage devices have been used with these maxillary protraction protocols to assist in expanding the maxilla, increasing skeletal anchorage during protraction, limiting dental compensations and reducing skeletal relapse. PMID:21765629

Distalization of maxillary arch and correction of Class II with mini-implants: A report of two cases

PubMed Central

Tekale, Pawankumar Dnyandeo; Vakil, Ketan K.; Vakil, Jeegar K.; Gore, Ketan A.

2015-01-01

This article reports the successful use of mini-screws in the maxilla to treat two patients of age 21-year and 17-year-old girls. Both the patients had a skeletal Class II malocclusion with protrusive maxillary teeth and angels Class II mal-occlusion. Temporary anchorage devices (TADs) in the posterior dental region between maxillary second premolar and maxillary first molar teeth on both sides were used as anchorage for the retraction and intrusion of her maxillary anterior teeth. Those appliances, combined with a compensatory curved maxillary archwire, eliminated spacing, deep bite, forwardly placed and proclined upper front teeth and the protrusive profile, corrected the molar relationship from Class II to Class I. With no extra TADs in the anterior region for intrusion, the treatment was workable and simple. The patient received a satisfactory occlusion and an attractive smile. This technique requires minimal compliance and is particularly useful for correcting Class II patients with protrusive maxillary front teeth and dental deep bite. PMID:26097360

The John Kay Williams gold medal of the Royal Colleges of England and Glasgow 2011.

PubMed

Levisianos, Ioannis

2013-03-01

This paper describes the orthodontic treatment of two cases presented at the bi-collegiate examination of the Royal Colleges of Surgeons of England and Glasgow as part of the Membership in Orthodontics examination. The first case details the management of an 11-year-old Caucasian female patient with a Class II Division 2 malocclusion who was treated with a combination of extra-oral anchorage and fixed appliances. The second case details the management of a 14-year-old Indian male with a Class II Division 1 malocclusion who was treated with a combination of functional and fixed appliance therapy.

Class III camouflage treatment: what are the limits?

PubMed

Burns, Nikia R; Musich, David R; Martin, Chris; Razmus, Thomas; Gunel, Erdogan; Ngan, Peter

2010-01-01

The purpose of this study was to determine the skeletal, dental, and soft-tissue changes in response to camouflage Class III treatment. Thirty patients (average age, 12.4 + or - 1.0 years) with skeletal Class III malocclusions who completed comprehensive nonextraction orthodontic treatment were studied. Skeletal, dental, and soft-tissue changes were determined by using published cephalometric analyses. The quality of orthodontic treatment was standardized by registering the peer assessment rating index on the pretreatment and posttreatment study models. The change in the level of gingival attachment with treatment was determined on the study casts. The results were compared with a group of untreated subjects. Data were analyzed with repeated measures analysis and paired t tests. The average change in the Wits appraisal was greater in the treated group (1.2 + or - 0.1 mm) than in the control group (-0.5 + or - 0.3 mm). The average peer assessment rating index score improved from 33.5 to 4.1. No significant differences were found for the level of gingival attachments between the treatment and control groups. The sagittal jaw relationship (ANB angle) did not improve with camouflage treatment. A wide range of tooth movements compensated for the skeletal changes in both groups. The upper and lower limits for incisal movement to compensate for Class III skeletal changes were 120 degrees to the sella-nasion line and 80 degrees to the mandibular plane, respectively. Greater increases in the angle of convexity were found in the treated group, indicating improved facial profiles. Greater increases in length of the upper lip were found in the treated group, corresponding to the changes in the hard tissues with treatment. Significant dental and soft-tissue changes can be expected in young Class III patients treated with camouflage orthodontic tooth movement. A wide range of skeletal dysplasias can be camouflaged with tooth movement without deleterious effects to the periodontium. However, proper diagnosis and realistic treatment objectives are necessary to prevent undesirable sequelae. Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Combined Orthodontic and Surgical Approach in the Correction of a Class III Skeletal Malocclusion with Mandibular Prognathism and Vertical Maxillary Excess Using Bimaxillary Osteotomy.

PubMed

Jose Cherackal, George; Thomas, Eapen; Prathap, Akhilesh

2013-01-01

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess.

Treatment of maxillary cleft palate: Distraction osteogenesis vs. orthognathic surgery

PubMed Central

Rachmiel, Adi; Even-Almos, Michal; Aizenbud, Dror

2012-01-01

Purpose: The purpose of this paper is to compare the treatment of hypoplastic, retruded maxillary cleft palate using distraction osteogenesis vs. orthognathic surgery in terms of stability and relapse, growth after distraction and soft tissue profile changes. Materials and Methods: The cleft patients showed anteroposterior maxillary hypoplasia with class III malocclusion and negative overjet resulting in a concave profile according to preoperative cephalometric measurements, dental relationship, and soft tissue analysis. The patients were divided in two groups of treatment : S0 eventeen were treated by orthognathic Le Fort I osteotomy fixed with four mini plates and 2 mm screws, and 19 were treated by maxillary distraction osteogenesis with rigid extraoral devices (RED) connected after a Le Fort I osteotomy. The rate of distraction was 1 mm per day to achieve Class I occlusion with slight overcorrection and to create facial profile convexity. Following a 10 week latency period the distraction devices were removed. Results: In the RED group the maxilla was advanced an average of 15.80 mm. The occlusion changed from class III to class I. The profile of the face changed from concave to convex. At a 1-year follow up the results were stable. The mean orthognathic movement was 8.4 mm. Conclusion: In mild maxillary deficiency a one stage orthognathic surgery is preferable. However, in patients requiring moderate to large advancements with significant structural deficiencies of the maxilla or in growing patients the distraction technique is preferred. PMID:23483803

Long-term outcome in a patient with a dentoskeletal open-bite malocclusion treated without extraction.

PubMed

Celli, Daniel; Gasperoni, Enrico; Deli, Roberto

2007-01-01

This case report describes the treatment of a patient with a Class II malocclusion with an anterior open bite. The patient, a girl 16 years of age, had a significant anteroposterior discrepancy and a high-angle tendency. Her face was convex, with competent lips. Intraorally she had an anterior open bite of 3 mm, space in the mandibular arch, and an overjet of 2 mm. High-pull headgear, anterior intermaxillary elastics, and appropriate wire bending were used to close the bite and to correct the anteroposterior dental relationship. Modification of a tongue thrust habit helped to correct this significant malocclusion and provided stability at 11 years posttreatment.

How Do Patients and Parents Decide for Orthodontic Treatment-Effects of Malocclusion, Personal Expectations, Education and Media.

PubMed

Tuncer, C; Canigur Bavbek, N; Balos Tuncer, B; Ayhan Bani, A; Çelik, B

2015-01-01

To examine patients' and parents' perceptions and expectations from orthodontic treatment. 491 patients (274 female, 217 male) aged 14-22 years, and 399 parents (245 female, 154 male) completed a questionnaire about preferences, needs and expectations about orthodontic treatment, and scored the present problem. Continuous variables were compared by Mann-Whitney U and Kruskal-Wallis tests, whereas Chi-square test was used for categorical variables. Patients'(77.1%) and parents'(84.6%), decision about orthodontic treatments were influenced by suggestion of dentists. Patients who decided to attend to clinic by themselves were higher than parents (p=0.006). Dental aesthetics was the determinant factor for treatment demand for patients(61.0%) and parents(57.3%). Improvement in oral functions was more important for Class III patients than Class I patients (p=0.040). Adult patients/parents with higher education gave more importance to oral functions as well as dental aesthetics (p=0.031). There was no difference among Angle classifications regarding orthodontic problem scores. Parents found media sources valuable (p=0.018) but majority expected dentists for information about orthodontic treatments. Education degree of adult patients/parents effected this decision(p=0.002). Desire to have better dental aesthetics was the primary motivating factor for all participants. Clinicians should consider concerns of Class III patients about oral functions during treatment planning.

The John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow 2013.

PubMed

Clayton, Christopher Jonathan

2015-06-01

This paper describes the clinical treatment of two cases treated by the recipient of the 2013 Membership in Orthodontics John Kay Williams Gold Medal of the Royal College of Surgeons of England and Glasgow. The first case describes the management of a 12-year-old male with a class II division 1 malocclusion complicated by Molar Incisal Hypominaralization, an increased overjet and severe upper arch crowding using fixed appliances with anchorage support from temporary anchorage devices. The second case involves the management of a class II division 2 malocclusion complicated by crowding of the upper and lower arches treated on an extraction basis using fixed appliances.

Class II malocclusion with accentuated occlusal plane inclination corrected with miniplate: a case report

PubMed Central

Farret, Marcel Marchiori; Farret, Milton M. Benitez

2016-01-01

ABSTRACT Introduction: A canted occlusal plane presents an unesthetic element of the smile. The correction of this asymmetry has been typically considered difficult by orthodontists, as it requires complex mechanics and may sometimes even require orthognathic surgery. Objective: This paper outlines the case of a 29-year-old woman with Class II malocclusion, pronounced midline deviation and accentuated occlusal plane inclination caused by mandibular deciduous molar ankylosis. Methods: The patient was treated with a miniplate used to provide anchorage in order to intrude maxillary teeth and extrude mandibular teeth on one side, thus eliminating asymmetry. Class II was corrected on the left side by means of distalization, anchored in the miniplate as well. On the right side, maxillary first premolar was extracted and molar relationship was kept in Class II, while canines were moved to Class I relationship. The patient received implant-prosthetic rehabilitation for maxillary left lateral incisor and mandibular left second premolar. Results: At the end of treatment, Class II was corrected, midlines were matched and the canted occlusal plane was totally corrected, thereby improving smile function and esthetics. PMID:27409658

The effectiveness of the Herbst appliance for patients with Class II malocclusion: a meta-analysis

PubMed Central

Yang, Xin; Zhu, Yafen; Long, Hu; Zhou, Yang; Jian, Fan; Ye, Niansong; Gao, Meiya

2016-01-01

Summary Objective: To systematically investigate review in literature the effects of the Herbst appliance for patients with Class II malocclusion patients. Method: We performed a comprehensive literature survey on PubMed, Web of Science, Embase, CENTRAL, SIGLE, and ClinicalTrial.gov up to December 2014. The selection criteria: randomized controlled trials or clinical controlled trials; using any kind of Herbst appliances to correct Class II division 1 malocclusions; skeletal and/or dental changes evaluated through lateral cephalograms. And the exclusion criteria: syndromic patients; individual case reports and series of cases; surgical interventions. Article screening, data extraction, assessment of risk of bias, and evaluation of evidence quality through GRADE were conducted independently by two well-trained orthodontic doctors. Consensus was made via group discussion of all authors when there is inconsistent information from the two. After that, sensitivity analysis and subgroup analysis were performed to evaluate the robustness of the meta-analysis. Results: Twelve clinical controlled trials meet the above-mentioned criteria, and were included in this analysis. All included studies have eleven measures taken during both active treatment effect and long term effect periods, including four angular ones (i.e., SNA, SNB, ANB, mandibular plane angle) and seven linear ones (i.e. Co-Go, Co-Gn, overjet, overbite, molar relationship, A point-OLp, Pg-OLp) during active treatment effect period were statistically pooled. Meta-analysis and sensitivity analysis demonstrated that all these measures showed consistent results except for SNA, ANB, and overbite. Subgroup analysis showed significant changes in SNA, overbite, and Pg-OLp. Publication bias was detected in SNB, mandibular plane angle, and A point-OLp. Conclusion: The Herbst appliance is effective for patients with Class II malocclusion in active treatment period. Especially, there are obvious changes on dental discrepancy and skeletal changes on Co-Gn. As to its long-term effects, more evidence is needed to draw conclusions. PMID:26306822

Comparison between Growth Patterns and Pharyngeal Widths in Different Skeletal Malocclusions in South Indian Population.

PubMed

Lakshmi, K Bhagya; Yelchuru, Sri Harsha; Chandrika, V; Lakshmikar, O G; Sagar, V Lakshmi; Reddy, G Vivek

2018-01-01

The main aim is to determine whether growth pattern had an effect on the upper airway by comparing different craniofacial patterns with pharyngeal widths and its importance during the clinical examination. Sixty lateral cephalograms of patients aged between 16 and 24 years with no pharyngeal pathology or nasal obstruction were selected for the study. These were divided into skeletal Class I ( n = 30) and skeletal Class II ( n = 30) using ANB angle subdivided into normodivergent, hyperdivergent, and hypodivergent facial patterns based on SN-GoGn angle. McNamara's airway analysis was used to determine the upper- and lower-airway dimensions. One-way ANOVA was used to do the intergroup comparisons and the Tukey's test as the secondary statistical analysis. Statistically significant difference exists between the upper-airway dimensions in both the skeletal malocclusions with hyperdivergent growth patterns when compared to other growth patterns. In both the skeletal malocclusions, vertical growers showed a significant decrease in the airway size than the horizontal and normal growers. There is no statistical significance between the lower airway and craniofacial growth pattern.

Combined Orthodontic and Surgical Approach in the Correction of a Class III Skeletal Malocclusion with Mandibular Prognathism and Vertical Maxillary Excess Using Bimaxillary Osteotomy

PubMed Central

Jose Cherackal, George; Thomas, Eapen; Prathap, Akhilesh

2013-01-01

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess. PMID:24455321

Transdisciplinary treatment of Class III malocclusion using conventional implant-supported anchorage: 10-year posttreatment follow-up

PubMed Central

Rinaldi, Mariana Roennau Lemos; Rizzatto, Susana Maria Deon; de Menezes, Luciane Macedo; Polido, Waldemar Daudt; de Lima, Eduardo Martinelli Santayanna

2015-01-01

INTRODUCTION: Combined treatment offers advantages for partially edentulous patients. Conventional implants, used as orthodontic anchorage, enable previous orthodontic movement, which provides appropriate space gain for crown insertion. OBJECTIVE: This case report describes the treatment of a 61-year and 10-month-old patient with negative overjet which made ideal prosthetic rehabilitation impossible, thereby hindering dental and facial esthetics. CASE REPORT: After a diagnostic setup, conventional implants were placed in the upper arch to anchor intrusion and retract anterior teeth. Space gain for lateral incisors was achieved in the lower arch by means of an orthodontic appliance. CONCLUSIONS: Integrated planning combining Orthodontics and Implantology provided successful treatment by means of conventional implant-supported anchorage. The resulting occlusal relationship proved stable after 10 years. PMID:26154459

Dentinogenesis imperfecta associated with osteogenesis imperfecta

PubMed Central

Biria, Mina; Abbas, Fatemeh Mashhadi; Mozaffar, Sedighe; Ahmadi, Rahil

2012-01-01

This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared to permanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients. PMID:23162594

Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: A retrospective clinical study.

PubMed

Celikoglu, Mevlut; Buyuk, Suleyman Kutalmis; Ekizer, Abdullah; Unal, Tuba

2016-03-01

To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus FRD appliance with miniplate anchorage inserted in the mandibular symphyses and to compare the findings with a well-matched control group treated with a Herbst appliance for the correction of a skeletal Class II malocclusion due to mandibular retrusion. The sample consisted of 32 Class II subjects divided into two groups. Group I consisted of 16 patients (10 females and 6 males; mean age, 13.20 ± 1.33 years) treated using the Forsus FRD EZ appliance with miniplate anchorage inserted in the mandibular symphyses. Group II consisted of 16 patients (9 females and 7 males; mean age, 13.56 ± 1.27 years) treated using the Herbst appliance. Seventeen linear and 10 angular measurements were performed to evaluate and compare the skeletal, dentoalveolar, and soft tissue effects of the appliances using paired and Student's t-tests. Both appliances were effective in correcting skeletal class II malocclusion and showed similar skeletal and soft tissue changes. The maxillary incisor was statistically significantly more retruded in the skeletally anchored Forsus FRD group (P < .01). The mandibular incisor was retruded in the skeletally anchored Forsus FRD group (-4.09° ± 5.12°), while it was protruded in the Herbst group (7.50° ± 3.98°) (P < .001). Although both appliances were successful in correcting the skeletal Class II malocclusion, the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors.

Maxillary molar distalization with MGBM-system in class II malocclusion

PubMed Central

Maino, Giuliano; Mariani, Lisa; Bozzo, Ida; Maino, Giovanna; Caprioglio, Alberto

2013-01-01

Aims: Objective of this retrospective study was to evaluate the treatment effects of the MGBM-System (G.B Maino, A. Giannelly, R. Bernard, P. Mura), a new intraoral device to treat Class II malocclusions Materials and Methods: A retrospective study was conducted to compare the pre-distalization and post-distalization cephalograms and dental model casts of 30 patients (15 male, 15 female) with Class II malocclusion treated with MGBM-System. Mean age at the beginning of treatment was 13.3 years (standard deviation 3.3). Angular, horizontal and vertical measurements were recorded to monitor skeletal and dental-alveolar changes. Molar movements in horizontal plane were monitored by making dental measurements on dental model casts. Results: The MGBM-System produced a rapid molar distalization and Class II relationship was corrected in 8 months ± 2.05, on average. The maxillary first molars were distalized of 4.14 (PTV-6 cemento-enamel junction), associated with a significant distal axis incline of 10. 5° referred to SN and a significant intrusion of 1.3 mm (PP). As for anchorage loss, the first premolar exhibited a significant mesial movement of 0.86 mm, associated with a significant mesial axis incline of 2.46°. No significative changes in either sagittal or vertical skeletal relationship were observed. Conclusion: The results suggest that the MGBM-System is an efficient and reliable device for distalizing the maxillary permanent first and second molars. PMID:24987649

Treatment of a skeletal Class II malocclusion using fixed functional appliance with miniplate anchorage

PubMed Central

Celikoglu, Mevlut; Unal, Tuba; Bayram, Mehmet; Candirli, Celal

2014-01-01

Based on our literature search, we found that the use of miniplate anchorage with Forsus fatigue-resistance device (FRD) has not yet been reported. Therefore, the aim of the present case report was to present the treatment of a patient with skeletal Class II malocclusion with mandibular retrusion using Forsus FRD with miniplate anchorage. Fixed appliances with 0.022-inch slots were attached to the maxillary teeth and after 8 months of the leveling and alignment of the upper arch, 0.019 × 0.025-inch stainless steel archwire was inserted and cinched back. Two weeks after the placement of the miniplates bilaterally at the symphysis of the mandible, Forsus FRD was adjusted to the miniplates with a 35-mm length of rod chosen. Nine months after the skeletal anchored Forsus worn, Class I canine and molar relations were achieved and overjet was eliminated. PMID:24966783

Effects of the functional regulator III on transversal changes: a postero-anterior cephalometric and model study.

PubMed

Kilic, Nihat; Celikoglu, Mevlüt; Oktay, Hüsamettin

2011-12-01

Studies assessing the transversal treatment changes caused by the functional regulator III (FR-3) are limited in number. This clinical study was planned to analyse the transversal effects of the FR-3 appliance therapy. The treatment group consisted of 17 patients (8 males and 9 females) with Class III malocclusion, who were treated with the FR-3 appliance. The control group consisted of 17 subjects (7 males and 10 females) with a normal occlusion. Mean ages of the subjects were 10.73 and 10.66 years in the treatment and control groups, respectively. Postero-anterior radiographs and stone casts were obtained before (T1) and after (T2) treatment/observation. The results of the Student's t-test comparing initial values showed that maxillary dentoalveolar and skeletal widths are significantly larger in the control group than those in the treatment group. At the end of the treatment, significant transverse increments occurred only at the dentoalveolar level of the maxilla. The transversal changes in the mandible were not statistically significant. Buccal shields of FR-3 did not stimulate the growth of maxillary apical base but caused an enhanced and supplementary widening of maxillary dental and alveolar structures.

Indication for and frequency of early orthodontic therapy or interceptive measures.

PubMed

Schopf, Peter

2003-05-01

The early treatment of nonskeletal and skeletal orthodontic anomalies in the deciduous and early mixed dentition is intended to prevent the development of pronounced anomalies in the late mixed and permanent dentition with the ultimate aim of reducing or even eliminating the need for later orthodontic treatment. There is a general consensus in the international literature that early therapy is indicated in cases of anterior and lateral crossbite and Class III malocclusion, and possibly for extreme forms of mandibular retrognathism (overjet > or =10 mm) and of open bite. However, evidence of the efficiency of early orthodontic measures is just as rare as studies providing serviceable information on the incidence of tooth malalignments and malocclusions in the deciduous and early mixed dentition, some of whose findings are in any case highly divergent. This makes it substantially more difficult to draw conclusions on the extent to which early orthodontic therapy may be indicated. In order to obtain information on the incidence of nonskeletal and skeletal orthodontic problems constituting a treatment need, 2326 first-year schoolchildren aged between 6 and 7 years were examined in Frankfurt am Main and in the Rural District of Offenbach. In only 14.7% of the children were no relevant orthodontic findings recorded. 77.2% displayed mild to severe dysgnathic symptoms, though without early orthodontic therapy being considered indicated. Treatment with orthodontic appliances was considered urgent for 187 of the children (8.04%). With 8.3% and 7.9% respectively, lateral and anterior crossbite were top of the list of anomalies with an urgent treatment need. Among the patients with lateral crossbite, the prognostically less favorable unilateral form was recorded approximately four times more often than the bilateral form. Markedly increased sagittal overjet > or =10 mm) was registered in only 1.4% of the children, and negative overjet (Class III) (with the exception of edge-to-edge bite) in 1.9%. Extreme anterior open bite > or =6 mm) was recorded in only two children (0.09%). In 19.6% of the children, a supporting zone was reduced in at least one quadrant, necessitating interceptive measures such as the insertion of a space maintainer or later orthodontic treatment (space opening or extraction therapy).

Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System.

PubMed

Alkhouri, Shadi; Waite, Peter D; Davis, Matthew B; Lamani, Ejvis; Kau, Chung How

2017-01-01

Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from -9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time.

Dentoskeletal changes induced by the Jasper jumper and the activator-headgear combination appliances followed by fixed orthodontic treatment.

PubMed

Lima, Karina Jerônimo Rodrigues Santiago de; Henriques, José Fernando Castanha; Janson, Guilherme; Pereira, Suelen Cristina da Costa; Neves, Leniana Santos; Cançado, Rodrigo Hermont

2013-05-01

The aim of this study was to compare the dentoskeletal changes of patients with Class II Division 1 malocclusion treated with either the Jasper jumper appliance or the activator-headgear combination, both associated with fixed appliances. The sample comprised 72 subjects with Class II Division 1 malocclusion divided into 3 groups: group 1 included 25 subjects treated with fixed appliances and the force modules of the Jasper jumper at an initial mean age of 12.72 years, group 2 included 25 subjects treated with the activator-headgear combination followed by fixed appliances at an initial mean age of 11.07 years, and group 3 included 22 untreated subjects at an initial mean age of 12.67 years. Initial cephalometric characteristics and dentoskeletal changes were compared with analysis of variance. Both experimental groups had similar dentoskeletal changes: restrictive effect on the maxilla, clockwise mandibular rotation and a slight increase in anterior face height, retrusion of the maxillary incisors, distalization of the maxillary molars, protrusion of the mandibular incisors, extrusion of the mandibular molars, and significant improvements of the maxillomandibular relationship, overjet, overbite, and the molar relationship. The effects of the Jasper jumper and the activator-headgear combination followed by fixed orthodontic appliances were similar in Class II malocclusion treatment. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Multiple tooth anomalies in a nonsyndromic patient with class II division 2 malocclusions: A case report and a literature review.

PubMed

Isman, E; Isman, O; Aktan, A M; Ciftci, E; Topcuoglu, T

2015-01-01

Reports in the literature about the craniofacial characteristics of patients with class II division 2 malocclusions show a lot of different patterns accompanied by palatally displaced upper incisors, congenital missing teeth, polydiastema, fusion, germination, tooth impaction, peg-shaped lateral incisors, persistent teeth, hypodontia, persistent deciduous teeth, transpositions, and supernumerary teeth. The following case report focuses on the description of the clinical characteristics observed on a patient with a very unusual conjunction of dental and skeletal anomalies mentioned above, as well as a literature review on the related issues. Extra-intra-oral examinations, radiographic evaluations, orthodontic consultation, and reviewing the literature concluded that this nonsyndromic patient that refused to receive all dental treatment approaches is special with its uniqueness.

Eruption of supernumerary permanent teeth in a sample of urban primary school population in Genoa, Italy.

PubMed

Alberti, G; Mondani, P M; Parodi, V

2006-06-01

The aim of this epidemiological study was to describe the incidence and distribution of hyperdontia in the primary school population in Genoa (Italy) and to check its influence on the development of orthodontic problems in children. The collected data should also help to find out what is the best age range among children to direct a program for early diagnosis and prevention of malocclusion and oral diseases related to hyperdontia. The participating children (total number 1577, 814 males and 763 females, between 6 and 10 years of age) chosen in 19 public primary schools in Genoa have been examined by the same specialist through year 2004. Erupted permanent teeth, presence, position and form of supernumerary teeth, malocclusion presence and class, presence of orthodontic devices, age and sex have been noted down for each child. The global percentage of hyperdontia was 0.38%, more frequent in males (0.49%) than in females (0.26%). The most common kind of supernumerary tooth was mesiodens (83%). A significant increase of hyperdontia prevalence (from 0.64% to 1.06%) was noticed in children 9 years old. The incidence of malocclusion among children presenting hyperdontia was 83.3%, while the global incidence of malocclusion was 40%. An orthodontic treatment had been planned and started for 20% of children presenting malocclusion. The study has revealed an incidence of hyperdontia much more frequent in males than in females (2:1). The most common site of eruption of supernumerary teeth is maxillary anterior region. Hyperdontia is strictly related with dental malocclusion. The best age range to direct a program of early diagnosis and prevention of malocclusion and hyperdontia is 9 years old children.

Oral Rehabilitation of Young Adult with Amelogenesis Imperfecta.

PubMed

Leung, Vincent Ws; Low, Bernard; Yang, Yanqi; Botelho, Michael G

2018-05-01

Amelogenesis imperfecta is a heterogeneous group of hereditary disorders that affect the enamel formation of the primary and permanent dentitions while the remaining tooth structure is normal. Appropriate patient care is necessary to prevent adverse effects on dental oral health, dental disfigurement, and psychological well-being. This clinical report presents a 27-year-old Chinese male with amelogenesis imperfecta (AI) and his restorative management. This clinical report presents a 27-year-old Chinese male with AI and his restorative management. Extraoral examination showed a skeletal class III profile and increased lower facial proportion. Intraorally, all the permanent dentition was hypoplastic with noticeable tooth surface loss and a yellow-brown appearance. This was complicated with a mild maloc-clusion and food packing on his posterior teeth. The patient wanted to improve his appearance and masticatory efficiency. Orthodontic treatment was performed to treat the mild malocclu-sion and create physiological interproximal spacing to minimize tooth preparation and facilitate oral hygiene. This report demonstrates how a multidisciplinary approach for the management of AI can achieve a predictable, functional, and esthetic outcome. Orthodontic treatment facilitated a conservative prosthodontic treatment outcome by selectively increasing interproximal space, minimizing tooth preparation, correcting posterior bilateral cross-bite, as well as an anterior reverse overjet and derotation of the canines. This case report demonstrates the effective restoration of AI using a multidisciplinary approach to overcome crowding using a relatively conservative approach.

European Board of Orthodontics case report: severe skeletal discrepancy.

PubMed

Paduano, Sergio

2009-01-01

The 10.3 year-old patient presented a sagittal skeletal and dental Class II division I malocclusion with a severe overjet in the mixed dentition. The convex profile aesthetically improved with the mandibular advancement (positive Frankel manoeuvre). No signs or symptoms of TMJ disorders were present. Oral mucosa and gingiva conditions were good notwithstanding a scanty oral hygiene. The treatment plan included: a) Bass appliance to improve the retruded profile and, partially, OVJ; b) upper and lower arch fixed appliance for alignment, levelling and correction of the malocclusion c) posttreatment retention.

IOTN - a tool to prioritize treatment need in children and plan Dental Health services.

PubMed

Sharma, Jaideep; Sharma, Ruchi Dhir

2014-03-01

The study aimed to evaluate the orthodontic treatment need in school going children in Moradabad, North India, to assess the malocclusion traits, concern towards Dental Health and individual aesthetic perception compared to orthodontist's opinion. 5232 children, aged 11-14 yrs formed the sample. The Dental Health Component (DHC) and Aesthetic Component (AC) were recorded as defined by Brook and Shaw, with slight modification for AC assessment. Statistical analysis revealed that only 12.5% children had no treatment need while 87.5% presented malocclusion with varying treatment needs. There was insignificant sex difference for aesthetic perception. Examiner graded children less attractive than children. Class I was the most common malocclusion and crowding was the most common malocclusion trait. High intra-examiner and substantial inter-examiner agreements were observed for DHC and substantial intra- examiner and moderate inter-examiner agreements for AC. It can be concluded from the present study that, IOTN is a reliable epidemiologic tool to benefit local health services in planning their budget, and improve focus of services by inducing greater uniformity and standardization in the assessment of Orthodontic treatment need.

[Osteosynthesis in the Surgical Treatment of Prognathism: State of The Art].

PubMed

Durão, Nuno; Amarante, José

2017-03-31

Prognathism is a common skeletal facial abnormality, associated with class III malocclusion, often with repercussions in quality of life. In addition to orthodontic treatment, sagittal split ramus osteotomy is the most common technique for its correction, and segment osteosynthesis is an important element of the post-surgical outcome. A search for relevant literature was conducted in the PubMed/MEDLINE database and in other relevant sources. The stability of different fixation methods, their repercussions on inferior alveolar nerve lesions, and the type of material are among the most researched subjects. Recent research about the type of osteosynthesis applied in the sagittal split ramus osteotomy for mandibular setback is discussed. Miniplates appear to be the better option for fixation of sagittal split osteotomy for mandibular setback. Bioabsorbable osteosynthesis may be an acceptable alternative to titanium.

A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS2) and Forsus FRD appliances

PubMed Central

Oztoprak, Mehmet Oguz; Nalbantgil, Didem; Uyanlar, Ayhan; Arun, Tulin

2012-01-01

Objective The purpose of this clinical prospective study was to compare the dentofacial changes produced by the Sabbagh Universal Spring (SUS2) and Forsus FRD appliances in late adolescent patients with Class II malocclusion, and quantify them in comparison with an untreated group. Method: The study was carried out on 59 patients with skeletal and dental Class II malocclusion due to retrognatic mandible. Among these, 20 were treated with SUS2, 20 were treated with FRD, and no treatment was done to 19 subjects as the control group. 36 cephalometric landmarks were identified on each lateral cephalometric radiograph. Results: The effects of both appliances were dentoalveolar and no significant vertical and sagittal skeletal effect on maxilla and mandible was achieved. The retrusion and extrusion of the maxillary incisors as well as the protrusion and intrusion of mandibular incisors were found to be statistically significant in both treatment groups. Soft tissue profile improvement was limited in both treatment groups. Conclusions: Both appliances corrected Class II discrepancies through dentoalveolar changes; however lower incisor proclination was more prominent with the Forsus FRD. PMID:22904659

A cephalometric comparative study of class II correction with Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances.

PubMed

Oztoprak, Mehmet Oguz; Nalbantgil, Didem; Uyanlar, Ayhan; Arun, Tulin

2012-07-01

The purpose of this clinical prospective study was to compare the dentofacial changes produced by the Sabbagh Universal Spring (SUS(2)) and Forsus FRD appliances in late adolescent patients with Class II malocclusion, and quantify them in comparison with an untreated group. The study was carried out on 59 patients with skeletal and dental Class II malocclusion due to retrognatic mandible. Among these, 20 were treated with SUS(2), 20 were treated with FRD, and no treatment was done to 19 subjects as the control group. 36 cephalometric landmarks were identified on each lateral cephalometric radiograph. The effects of both appliances were dentoalveolar and no significant vertical and sagittal skeletal effect on maxilla and mandible was achieved. The retrusion and extrusion of the maxillary incisors as well as the protrusion and intrusion of mandibular incisors were found to be statistically significant in both treatment groups. Soft tissue profile improvement was limited in both treatment groups. Both appliances corrected Class II discrepancies through dentoalveolar changes; however lower incisor proclination was more prominent with the Forsus FRD.

Functional condition of masseters muscles of patients with class ?? subdivision.

PubMed

Kuroyedova, Vera D; Makarova, Alexandra N; Chicor, Tatyana A

Main functional characteristics of masticator muscles in patients with class ?? malocclusions is activity dominance of m. temporalis in comparison with m. ?asseter. We have not found datum about functional status of the masticators in patients with class II subdivision. The purpose of our study was to investigate the functional characteristics of m. ?asseter, m. temporalis in adult patients with class II subdivision malocclusion. There have been carried out the surface electromyographic study of m. masseter, m. temporalis in 17 adult patients with class II subdivision. It was realized quantitative analysis of 271 electromyogram, it was determined the average bioelectric activity, index activity, symmetry and torsion index. It was observed predominance of the bioelectrical activity of m. temporales on m. masseter for all persons with class II subdivision. Bioelectrical activity for m. masseter was bigger on side of distal ratio and for m. temporales on side of neutral ratio. In class ?? subdivision right, the mandible was deviated to the left side and in class ?? subdivision left is deviated to the right side. Thus, rotational moment generated during compression of the jaws, causes deviation of the lower jaw to the side, with a neutral molar ratio. During voluntary chewing bioelectrical activity of m. masseter and m. temporalis was higher in the right side. In accordance with the functional condition of the masticatory muscles of class II subdivision is characterized with functional features of distal occlusion.

Treatment and post-treatment effects of functional therapy on the sagittal pharyngeal dimensions in Class II subjects.

PubMed

Pavoni, Chiara; Cretella Lombardo, Elisabetta; Franchi, Lorenzo; Lione, Roberta; Cozza, Paola

2017-10-01

To evaluate the craniofacial changes induced by functional appliances with special regard to the oro and nasopharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions when compared with an untreated Class II control group immediately after therapy and at long-term observation. A group of 40 patients (21 females and 19 males) with Class II malocclusion treated consecutively either with a Bionator or an Activator followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.4 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation at the end of growth (mean age: 18.2 ± 2.1 years). Statistical comparisons were performed with independent sample t tests at T1 (baseline characteristics) and for the T1-T2, T2-T3, and T1-T3 changes. During active treatment the treated group showed a significant increment in lower airway dimension (PNS-AD1), as well as a significant improvement in the upper airway dimension (PNS-AD2). A significant decrease in the upper adenoid size (AD2-H) was also found. In the longterm evaluation, a significant increase in both lower and upper airway thickness (PNS-AD1; PNS-AD2) and a significant decrease in the upper adenoid thickness were still present in the treated group. The treatment with functional appliances produced significant favorable changes during active treatment in the oro- and nasopharyngeal sagittal airway dimensions in dentoskeletal Class II subjects when compared with untreated controls, and these changes were stable in the long-term. Copyright © 2017 Elsevier B.V. All rights reserved.

Orthognathic Surgery in Patients With Congenital Myopathies and Congenital Muscular Dystrophies: Case Series and Review of the Literature.

PubMed

Bezak, Brett J; Arce, Kevin A; Jacob, Adam; Van Ess, James

2016-03-01

This case series examined preoperative findings and the surgical, anesthetic, and postoperative management of 6 patients with congenital myopathies (CMs) and congenital muscular dystrophies (CMDs) treated at a tertiary medical institution with orthognathic surgery over 15 years to describe pertinent considerations for performing orthognathic surgery in these complex patients. According to the institutional review board-approved protocol, chart records were reviewed for all orthognathic surgical patients with a clinical, genetic, or muscle biopsy-proved diagnosis of CM or CMD. Six patients (5 male, 1 female) qualified, and they were treated by 4 surgeons in the division of oral and maxillofacial surgery from 1992 through 2007. Average age was 19.5 years at the time of orthognathic surgery. Five patients had Class III malocclusions and 1 patient had Class II malocclusion. All 6 patients had apertognathia with lip incompetence. Nasoendotracheal intubation with a difficulty of 0/3 (0=easiest, 3=most difficult) was performed in all cases. Routine induction and maintenance anesthetics, including halogenated agents and nondepolarizing muscle relaxants, were administered without malignant hyperthermia. All 6 patients underwent Le Fort level osteotomies; 4 also had mandibular setback surgery with or without balancing mandibular inferior border osteotomies. Five patients required planned intensive care unit care postoperatively (average, 18.4 days; range, 4 to 65 days). Postoperative respiratory complications resulting in major blood oxygen desaturations occurred in 5 patients; 4 of these patients required reintubation during emergency code response. Five patients required extended postoperative intubation (average, 4.2 days; range, 3 to 6 days) and ventilatory support. Average hospital length of stay was 21.8 days (range, 6 to 75 days). Average postoperative follow-up interval was 29.8 weeks (range, 6 to 128 weeks). Patients with CMs or CMDs often have characteristic dentofacial malocclusions that contribute to functional problems with feeding and drooling and psychosocial problems. Orthognathic surgery, usually bimaxillary, can be judiciously considered in these patients; these procedures typically require multidisciplinary pre- and postoperative evaluation and care over lengthy hospital stays with a high risk of respiratory complications that bear consideration in treatment planning. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Voice characteristics before versus after mandibular setback surgery in patients with mandibular prognathism using nonlinear dynamics and conventional acoustic analyses.

PubMed

Mishima, Katsuaki; Moritani, Norifumi; Nakano, Hiroyuki; Matsushita, Asuka; Iida, Seiji; Ueyama, Yoshiya

2013-12-01

The purpose of this study was to explore the voice characteristics of patients with mandibular prognathism, and to investigate the effects of mandibular setback surgery on these characteristics using nonlinear dynamics and conventional acoustic analyses. Sixteen patients (8 males and 8 females) who had skeletal 3, class III malocclusion without cleft palate, and who underwent a bilateral sagittal split ramus osteotomy (BSSRO), were enrolled. As controls, 50 healthy adults (25 males and 25 females) were enrolled. The mean first LEs (mLE1) computed for each one-second interval, and the fundamental frequency (F0) and frequencies of the first and second formant (F1, F2) were calculated for each Japanese vowel. The mLE1s for /u/ in males, and /o/ in females and the F2s for /i/ and /u/ in males, changed significantly after BSSRO. Class III voice characteristics were observed in the mLE1s for /i/ in both males and females, in the F0 for /a/, /i/, /u/ and /o/ in females, and in the F1 and F2 for /a/ in males, and the F1 for /u/ and the F2 for /i/ in females. Most of these characteristics were preserved after BSSRO. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Extra-oral Appliances in Orthodontic Treatment.

PubMed

Almuzian, Mohammed; Alharbi, Fahad; McIntyre, Grant

2016-01-01

Extra-oral appliances are used in orthodontics to apply forces to the jaws, dentition or both and the popularity of these appliances is cyclical. Although the use of retraction headgear for the management of Class II malocclusion has declined over the last 20 years with the refinement of non-compliance approaches, including temporary anchorage devices, headgear still has a useful role in orthodontics. The use of protraction headgear has increased as more evidence of its effectiveness for the treatment of Class lIl malocclusion has become available. This paper describes the mechanics and contemporary uses of headgear in orthodontics for primary care dentists and specialist orthodontists. CPD/CLINICAL RELEVANCE: Extra-oral appliances have specific uses in orthodontic biomechanics. Clinicians using retraction headgear and protraction headgear should be familiar with their clinical indications, the potential problems and how these can be avoided.

Maxillary Distraction Osteogenesis in Unilateral Cleft Lip and Palate Patients with Rigid External Distraction System

PubMed Central

Alkhouri, Shadi; Waite, Peter D.; Davis, Matthew B.; Lamani, Ejvis; Kau, Chung How

2017-01-01

Aim: Distraction osteogenesis (DO) is a treatment option for patients with maxillary hypoplasia secondary to cleft lip and palate (CLP). Purpose: The aim of this study is to present a technique for maxillary DO using Le Fort I osteotomy with rigid external distraction (RED) system. Subjects and Methods: The patient presented in this paper was an Asian female with CLP aged 13 years and 6 months. She presented with severe midfacial deficiency with a Class III dental malocclusion with a negative overjet and concave facial profile. Cone-beam computed tomography images were recorded preoperatively and the operation performed involved a high Le Fort I osteotomy. The appliance fabricated was banded to upper first molars used for anchorage of the RED system. Distraction of the maxilla was initiated after 7-day latency period. Results: Postoperative cephalometric analysis showed maxillary advancement anteriorly and superiorly, the total distraction treatment period was 10 days. The maxillary advancement was 10.5 mm and the SNA angle increased from 67.5° to 77.9°. Furthermore, the ANB angle changed from −9.8° to 1.6° and the occlusion changed from Class III to Class I. The profile of the face changed from concave to convex and a much better esthetic result was achieved. Conclusion: The study suggests RED system to be a reliable alternative procedure for the treatment of midfacial hypoplasia with or without cleft. Furthermore, it minimizes the risk of the surgical procedure and shortens the operating time. PMID:28713737

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region.

PubMed

Ozer, Mete; Akdeniz, Berat Serdar; Sumer, Mahmut

2013-12-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Nasomaxillary hypoplasia with a congenitally missing tooth treated with LeFort II osteotomy, autotransplantation, and nickel-titanium alloy wire.

PubMed

Ishida, Takayoshi; Ikemoto, Shigehiro; Ono, Takashi

2015-09-01

In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar. We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation. The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved. The methods used in this case represent a remarkable treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

PubMed Central

Akdeniz, Berat Serdar; Sumer, Mahmut

2013-01-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region. PMID:24396740

Pharyngeal airway space and frontal and sphenoid sinus changes after maxillomandibular advancement with counterclockwise rotation for class II anterior open bite malocclusions

PubMed Central

Prado, FB; Rossi, AC; Freire, AR; Groppo, FC; De Moraes, M; Caria, PHF

2012-01-01

Objectives The purpose of this study was to cephalometrically evaluate the pharyngeal airway space and frontal and sphenoid sinus changes after maxillomandibular advancement counterclockwise rotation for class II anterior open bite malocclusion. Methods The study included 49 patients (98 lateral teleradiographs; 36 females and 13 males) who were analysed in the pre-operative (1 week before surgery) and post-operative (6 months after surgery) periods. In each lateral teleradiography, the dimensions of the inferior and superior pharyngeal airway space, TB-PhW1 [the point between the posterior aspect of the tongue to the dorsal pharyngeal wall (oropharynx) (TB) and the point on the dorsal pharyngeal wall closest to TB (PhW1)] and UP-PhW2 [and the point between the posterior aspect of the soft palate to the dorsal pharyngeal wall (nasopharynx) (UP) (PhW2)] measurements were evaluated, as well as the dimensions of the frontal and sphenoid sinuses. The differences between the two operative times were evaluated by Student's t-test. Results All measurements showed excellent reproducibility for the intraclass correlation coefficient (ICC > 0.9; p < 0.0001). There was an increase in the measurements TB-PhW1 and UP-PhW2 and a decrease in the dimensions of the frontal and sphenoid sinuses after orthognathic surgery. Conclusions The morphology of the superior and inferior pharyngeal airway space and frontal and sphenoid sinuses changes after 6 months of maxillomandibular advancement counterclockwise rotation for class II anterior open bite malocclusion. PMID:22116128

Cephalometric effects of the Jones Jig appliance followed by fixed appliances in Class II malocclusion treatment

PubMed Central

Patel, Mayara Paim; Henriques, José Fernando Castanha; de Freitas, Karina Maria Salvatore; Grec, Roberto Henrique da Costa

2014-01-01

Objective The aim of this study was to cephalometrically assess the skeletal and dentoalveolar effects of Class II malocclusion treatment performed with the Jones Jig appliance followed by fixed appliances. Methods The sample comprised 25 patients with Class II malocclusion treated with the Jones Jig appliance followed by fixed appliances, at a mean initial age of 12.90 years old. The mean time of the entire orthodontic treatment was 3.89 years. The distalization phase lasted for 0.85 years, after which the fixed appliance was used for 3.04 years. Cephalograms were used at initial (T1), post-distalization (T2) and final phases of treatment (T3). For intragroup comparison of the three phases evaluated, dependent ANOVA and Tukey tests were used. Results Jones Jig appliance did not interfere in the maxillary and mandibular component and did not change maxillomandibular relationship. Jones Jig appliance promoted distalization of first molars with anchorage loss, mesialization and significant extrusion of first and second premolars, as well as a significant increase in anterior face height at the end of treatment. The majority of adverse effects that occur during intraoral distalization are subsequently corrected during corrective mechanics. Buccal inclination and protrusion of mandibular incisors were identified. By the end of treatment, correction of overjet and overbite was observed. Conclusions Jones Jig appliance promoted distalization of first molars with anchorage loss represented by significant mesial movement and extrusion of first and second premolars, in addition to a significant increase in anterior face height. PMID:25162565

Mandibular growth and dentoalveolar development in the treatment of class II, division 1, malocclusion using Balters Bionator according to the skeletal maturation.

PubMed

dos Santos-Pinto, Paulo Roberto; Martins, Lídia Parsekian; dos Santos-Pinto, Ary; Gandini Júnior, Luiz Gonzaga; Raveli, Dirceu Barnabé; dos Santos-Pinto, Cristiane Celli Matheus

2013-01-01

The purpose of the study was to evaluate the influence of the skeletal maturation in the mandibular and dentoalveolar growth and development during the Class II, division 1, malocclusion correction with Balters bionator. Three groups of children with Class II, division 1, malocclusion were evaluated. Two of them were treated for one year with the bionator of Balters appliance in different skeletal ages (Group 1: 6 children, 7 to 8 years old and Group 2: 10 children, 9 to 10 years old) and the other one was followed without treatment ( 7 children, 8 to 9 years old). Lateral 45 degree cephalometric radiographs were used for the evaluation of the mandibular growth and dentoalveolar development. Tantalum metallic implants were used as fixed and stable references for radiograph superimposition and data acquisition. Student's t test was used in the statistical analysis of the displacement of the points in the condyle, ramus, mandibular base and dental points. One-fixed criteria analysis of variance was used to evaluate group differences (95% of level of significance). The intragroup evaluation showed that all groups present significant skeletal growth for all points analyzed (1.2 to 3.7 mm), but in an intergroup comparison, the increments of the mandibular growth in the condyle, ramus and mandibular base were not statically different. For the dentoalveolar modifications, the less mature children showed greater labial inclination of the lower incisors (1.86 mm) and the most mature children showed greater first permanent molar extrusion (4.8 mm).

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages.

PubMed

Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-06-01

To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage.

Cephalometric evaluation of the effects of the Twin Block appliance in subjects with Class II, Division 1 malocclusion amongst different cervical vertebral maturation stages

PubMed Central

Khoja, Aisha; Fida, Mubassar; Shaikh, Attiya

2016-01-01

ABSTRACT Objectives: To evaluate the cephalometric changes in skeletal, dentoalveolar and soft tissue variables induced by Clark's Twin Block (CTB) in Class II, Division 1 malocclusion patients and to compare these changes in different cervical vertebral maturation stages. Methods: Pre- and post-treatment/observation lateral cephalograms of 53 Class II, Division 1 malocclusion patients and 60 controls were compared to evaluate skeletal, dentoalveolar and soft tissue changes. Skeletal maturity was assessed according to cervical vertebral maturation stages. Pre- and post-treatment/observation mean changes and differences (T2-T1) were compared by means of Wilcoxon sign rank and Mann-Whitney U-tests, respectively. Intergroup comparisons between different cervical stages were performed by means of Kruskal-Wallis test and Mann-Whitney U-test (p ≤ 0.05) . Results: When compared with controls, there was a significant reduction in ANB angle (p < 0.001), which was due to a change in SNB angle in CS-2 and CS-3 (p < 0.001), and in SNA (p < 0.001) and SNB (p = 0.016) angles in the CS-4 group. There was significant increase in the GoGn-SN angle in CS-2 (p = 0.007) and CS-4 (p = 0.024), and increase in Co-Gn and Go-Gn amongst all cervical stages (p < 0.05). There was significant decrease in U1-SN and increase in IMPA amongst all cervical stages (p < 0.05). There was significant retraction of the upper lip in CS-3 (p = 0.001), protrusion of the lower lip in CS-2 (p = 0.005), increase in nasolabial angle in CS-4 (p = 0.006) and Z-angle in CS-3 (p = 0.016), reduction in H-angle in CS-2 (p = 0.013) and CS-3 (p = 0.002) groups. When pre- and post-treatment mean differences were compared between different cervical stages, significant differences were found for SNA, SNB and UI-SN angles and overjet. . Conclusions: The Twin-Block along with the normal craniofacial growth improves facial esthetics in Class II, Division 1 malocclusion by changes in underlying skeletal and dentoalveolar structures. The favorable mandibular growth occurs during any of the cervical vertebral maturation stages, with more pronounced effect during CS-3 stage. PMID:27409656

Comparison of the effects of fixed and removable functional appliances on the skeletal and dentoalveolar structures.

PubMed

Bilgiç, Fundagül; Hamamci, Orhan; Başaran, Güvenç

2011-11-01

To compare and analyse the effects of activator and Forsus FRD EZ appliances in the treatment of skeletal Class II division I malocclusion. Lateral cephalograms and hand-wrist radiographs were collected from 24 Class II division I growing patients (14 females, 10 males). The patients were randomly divided into two equal groups and either treated with an activator appliance (Mean age 12.67 +/- 1.24 years) or with a Forsus FRD EZ appliance (Mean age 12.31 +/- 1.09 years). Pretreatment and posttreatment cephalometric radiographs were obtained, traced, superimposed and data analysed using paired t-tests and the Wilcoxon signed rank test. The results demonstrated that the Forsus FRD EZ effectively corrected the Class II malocclusion, but the changes were mainly dentoalveolar. The Forsus FRD EZ appliance induced a clockwise rotation of the occlusal plane without significant alteration in the vertical facial dimension. Skeletally, maxillary growth was restricted and pogonion moved forward which improved the profile. The Forsus FRD EZ appliance may be an effective dentoalveolar treatment method to manage a skeletal imbalance and improve the profile in growing patients.

Class II malocclusion with complex problems treated with a novel combination of lingual orthodontic appliances and lingual arches.

PubMed

Yanagita, Takeshi; Nakamura, Masahiro; Kawanabe, Noriaki; Yamashiro, Takashi

2014-07-01

This case report describes a novel method of combining lingual appliances and lingual arches to control horizontal problems. The patient, who was 25 years of age at her first visit to our hospital with a chief complaint of crooked anterior teeth, was diagnosed with skeletal Class II and Angle Class II malocclusion with anterior deep bite, lateral open bite, premolar crossbite, and severe crowding in both arches. She was treated with premolar extractions and temporary anchorage devices. Conventionally, it is ideal to use labial brackets simultaneously with appliances, such as a lingual arch, a quad-helix, or a rapid expansion appliance, in patients with complex problems requiring horizontal, anteroposterior, and vertical control; however, this patient strongly requested orthodontic treatment with lingual appliances. A limitation of lingual appliances is that they cannot be used with other conventional appliances. In this report, we present the successful orthodontic treatment of a complex problem using modified lingual appliances that enabled combined use of a conventional lingual arch. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Predicted versus executed surgical orthognathic treatment.

PubMed

Falter, B; Schepers, S; Vrielinck, L; Lambrichts, I; Politis, C

2013-10-01

This study aimed to analyse combined surgical-orthodontic treatment plans, compare them with the actual surgery performed, and define factors resulting in changes of the original plan during orthodontic pre-surgical preparation. The clinical files of 312 orthognathic surgery patients, operated between January 2008 and December 2010, were retrospectively reviewed. Of these 312 patients, 129 had a bimaxillary operation. One hundred sixty patients had osteotomy of the lower jaw only and 23 had osteotomy of the upper jaw only. Factors analysed in the study include Angle Class malocclusion, patient sex, and age. Lip-to-incisor relationship, overjet, overbite and midline deviations of the upper and lower jaw were recorded. Effects of surgical assisted rapid palatal expansion (SARPE) on the eventual surgery were also investigated. Reasons for changing the original treatment plan at the time of the finished pre-surgical-orthodontic alignment were analysed. The original treatment plan was changed in 42 of the 312 patients (13.5%). Changes occurred generally in case of a larger interval between set-up of the first treatment plan and the eventual operation (average 22.4 versus 16.4 months for patients with changed versus unchanged treatment plan, respectively). All Class I patients had surgery performed as planned. Class III patients had a significantly higher rate of altered treatment plan (27.3%) than Class II patients (7.6%). More men (52.4%) saw their treatment plan changed, although there were more women than men in the study population (59.6 versus 40.4%). One in seven patients (13.5%) had a different operation than was planned at the start of treatment. Class III patients with small overjet and overbite commonly have a treatment plan for a monomaxillary operation that, after decompensation, needs to be adapted to a bimaxillary operation. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Angle classification revisited 2: a modified Angle classification.

PubMed

Katz, M I

1992-09-01

Edward Angle, in his classification of malocclusions, appears to have made Class I a range of abnormality, not a point of ideal occlusion. Current goals of orthodontic treatment, however, strive for the designation "Class I occlusion" to be synonymous with the point of ideal intermeshing and not a broad range. If contemporary orthodontists are to continue to use Class I as a goal, then it is appropriate that Dr. Angle's century-old classification, be modified to be more precise.

General anesthesia in orthognathic surgeries: does it affect horizontal jaw relations?

PubMed

Yaghmaei, Masoud; Ejlali, Masoud; Nikzad, Sekieneh; Sayyedi, Ashraf; Shafaeifard, Shahrouz; Pourdanesh, Fereydoun

2013-10-01

The aim of this study was to evaluate the influence of general anesthesia on centric jaw relation (CR) records of orthognathic surgical patients in different postural positions. Fifty patients undergoing orthognathic surgery at Taleghani Hospital (Tehran, Iran) in 2008 were prospectively studied. CR records were obtained in conscious patients in 2 different positions (upright and supine) 1 day before surgery and in the supine position under general anesthesia. The impressions were made and the corresponding casts were mounted on a semiadjustable articulator. Differences were measured to the nearest 0.10 mm using a caliper. Paired t test and a general linear regression model were used for statistical analysis. Fifty patients (27 women and 23 men; mean age, 22.5 ± 3.5 yr) were enrolled. Angle Class I (group I), Class II (group II), and Class III (group III) malocclusions were detected in 16% (n = 8), 54% (n = 27), and 30% (n = 15) of patients, respectively. Although mean changes were smaller than 2 mm, statistically significant differences were found by paired t test in all Angle classification groups. No significant differences were found between the supine and conscious and the supine and unconscious patient positions in groups I and III (P > .05). However, in group II, this difference was statistically significant (P = .001). Regarding the impact of anesthesia on CR records of patients with different Angle classes, this study showed a significant effect, particularly in group II. Assessment of the outcome of interest (difference between the supine and conscious and the upright and conscious positions) versus position after adjustment for Angle class using a general linear regression model showed that the difference was significant only for Angle class (β = +0.29; t = 3.05; P = .003). General anesthesia may not adversely affect the mandibular condylar position in orthognathic patients in a supine position compared with a supine and conscious position. However, among all study groups, group II showed more significant changes in CR records under general anesthesia. Oral and maxillofacial surgeons should be well aware of such changes in these particular positions and avoid possible mismanagement and potential complications. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Orthodontic camouflage versus orthognathic surgery for class III deformity: comparative cephalometric analysis.

PubMed

Martinez, P; Bellot-Arcís, C; Llamas, J M; Cibrian, R; Gandia, J L; Paredes-Gallardo, V

2017-04-01

The objective of this study was to compare different cephalometric variables in adult patients with class III malocclusions before and after treatment, in order to determine which variables are indicative of orthodontic camouflage or orthognathic surgery. The cases of 156 adult patients were assessed: 77 treated with orthodontic camouflage and 79 treated with orthodontics and orthognathic surgery. The following cephalometric variables were measured on pre-treatment (T1) and post-treatment (T2) lateral cephalograms: sella-nasion-A-point (SNA), sella-nasion-B-point (SNB), and A-point-nasion-B-point (ANB) angles, Wits appraisal, facial axis angle, mandibular plane angle, upper and lower incisor inclination, and inter-incisal angle. There were statistically significant differences in cephalometric variables before and after treatment between the two groups. The percentage of normal pre-treatment measurements in the camouflage orthodontics group was 30.7%, which worsened slightly to 28.4% post-treatment. However in the group receiving surgery, this was 24.5% pre-treatment, improving to 33.5% after surgery. SNA, SNB, Wits appraisal, lower incisor inclination, and inter-incisal angle showed differences between the two groups before and after treatment. Wits appraisal, lower incisor inclination, and inter-incisal angle were indicative of one or other treatment. Upper and lower incisor decompensation in both groups did not reach ideal values, which impeded complete skeletal correction in 52% of surgical cases. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[Limiting factors in the class III camouflage treatment: a potential protocol].

PubMed

Chaques Asensi, José

2016-06-01

The Class III skeletal malocclusion has been traditionally treated with a combined approach of orthodontics and orthognathic surgery or with a strategy of orthodontic camouflage. Some severe cases can be identified as ideal candidates for a surgical treatment whereas some others can be handled with orthodontics alone, with a reasonable expectation of an acceptable result. However, the problem remains for the borderline patient. In fact, limited information is available in the literature regarding the identification of the factors that can help in establishing the limits for one treatment modality or the other. Furthermore, the quantification of some of these factors, for practical purposes, is practically missing or very seldom suggested. Therefore, the decision making process remains a subjective reflection based on the "good clinical sense" of the orthodontist or just reduced to an "educated guess". In order to add some information, hopefully useful in deciding the most suitable treatment option for the individual patient, we propose a clinical protocol based on four different factors. Namely: the skeletal discrepancy, the occlusal discrepancy, the periodontal condition and facial aesthetics. For each one of these factors several parameters will be evaluated and, for some of them, an attempt to provide some reference numerical values will be made. Finally, clinical examples will be presented to illustrate the concepts discussed and the treatment alternatives, final treatment plan and treatment outcome will be analyzed for each one of them. © EDP Sciences, SFODF, 2016.

Class III correction using an inter-arch spring-loaded module

PubMed Central

2014-01-01

Background A retrospective study was conducted to determine the cephalometric changes in a group of Class III patients treated with the inter-arch spring-loaded module (CS2000®, Dynaflex, St. Ann, MO, USA). Methods Thirty Caucasian patients (15 males, 15 females) with an average pre-treatment age of 9.6 years were treated consecutively with this appliance and compared with a control group of subjects from the Bolton-Brush Study who were matched in age, gender, and craniofacial morphology to the treatment group. Lateral cephalograms were taken before treatment and after removal of the CS2000® appliance. The treatment effects of the CS2000® appliance were calculated by subtracting the changes due to growth (control group) from the treatment changes. Results All patients were improved to a Class I dental arch relationship with a positive overjet. Significant sagittal, vertical, and angular changes were found between the pre- and post-treatment radiographs. With an average treatment time of 1.3 years, the maxillary base moved forward by 0.8 mm, while the mandibular base moved backward by 2.8 mm together with improvements in the ANB and Wits measurements. The maxillary incisor moved forward by 1.3 mm and the mandibular incisor moved forward by 1.0 mm. The maxillary molar moved forward by 1.0 mm while the mandibular molar moved backward by 0.6 mm. The average overjet correction was 3.9 mm and 92% of the correction was due to skeletal contribution and 8% was due to dental contribution. The average molar correction was 5.2 mm and 69% of the correction was due to skeletal contribution and 31% was due to dental contribution. Conclusions Mild to moderate Class III malocclusion can be corrected using the inter-arch spring-loaded appliance with minimal patient compliance. The overjet correction was contributed by forward movement of the maxilla, backward and downward movement of the mandible, and proclination of the maxillary incisors. The molar relationship was corrected by mesialization of the maxillary molars, distalization of the mandibular molars together with a rotation of the occlusal plane. PMID:24934153

Premature birth--Studies on orthodontic treatment need, craniofacial morphology and function.

PubMed

Paulsson, Liselotte

2009-01-01

A series of studies have been initiated implying a unique opportunity to evaluate and compare malocclusion traits, orthodontic treatment need, craniofacial morphology, mandibular function, signs and symptoms of temporomandibular disorders (TMD) and headache between extremely preterm (EPT; born before the 29th week of gestation) and very preterm (VPT; born between 29 and 32 weeks of gestation) and full-term born children. THIS THESIS WAS BASED ON FOUR STUDIES: Paper I. A systematic literature review was undertaken to answer the following questions: Does prematurity result in alterations of palatal morphology, dental occlusion, tooth-crown dimensions, tooth maturation and eruption? What role does neonatal oral intubation play in the appearance of the alterations? Are the alterations in morphology permanent or transient? The literature search spanned from January 1966 to November 2002 and was later extended to September 2008. Furthermore, a quality analysis of the methodological soundness of the studies in the review was performed. Paper II-IV. The aims were to compare EPT and VPT 8- to 10-year-old children with matched full-term controls considering: Prevalence of malocclusion traits and orthodontic treatment need (Paper II). Craniofacial morphology (Paper III). Mandibular function, signs and symptoms of TMD and headache (Paper IV). KEY FINDINGS IN PAPER I AND THE SUPPLEMENTARY SEARCH: Moderate scientific evidence existed for more malocclusion traits among premature children. Limited evidence was found for no delay in dental eruption, if corrected age was considered for the premature children. Insufficientwas considered for the premature children. Insufficient evidence was found for altered tooth-crown dimensions and permanent alteration of palatal morphology among prematurely children. Thus, further well-designed controlled studies which should also consider orthodontic treatment need, craniofacial morphology, TMD and headache are needed. KEY FINDINGS IN PAPER II-IV: A higher prevalence of malocclusion traits and the assessed need of orthodontic treatment were higher among the preterm children compared with full-term born children (Paper II). Several craniofacial parameters differed significantly between preterm and full-term born children (Paper III). Preterm children did not differ from full-term born children when considering diagnoses according to the Research Diagnostic Criteria for TMD (RDC/TMD), signs and symptoms of TMD or headache (Paper IV). The increased survival rate of very preterm and especially the extremely preterm children contribute to a new group of children in society. The dental clinician should, therefore, be aware of the potential for a higher number of malocclusion traits, more malocclusion traits per individual, greater orthodontic treatment need and altered craniofacial morphology in prematurely born children compared with full-term born children. In spite of this, the prematurely born children had not more TMD or headache than full-term born children at the age of 8-10 years.

A retrospective study comparing the loss of anchorage following the extraction of maxillary first or second premolars during orthodontic treatment with fixed appliances in adolescent patients.

PubMed

Haque, Samantha; Sandler, Jonathan; Cobourne, Martyn T; Bassett, Paul; DiBiase, Andrew T

2017-12-01

This retrospective study assessed the difference in anchorage loss using 3D superimposition of study models between cases treated with extraction of maxillary first premolars and maxillary second premolars carried out in orthodontic specialist practice. Sixty subjects who have undergone extractions of either maxillary first or second premolars as part of their orthodontic treatment were selected. Eligibility criteria included patients with a Class I, mild Class II or III malocclusions, mild-to-moderate crowding with no anchorage reinforcement. Pre- and post-treatment maxillary dental study cases were scanned using a surface laser scanner to produced 3D digital images which were superimposed using areas of stability on the anterior hard palate. Anchorage loss was measured by the mesial movement of the maxillary first permanent molar. The mean mesial movement for the maxillary first molars, when adjusted for confounding factors was 4.7 mm (SD 1.6) in the maxillary first premolar extraction group and 4.6 mm (SD 1.6) in the maxillary second premolar extraction group. There is no difference in anchorage loss when comparing the extraction of the maxillary first premolars to the extraction maxillary second premolars.

A comparison of the efficacy of fixed versus removable functional appliances in children with Class II malocclusion: A systematic review.

PubMed

Pacha, Moaiyad Moussa; Fleming, Padhraig S; Johal, Ama

2016-12-01

To systematically compare the efficacy of fixed and removable functional appliances in Class II malocclusion in terms of morphological and patient-centred outcomes. A comprehensive search of electronic databases without language or time restrictions was undertaken, applying a pre-specified search strategy. Supplementary electronic searching of orthodontics journals and references list of included studies was performed. Randomized (RCTs) and controlled (CCTs) clinical trials involving children under 16 years with Class II malocclusion and overjet more than 5mm were included. A range of clinician- and patient-centred outcomes were evaluated and compared. Risk of bias assessment was carried out using the Cochrane Collaboration tool. Only four clinical trials were found to meet our criteria, of which two were RCTs, comparing the Herbst and the Twin Block appliances. Two further CCTs, compared the Activator to the Forsus and the Twin Force Bite Corrector, respectively. One study was assessed to be at unclear and the remaining at high risk of bias, precluding meta-analysis. There was also significant clinical heterogeneity in terms of methodology, type of intervention and the measured outcomes. Both modalities were effective in correcting the overjet with little differences found in cephalometric changes and a shortage of data concerning patient-centred outcomes. There is little evidence concerning the relative effectiveness of fixed and functional appliances or in relation to patient experiences and perceptions of these treatment modalities. Further well-designed clinical trials assessing the relative merits of both clinician- and patient-centred outcomes are needed. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Surgical-orthodontic treatment of patients suffering from severe periodontal disorders - a clinical case study.

PubMed

Halimi, Abdelali; Zaoui, Fatima

2013-09-01

Orthodontic or, more precisely, surgico-orthodontic treatment of patients suffering from periodontal disorders generally requires a multidisciplinary approach by a qualified dental team. Periodontal bone healing is an essential factor for successful orthodontic treatment in a compromised periodontal situation. We report on the case of an adult patient suffering from severe chronic periodontitis; he was a hyperdivergent skeletal Class III with dento-alveolar compensation, esthetic problems and a significant lack of dental material. A multidisciplinary approach was adopted. First of all, periodontal treatment was undertaken (root scaling and planing) accompanied by appropriate medical treatment and a bone graft to strengthen the area of the lower incisors. After that, surgical and orthodontic treatment to correct the malocclusion was begun. The difficulty lay in the significant absence of dental material to ensure proper intercuspation. A surgical repositioning splint was constructed on an articulator to ensure adequate mandibular retraction after maxillary advancement surgery. After treatment, the missing teeth were replaced by a prosthesis. Following treatment, the periodontal bone resorption was stabilized; the bone deficit was improved and the malocclusion had been corrected; the missing teeth were replaced by appropriate dentures. Short- and medium-term follow-up confirmed the stability of the results obtained, which will be discussed. The right combination of properly managed orthodontic, periodontal and prosthetic treatment can contribute to effective elimination of chronic periodontitis, even at an advanced stage in an adult patient, while at the same time improving esthetic and functional parameters. Copyright © 2013. Published by Elsevier Masson SAS.

A patient with mandibular deviation and 3 mandibular incisors treated with asymmetrically bent improved superelastic nickel-titanium alloy wires.

PubMed

Ikeda, Yuhei; Kokai, Satoshi; Ono, Takashi

2018-01-01

Skeletal and dental discrepancies cause asymmetric malocclusions in orthodontic patients. It is difficult to achieve adequate functional occlusion and guidance in patients with congenital absence of a mandibular incisor due to the tooth-size discrepancy. Here, we describe the orthodontic treatment of a 22-year-old woman with an asymmetric Angle Class II malocclusion, mandibular deviation to the left, and 3 mandibular incisors. The anterior teeth and maxillary canines were crowded. We used an improved superelastic nickel-titanium alloy wire (Tomy International, Tokyo, Japan) to compensate for the asymmetric mandibular arch and an asymmetrically bent archwire to move the maxillary molars distally. A skeletal anchorage system provided traction for intermaxillary elastics, and extractions were not needed. We alleviated the crowding and created an ideal occlusion with proper overjet, overbite, and anterior guidance with Class I canine and molar relationships. This method of treatment with an asymmetrically bent nickel-titanium alloy wire provided proper Class I occlusion and anterior guidance despite the mandibular deviation to the left and 3 mandibular incisors, without the need for extractions. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Botulinum toxin as a therapeutic agent to prevent relapse in deep bite patients.

PubMed

Mücke, Thomas; Löffel, Anja; Kanatas, Anastasios; Karnezi, Sandy; Rana, Majeed; Fichter, Andreas; Haarmann, Stephan; Wolff, Klaus-Dietrich; Loeffelbein, Denys John

2016-05-01

The etiology of deep bite is multifactorial. One of the causes is increased muscular activity. This makes the treatment of deep bite malocclusions difficult and often results in relapse in many cases. In this work we compared patients with surgical orthognathic treatment only and surgical orthognathic treatment with additional injections of botulinum toxin after mandibular advancement for class II division 2 malocclusion. This is a prospective study. Adult patients were assessed pretreatment (T1), posttreatment (T2), and long-term after 1 year (T3). In total, 32 patients (mean age, 30.7 years; 23 women and 9 men) reached the study end point (T3); 24 patients were treated without botulinum toxin and 8 patients received preoperative injections of botulinum toxin. Significant differences between both groups were observed, with a more stable result for the experimental group treated with botulinum toxin. In a selective group of adult patients with a class II division II incisor relationship and with a class II skeletal base, botulinum toxin injections can effectively prevent relapse. This may present an alternative to a conventional myotomy. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Clinical effectiveness of late maxillary protraction in cleft lip and palate: a methods paper

PubMed Central

Lee, MK; Lane, C; Azeredo, F; Landsberger, M; Kapadia, H; Sheller, B; Yen, SL

2017-01-01

Objectives A prospective parallel cohort trial was conducted to compare outcomes of patients treated with maxillary protraction vs. LeFort 1 maxillary advancement surgery. Setting and Sample Population The primary site for the clinical trial is Children’s Hospital Los Angeles; the satellite test site is Seattle Children’s Hospital. All patients have isolated cleft lip and palate and a skeletal Class III malocclusion. Material & Methods A total of 50 patients, ages 11–14 will be recruited for the maxillary protraction cohort. The maxillary surgery cohort consists of 50 patients, ages 16–21, who will undergo LeFort 1 maxillary advancement surgery. Patients with additional medical or cognitive handicaps were excluded from the study. Results Current recruitment of patients is on track to complete the study within the proposed recruitment period. Conclusion This observational trial is collecting information that will examine dental, skeletal, financial, and quality of life issues from both research cohorts. PMID:28643931

Oral manifestations and dental management of a child with Zellweger syndrome.

PubMed

Lertsirivorakul, Jinda; Wongswadiwat, Malinee; Treesuwan, Panta

2014-01-01

Zellweger syndrome (ZS) is a rare autosomal recessive disorder, resulting from an impairment in peroxisome function. It is characterized by craniofacial dysmorphism and neurological abnormalities, and involves several systems, which may complicate dental and anesthesia management. The case of a 7-year-old girl diagnosed with ZS is described with emphasis on oral manifestations, oral rehabilitation under general anesthesia (GA), and home oral care. Apart from the unique features of ZS, she presented with clinodactyly, distinctive palatal vault, Class III malocclusion, missing teeth, microdontia, and delayed dental formation. Dental treatment under GA was conducted with concerns of risk of respiratory insufficiency. Oral home care by the parent and regular recall visits were essential to maintain good oral health. Children with ZS may survive into late childhood. They, however, present multiple health problems that are of special concern for not only the pediatric dentist but also the anesthesiologist. Collaboration with the medical team is essential for optimal care of these patients. ©2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

A retrospective study of Class II mixed-dentition treatment.

PubMed

Oh, Heesoo; Baumrind, Sheldon; Korn, Edward L; Dugoni, Steven; Boero, Roger; Aubert, Maryse; Boyd, Robert

2017-01-01

To consider the effectiveness of early treatment using one mixed-dentition approach to the correction of moderate and severe Class II malocclusions. Three groups of Class II subjects were included in this retrospective study: an early treatment (EarlyTx) group that first presented at age 7 to 9.5 years (n = 54), a late treatment (LateTx) group whose first orthodontic visit occurred between ages 12 and 15 (n = 58), and an untreated Class II (UnTx) group to assess the pretreatment comparability of the two treated groups (n = 51). Thirteen conventional cephalometric measurements were reported for each group and Class II molar severity was measured on the study casts of the EarlyTx and LateTx groups. Successful Class II correction was observed in approximately three quarters of both the EarlyTx group and the LateTx group at the end of treatment. EarlyTx patients had fewer permanent teeth extracted than did the LateTx patients (5.6% vs 37.9%, P < .001) and spent less time in full-bonded appliance therapy in the permanent dentition than did LateTx patients (1.7 ± 0.8 vs 2.6 ± 0.7years, P < .001). When supervision time is included, the EarlyTx group had longer total treatment time and averaged more visits than did the LateTx group (53.1 ± 18. 8 vs 33.7 ± 8.3, P < .0001). Fifty-five percent of the LateTx extraction cases involved removal of the maxillary first premolars only and were finished in a Class II molar relationship. EarlyTx comprehensive mixed-dentition treatment was an effective modality for early correction of Class II malocclusions.

The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles.

PubMed

Ko, Ellen Wen-Ching; Teng, Terry Te-Yi; Huang, Chiung Shing; Chen, Yu-Ray

2015-01-01

The study was conducted to evaluate the effect of early physical rehabilitation by comparing the differences of surface electromyographic (sEMG) activity in the masseter and anterior temporalis muscles after surgical correction of skeletal class III malocclusion. The prospective study included 63 patients; the experimental groups contained 31 patients who received early systematic physical rehabilitation; the control group (32 patients) did not receive physiotherapy. The amplitude of sEMG in the masticatory muscles reached 72.6-121.3% and 37.5-64.6% of pre-surgical values in the experimental and control groups respectively at 6 weeks after orthognathic surgery (OGS). At 6 months after OGS, the sEMG reached 135.1-233.4% and 89.6-122.5% of pre-surgical values in the experimental and control groups respectively. Most variables in the sEMG examination indicated that recovery of the masticatory muscles in the experimental group was better than the control group as estimated in the early phase (T1 to T2) and the total phase (T1 to T3); there were no significant differences between the mean recovery percentages in the later phase (T2 to T3). Early physical rehabilitative therapy is helpful for early recovery of muscle activity in masticatory muscles after OGS. After termination of physical therapy, no significant difference in recovery was indicated in patients with or without early physiotherapy. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Factors influencing soft tissue profile changes following orthodontic treatment in patients with Class II Division 1 malocclusion.

PubMed

Maetevorakul, Suhatcha; Viteporn, Smorntree

2016-01-01

Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. The subjects comprised 104 Thai patients age 8-16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3%. Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R(2) = 0.099), whereas protrusion of the lower lip at the labrale inferius was correlated with initial inclination of the lower incisor (L1 to NB), jaw relation (ANB angle), lower lip thickness and sex (R(2) = 0.403). Prediction of chin protrusion at the soft tissue pogonion was also low predictable (R(2) = 0.190) depending upon sex, age and initial mandibular plane angle (SN-GoGn). Additionally, age and sex also had mainly effect on change of the soft tissue profile in the vertical direction.

Perceived aesthetic impact of malocclusion and oral self-perceptions in 14-15-year-old Asian and Caucasian children in greater Manchester.

PubMed

Mandall, N A; McCord, J F; Blinkhorn, A S; Worthington, H V; O'Brien, K D

2000-04-01

The aims of this study were to evaluate (i) the effect of ethnicity, social deprivation, and normative orthodontic treatment need on orthodontic aesthetic self-perception, self-perceived need for orthodontic treatment, and oral aesthetic impact of malocclusion; (ii) the effect of ethnicity, social deprivation, and gender on perceived orthodontic treatment need and use of orthodontic services; (iii) the influence of perceived oral aesthetic impact of malocclusion on perceived need and wish for orthodontic treatment; and (iv) whether orthodontic treatment experience influences perceived oral aesthetic impact of malocclusion. A stratified, random sample of 434 14-15-year-old children from schools in Manchester, UK, was obtained. Information was collected on orthodontic aesthetic self-perception and orthodontic treatment experience using a questionnaire. The former data were combined to form an Oral Aesthetic Subjective Impact Scale (OASIS). Normative orthodontic treatment need was measured with the Index of Orthodontic Treatment Need (IOTN). Children with higher clinical need for orthodontic treatment perceived themselves as worse off than their peers with lower need. More socially deprived children or those with high IOTN aesthetic component (AC) scores had a higher (i.e. more negative) aesthetic impact (OASIS) score. Asians and females had higher IOTN dental health component (DHC) scores, but a better aesthetic appearance than Caucasians and males. More deprived children were less likely to have received orthodontic treatment. Despite this, OASIS scores were similar between treated and untreated children. Untreated children who wished for orthodontic treatment had higher IOTN AC and OASIS scores.

Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions.

PubMed

Bilbo, E Erin; Marshall, Steven D; Southard, Karin A; Allareddy, Verrasathpurush; Holton, Nathan; Thames, Allyn M; Otsby, Marlene S; Southard, Thomas E

2018-04-18

The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = -1.925°, P < .0001; FH-NA = -3.042°, P < .0001; linear measurement A-point to Vertical Reference = -3.859 mm, P < .0001) and reduction of the ANB angle (-1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

Treatment Effects of Removable Functional Appliances in Pre-Pubertal and Pubertal Class II Patients: A Systematic Review and Meta-Analysis of Controlled Studies

PubMed Central

Perinetti, Giuseppe; Primožič, Jasmina; Franchi, Lorenzo; Contardo, Luca

2015-01-01

Background Treatment effects of removable functional appliances in Class II malocclusion patients according to the pre-pubertal or pubertal growth phase has yet to be clarified. Objectives To assess and compare skeletal and dentoalveolar effects of removable functional appliances in Class II malocclusion treatment between pre-pubertal and pubertal patients. Search methods Literature survey using the Medline, SCOPUS, LILACS and SciELO databases, the Cochrane Library from inception to May 31, 2015. A manual search was also performed. Selection criteria Randomised (RCTs) or controlled clinical trials with a matched untreated control group. No restrictions were set regarding the type of removable appliance whenever used alone. Data collection and analysis For the meta-analysis, cephalometric parameters on the supplementary mandibular growth were the main outcomes, with other cephalometric parameters considered as secondary outcomes. Risk of bias in individual and across studies were evaluated along with sensitivity analysis for low quality studies. Mean differences and 95% confidence intervals for annualised changes were computed according to a random model. Differences between pre-pubertal and pubertal patients were assessed by subgroup analyses. GRADE assessment was performed for the main outcomes. Results Twelve articles (but only 3 RCTs) were included accounting for 8 pre-pubertal and 7 pubertal groups. Overall supplementary total mandibular length and mandibular ramus height were 0.95 mm (0.38, 1.51) and 0.00 mm (-0.52, 0.53) for pre-pubertal patients and 2.91 mm (2.04, 3.79) and 2.18 mm (1.51, 2.86) for pubertal patients, respectively. The subgroup difference was significant for both parameters (p<0.001). No maxillary growth restrain or increase in facial divergence was seen in either subgroup. The GRADE assessment was low for the pre-pubertal patients, and generally moderate for the pubertal patients. Conclusions Taking into account the limited quality and heterogeneity of the included studies, functional treatment by removable appliances may be effective in treating Class II malocclusion with clinically relevant skeletal effects if performed during the pubertal growth phase. PMID:26510187

Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with Class II Division 1 malocclusion treated with maxillary first molar extractions.

PubMed

Livas, Christos; Halazonetis, Demetrios J; Booij, Johan Willem; Pandis, Nikolaos; Tu, Yu-Kang; Katsaros, Christos

2013-04-01

Our objective was to investigate potential associations between maxillary sinus floor extension and inclination of maxillary second premolars and second molars in patients with Class II Division 1 malocclusion whose orthodontic treatment included maxillary first molar extractions. The records of 37 patients (18 boys, 19 girls; mean age, 13.2 years; SD, 1.62 years) treated between 1998 and 2004 by 1 orthodontist with full Begg appliances were used in this study. Inclusion criteria were white patients with Class II Division 1 malocclusion, sagittal overjet of ≥4 mm, treatment plan including extraction of the maxillary first permanent molars, no missing teeth, and no agenesis. Maxillary posterior tooth inclination and lower maxillary sinus area in relation to the palatal plane were measured on lateral cephalograms at 3 time points: at the start and end of treatment, and on average 2.5 years posttreatment. Data were analyzed for the second premolar and second molar inclinations by using mixed linear models. The analysis showed that the second molar inclination angle decreased by 7° after orthodontic treatment, compared with pretreatment values, and by 11.5° at the latest follow-up, compared with pretreatment. There was evidence that maxillary sinus volume was negatively correlated with second molar inclination angle; the greater the volume, the smaller the inclination angle. For premolars, inclination increased by 15.4° after orthodontic treatment compared with pretreatment, and by 8.1° at the latest follow-up compared with baseline. The volume of the maxillary sinus was not associated with premolar inclination. We found evidence of an association between maxillary second molar inclination and surface area of the lower sinus in patients treated with maxillary first molar extractions. Clinicians who undertake such an extraction scheme in Class II patients should be aware of this potential association and consider appropriate biomechanics to control root uprighting. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

A controlled evaluation of oral screen effects on intra-oral pressure curve characteristics.

PubMed

Knösel, Michael; Jung, Klaus; Kinzinger, Gero; Bauss, Oskar; Engelke, Wilfried

2010-10-01

The purpose of this study was to quantify the impact of oral screen (OS) application on intra-oral pressure characteristics in three malocclusion groups. Fifty-six randomly recruited participants (26 males and 30 females) who met the inclusion criteria of either an Angle Class I occlusal relationships or Angle Class II1 or II2 malocclusions, were assigned by dentition to group I (n = 31), group II1 (n = 12), or group II2 (n = 13). Two 3 minute periods of intra-oral pressure monitoring were conducted on each participant, using two different oral end fittings connected to a piezo-resistive relative pressure sensor: (1) a flexible OS and (2) a small-dimensioned air-permeable end cap (EC), which was placed laterally in the premolar region, thus recording intra-oral pressure independent of the influence of the OS. Pressure curve characteristics for both periods and between the malocclusion groups were evaluated with reference to the frequency of swallowing peaks, duration, and altitude of negative pressure plateau phases and the area under the pressure curve. Statistical analysis was undertaken using analysis of variance (ANOVA), the Wilcoxon Mann-Whitney test, and spearman correlation coefficient. A median number of two peaks (median height -20.9 mbar) and three plateau phases (median height of -2.3 mbar) may be regarded as normative for normal occlusion subjects during a 3 minute period, at rest. OS application raised the median average duration and height of intra-oral negative pressure plateau phases in the II1 subjects, exceeding those of group I, but less than the plateau duration in group II2. Median peak heights were distinctively lower in groups I and II1 during OS application. It is concluded that additional training for extension of intra-oral pressure phases may be a promising approach to pre-orthodontic Class II division 1 treatment.

Effects of zygoma-gear appliance for unilateral maxillary molar distalization: A prospective clinical study.

PubMed

Kilkis, Dogan; Celikoglu, Mevlut; Nur, Metin; Bayram, Mehmet; Candirli, Celal

2016-12-01

The aim of the study was to evaluate the dentoskeletal effects of the zygoma-gear appliance used for unilateral maxillary molar distalization in patients with Class II subdivision malocclusion. This prospective clinical study consisted of 21 patients (9 boys, 12 girls; mean age, 15.68 ± 2.18 years) with unilateral Class II malocclusion treated using the unilateral zygoma-gear appliance supported by a zygomatic miniplate inserted on the Class II malocclusion side. The dentoskeletal effects of the system were evaluated using cephalometric lateral and panoramic films with a paired t test. The mean amount of distalization for the maxillary first molar was found to be 5.31 ± 2.46 mm (P <0.001) in 0.45 ± 0.12 years, showing an amount of 0.98 mm of distalization per month. It was also accompanied by a slight intrusion (0.76 ± 2.85 mm; P >0.05) and distal tipping (6.39° ± 5.39°; P <0.001) of the maxillary molars. The maxillary premolar also spontaneously moved distally 1.63 ± 1.90 mm (P <0.01) with distal tipping (4.05° ± 3.47°; P <0.001). Moreover, the inclination of the maxillary incisors and overjet were decreased (-1.59° ± 1.45°, P <0.001; and -0.29 ± 0.63 mm, P <0.05; respectively) showing no anchorage loss. No statistically significant changes were found for the skeletal and soft tissue measurements (P >0.05). The zygoma-gear appliance system is an effective method for unilateral maxillary molar distalization. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Treatment of adolescent patients with class II division 1 malocclusion using Eruption guidance appliance: A comparative study with Twin-block and Activator-Headgear appliances.

PubMed

Nilsson, Jenny Jiayan Luo; Shu, Xiaochen; Magnusson, Britt Hedenberg; Burt, Idil Alatli

2016-01-01

The aim of this study was to evaluate the compliance and short-term effects of eruption guidance appliance (EGA) in adolescents with class II division 1 malocclusion in comparison with twin-block appliance (TBA) and activator-headgear appliance (A-HG). Dental records of 1886 patients were viewed in this retrospective study 129 patients treated with one of these three functional appliances were identified. 123 fulfilled the inclusion criteria and data were extracted from the dental records. Gender, age, compliance, overjet change at every visit, number of appliance breakages and number of emergency visits apart from appliance breakage were studied. The data were analyzed with Chi-square test, General Linear Model and Fisher scoring test. Results showed that 47 patients were treated with EGA, 38 patients with TBA and 38 patients with A-HG. Mean ages starting the treatment were slightly lower with EGA (11.5 years) than with TBA (12.3 years) and A-HG (11.8 years). Non-compliance was higher in the EGA group (31.9%) than TBA group (26.3%) and A-HG group (23.7%). Mean overjet reduction per month was 0.6 mm for EGA which was lower than TBA group (0.7 mm) and A-HG groups (0.7 mm).The number of emergency visits and appliance breakage were lower in EGA group. However, there was no statistically significant difference between the 3 groups regarding ages,compliance, mean overjet reduction, emergency visits and appliance breakage aspects. In conclusion, this study indicates that EGA is an alternative choice in the treatment of adolescent patients with class II division 1 malocclusion. However, long-term follow-up and cephalometric prospective study should be performed to continue our understanding more about the mechanisms of EGA and more definite conclusions can be made.

Relationship between Bruxism and Malocclusion among Preschool Children in Isfahan

PubMed Central

Ghafournia, Maryam; Hajenourozali Tehrani, Maryam

2012-01-01

Background and aims Bruxism is defined as a habitual nonfunctional forceful contact between occlusal tooth surfaces. In younger children bruxism may be a consequence of the masticatory neuromuscular system immaturity. The aim of this study was to assess the prevalence of bruxism and investigate the relationship between occlusal factors and bruxism among preschool children. Materials and methods In this cross-sectional survey, 400 3-6-year-old children were selected randomly from different preschools in Isfahan, Iran. The subjects were divided into two groups of bruxers and non-bruxers as determined by the clinical examination and their parents’ reports. The examiner recorded the primary canines (Class I, Class II, and Class III) and molars (mesial step, distal step, flash terminal plane) relationship, existence of anterior and posterior crossbite, open and deep bite. Also, rotated teeth, food impaction, sharp tooth edges, high restorations, extensive tooth caries, and painful teeth (categorized as irritating tooth conditions) were evaluated. The relationship between bruxism and occlusal factors and irritating tooth conditions was evaluated with chi-square test. Results Bruxism was seen in 12.75% of the subjects. Statistically significant relationships existed between bruxism and some occlusal factors, such as flash terminal plane (P = 0.023) and mesial step (P = 0.001) and also, between food impaction, extensive tooth caries, tooth pain, sharp tooth edge and bruxism. Conclusion The results showed significant relationship of bruxism with primary molar relationships and irritating tooth conditions among preschool children. PMID:23277860

Long-term treatment effects of the FR-2 appliance: a prospective evalution 7 years post-treatment

PubMed Central

Franchi, Lorenzo; Cevidanes, Lucia H. S.; Scanavini, Marco A.; McNamara, James A.

2014-01-01

AIM To examine the long-term effects induced by treatment with the function regulator (FR-2) appliance 7 years post-treatment compared with untreated class II subjects. SUBJECTS AND METHODS The FR-2 sample was collected prospectively and comprised 17 subjects (10 boys and 7 girls, mean age 10.8 years) who were treated with the FR-2 appliance for 1.7 years and re-evaluated 7.1 years after treatment. The step-by-step mandibular advancement was performed gradually (increments up to 3–4 mm), until a ‘super class I’ molar relationship was obtained. The control group consisted of 17 class II subjects (9 boys and 8 girls, mean age 11.3 years) with class II malocclusion, excessive overjet, and class II molar relationship, matched to the treated group as to ages at all times, gender distribution, and stages of skeletal maturity (evaluated by the cervical vertebral maturation method). The lateral cephalograms were analysed at T1 (initial), T2 (final), and T3 (7.1 years post-treatment). The compatibility between the groups and the comparisons of their changes at T1–T2, T2–T3, and T1–T3 intervals were examined by independent sample t-tests (P < 0.05). RESULTS FR-2 treatment provided a significant improvement in the maxillomandibular relationship due to an increase in mandibular length compared with controls, which remained stable over time. Also overjet, overbite, and molar relationship corrections demonstrated stability. Among dentoalveolar changes, only the increased mesial movement of the mandibular molars in the FR-2 group demonstrated stability. CONCLUSIONS Correction of class II malocclusion remained stable 7 years after FR-2 treatment mainly due to the stability of the skeletal changes. PMID:23736378

Scoliosis and dental occlusion: a review of the literature

PubMed Central

2011-01-01

Background Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports. Objectives The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis Search strategy All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010. Selection criteria All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis. Data collection and analysis Data were extracted without blinding to the authors, age of patients or type of occlusion. Main results Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions. Authors' conclusions Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis. PMID:21801357

Resorption of maxillary incisors after orthodontic treatment--clinical study of risk factors.

PubMed

Elhaddaoui, Rajae; Benyahia, Hicham; Azeroual, Mohamed-Faouzi; Zaoui, Fatima; Razine, Rachid; Bahije, Loubna

2016-03-01

External apical root resorption (EARR) is one of the major problems associated with orthodontic treatment. Such lesions represent an iatrogenic risk that must be detected as early as possible, with regular radiological follow-up and appropriate therapeutic precautions. The causes and mechanisms leading to susceptibility to root resorption following the application of an orthodontic force are often not clear and are generally said to be of multifactorial origin. The aim of this clinical study was to analyze the factors linked to the occurrence of moderate to severe resorption (MSR) of upper incisors during orthodontic treatment in a group of Moroccan patients treated in the Dento-Facial Orthopedic Department of the Dental Consultation and Treatment Center (Centre de consultation et de traitements dentaires [CCTD]) in Rabat. A total of 82 patients (28% males, 72% females) aged between 12 and 27, with various malocclusions, who had been treated with fixed appliances for at least 1 year and for whom panoramic X-rays at the start, during and at the end of treatment were available, were selected randomly. The reduction in maxillary incisor root length was evaluated using resorption scores. The factors studied in relation to the risk of occurrence of MSR were: age, sex, treatment duration, extraction or non-extraction, type of malocclusion (Class I arch-length discrepancy, Class II, Class III), the vertical diagnosis (normal, supraocclusion, open bite), presence of dysfunction, impacted canines and root morphology. Statistical analysis was performed using SPSS software, version 18.0. Statistical tests used were: Kaplan-Meier analysis and the univariate and multivariate Cox models for the study of factors associated with MSR. The threshold of significance adopted was 0.05. The factors that were significantly associated with the occurrence of MSR at the level of the upper incisors were: tooth type, with a greater risk for the lateral incisor (HR=3.2 95% CI [2.3-4.5] P<0.001), treatments with extraction (HR=1.64 95% CI [1.16-2.33] P<0.05), the presence of supraocclusion (HR=2.17 95% CI [1.33-3.53] P<0.05) or open bite (HR=3.12 95% CI [1.66-5.86] P<0.001) and root malformation (HR=1.5 95% CI [1.09-2.07] P<0.05). Age, sex, type of malocclusion, dysfunction and impaction of canines were not associated at a statistically significant level with the risk of occurrence of MSR of the upper incisors. EARR is difficult to avoid; the orthodontist's role remains crucial in identifying risk factors so as to adopt a treatment strategy taking these factors into account. In our population, the risk of MSR in the upper incisors appeared to increase in treatments with extraction, situations of supraocclusion or open bite, and in the presence of root abnormalities. Finally, clinical recommendations for the prevention of the occurrence of MSR of the maxillary incisors are proposed, taking into account all the risk factors identified. Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.

Dental and skeletal changes in patients with mandibular retrognathism following treatment with Herbst and pre-adjusted fixed appliance

PubMed Central

Vigorito, Fabio de Abreu; Dominguez, Gladys Cristina; Aidar, Luís Antônio de Arruda

2014-01-01

Objective To assess the dentoskeletal changes observed in treatment of Class II, division 1 malocclusion patients with mandibular retrognathism. Treatment was performed with the Herbst orthopedic appliance during 13 months (phase I) and pre-adjusted orthodontic fixed appliance (phase II). Methods Lateral cephalograms of 17 adolescents were taken in phase I onset (T1) and completion (T2); in the first thirteen months of phase II (T3) and in phase II completion (T4). Differences among the cephalometric variables were statistically analyzed (Bonferroni variance and multiple comparisons). Results From T1 to T4, 42% of overall maxillary growth was observed between T1 and T2 (P < 0.01), 40.3% between T2 and T3 (P < 0.05) and 17.7% between T3 and T4 (n.s.). As for overall mandibular movement, 48.2% was observed between T1 and T2 (P < 0.001) and 51.8% between T2 and T4 (P < 0.01) of which 15.1% was observed between T2 and T3 (n.s.) and 36.7% between T3 and T4 (P < 0.01). Class II molar relationship and overjet were properly corrected. The occlusal plane which rotated clockwise between T1 and T2, returned to its initial position between T2 and T3 remaining stable until T4. The mandibular plane inclination did not change at any time during treatment. Conclusion Mandibular growth was significantly greater in comparison to maxillary, allowing sagittal maxillomandibular adjustment. The dentoalveolar changes (upper molar) that overcorrected the malocclusion in phase I, partially recurred in phase II, but did not hinder correction of the malocclusion. Facial type was preserved. PMID:24713559

Chincup treatment modifies the mandibular shape in children with prognathism.

PubMed

Alarcón, José Antonio; Bastir, Markus; Rosas, Antonio; Molero, Julia

2011-07-01

Although chincups are the preferred treatment for growing children with mandibular prognathism, the mechanism by which chincups improve this condition remains unclear. The aim of this study was to use geometric morphometrics to evaluate changes in the shape of the mandible of prognathic children treated with a chincup. Geometric morphometrics were used to evaluate the short-term mandibular shape changes in 50 prognathic children treated with chincups compared with 40 untreated matched controls. Twenty-one 2-dimensional mandibular landmarks from cephalograms taken before and after 36 months of treatment or observation were analyzed by Procrustes superimposition and thin plate spline. Permutation tests of the treated patients showed highly significant differences in the mandibular shapes before and after treatment, and compared with the control group after the observation period. The thin plate spline grid deformations indicated more rectangular mandibular configuration, forward condyle orientation, condyle neck compression, gonial area compression, and symphysis narrowing. Early chincup treatment widely modifies the mandibular shape of prognathic children to improve Class III malocclusion. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Orthodontic treatment of a patient with unilateral orofacial muscle dysfunction: The efficacy of myofunctional therapy on the treatment outcome.

PubMed

Sugawara, Yasuyo; Ishihara, Yoshihito; Takano-Yamamoto, Teruko; Yamashiro, Takashi; Kamioka, Hiroshi

2016-07-01

The orofacial muscle is an important factor in the harmony of the occlusion, and its dysfunction significantly influences a patient's occlusion after craniofacial growth and development. In this case report, we describe the successful orthodontic treatment of a patient with unilateral orofacial muscle dysfunction. A boy, 10 years 0 months of age, with a chief complaint of anterior open bite, was diagnosed with a Class III malocclusion with facial musculoskeletal asymmetry. His maxillomandibular relationships were unstable, and he was unable to lift the right corner of his mouth upon smiling because of weak right orofacial muscles. A satisfactory occlusion and a balanced smile were achieved after orthodontic treatment combined with orofacial myofunctional therapy, including muscle exercises. An acceptable occlusion and facial proportion were maintained after a 2-year retention period. These results suggest that orthodontic treatment with orofacial myofunctional therapy is an effective option for a patient with orofacial muscle dysfunction. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Malocclusion and socioeconomic indicators in primary dentition.

PubMed

Sousa, Raulison Vieira de; Pinto-Monteiro, Ana Karla de Almeida; Martins, Carolina Castro; Granville-Garcia, Ana Flávia; Paiva, Saul Martins

2014-01-01

The aim of the present study was to determine the prevalence of malocclusion and associations with socioeconomic indicators among preschoolers. A cross-sectional study was conducted with 732 children 3 to 5 years of age in the city of Campina Grande, Brazil. Three dentists underwent a calibration exercise (K = 0.85–0.90) and diagnosed malocclusion based on the criteria proposed by Foster & Hamilton and Grabowski et al. Parents/guardians answered a questionnaire addressing sociodemographic aspects. Data analysis involved descriptive statistics and bivariate Poisson regression (PR; α = 5%). The prevalence of malocclusion was 62.4%. The most frequent types were increased overjet (42.6%), anterior open bite (21%) and deep overbite (19.3%). An association was found between malocclusion and age: the prevalence of malocclusion was greater among younger children, with the highest prevalence among 3-year-olds (PR = 1.116; 95%CI = 1.049–1.187). The prevalence of malocclusion was high. Mother's schooling and household income were not associated with malocclusion. Socioeconomic factors were also not associated with the occurrence of malocclusion.

Orthodontic treatment by general practitioners in consultation with orthodontists--a survey of appliances recommended by Swedish orthodontists.

PubMed

Petrén, Sofia; Bjerklin, Krister; Hedrén, Pontus; Ecorcheville, Agnes

2014-01-01

The aim of the present study was to disclose the treatment procedures most frequently recommended by Swedish orthodontists for use by general practitioners and to determine whether these recommendations are reflected in the undergraduate dental program in orthodontics at Malmö University. Potential differences between the ortho- dontists' recommendations were also investigated. A questionnaire was sent to 169 consulting orthodontists, seeking their recommenda- tions for appliance therapy to be undertaken by general practitioners: 129 (63 males and 66 females) responded. The Quad Helix was the appliance most commonly recommended for correction of posterior crossbite, a plate with Z-springs for correction of anterior crossbite and the headgear activator for correction of Class II malocclusions. A significant gender difference was disclosed with respect to orthodontists' recommendations for treatment of Class II malocclusions by general practitioners, namely that female orthodontists recommended the headgear activator more frequently than males. However, this difference is most likely attributable to the gender distribution among orthodontists qualifying as specialists during the last five decades: more recently qualified orthodontists are predominantly female. The choice of appliances corresponded well with undergraduate training in orthodontics at the Faculty of Odontology in Malmö.

Effect of functional appliances on the airway dimensions in patients with skeletal class II malocclusion: A systematic review.

PubMed

Kannan, Annapurna; Sathyanarayana, Haritha Pottipalli; Padmanabhan, Sridevi

2017-01-01

The aim of the present systematic review was to assess the effect of functional appliances on the airway dimensions in patients with skeletal Class II malocclusion. Articles were identified through a literature survey carried out through the following databases: (1) PUBMED, (2) Google Scholar, (3) The Cochrane Library, (4) Embase, (5) Lilac, and (6) Web of Scholars. The systematic review analyzed 12 articles comprising removable functional appliances, 3 articles with fixed functional appliances, and 2 articles having both fixed and removable functional appliances. Qualitative assessment was done for all the 17 studies. The effect of functional appliances in the dimensions of three airway spaces - nasopharynx, oropharynx, and hypopharynx were analyzed. Significant increase in the dimensions of nasopharynx and oropharynx was observed with Activator. Significant increase in the nasopharynx and hypopharynx (male patients) was observed with Bionator. Insignificant increase in the oropharynx was observed with the same. Significant increase in the oropharynx and hypopharynx was observed with Twin Block. Insignificant increase in the nasopharynx was observed with the same. Significant increase was observed only in the hypopharynx for Frankel II. Decreased or insignificant change was observed with FMA, MPA IV, and Herbst appliances.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

PubMed Central

Peixoto, Adriano Porto; Pinto, Ary dos Santos; Garib, Daniela Gamba; Gonçalves, João Roberto

2014-01-01

Introduction This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. Methods Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. Results During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. Conclusions Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods. PMID:25279524

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion.

PubMed

Peixoto, Adriano Porto; dos Santos Pinto, Ary; Garib, Daniela Gamba; Gonçalves, João Roberto

2014-01-01

This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between changes in centroid and gingival points suggested that upper and lower premolars buccaly proclined during the pre-surgical period. Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods.

Malocclusion: social, functional and emotional influence on children.

PubMed

Martins-Júnior, P A; Marques, L S; Ramos-Jorge, M L

2012-01-01

To determine the association between types of malocclusion and quality of life in children between 8-10 years of age and establish correlations between the severity of the malocclusion and particular bio-psychosocial variables. The sample was made up of 102 schoolchildren aged 8-10 years. Clinical exams were performed using the criteria of the Dental Aesthetic Index (DAI) to determine the presence and severity of malocclusions. The impact on quality of life was assessed using the Child Perceptions Questionnaire (CPQ8-10). Statistical analysis involved the chi-square test, Fisher's exact test and Spearman's correlation analysis. Malocclusions affected 61% of the children examined. There was a positive correlation between total CPQ8-10 and DAI scores (P = 0.034). The following types of malocclusion had a significant effect on the quality of life of the children: upper anterior irregularity > or = 2 mm, anterior open bite > or = 2 mm and diastema > or = 2 mm. Children with malocclusion experienced a greater negative impact on quality of life in comparison to those without malocclusion. Malocclusions had a negative influence over the quality of life of children between 8-10 years of age. More severe malocclusions had a greater impact with regard to social, emotional and functional aspects.

A comparision of Twin-block and Forsus (FRD) functional appliance--a cephalometric study.

PubMed

Mahamad, Irfanulla Khan; Neela, Praveen Kumar; Mascarenhas, Rohan; Husain, Akhter

2012-01-01

The aim was to compare the effects of Twin-block & Forsus (FRD) functional appliances in the correction of Angles Class II division 1 malocclusions. Pre- and post-treatment lateral cephalograms of 25 patients who underwent treatment with twin block for the correction of class II div 1 were compared with 25 patients who underwent treatment with Forsus appliance. These were again compared with the pre follow up and post follow up lateral cephalograms of 25 patients who have not undergone any treatment during this period. All the 3 group patients were compared for skeletal, dental and soft tissue parameters. Cephalometric analysis revealed that both Twin-block & Forsus Fatigue Resistant Device (FRD) appliances stimulated mandibular growth. Statistically significant differences between the two groups were found. Twin-block patients showed statistically very high significant (p < 0.001) increase in mandibular length (6.02 mm) whereas Forsus appliance patients showed significant (p < 0.05) increase in mandibular length (1.6 mm) when compared with control group (0.3 mm). No significant restriction of maxillary growth was found in either of the two experimental groups when compared to control group. Significant increase in lower anterior facial height & posterior facial height was observed in both experimental groups in relation to control group. Significant reduction of overjet and overbite was observed in both experimental groups. Class I molar relationship and improvement in the soft tissue profile were achieved in both treatment groups compared with control group. Both Twin Block and Forsus were effective in the treatment of Class II Div 1 malocclusion. Class II correction with Twin-block is more due to mandibular skeletal and dentoalveolar changes whereas in Forsus, it is more due to dentoalveolar changes and less skeletal changes.

Treatment timing for functional jaw orthopaedics followed by fixed appliances: a controlled long-term study.

PubMed

Pavoni, Chiara; Lombardo, Elisabetta Cretella; Lione, Roberta; Faltin, Kurt; McNamara, James A; Cozza, Paola; Franchi, Lorenzo

2017-11-01

To evaluate the role of treatment timing on long-term dentoskeletal effects of Class II treatment with removable functional appliances followed by full-fixed appliance therapy. A group of 46 patients (23 females and 23 males) with Class II malocclusion treated consecutively with either Bionator or Activator, followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.3 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation (mean age: 18.3 ± 2.1 years). The treated and the control samples were divided into pre-pubertal and pubertal groups according to skeletal maturity observed at the start of treatment. Statistical comparisons were performed with independent sample t-tests. When treatment was initiated before puberty, Class II correction was mostly confined to the dentoalveolar changes, with significant improvements of both overjet and molar relationships. On the other hand, treatment with the outset at puberty produced significant long-term improvement of sagittal skeletal relationships, which were mainly sustained by mandibular changes. Treatment with removable functional appliances (Bionator or Activator) followed by full-fixed appliances produced significant skeletal long-term changes when it begins at puberty. Prepubertal Class II treatment results primarily in dentoalveolar changes. © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

[The influence of breathing mode on the oral cavity].

PubMed

Surtel, Anna; Klepacz, Robert; Wysokińska-Miszczuk, Joanna

2015-12-01

Nose breathing is one of the key factors in the proper development and functioning of the oral cavity. The air passing through the nasal cavity is warmed and humidified while dust and other particulate matter is removed. It is also important as far as bone formation is concerned. The obstruction or congestions of the upper respiratory tract may negatively affect the correct and most optimal (nasal) respiratory tract. The switch from nasal to mouth breathing may lead to serious clinical consequences. Children with the clinical diagnosis of mouth breathing are usually pale, apathetic and they lack concentration and often get tired. Disorders resulting from hypoxy may also be the reason from sleep disturbances, such as frequent waking-up, nocturia, difficulties falling aslee. The main clinical manifestations of mouth breathing appear in the craniofacial structures. Mouth breathers frequently suffer from dental malocclusions and craniofacial bone abnormalities. Chronic muscle tension around the oral cavity could result in the widening of cranio-vertebral angle, posterior position of mandibula and narrow maxillary arch. Among dental alterations the most common are class II malocclusion (total or partial) with the protrusion of the anterior teeth, cross bite (unilateral or bilateral), anterior open bite and primary crowded teeth. Apart from malocclusion, chronic gingivitis, periodontitis, candida infections and halitosis are frequently present in mouth--breathing patients. © 2015 MEDPRESS.

One-step transversal palatal distraction and maxillary repositioning: technical considerations, advantages, and long-term stability.

PubMed

Cortese, Antonio; Savastano, Mauro; Savastano, Germano; Claudio, Pier Paolo

2011-09-01

Transversal maxillary hypoplasia in adolescence is a frequently seen pathology, which can be treated with a combination of surgery and orthodontic treatment to widen the maxilla in skeletally matured patients.We evaluated the advantages of a new surgical technique: Le Fort I distraction osteogenesis using a bone-borne device. Because relapse is one of the main problems in surgical maxillary expansion, long-term stability of this new technique was evaluated. Data from 4 adult patients with maxillary restriction, class III malocclusion, or maxillary malposition were collected preoperatively, 4 months after distraction, and 5 years after distraction. Measurements were recorded on dental models to detect palatal expansion at dental level; cephalograms by lateral and posteroanterior plane were analyzed to detect maxillary movements. Maxillary measurements were substantially stable 5 years after distractions. Only minor dental movements occurred at the dental analysis after 5 years related to a lack of orthodontic contention without any compromise of the dental result (no crossbite relapse and class I stability). Le Fort I with down-fracture for expansion and repositioning by bone-borne distractor device can [corrected] be used to simultaneously widen, advance, and vertically reposition the maxilla without causing healing problems, particularly using a rigid distraction device. Long-term stability can be achieved; however, further studies with a larger number of patients will be necessary for better evaluation.

Treatment of Class II Division 2 Malocclusion Using the Forsus Fatigue Resistance Device and 5-Year Follow-Up

PubMed Central

Atik, Ezgi; Kocadereli, Ilken

2016-01-01

This case report presents the treatment of a 14-year-and-8-month-old boy with Class II division 2 mandibular retrusion, severe deep bite, and concave profile. The Forsus fatigue resistance device (FRD) was effective in correcting both skeletal and dental parameters. At 5-year posttreatment follow-up, the teeth were well aligned and the occlusion was stable. FRD application with appropriate treatment time can result with prominent changes in the facial profile and dentition, and the outcomes can be maintained at the long-term follow-up periods. PMID:27034855

Genetics of the dentofacial variation in human malocclusion

PubMed Central

Moreno Uribe, L. M.; Miller, S. F.

2015-01-01

Malocclusions affect individuals worldwide, resulting in compromised function and esthetics. Understanding the etiological factors contributing to the variation in dentofacial morphology associated with malocclusions is the key to develop novel treatment approaches. Advances in dentofacial phenotyping, which is the comprehensive characterization of hard and soft tissue variation in the craniofacial complex, together with the acquisition of large-scale genomic data have started to unravel genetic mechanisms underlying facial variation. Knowledge on the genetics of human malocclusion is limited even though results attained thus far are encouraging, with promising opportunities for future research. This review summarizes the most common dentofacial variations associated with malocclusions and reviews the current knowledge of the roles of genes in the development of malocclusions. Lastly, this review will describe ways to advance malocclusion research, following examples from the expanding fields of phenomics and genomic medicine, which aim to better patient outcomes. PMID:25865537

[A preliminary approach of the malocclusion of second permanent molar].

PubMed

Lin, Z

1992-11-01

We examined 2183 cases of orodental malocclusion in our clinic. 420 cases of deep-overjet of second permanent molar were found. In this paper we discussed the sex and age of the patients, distribution of tooth position, ratio, degree of overjet, causes of malocclusion, malocclusion condition, endangerment, prevention and treatment.

Effect of malocclusion on the self-esteem of adolescents.

PubMed

Taibah, Salwa Mahmoud; Al-Hummayani, Fadia Mohammed

2017-01-01

Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment. This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships. Adolescent students aged 12-19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN. The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference ( P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem ( P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem. The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects.

Effect of malocclusion on the self-esteem of adolescents

PubMed Central

Taibah, Salwa Mahmoud; Al-Hummayani, Fadia Mohammed

2017-01-01

INTRODUCTION: Esthetics plays an essential role in orthodontic treatment. The psychological effects of malocclusion are an inspiration to improve one's esthetics and seek treatment. OBJECTIVES: This study aimed to assess relationships between self-esteem and malocclusion severity and type in adolescents using a self-esteem measurement scale and the index of treatment need (IOTN) and to investigate the influence of age, sex, and school type in these relationships. MATERIALS AND METHODS: Adolescent students aged 12–19 years randomly selected from four private and two governmental schools were enrolled for this study. After completing the self-esteem questionnaire, participants were examined by researchers to evaluate malocclusion severity and type using the IOTN. RESULTS: The sample consisted of 886 participants: 558 females (62.9%) and 328 males (37.1%) with a mean age of 16 years. Chi-square analysis showed that 17.1% of males and 31% of females showed low levels of self-esteem, with a statistically significant difference (P < 0.001). Cases with multiple malocclusions showed significantly lower self-esteem (P = 0.018) compared with single-category malocclusion. Anterior teeth spacing, crowding, and overjet malocclusion showed the highest percentages of low self-esteem. CONCLUSIONS: The present study supports that malocclusion has negative effects on self-esteem; multiple malocclusions with spacing, crowding, and overjet had the greatest effects. PMID:29119092

Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study.

PubMed

Dimberg, Lillemor; Lennartsson, Bertil; Arnrup, Kristina; Bondemark, Lars

2015-09-01

To follow a group of children from primary to early permanent dentition and determine the prevalence, self-correction, and new development of malocclusions; the need for orthodontic treatment; and the possible influences of habits, breathing disturbances, and allergies. Two hundred and seventy-seven children were followed at 3, 7, and 11.5 years of age. Malocclusions and orthodontic treatment need were determined by clinical examinations. Data on sucking habits, breathing disturbances, allergies, dental trauma, and orthodontic treatments were collected from a questionnaire and dental records. Malocclusions were found in 71% of participants at 3 years of age, 56% at 7 years of age, and 71% at 11.5 years of age. Self-correction was noted for anterior open bite, sagittal malocclusions, and posterior crossbite, while deep bite developed. A high number of contact point displacements and spacings contributed to the prevalence of malocclusion rate of 71% at 11.5 years. Severe or extreme orthodontic treatment need was apparent in 22%. Habits, allergies, or breathing disturbances found at 3 years of age had no associations with malocclusions at 11.5 years of age. This sample revealed a significant percentage of malocclusions and orthodontic treatment need. A substantial number of self-corrections and establishment of new malocclusions occurred during the transition from primary to early permanent dentition.

Mandibular dental arch changes with active self-ligating brackets combined with different archwires.

PubMed

Atik, E; Akarsu-Guven, B; Kocadereli, I

2018-05-01

The aim was to compare mandibular arch and incisor inclinational changes by comparing active self-ligating brackets used with different forms of archwires with a control group in nonextraction cases. The sample of 50 patients with Class I malocclusion was divided into three groups: Group I was treated with active self-ligating brackets (Nexus, Ormco/Orange, CA, USA) used with Damon arch form copper nickel-titanium (Cu-NiTi) and stainless steel (SS) wires; Group II was treated with interactive self-ligating bracket system (Empower, American Orthodontics, Sheboygan, Wis, USA) used with standard Cu-NiTi and SS wires; and Group III was treated with Roth prescribed conventional brackets (Forestadent, Pforzheim, Germany) with standard Cu-NiTi and SS wires which was designed as a control group. Changes in dimension of mandibular arch and inclination of incisors were assessed on dental models and lateral cephalometric radiographs at pretreatment (T1) and posttreatment (T2) periods. Paired-t test and one-way analysis of variance were used to perform intragroup and intergroup comparisons, respectively. In all groups, an average increase of transversal distances occurred from pretreatment to the posttreatment period (P < 0.05). However, mandibular arch length increase was significantly different among the Groups I-III (P = 0.008) and I-II (P = 0.006). No significant intergroup difference was found with regard to incisor inclinational changes. Bracket type had no significant effect on the mandibular dimensional or incisor inclination changes. Besides this, archwire type had only little effect on the treatment results as active self-ligating bracket with Damon archwires increased mandibular arch length greater than other groups.

Association of malocclusion, happiness, and oral health-related quality of life (OHRQoL) in schoolchildren.

PubMed

da Rosa, Guilherme Nascimento; Del Fabro, Joana Possamai; Tomazoni, Fernanda; Tuchtenhagen, Simone; Alves, Luana Severo; Ardenghi, Thiago Machado

2016-03-01

The aim of this study was to assess the impact of malocclusion on children's oral health-related quality of life (COHRQoL) and self-reported happiness. A cross-sectional study was conducted in a representative sample of 12-year-old schoolchildren from Santa Maria, South Brazil. Four calibrated examiners carried out clinical exams to evaluate malocclusion [Dental Aesthetic Index (DAI)], dental caries (DMFT), and dental trauma (O'Brien classification, used in the Children's dental health survey in the UK, 1994). Participants answered the Brazilian versions of the Child Perceptions Questionnaire (CPQ11-14 ) and the Subjective Happiness Scale (SHS). Parents completed a structured questionnaire regarding socioeconomic status. Data analysis was conducted using multilevel Poisson regression models. A total of 1,134 adolescents (boys: 45.8 percent; girls: 54.1 percent) were enrolled in the study. The DAI overall score ranged from 13 to 63 (mean: 25.19, standard error: 0.19); 57.6 percent of the subjects had minor or no malocclusion and 24.4 percent had definite malocclusion. Severe malocclusion and handicapping malocclusion were found in 10.4 percent and 7.4 percent of the subjects, respectively. After adjustment, the severity of malocclusion was associated with high mean values of the CPQ11-14 overall score, and the emotional well-being and social well-being domains were the most affected. Lower levels of happiness were also associated with the severity of malocclusion: those with definite malocclusion presented lower scores on the SHS scale (Rate Ratio 0.97; 95 percent CI 0.94-0.99). Malocclusion had a negative impact on COHRQoL and happiness, mainly on the emotional and social domains. © 2015 American Association of Public Health Dentistry.

Malocclusion, dental aesthetic self-perception and quality of life in a 18 to 21 year-old population: a cross section study.

PubMed

Claudino, Dikson; Traebert, Jefferson

2013-01-07

Aesthetic alterations in the face can be self-perceived and can affect quality of life. For young people, physical attractiveness is an important factor affecting social relationships. The aim of this study was to estimate the prevalence of malocclusion, identify the most common types and test its association with oral aesthetic self-perception in 18 to 21 year-old population of male young adults. A cross-sectional study was carried out involving 138 Brazilian Army soldiers. Data collection included socio demographic profile, malocclusion status through the Dental Aesthetic Index (DAI) and oral aesthetic self-perception as indicated by the Oral Aesthetic Subjective Impact Scale (OASIS). The chi-square and Fisher's exact test were used to test for homogeneity of proportions. The stepwise multivariate logistic regression analysis was used to test for the relationship between the poorer oral aesthetic self-perception and parental and soldier's education, per capita income, history of caries in all teeth and only on anterior teeth, dental trauma, previous orthodontic treatment and malocclusion. The prevalence of malocclusion was 45.6%. Incisor teeth crowding and misalignment of lower incisors were the most common types of malocclusions. A statistically significant and independent association between malocclusion and poorer oral aesthetic self-perception in the multivariate analysis was observed. Subjects with severe malocclusion conditions showed 88% higher prevalence [prevalence ratio =1.88 (95% CI, 1.30 - 2.72); p = 0.001] of poorer aesthetic self-perception comparing to those with minor malocclusion. A high prevalence of malocclusion was observed. The young adults presenting severe malocclusion had a higher and independent prevalence of poorer oral aesthetic self-perception.

Treatment effects produced by the Twin-block appliance vs the Forsus Fatigue Resistant Device in growing Class II patients.

PubMed

Giuntini, Veronica; Vangelisti, Andrea; Masucci, Caterina; Defraia, Efisio; McNamara, James A; Franchi, Lorenzo

2015-09-01

To compare the dentoskeletal changes produced by the Twin-block appliance (TB) followed by fixed appliances vs the Forsus Fatigue Resistant Device (FRD) in combination with fixed appliances in growing patients having Class II division 1 malocclusion. Twenty-eight Class II patients (19 females and 9 males; mean age, 12.4 years) treated consecutively with the TB followed by fixed appliances were compared with a group of 36 patients (16 females and 20 males; mean age, 12.3 years) treated consecutively with the FRD in combination with fixed appliances and with a sample of 27 subjects having untreated Class II malocclusion (13 females and 14 males; mean age, 12.2 years). Mean observation interval was 2.3 years in all groups. Cephalometric changes were compared among the three groups by means of ANOVA and Tukey's post hoc tests. The FRD produced a significant restraint of the maxilla compared with the TB and control samples (SNA, -1.1° and -1.8°, respectively). The TB sample exhibited significantly greater mandibular advancement and greater increments in total mandibular length than either the FRD or control groups (SNB, 1.9° and 1.5°, respectively; and Co-Gn, 2.0 mm and 3.4 mm, respectively). The FRD produced a significantly greater amount of proclination of the mandibular incisors than what occurred with the TB or the control samples (2.9° and 5.6°, respectively). The TB appliance produced greater skeletal effects in terms of mandibular advancement and growth stimulation while the Forsus caused significant proclination of the mandibular incisors.

Emotional effects of malocclusion in Nigerian orthodontic patients.

PubMed

Onyeaso, Chukwudi O; Utomi, Ifeoma L; Ibekwe, Titus S

2005-02-15

To assess the emotional effects of malocclusion among Nigerian orthodontic patients. A questionnaire survey. A questionnaire was completed by 221 Nigerian orthodontic patients undergoing routine orthodontic care at the Orthodontic Unit, Department of Preventive Dentistry, University College Hospital, Ibadan and the Department of Child Dental Health, Lagos University Teaching Hospital, Lagos, both in South-West Nigeria. The participants were comprised of 97 (43%) males and 124 (56.1%) females with age range of 6-40 years (mean age, 13.82 +/- 8.01 SD). Data were analyzed using descriptive statistics and Chi-square test. About 44% of all participants had not yet accepted their malocclusions, while 56.6% of all subjects reported for orthodontic care due to aesthetic reasons. Twenty-seven percent of the subjects were depressed the first time they notice their malocclusions. Over 40% of the participants reported feeling less confident as a result of their malocclusions and about 55% of them felt their malocclusions negatively affected their general facial appearances. Normal activities restricted in some of the subjects due to malocclusion included laughing in public (48.9%), meeting people in public (32%), and forming close relationships (20.4%). The majority (64.7%) of the subjects discussed their malocclusions with their parents, followed by dentists (35.3%). The psychosocial effects of malocclusion in Nigerian orthodontic patients were considerable with no significant gender differences. Considering such factors, professional counseling of Nigerian orthodontic patients is encouraged.

The effects of fixed and removable face masks on maxillary deficiencies in growing patients.

PubMed

Jamilian, Abdolreza; Showkatbakhsh, Rahman; Taban, Tannaz

2012-01-01

To compare the effects of two different types of face masks in the treatment of Class III malocclusions with maxillary deficiency in growing patients. Forty-three patients (21 boys and 22 girls) with maxillary deficiencies were selected. Twenty-one patients (10 boys and 11 girls) with a mean age of 8.9 ± 1.4 years were treated with maxillary removable appliances and face masks. Twenty-two patients (10 boys and 12 girls) with a mean age of 9.3 ± 1.2 years were treated with maxillary fixed appliances and face masks. Lateral cephalograms obtained at the beginning and end of the study were analyzed. Paired t tests and Wilcoxon tests showed that SNA and ANB significantly increased in both groups. The Mann-Whitney test showed that there were no statistically significant differences between the two groups except for U1-SN, which increased by 6.2 ± 7.1 degrees in the removable face mask group and 11.1 ± 6.9 degrees in the fixed face mask group (P < .02). Both treatment modalities were successful in moving the maxilla forward. However, the maxillary incisors had more labial inclination in the fixed appliance group.

Adjustable selective maxillary expansion combined with maxillomandibular surgery: A case report.

PubMed

Leyder, Patrick; Altounian, Gérard; Chardain, Jacques; Quilichini, Julien

2015-09-01

Surgically assisted rapid maxillary expansion (SARME) is usually considered the gold standard for maxillary transverse expansion in adults. However, a second surgical procedure is needed in cases of associated sagittal or vertical discrepancies. We describe the use of two new innovative devices for the correction of discrepancies in all dimensions during a single surgical procedure, thus reducing treatment duration. We report the case of a 21-year-old female patient, referred to our department for skeletal Class III malocclusion associated with right-side laterognathism and transverse maxillary deficiency. The patient underwent one-stage surgery, using sliding osteosynthesis plates and an adjustable bone-borne distractor. Pre-surgical orthodontics consisted in leveling and aligning the mandibular arch; maxillary leveling was initiated 3 months before surgery. Postoperative palatal distraction combined with orthodontic finishing enabled complete correction of dental and bony discrepancies after 3 months. In our experience, treatment of transverse, sagittal and vertical discrepancies has been possible in a single surgical procedure, using two innovative techniques: sliding osteosynthesis and an adjustable bone distractor. Two years post-surgery, the correction is stable in all dimensions. Copyright © 2015. Published by Elsevier Masson SAS.

Failure of tooth eruption in two patients with cerebral palsy and bruxism-a 10-year follow-up: a case report.

PubMed

Staufer, Kirsten; Hamadeh, Sinan; Gesch, Dietmar

2009-01-01

The aim of this paper was to analyze delayed tooth eruption in two children with cerebral palsy who had severe bruxism and to determine whether treatment could influence tooth eruption and alignment. Extraction of primary teeth was carried out and orthodontic treatment was considered due to severe tooth wear of primary teeth, lack of space, and development of a class III malocclusion. Analysis was based on clinical examination, photographs, radiographs, and dental casts. In both patients, early mixed dentition was delayed for more than 5 years. Calcification and root development of posterior permanent teeth corresponded with the chronological age. Root resorption of the severely abraded primary teeth and eruption of their successors were delayed or failed. Eruption of permanent teeth occurred slowly after primary teeth were extracted. Orthodontic treatment succeeded in one patient, achieving a normal overjet in combination with a successful orofacial therapy. The disturbed exfoliation of abraded primary teeth and failure of tooth eruption of the posterior teeth could be linked to the systemic pathology and to bruxism. At age 20, eruption of the canines and premolars remained questionable.

Assisted eruption of impacted teeth into an alveolar bone graft in a patient with cleft lip and palate.

PubMed

Peamkaroonrath, Chonthicha; Manosudprasit, Montien; Godfrey, Keith

2008-11-01

To assist the eruption of impacted upper teeth into an alveolar bone graft in a patient with a unilateral cleft lip and palate. An 8-year-old Thai boy with left unilateral complete cleft lip and palate had the chief complaint of anterior crossbite. He presented with a mild skeletal 3, dental Class III subdivision malocclusion, anterior crossbite, left unilateral posterior crossbite, moderate crowding in the upper arch with impaction of upper the left lateral incisor (tooth 22) and canine (tooth 23). In the first phase of treatment the posterior crossbite was corrected with a removable appliance with a 3-way screw. In the second phase the impacted teeth were surgically exposed, moved into the alveolar bone graft and the teeth aligned with fixed appliances. The upper left lateral incisor was extracted because of its questionable longevity. The orthodontic treatment resulted in normal overjet, overbite and an acceptable facial profile. A prosthesis replaced tooth 22. Forced eruption of impacted teeth can be carried out successfully in the cleft patients after an appropriate treatment plan has been formulated and following preparation of alveolar bone graft in the cleft site.

Thin-plate spline analysis of the effects of face mask treatment in children with maxillary retrognathism.

PubMed

Chang, Jenny Zwei-Chieng; Liu, Pao-Hsin; Chen, Yi-Jane; Yao, Jane Chung-Chen; Chang, Hong-Po; Chang, Chih-Han; Chang, Frank Hsin-Fu

2006-02-01

Face mask therapy is indicated for growing patients who suffer from maxillary retrognathia. Most previous studies used conventional cephalometric analysis to evaluate the effects of face mask treatment. Cephalometric analysis has been shown to be insufficient for complex craniofacial configurations. The purpose of this study was to investigate changes in the craniofacial structure of children with maxillary retrognathism following face mask treatment by means of thin-plate spline analysis. Thirty children with skeletal Class III malocclusions who had been treated with face masks were compared with a group of 30 untreated gender-matched, age-matched, observation period-matched, and craniofacial configuration-matched subjects. Average geometries, scaled to an equivalent size, were generated by means of Procrustes analysis. Thin-plate spline analysis was then performed for localization of the shape changes. Face mask treatment induced a forward displacement of the maxilla, a counterclockwise rotation of the palatal plane, a horizontal compression of the anterior border of the symphysis and the condylar region, and a downward deformation of the menton. The cranial base exhibited a counterclockwise deformation as a whole. We conclude that thin-plate spline analysis is a valuable supplement to conventional cephalometric analysis.

ORAL FINDINGS IN PATIENTS WITH APERT SYNDROME

PubMed Central

Dalben, Gisele da Silva; Neves, Lucimara Teixeira das; Gomide, Marcia Ribeiro

2006-01-01

Introduction: The Apert syndrome is a rare disorder of autosomal dominant inheritance caused by mutations in the FGFR2 gene at locus 10q26; patients with this syndrome present severe syndactyly, exophthalmia, ocular hypertelorism and hypoplastic midface with Class III malocclusion, besides systemic alterations. Most investigations available on the Apert syndrome address the genetic aspect or surgical management, with little emphasis on the oral aspects. Objective: to investigate the oral findings, including dental anomalies, ectopic eruption of the maxillary permanent first molars and soft tissue alterations, in subjects with Apert syndrome. Material and methods: clinical and radiographic examination of nine patients with Apert syndrome, aged 6 to 15 years, not previously submitted to orthodontic or orthognathic treatment. Results: dental anomalies were present in all patients, with one to eight anomalies per individual. The most frequent anomalies were tooth agenesis, mainly affecting maxillary canines, and enamel opacities (44.4% for both). Ectopic eruption of maxillary first molars was found in 33.3% of patients; lateral palatal swellings were observed in 88.8% of patients. Conclusions: The occurrence of typical lateral palatal swellings agrees with the literature. The high prevalence of dental anomalies and ectopic eruption may suggest a possible etiologic relationship with the syndrome. PMID:19089249

Trans-sinusal maxillary distraction for correction of midfacial hypoplasia: long-term clinical results.

PubMed

Nadjmi, N; Schutyser, F; Van Erum, R

2006-10-01

Maxillary distraction osteogenesis is indicated in severe angle class III malocclusions, and severe maxillary hypoplasia among some cleft patients and other craniofacial deformities. Twenty patients, aged 8-48 years (mean 17.8+/-10.5 SD) with maxillary and midfacial hypoplasia were treated. The follow-up period was 13-65 months (mean 35+/-16.3 SD). A trans-sinusal maxillary distractor was placed intraorally at each side of the maxilla. The distraction vector was predicted using specialist software, and was transferred to the patients using stereolithographic models and individual templates. A (high) Le Fort I type osteotomy was performed. The amount of activation varied from 8 to 17.5 mm (mean 13.1+/-2.9 SD). Soft and hard tissue formation resulted in complete healing across the distraction gaps. The distractors are almost completely submerged, and can be left in place as long as necessary to avoid relapse. Wit's appraisal was used to measure the stability of the long-term distraction results. Results up to 5 years after distraction showed considerable maxillary advancement with long-term stability. Ongoing growth of the facial skeleton must be considered when distraction osteogenesis is chosen in growing patients.

[Prevalence of cross-bite in Mexican children].

PubMed

Ojeda León, S; De la Teja Angeles, E

1990-10-01

As observed, the problem of lining and accommodation of teeth in the child population is increasingly larger. This fact prompted the authors to attempt determining the prevalence of cross-bite in a sample of Mexican children. A total of 306 patients, aged between two and 17 and attending the Stomatology service of the National Institute of Pediatrics, were evaluated, from which all pertinent data regarding age, sex, molar-temporal relationship (terminal, rectus, distal, messial and exaggerated messial planes), permanent molar status (Angle I, II, III), cross-bite, type of dentition affected (primary, mixed or permanent), cross-bite classification (anterior, posterior or mixed), whether unilateral, bilateral, dental or skeletal, right or left, and number of teeth affected, were duly recorded. Out of 306 evaluated patients (160 males, 146 female), 112 evidenced cross-bite (36.6%), 56 of each sex; in 69.6% the teeth were anterior, in 17.8% they were posterior, and in 15.5% their position was mixed. Their average age was 8 years, and malocclusion was Angle class I. From this experience, it is to be concluded that early detection and correction of any dental occlusion abnormality will permit correcting defects in dentofacial development; it is thus necessary to ascertain the frequency of cross-bite.

Reduced somatosensory impairment by piezosurgery during orthognathic surgery of the mandible.

PubMed

Brockmeyer, Phillipp; Hahn, Wolfram; Fenge, Stefan; Moser, Norman; Schliephake, Henning; Gruber, Rudolf Matthias

2015-09-01

This clinical trial aimed to test the hypothesis that piezosurgery causes reduced nerval irritations and, thus, reduced somatosensory impairment when used in orthognathic surgery of the mandible. To this end, 37 consecutive patients with Angle Class II and III malocclusion were treated using bilateral sagittal split osteotomies (BSSO) of the mandible. In a split mouth design, randomized one side of the mandible was operated using a conventional saw, while a piezosurgery device was used on the contralateral side. In order to test the individual qualities of somatosensory function, quantitative sensory testings (QSTs) were performed 1 month, 6 months and 1 year after surgery. A comparison of the data using a two-way analysis of variance (ANOVA) revealed a significant reduction in postoperative impairment in warm detection threshold (WDT) (P = 0.046), a decreased dynamic mechanical allodynia (ALL) (P = 0.002) and a decreased vibration detection threshold (VDT) (P = 0.030) on the piezosurgery side of the mandible as opposed to the conventionally operated control side. In the remaining QSTs, minor deviations from the preoperative baseline conditions and a more rapid regression could be observed. Piezosurgery caused reduced somatosensory impairment and a faster recovery of somatosensory functions in the present investigation.

Orthodontic treatment for prominent lower front teeth (Class III malocclusion) in children.

PubMed

Watkinson, Simon; Harrison, Jayne E; Furness, Susan; Worthington, Helen V

2013-09-30

Prominent lower front teeth (termed reverse bite; under bite; Class III malocclusion) may be due to a combination of the jaw or tooth positions or both. The upper jaw (maxilla) can be too far back or the lower jaw (mandible) too far forward, or both. Prominent lower front teeth can also occur if the upper front teeth (incisors) are tipped back or the lower front teeth are tipped forwards, or both. Various treatment approaches have been described to correct prominent lower front teeth in children and adolescents. To assess the effects of orthodontic treatment for prominent lower front teeth in children and adolescents. We searched the following databases: Cochrane Oral Health Group's Trials Register (to 7 January 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE via OVID (1946 to 7 January 2013), and EMBASE via OVID (1980 to 7 January 2013). Randomised controlled trials (RCTs) recruiting children or adolescents or both (aged 16 years or less) receiving any type of orthodontic treatment to correct prominent lower front teeth (Class III malocclusion). Orthodontic treatments were compared with control groups who received either no treatment, delayed treatment or a different active intervention. Screening of references, identification of included and excluded studies, data extraction and assessment of the risk of bias of the included studies was performed independently and in duplicate by two review authors. The mean differences with 95% confidence intervals were calculated for continuous data. Meta-analysis was only undertaken when studies of similar comparisons reported comparable outcome measures. A fixed-effect model was used. The I2 statistic was used as a measure of statistical heterogeneity. Seven RCTs with a total of 339 participants were included in this review. One study was assessed as at low risk of bias, three studies were at high risk of bias, and in the remaining three studies risk of bias was unclear. Four studies reported on the use of a facemask, two on the chin cup, one on the tandem traction bow appliance, and one on mandibular headgear. One study reported on both the chin cup and mandibular headgear appliances.One study (n = 73, low quality evidence), comparing a facemask to no treatment, reported a mean difference (MD) in overjet of 4.10 mm (95% confidence interval (CI) 3.04 to 5.16; P value < 0.0001) favouring the facemask treatment. Two studies comparing facemasks to untreated control did not report the outcome of overjet. Three studies (n = 155, low quality evidence) reported ANB (an angular measurement relating the positions of the top and bottom jaws) differences immediately after treatment with a facemask when compared to an untreated control. The pooled data showed a statistically significant MD in ANB in favour of the facemask of 3.93 ° (95% CI 3.46 to 4.39; P value < 0.0001). There was significant heterogeneity between these studies (I2 = 82%). This is likely to have been caused by the different populations studied and the different ages at the time of treatment.One study (n = 73, low quality evidence) reported outcomes of the use of the facemask compared to an untreated control at three years follow-up. This study showed that improvements in overjet and ANB were still present three years post-treatment. In this study, adverse effects were reported but due to the low prevalence of temporomandibular (TMJ) signs and symptoms no analysis was undertaken.Two studies (n = 90, low quality evidence) compared the chin cup with an untreated control. Both studies found a statistically significant improvement in ANB, and one study also found an improvement in the Wits appraisal. Data from these two studies were not suitable for pooling.A single study of the tandem traction bow appliance compared to untreated control (n = 30, very low quality evidence) showed a statistically significant difference in both overjet and ANB favouring the intervention group.The remaining two studies did not report the primary outcome of this review. There is some evidence that the use of a facemask to correct prominent lower front teeth in children is effective when compared to no treatment on a short-term basis. However, in view of the general poor quality of the included studies, these results should be viewed with caution. Further randomised controlled trials with long follow-up are required.

Stability of interceptive/corrective orthodontic treatment for tooth ankylosis and Class II mandibular deficiency: A case report with 10 years follow-up.

PubMed

Guimarães, Carlos Henrique; Henriques, José Fernando Castanha; Janson, Guilherme; Moura, Wilana S

2015-01-01

The purpose of this article is to present the treatment of a 8-year-old boy with tooth ankylosis in teeth 85 and Class II division 1 malocclusion and to report a 10-year follow-up result. The patient was initially treated with a sagittal removable appliance, followed by an eruption guidance appliance and braces. The interceptive orthodontic treatment performed to recover the space lost by ankylosis of a deciduous tooth allowed a spontaneous eruption and prevented progression of the problem. The use of an eruption-guidance appliance corrected the dentoskeletal Class II, thus improving the patient's appearance. Besides the treatment producing a good occlusal relationship with the Class I molar, the correction of the overjet and overbite was stable over a ten-year period.

Application of the dental aesthetic index in the prioritisation of orthodontic service needs.

PubMed

Maumela, P M; Hlongwa, P

2012-08-01

The provision of orthodontic treatment to patients in government funded training institutions is a major challenge due to constrained budget and resource allocation. The Dental Aesthetic Index (DAI) has been used to estimate orthodontic treatment need and as a screening tool to determine treatment priority. The DAI focuses on aesthetics and therefore omits other malocclusion traits that might require orthodontic treatment. The aim of the study was to compare the application of the DAI with the influence other malocclusion traits not included in the DAI might have on the determination of the prioritisation of orthodontic service need. Hundred-and-twenty pretreatment study models of orthodontic patients in the permanent dentition stage were selected from the archived records of the Department of Orthodontics, University of Limpopo, using a systematic sampling method. The study casts were assessed using the DAI. Other malocclusion traits not included in the DAI were also recorded. Descriptive statistics, the Pearson correlation coefficient, Chi-square values and t-tests were employed to analyse the data. P values less than or equal to 0,05 were considered statistically significant. The mean DAI score was 35.2. Normal or minor malocclusion was found in 19.1% of the sample, whilst 17.5% had definitive malocclusion, 21.7% severe malocclusion, and 41.7% showed handicapping malocclusion. Other malocclusion traits not included in the DAI were identified and these traits accounted for 21.6% of all traits recorded in the study (DAI malocclusion traits accounted for 78.4%). Two thirds of other malocclusion traits were accounted for in categories which the DAI had already prioritised for treatment. The study showed that the DAI can be used to prioritise orthodontic service needs and could be applied in government funded institutions.

Transforce lingual appliances pre-adjusted invisible appliances simplify treatment.

PubMed

Clark, William John

2011-01-01

Transforce lingual appliances are designed to be used in conjunction with conventional fixed appliances. Lingual arch development is normally followed by bonded fixed appliances to detail the occlusion. Alternatively Transforce appliance treatment is an efficient method of preparing complex malocclusions prior to a finishing stage with invisible appliances. This approach is ideal for adult treatment, using light continuous forces for arch development with appliances that are comfortable to wear. Sagittal and Transverse appliances are designed for arch development in a range of sizes for contracted arches. They can be used to treat all classes of malocclusion and are pre-adjusted fixed/removable devices for non-compliance treatment. Force modules with nickel titanium coil springs enclosed in a tube deliver a gentle, biocompatible continuous force with a long range of action. They are excellent for mixed dentition and ideal for adult arch development. There are multiple sizes for upper and lower arch development and a sizing chart may be placed over a study model for correct selection, eliminating the need for laboratory work.

Conservative orthodontic-prosthodontic approach for excessive gingival display: A clinical report.

PubMed

del Castillo, Rafael; Hernández, Ana M; Ercoli, Carlo

2015-07-01

A differential diagnosis of excessive gingival display is critical in determining appropriate treatment options and sequence. Anterior tooth malposition for patients with deep vertical overlap has been suggested as one of the 3 main causes of excessive gingival display. Specifically, patients with Angle class II, division 2 malocclusions show an occlusal scheme that might be responsible for additional anterior tooth wear when compared with individuals without malocclusion. In the long term, this condition can cause dentoalveolar compensation and overeruption of maxillary incisors with concomitant coronal movement of the gingival margin with excessive gingival display. A combined orthodontic and restorative treatment was proposed as a conservative treatment to reposition maxillary anterior teeth and their gingival margins to a more ideal position and create the necessary interocclusal restorative space to restore worn teeth with ceramic restorations, enhance dental and facial esthetics, and reestablish anterior guidance. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up.

PubMed

Farronato, Giampietro; Garagiola, Umberto; Carletti, Vera; Cressoni, Paolo; Mortellaro, Carmen

2011-01-01

Traditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion. A 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used. : The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives. Postsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.

Extraction of Maxillary Central Incisors: An Orthodontic-Restorative Treatment

PubMed Central

Hedayati, Zohreh; Zare, Maryam; Bahramnia, Fateme

2014-01-01

Malformed central incisors with poor prognosis could be candidates for extraction especially in crowded dental arches. This case report refers to a 12-year-old boy who suffered from malformed upper central incisors associated with severe attrition. Upper lateral incisors were positioned palatally and canines were rotated and positioned in the high buccal area. The patient had class II malocclusion and space deficiency in both dental arches. Due to incisal wear and malformed short maxillary central incisors and the need for root canal therapy with a major crown build-up, these teeth were extracted. The maxillary lateral incisors were substituted. Thus the maxillary canines were substituted for lateral incisors and the first premolars were substituted for canines. In the lower dental arch the first bicuspids were extracted. Composite resin build-up was performed on the maxillary lateral incisors and canines. This allowed for the crowding and the malocclusion to be corrected. Subsequent gingivectomy improved the patient's gingival margins and smile esthetics one month after orthodontic therapy. PMID:25400954

"Redefining smile-a multidisciplinary approach".

PubMed

Manne, Prakash; Zakkula, Srujana; Atla, Jyothi; Muvva, Suresh Babu; Sampath, Anche

2013-07-01

This article presents a case report of a 20 year old female who was very much dissatisfied with her facial appearance and smile.On examination, it was found that there was a Angles class II division 1 malocclusion and a generalised spacing in the anterior teeth, with a retained, deciduous, left maxillary canine and a malposed 15. On radiographic examination, an impacted 18, 23 was noticed. As the part of the treatment plan, the retained deciduous canine and the impacted permanent canine were extracted and an orthodontic correction of the malocclusion was accomplished. The missing canine was planned to be replaced with a fixed partial denture.The short clinical crown height of the abutment teeth was increased by crown lengthening procedures and the pontic space was contoured to receive a ovate pontic by using diode lasers. The missing tooth was restored by using an all ceramic three unit zirconia bridge. This multi-disciplinary approach improved the smile of the patient and it ultimately enhanced her aesthetics and self confidence.

“Redefining Smile-A Multidisciplinary Approach”

PubMed Central

Manne, Prakash; Zakkula, Srujana; Atla, Jyothi; Muvva, Suresh Babu; Sampath, Anche

2013-01-01

This article presents a case report of a 20 year old female who was very much dissatisfied with her facial appearance and smile.On examination, it was found that there was a Angles class II division 1 malocclusion and a generalised spacing in the anterior teeth, with a retained, deciduous, left maxillary canine and a malposed 15. On radiographic examination, an impacted 18, 23 was noticed. As the part of the treatment plan, the retained deciduous canine and the impacted permanent canine were extracted and an orthodontic correction of the malocclusion was accomplished. The missing canine was planned to be replaced with a fixed partial denture.The short clinical crown height of the abutment teeth was increased by crown lengthening procedures and the pontic space was contoured to receive a ovate pontic by using diode lasers. The missing tooth was restored by using an all ceramic three unit zirconia bridge. This multi–disciplinary approach improved the smile of the patient and it ultimately enhanced her aesthetics and self confidence. PMID:23998114

Malocclusion of teeth (image)

MedlinePlus

Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). Malocclusion is the most common reason for referral to an orthodontist. Most malocclusion is mild enough not to ...

Effects of the pendulum appliance, cervical headgear, and 2 premolar extractions followed by fixed appliances in patients with Class II malocclusion.

PubMed

de Almeida-Pedrin, Renata Rodrigues; Henriques, José Fernando Castanha; de Almeida, Renato Rodrigues; de Almeida, Marcio Rodrigues; McNamara, James A

2009-12-01

In this retrospective study, we compared the cephalometric effects, the dental-arch changes, and the efficiency of Class II treatment with the pendulum appliance, cervical headgear, or extraction of 2 maxillary premolars, all associated with fixed appliance therapy. The sample of 82 patients with Class II malocclusion was divided into 3 groups: group 1 patients (n = 22; treatment time, 3.8 years) were treated with the pendulum appliance and fixed orthodontic appliances. Group 2 patients (n = 30; treatment time, 3.2 years) were treated with cervical headgear followed by fixed appliances; group 3 patients (n = 30; treatment time, 2.1 years) were treated with 2 maxillary premolar extractions and fixed appliances. The average starting ages of the groups ranged from 13.2 to 13.8 years. Data were obtained from serial cephalometric measurements and dental casts. The dental casts were analyzed with the treatment priority index. The treatment efficiency index was also used. The 3 treatment protocols produced similar cephalometric effects, especially skeletally. Comparisons among the 2 distalizing appliances (pendulum and cervical headgear) and extraction of 2 maxillary premolars for Class II treatment showed changes primarily in the maxillary dentoalveolar component and dental relationships. The facial profile was similar after treatment, except for slightly more retrusion of the upper lip in the extraction patients. The treatment priority index demonstrated that occlusal outcomes also were similar among the groups. The treatment efficiency index had higher values for the extraction group. The effects of treatment with the pendulum appliance or cervical headgear and extraction of 2 maxillary premolars associated with fixed appliances were similar from both occlusal and cephalometric standpoints. Class II treatment with extraction of maxillary teeth was more efficient because of the shorter treatment time. Differences in maxillary incisor retraction should be noted, but these differences might have been due to greater maxillary dentoalveolar protrusion in the extraction group before treatment.

Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis

PubMed Central

Zymperdikas, Vasileios F.; Koretsi, Vasiliki; Papageorgiou, Spyridon N.

2016-01-01

Summary Objective: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. Search methods: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. Selection criteria: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. Data collection and analysis: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. Results: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = −0.83 degree/year, 95 % CI: −1.17 to −0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30–1.43), and moderate decrease of ANB angle (MD = −1.74 degree/year, 95 % CI: −2.50 to −0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. Conclusions: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal. PMID:25995359

Quantitative assessment of the effectiveness of phase 1 orthodontic treatment using the American Board of Orthodontics Discrepancy Index.

PubMed

Vasilakou, Nefeli; Araujo, Eustaquio A; Kim, Ki Beom; Oliver, Donald R

2016-12-01

This retrospective study included a sample of 300 randomly selected patients from the archived records of Saint Louis University's graduate orthodontic clinic, St. Louis, Mo, from 1990 to 2012. The objective of this study was to quantify the changes obtained in phase 1 of orthodontic treatment and determine how much improvement, if any, has occurred before the initiation of the second phase. For the purpose of this study, prephase 1 and prephase 2 records of 300 subjects were gathered. All were measured using the American Board of Ortodontics Discrepancy Index (DI), and a score was given for each phase. The difference of the 2 scores indicated the quantitative change of the complexity of the treatment. Paired t tests were used to compare the scores. Additionally, the sample was categorized into 3 groups according to the Angle classifications, and the same statistics were used to identify significant changes between the 2 scores. Analysis of variance was applied to compare the 3 groups and determine which had the most change. Percentages of change were calculated for the significant scores. The total DI score overall and the scores of all 3 groups were significantly reduced from before to after phase 1. Overall, 42% improvement was observed. The Class I group showed 49.3% improvement, the Class II group 34.5% and the Class III group 58.5%. Most components of the DI improved significantly, but a few showed negative changes. Significant reductions of DI scores were observed in the total sample and in all Angle classification groups. This indicates that early treatment reduces the complexity of the malocclusions. Only 2 components of the DI showed statistically significant negative changes. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Comparison of K-loop Molar Distalization with that of Pendulum Appliance - A Prospective Comparative Study.

PubMed

Shashidhar, Nagam Reddy; Reddy, S Rama Koteswara; Rachala, Madhukar Reddy

2016-06-01

Molar distalization is the non extraction method of managing Class II malocclusions. The purpose of this study was to evaluate the skeletal and dentoalveolar effects of maxillary molar distalization with K-loop appliance, and to compare these effects with that of pendulum group. Class I and dental Class II malocclusions were divided into two groups of 15 each: In Group 1 (nine females and six males; mean age, 16.0±2.6 years) patients were treated with K-Loop molar distalization supported palatally by Nance button, while in Group 2 (seven females and eight males; mean age, 15.4±4.7 years), the patients were treated with conventional pendulum appliance. Standardized lateral cephalograms were taken at the beginning of treatment (T0) and at the end of molar distalization (T1) and the changes were statistically analyzed with paired t-test. The results showed no statistically significant difference in the amount of molar distalization in either of the appliance groups: the mean amount of molar distal movement of 5.1±0.8 mm and 4.93±1.68 mm was observed in the Group 1 and 2 respectively. The incisors moved mesially by 1.3±0.63 mm in Group 1 and 1.57±0.58 mm in Group 2. K-Loop molar distalizing appliance has similar skeletal and dentoalveolar effects as that of pendulum appliance, with the advantages of simple yet efficient to control the moment-force ratio to produce all types of tooth movements and also requires minimal patient co-operation.

[Clinical study of extraction treatment of Class II division I malocclusion with Empower self-ligating brackets].

PubMed

Chen, Xi-hua; Hua, Yong-mei; Xie, Xing-qian; Yu, Xiao-jia; Wang, Jian; Liu, Li-ming

2013-06-01

To evaluate and compare the treatment efficiency of Empower interactive self-ligating brackets and traditional brackets in Class II division I extraction patients. Forty patients with Class II division I malocclusion were randomly divided into 2 groups. Twenty patients received Empower self-ligating technique (group A) and the other 20 patients received MBT technique (group B). Four first premolars were extracted and without any other anchorage devices added in both groups. The duration of treatment, the number of visits and chair-side time were recorded. Cephalometric analysis was performed before and after treatment. The data was analyzed with SPSS 13.0 software package for paired t test. Treatment time and number of visits in group A were more than in group B, but there was no significant difference between the 2 groups. Chair-side time in group A reduced 151.15s on average compared with group B. Significant changes were observed in both groups after treatment. Upper and lower anterior teeth retracted and convex profile improved.U1-SN, U1-NA, L1-MP, L1-NB, UI-PTV, LI-PTV, UL-EP, LL-EP decreased. Significant differences were found in UM-PTV between the 2 groups(P<0.05). Compared with traditional brackets, Empower self-ligating brackets can save chair-side time, control anterior teeth torque and posterior teeth anchorage effectively, but can not reduce the treatment time or number of visits. Supported by Youth Research Project of Shanghai Municipal Health Bureau(2010Y155).

Correlation of Orthodontic Treatment by Fixed or Myofunctional Appliances and Periodontitis: A Retrospective Study.

PubMed

Sharma, Kanchan; Mangat, Sukhpreet; Kichorchandra, Modi S; Handa, Akash; Bindhumadhav, Suresh; Meena, Meenakshi

2017-04-01

Malocclusion plays an important role in the development of periodontitis. Thus, by treating malocclusion, a good gingival health can be achieved. This study was conducted to establish the correlation between orthodontic tooth movement and periodontitis. This is a retrospective study conducted on 220 patients who underwent orthodontic treatment for malocclusion. They were divided into two groups: Group I patients were treated with fixed orthodontics, while group II patients received myofunctional appliances. The value for plaque, gingival recession, and tooth mobility significantly increased in group I patients. However, the difference was statistically nonsignificant in group II patients. The authors concluded that there is correlation between malocclusion and periodontitis. Malocclusion leads to periodontitis. Malocclusion is the main reason for the development of poor periodontal health. Combined effort has to be played by both periodontist and orthodontist for the treatment of various orthodontic-periodontal problems.

Psychosocial implications of malocclusion among 12-18 year old secondary school children in Ibadan, Nigeria.

PubMed

Onyeaso, C O; Sanu, O O

2005-03-01

The main purpose of this study was to analyze the current psychosocial implications of malocclusion in Ibadan, Nigeria. The study sample comprised 614 secondary school children (327 males and 287 females) aged 12-18 years (mean age, 14.9 +/- 2.9 SD) who filled in a questionnaire containing general questions about body image and specific inquires concerning self-perception and social implications of dental appearance. The children's occlusions were also assessed using the Dental Aesthetic Index (DAI) and the malocclusion traits related to body image, self-perception, and social implications of dental appearance. Subjects with malocclusion rated only the teeth significantly least satisfactory among other twelve items of body image. The lowest rating was observed in subjects with crowding of the maxillary and mandibular incisor segments. Highly significant differences (P < 0.001) were found between subjects with normal or minor malocclusion and those with marked malocclusion in indicating awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavourable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred significantly more often in the presence of malocclusion (P < 0.001). Unfavourable perceptions of the teeth were expressed significantly more often by subjects with anterior maxillary irregularities of up to 1 mm and more, spacing of both maxillary and mandibular incisor segments, midline diastema, crowding (especially of the mandibular incisor segment), anterior open bite and molar relation deviations. It was concluded that certain malocclusions, especially occlusal and space anomalies, may adversely affect body image and self-concept of Nigerian adolescents.

Validation and reliability of the Malaysian English version of the psychosocial impact of dental aesthetics questionnaire for adolescents.

PubMed

Wan Hassan, Wan Nurazreena; Yusof, Zamros Yuzadi Mohd; Makhbul, Mohd Zambri Mohamed; Shahidan, Siti Safuraa Zahirah; Mohd Ali, Siti Farhana; Burhanudin, Rashidah; Gere, Maria Jirom

2017-03-21

The Malay version of the Psychosocial Impact of Dental Aesthetics Questionnaire has been validated for use by Malaysian adolescents. Although Malay is their national language, English is widely used as the lingua franca among Malaysians of different ethnicities. This study aimed to validate an English version of the PIDAQ adapted for use by Malaysian adolescents to optimize data capture from adolescents who prefer English as the medium for communication. The published English version of PIDAQ was pilot tested on 12- to 17-year-old adolescents, resulting in a few modifications to suit the Malaysian variety of English. Psychometric properties were tested on 393 adolescents who attended orthodontic practices and selected schools. Malocclusion was assessed using the Malocclusion Index, an aggregation of Perception of Occlusion Scale and the Aesthetic Component of the Index of Orthodontic Treatment Need, by the subjects (MI-S) and investigators (MI-D). Data were analysed for internal consistency and age-associated invariance, discriminant, construct and criterion validities, reproducibility and floor and ceiling effects using AMOS v.20 and SPSS v.20. The item Don't like own teeth on video of the Aesthetic Concern (AC) subscale was not relevant to a large proportion of participants (11.7%). Therefore, it was removed and the Malaysian English PIDAQ was analysed based on 22 items instead of 23 items. Confirmatory factor analysis showed good fit statistics (comparative fit index: 0.902, root-mean-square error of approximation: 0.066). Internal consistency was good for the Dental Self-Confidence, Social Impact and Psychological Impact subscales (Cronbach's alpha: 0.70-0.95) but lower (0.52-0.62) though acceptable for the AC subscale as it consisted of only 2 items. The reproducibility test was acceptable (intra-class correlations: 0.53-0.78). For all PIDAQ subscales, the MI-S and MI-D scores of those with severe malocclusion differed significantly from those with no or slight malocclusion. There were significant associations between the PIDAQ subscales with ranking of perceived dental appearance, need for braces and impact of malocclusion on daily activities. There were no floor or ceiling effects. The adapted Malaysian English PIDAQ demonstrated adequate psychometric properties that are valid and reliable for assessment of psychological impacts of dental aesthetics among Malaysian adolescents.

Studying the Prevalence and Etiology of Class II Subdivision Malocclusion Utilizing Cone-Beam Computed Tomography

DTIC Science & Technology

2013-04-24

Department/Center: Air Force Postgraduate Dental School (AFPDS), Tri- Service Orthodontic Dental School 4. Phone: (21 0) 292-9038 5. Type of clearance...June 2013 CHAIR OR DEPARTMENT HEAD APPROVAL 1. Name: Curtis M. Marsh, Col, USAF, DMD 2. School/Dept. : AFPDS/Tri-Service Orthodontic Dental School...SCHOOL ORTHODONTIC FLIGHT 2133 PEPPERRELL STREET, BLDG 3352 JOINT BASE SAN ANTONIO- LACKLAND TEXAS 78236-5345 The author hereby certifies that the use

Dental attrition and associated factors in adolescents 14 to 19 years of age: a pilot study.

PubMed

Casanova-Rosado, Juan F; Medina-Solís, Carlo E; Vallejos-Sánchez, Ana A; Casanova-Rosado, Alejandro J; Maupomé, Gerardo; Avila-Burgos, Leticia

2005-01-01

This cross-sectional study evaluated the relationship between attrition and diverse variables in 390 Mexican adolescents aged 14 to 19 years. An ordinal scoring system was used to describe the severity of attrition. Attrition prevalence was 33.3% and was associated with older age, presence of defective restorations, Class II malocclusion, and perception of stress level. Our results suggest that attrition is present in 1 of every 3 adolescents.

Treatment effects of the Jasper Jumper and the Bionator associated with fixed appliances.

PubMed

Neves, Leniana Santos; Janson, Guilherme; Cançado, Rodrigo Hermont; de Lima, Karina Jerônimo Rodrigues Santiago; Fernandes, Thaís Maria Freire; Henriques, José Fernando Castanha

2014-01-01

The aim of this study was to evaluate the effects of Class II malocclusion treatment with the Jasper Jumper and the Bionator, associated with fixed appliances. The sample comprised 77 young individuals divided into 3 groups: Group 1 consisted of 25 patients treated with the Jasper Jumper appliance associated with fixed appliances for a mean period of 2.15 years; group 2 had 30 patients, treated with the Bionator and fixed appliances, for a mean treatment time of 3.92 years; and the control group included 22 subjects followed for a mean period of 2.13 years. The initial and final lateral cephalograms of the patients were evaluated. Intergroup comparison at the initial stage and of the treatment changes were performed by analysis of variance. Their effects consisted in a restrictive effect on the maxilla, a slight increase in anterior face height, retrusion and extrusion of the maxillary incisors, labial tipping and protrusion of the mandibular incisors in both groups and intrusion with the Jasper Jumper appliance, maxillary molar distalization with the Jasper Jumper, extrusion and mesialization of the mandibular molars, both appliances provided significant improvement of the maxillomandibular relationship, overjet, overbite and molar relationship. The effects of both appliances in class II malocclusion treatment are similar; however, treatment with the Jasper Jumper was shorter than with the Bionator.

Dental and skeletal components of Class II open bite treatment with a modified Thurow appliance

PubMed Central

Jacob, Helder Baldi; dos Santos-Pinto, Ary; Buschang, Peter H.

2014-01-01

Introduction Due to the lack of studies that distinguish between dentoalveolar and basal changes caused by the Thurow appliance, this clinical study, carried out by the School of Dentistry - State University of São Paulo/Araraquara, aimed at assessing the dental and skeletal changes induced by modified Thurow appliance. Methods The sample included an experimental group comprising 13 subjects aged between 7 and 10 years old, with Class II malocclusion and anterior open bite, and a control group comprising 22 subjects similar in age, sex and mandibular plane angle. Maxillary/mandibular, horizontal/vertical, dental/skeletal movements (ANS, PNS, U1, U6, Co, Go, Pog, L1, L6) were assessed, based on 14 landmarks, 8 angles (S-N-ANS, SNA, PPA, S-N-Pog, SNB, MPA, PP/MPA, ANB) and 3 linear measures (N-Me, ANS-Me, S-Go). Results Treatment caused significantly greater angle decrease between the palatal and the mandibular plane of the experimental group, primarily due to an increase in the palatal plane angle. ANB, SNA and S-N-ANS angles significantly decreased more in patients from the experimental group. PNS was superiorly remodeled. Lower face height (ANS-Me) decreased in the experimental group and increased in the control group. Conclusions The modified Thurow appliance controlled vertical and horizontal displacements of the maxilla, rotated the maxilla and improved open bite malocclusion, decreasing lower facial height. PMID:24713556

Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in class II malocclusion: a systematic review and meta-analysis.

PubMed

Raposo, R; Peleteiro, B; Paço, M; Pinho, T

2018-04-01

This systematic review was performed to compare dental, skeletal, and aesthetic outcomes between orthodontic camouflage and surgical-orthodontic treatment, in patients with a skeletal class II malocclusion and a retrognathic mandible who have already finished their growth period. A literature search was conducted, and a modified Downs and Black checklist was used to assess methodological quality. The meta-analysis was conducted using the DerSimonian-Laird random-effects method to obtain summary estimates of the standardized mean differences and corresponding 95% confidence intervals. Nine articles were included in the qualitative synthesis and seven in the meta-analysis. The difference between treatments was not statistically significant regarding SNA angle, linear measurement of the lower lip to Ricketts' aesthetic line, convexity of the skeletal profile, or the soft tissue profile excluding the nose. In contrast, surgical-orthodontic treatment was more effective with regard to ANB, SNB, and ML/NSL angles and the soft tissue profile including the nose. Different treatment effects on overjet and overbite were found according to the severity of the initial values. These results should be interpreted with caution, due to the limited number of studies included and because they were non-randomized clinical trials. Further studies with larger sample sizes and similar pre-treatment conditions are needed. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Treatment stability with the eruption guidance appliance.

PubMed

Janson, Guilherme; Nakamura, Alexandre; Chiqueto, Kelly; Castro, Renata; de Freitas, Marcos Roberto; Henriques, José Fernando Castanha

2007-06-01

Although the eruption guidance appliance has been used to correct Class II malocclusions for many years and its effects have been demonstrated, there is no study on the stability of the changes it produces. Therefore, the objective of this study was to investigate the long-term stability of cephalometric dentoskeletal and occlusal changes after eruption guidance appliance therapy. Thirty-nine patients were evaluated. Occlusal evaluations were made with the peer asseessment rating index, and anterior tooth irregularity was evaluated with the Little irregularity index. Cephalometric and occlusal data were obtained at pretreatment, posttreatment, and postretention. The data were analyzed by dependent 1-way analysis of variance (ANOVA) for comparison between the 3 stages of the experimental group, with the Newman-Keuls test as a second step. To compare the cephalometric experimental group changes with mean population changes, the t test was used. Cephalometrically, in the postretention stage, overjet remained stable, overbite showed significant relapse, and molar relationship improved toward a Class I relationship. The peer asseessment rating index showed stability of the occlusion. The Little irregularity index demonstrated a statistically significant relapse of crowding in the postretention stage. Cephalometrically, overjet and molar relationship were stable in the long term after treatment with the eruption guidance appliance; however, there was relapse of the overbite. Occlusally, correction of the malocclusion elevated by the peer assessment rating was stable. There was relapse of the anterior teeth crowding.

A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report.

PubMed

Gelpi, Federico; De Santis, Daniele; Marconcini, Simone; Briguglio, Francesco; Finotti, Marco

2015-12-01

This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgical corticotomy and implantology (both performed with a piezo device). A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in the final outcome of treatment. In fact a dental class I occlusion has been established only on the right side. The left side could not be restored to an ideal class I relationship due to the pontic prosthesis. The original collapsed right posterior occlusion was corrected. A stable posterior occlusion was established, and the balancing interference was eliminated. Centric relation and centric occlusion were established at the same vertical dimension of occlusion. The cephalometric analysis and clinical aspect at the end of treatment showed that the patient had improvements in overbite and overjet.Multidisciplinary management, including endodontic and restorative dentistry, periodontics, corticotomy-assisted orthodontics, implants, and prosthetics, was used for a young female patient with multiple missing teeth, anterior deep bite, and a malocclusion with cant of the occlusal plane. The interaction of interdisciplinary specialties and careful treatment planning were required. The patient also benefited esthetically from our effort.

Oral health evaluation in special needs individuals

PubMed Central

Pini, Danielle de Moraes; Fröhlich, Paula Cristina Gil Ritter; Rigo, Lilian

2016-01-01

ABSTRACT Objective To identify the prevalence of the main oral problems present in special needs children and to relate the underlying conditions with the clinical and demographic variables. Methods The study was based on the physical examination of 47 students from the Associação de Pais e Amigos dos Excepcionais diagnosed as Down syndrome, cerebral palsy and intellectual deficit. For data collection, we used a self-administered questionnaire that included indices of dental caries and oral hygiene, Angle classification, malposition of dental groups and oral hygiene habits. Results The predominant age group was 12-25 years (46.8%) and most patients were male (55.3%). Regarding daily brushing, 63.8% reported brushing their teeth three times a day, and 85.1% did it by themselves. A total of 48.9% were rated as Angle class I, and 25.5% had no type of malocclusion. A high dental carries index (decayed, missing, filled >10) was observed in 44.7%, and 53.2% had inadequate oral hygiene (zero to 1.16). There was a statistically significant difference between cerebral palsy and the act of the participants brushing their teeth by themselves. Conclusion There was a high decayed-missing-filled teeth index and malocclusion class I, as well as inadequate oral hygiene. The type of underlying condition of the participants influenced the act of brushing teeth by themselves. PMID:28076597

[Breast-feeding, bottle-feeding, sucking habits and malocclusion in Brazilian preschool children].

PubMed

Leite-Cavalcanti, Alessandro; Medeiros-Bezerra, Priscila K; Moura, Cristiano

2007-01-01

This study was aimed at verifying the prevalence of nutritive (breast-feeding and bottle-feeding) and non-nutritive sucking habits and the presence of malocclusion in Brazilian preschool children. The study was a cross-sectional oral health survey of 342 children (196 boys and 146 girls) between the ages of 3 and 5 in Campina Grande, Brazil. The data was collected by interviews with the children's mothers or minders and by clinical examinations carried out by a calibrated examiner (kappa = 0,86). Descriptive statistics using the EPI-INFO Program (version 3.3) and Chi-square test at 0.05 probability level were produced. Sucking habit prevalence was very high in all groups, ranging from 70 % to 77,4 %. Malocclusion was present in 87 %, dummy use in 84,8 % and finger-sucking in 7,2 %. About 84,2 % of the children had a history of bottle-feeding and 79,9 % showed some evidence of malocclusion at the time of dental examination. There were significant differences for the following variables: sucking habits and malocclusion; breast-feeding time and sucking habits; breast-feeding time and malocclusion; type of feeding and sucking habits; and type of feeding and malocclusion. Dummy-sucking incidence was higher than that of finger-sucking in Brazilian children. Sucking habit incidence was higher in bottle-fed children than in breast-fed children. The relationship between incidence of habits and malocclusion was statistically significant.

Cephalometric study of Class II Division 1 patients treated with an extended-duration, reinforced, banded Herbst appliance followed by fixed appliances.

PubMed

Tomblyn, Travis; Rogers, Michael; Andrews, Lee; Martin, Chris; Tremont, Timothy; Gunel, Erdogan; Ngan, Peter

2016-11-01

The Herbst appliance has been used in the treatment of Class II malocclusions with deficient mandibles. Various protocols, including different durations of the orthopedic treatment phase and stepwise advancement of the mandible, have been advocated for increasing the orthopedic effects. The objective of this study was to investigate the skeletal and dental changes in patients treated with a reinforced banded Herbst appliance for an extended duration and fixed appliance therapy. The study group consisted of 30 patients (16 boys, 14 girls; mean age, 12.3 ± 2.5 years) with Class II Division 1 malocclusions who were successfully treated with the new Herbst protocol followed by fixed appliances. Lateral cephalometric radiographs were taken before treatment, at the completion of Herbst treatment, and after removal of fixed appliances. The average treatment times were 1.5 ± 0.7 years for the Herbst treatment and 1.8 ± 0.5 years for the fixed appliances. A control Class II sample from the Bolton-Brush study was used to subtract growth from treatment changes to determine the appliance effect. Data were analyzed using analysis of variance and the Tukey-Kramer test. After the Herbst treatment, the incisal relationships of all subjects had been overcorrected to end-to-end relationships. Overjet was reduced by 7.2 mm after subtracting changes from growth. The skeletal contribution was 2.5 mm (35%), and the dental contribution was 4.7 mm (65%). The molar relationship was overcorrected to a more Class I relationship by 7.5 mm. The Wits appraisal was improved by 4.2 mm. Vertically, overbite was decreased by 3.3 mm. The maxillary and mandibular molars were extruded by 1 mm. The occlusal plane rotated clockwise by 5° with little change in the mandibular plane angle. After the treatment with fixed appliances, the overjet correction was maintained at 7.6 mm. The skeletal contribution was 2.9 mm (38%), and the dental contribution was 4.7 mm (62%). The molar relationship was corrected to a Class I relationship by 5.9 mm. The Wits appraisal was improved by 3.2 mm. Vertically, overbite was decreased by 4.2 mm. The maxillary and mandibular molars were extruded by 0.3 and 0.8 mm, respectively. The occlusal plane rotated clockwise by 1.2° with little change in the mandibular plane angle. Doubling the usual orthopedic treatment time with the reinforced Herbst appliance followed by fixed appliance therapy was effective in correcting Class II Division 1 malocclusions with excess overjet and overbite. In this sample of successfully treated patients, most changes after Herbst and fixed appliance therapy were dentoalveolar (62%). However, the skeletal changes attained in the orthopedic phase of treatment were maintained after fixed appliance therapy. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Severity of malocclusion in adolescents: populational-based study in the north of Minas Gerais, Brazil

PubMed Central

Silveira, Marise Fagundes; Freire, Rafael Silveira; Nepomuceno, Marcela Oliveira; Martins, Andrea Maria Eleutério de Barros Lima; Marcopito, Luiz Francisco

2016-01-01

ABSTRACT OBJECTIVE To identify the factors associated with severity of malocclusion in a population of adolescents. METHODS In this cross-sectional population-based study, the sample size (n = 761) was calculated considering a prevalence of malocclusion of 50.0%, with a 95% confidence level and a 5.0% precision level. The study adopted correction for the effect of delineation (deff = 2), and a 20.0% increase to offset losses and refusals. Multistage probability cluster sampling was adopted. Trained and calibrated professionals performed the intraoral examinations and interviews in households. The dependent variable (severity of malocclusion) was assessed using the Dental Aesthetic Index (DAI). The independent variables were grouped into five blocks: demographic characteristics, socioeconomic condition, use of dental services, health-related behavior and oral health subjective conditions. The ordinal logistic regression model was used to identify the factors associated with severity of malocclusion. RESULTS We interviewed and examined 736 adolescents (91.5% response rate), 69.9% of whom showed no abnormalities or slight malocclusion. Defined malocclusion was observed in 17.8% of the adolescents, being severe or very severe in 12.6%, with pressing or essential need of orthodontic treatment. The probabilities of greater severity of malocclusion were higher among adolescents who self-reported as black, indigenous, pardo or yellow, with lower per capita income, having harmful oral habits, negative perception of their appearance and perception of social relationship affected by oral health. CONCLUSIONS Severe or very severe malocclusion was more prevalent among socially disadvantaged adolescents, with reported harmful habits and perception of compromised esthetics and social relationships. Given that malocclusion can interfere with the self-esteem of adolescents, it is essential to improve public policy for the inclusion of orthodontic treatment among health care provided to this segment of the population, particularly among those of lower socioeconomic status. PMID:27143611

Association between maternal education and malocclusion in Mongolian adolescents: a cross-sectional study

PubMed Central

Tumurkhuu, Tsasan; Fujiwara, Takeo; Komazaki, Yuko; Kawaguchi, Yoko; Inazawa, Johji; Ganburged, Ganjargal; Bazar, Amarsaikhan; Ogawa, Takuya; Moriyama, Keiji

2016-01-01

Objective Malocclusion is a highly prevalent condition, affecting 20–60% of adolescents worldwide. Although its treatment is often expensive and unaffordable for disadvantaged individuals, few studies have examined the relationship between malocclusion and socioeconomic status. We investigated the prevalence of malocclusion among Mongolian adolescents and its association with maternal education in a community-based sample in Mongolia. Design Cross-sectional study. Settings 2 large secondary schools with different backgrounds in Ulaanbaatar, Mongolia. Participants Complete dental casts of 557 randomly recruited Mongolian schoolchildren aged 11–16 years were evaluated using the Dental Health Component of the Index of Orthodontic Treatment Need to dichotomise orthodontic treatment requirements. Exclusion criteria were the presence of orthodontic treatment history and absence of maternal educational status. Questionnaires were administered to caregivers to assess socioeconomic status. Poisson regression analysis was performed to examine the association between malocclusion and maternal educational status. Results The prevalence of malocclusion requiring orthodontic treatment among all adolescents was 35.2% (95% CI 31.2 to 39.2). In the unadjusted analysis, the prevalence ratio (PR) for malocclusion was higher (PR=1.46; 95% CI 0.96 to 2.20) among adolescents of mothers with a high educational background than among those of mothers with a low educational background. After adjusting for covariates, the PR remained significantly higher (PR=1.72; 95% CI 1.06 to 2.82) among adolescents of mothers with a high educational background. Other socioeconomic status variables, including family income and the educational level of the father, showed no association with malocclusion. Conclusions These findings suggest that malocclusion requiring orthodontic treatment in adolescents is more prevalent among children of mothers with high levels of education. Further studies are needed to clarify the behavioural factors and environmental circumstance that contribute to this. PMID:27803108

Orthodontic management by functional activator treatment: a case report.

PubMed

Aprile, Giuseppe; Ortu, Eleonora; Cattaneo, Ruggero; Pietropaoli, Davide; Giannoni, Mario; Monaco, Annalisa

2017-12-02

Managing orthodontic treatment is often very difficult for the orthodontist. Many devices are used during the orthopedic phase of orthodontic treatment, always with different functions. We describe a case of orthodontic management treated with the Equilibrator O.S.A. device (equilibrator designed by Ovidi, Santi, and Aprile for Eptamed SRL; Cesena, Italy; www.eptamed.com ). A healthy 10-year-old white boy presented with a skeletal class II, division 1 malocclusion, molar class II, exhibiting an overjet of 7 mm prior to treatment. For treatment, we only used the Equilibrator O.S.A. device. We successfully treated an orthopedic/orthodontic case with a particular device that we describe here.

Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study.

PubMed

Kataoka, Kota; Ekuni, Daisuke; Mizutani, Shinsuke; Tomofuji, Takaaki; Azuma, Tetsuji; Yamane, Mayu; Kawabata, Yuya; Iwasaki, Yoshiaki; Morita, Manabu

2015-01-01

Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students. Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire. The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22-3.93) and underweight (BMI <18.5 kg/m(2)) (OR 1.89; 95% CI, 1.31-2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males. Awareness of clenching and underweight were related to malocclusion (crowding) in university male students.

Association Between Self-Reported Bruxism and Malocclusion in University Students: A Cross-Sectional Study

PubMed Central

Kataoka, Kota; Ekuni, Daisuke; Mizutani, Shinsuke; Tomofuji, Takaaki; Azuma, Tetsuji; Yamane, Mayu; Kawabata, Yuya; Iwasaki, Yoshiaki; Morita, Manabu

2015-01-01

Objectives Bruxism can result in temporomandibular disorders, oral pain, and tooth wear. However, it is unclear whether bruxism affects malocclusion. The aim of this study was to examine the association between self-reported bruxism and malocclusion in university students. Methods Students (n = 1503; 896 men and 607 women) aged 18 and 19 years were examined. Malocclusion was defined using a modified version of the Index of Orthodontic Treatment Need. The presence of buccal mucosa ridging, tooth wear, dental impression on the tongue, palatal/mandibular torus, and the number of teeth present were recorded, as well as body mass index (BMI). Additional information regarding gender, awareness of bruxism, orthodontic treatment, and oral habits was collected via questionnaire. Results The proportion of students with malocclusion was 32% (n = 481). The awareness of clenching in males with malocclusion was significantly higher than in those with normal occlusion (chi square test, P < 0.01). According to logistic regression analysis, the probability of malocclusion was significantly associated with awareness of clenching (odds ratio [OR] 2.19; 95% confidence interval [CI], 1.22–3.93) and underweight (BMI <18.5 kg/m2) (OR 1.89; 95% CI, 1.31–2.71) in males but not in females. In subgroup analyses, the probability of crowding was also significantly associated with awareness of clenching and underweight (P < 0.01) in males. Conclusions Awareness of clenching and underweight were related to malocclusion (crowding) in university male students. PMID:25865057

Invisible Cost Effective Mechanics for Anterior Space Closure.

PubMed

Jumle, Aatish Vinod; Bagrecha, Saurabh; Gharat, Ninad; Misal, Abhijit; Toshniwal, N G

2015-01-01

The shifting paradigm towards invisible orthodontic treatment and also awareness in patients has allured their focus towards the most esthetic treatment approach. Also the lingual treatment is proved successful and is very well accepted by the patients. The problem that persist is its high expenses, which is not affordable by all patients. This article is a effort to treat a simple Class I malocclusion with anterior spacing using a simple, esthetic, Cost effective approach with acceptable results when esthetics plays a priority role.

Comparison of K-loop Molar Distalization with that of Pendulum Appliance - A Prospective Comparative Study

PubMed Central

Shashidhar, Nagam Reddy; Reddy, S.Rama Koteswara

2016-01-01

Introduction Molar distalization is the non extraction method of managing Class II malocclusions. Aim The purpose of this study was to evaluate the skeletal and dentoalveolar effects of maxillary molar distalization with K-loop appliance, and to compare these effects with that of pendulum group. Materials and Methods Class I and dental Class II malocclusions were divided into two groups of 15 each: In Group 1 (nine females and six males; mean age, 16.0±2.6 years) patients were treated with K-Loop molar distalization supported palatally by Nance button, while in Group 2 (seven females and eight males; mean age, 15.4±4.7 years), the patients were treated with conventional pendulum appliance. Standardized lateral cephalograms were taken at the beginning of treatment (T0) and at the end of molar distalization (T1) and the changes were statistically analyzed with paired t-test. Results The results showed no statistically significant difference in the amount of molar distalization in either of the appliance groups: the mean amount of molar distal movement of 5.1±0.8 mm and 4.93±1.68 mm was observed in the Group 1 and 2 respectively. The incisors moved mesially by 1.3±0.63 mm in Group 1 and 1.57±0.58 mm in Group 2. Conclusion K-Loop molar distalizing appliance has similar skeletal and dentoalveolar effects as that of pendulum appliance, with the advantages of simple yet efficient to control the moment-force ratio to produce all types of tooth movements and also requires minimal patient co-operation. PMID:27504403

Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: A systematic review and meta-analysis.

PubMed

Xiang, MingLi; Hu, Bo; Liu, Yang; Sun, Jicheng; Song, Jinlin

2017-06-01

The purpose of the study was to evaluate the treatment effects of functional appliances (FAs) on upper airway dimensions in growing Class II patients with mandibular retrognathism. Five databases and the references of identified articles were electronically searched for relevant studies that met our eligibility criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The effects of FAs on airway dimensions were combined by meta-analysis using the RevMan and STATA software. Seven studies (177 treated patients with mean age: 11.48 years and 153 untreated controls with mean age: 11.20 years) were included in this review. Compared to the control group, the oropharyngeal dimensions in the treatment group subjects were significantly increased at the superior pharyngeal space (MD = 1.73 mm/year, 95% CI, 1.13-2.32 mm, P < 0.00001), middle pharyngeal space (MD = 1.68 mm/year, 95% CI, 1.13-2.23 mm, P < 0.00001) and inferior pharyngeal space (MD = 1.21 mm/year, 95% CI, 0.48-1.95 mm, P = 0.001). No significant differences were found in nasopharyngeal and hypopharyngeal dimensions and the position of hyoid bone (P > 0.05). Soft palate length and soft palate inclination were improved significantly in the treatment group (P < 0.05). The results showed that FAs can enlarge the upper airway dimensions, specifically in the oropharyngeal region, in growing subjects with skeletal Class II malocclusion. The early intervention for mandibular retrognathism with FAs may help enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of malocclusion or orthodontic treatment on oral health-related quality of life in adults

PubMed Central

Kang, Jang-Mi

2014-01-01

Objective The purpose of this study was to evaluate the effect of malocclusion or orthodontic treatment on oral health-related quality of life (OHRQoL) in adults. Methods The sample consisted of 860 adults (378 men and 482 women, aged 18-39 years) who were clinically evaluated for malocclusion or orthodontic treatment experience. Participants were divided into 4 groups as follows: normal occlusion, malocclusion, fixed treatment, and retention. OHRQoL was assessed with the short form of the Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Results The malocclusion group and the fixed treatment group had significantly higher OHIP-14 scores than the normal occlusion group and the retention group (p < 0.001). The malocclusion group had the highest PIDAQ score, while the normal occlusion group and the retention group had the lowest PIDAQ score (p < 0.001). Women had higher OHIP-14 and PIDAQ scores than men. A significant positive correlation was found between OHIP-14 and PIDAQ scores (p < 0.01). Conclusions Malocclusion has a negative impact on OHRQoL, but this could be improved in adults through orthodontic treatment. These OHRQoL questionnaires can provide additional useful information on specific aspects of orthodontic patients' psychological state. PMID:25473646

Fixed-functional appliance treatment combined with growth hormone therapy.

PubMed

Jung, Min-Ho

2017-09-01

The purpose of this study was to illustrate the effects of growth hormone (GH) therapy and fixed functional appliance treatment in a 13-year-old Class II malocclusion patient without GH deficiency. GH has been shown to effectively increase endochondral growth and induce a more prognathic skeletal pattern. Although a major concern in Class II retrognathic patients is chin deficiency, long-term studies have shown that the mandibular growth enhancement effects of functional appliances are clinically insignificant. This case report demonstrates that the mandible grew significantly during fixed functional appliance treatment combined with GH therapy, with stable results during 2 years 11 months of retention. More studies are needed to evaluate GH therapy as a supplement in Class II treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

A tensor analysis to evaluate the effect of high-pull headgear on Class II malocclusions.

PubMed

Ngan, P; Scheick, J; Florman, M

1993-03-01

The inaccuracies inherent in cephalometric analysis of treatment effects are well known. The objective of this article is to present a more reliable research tool in the analysis of cephalometric data. Bookstein introduced a dilation function by means of a homogeneous deformation tensor as a method of describing changes in cephalometric data. His article gave an analytic description of the deformation tensor that permits the rapid and highly accurate calculation of it on a desktop computer. The first part of this article describes the underlying ideas and mathematics. The second part uses the tensor analysis to analyze the cephalometric results of a group of patients treated with high-pull activator (HPA) to demonstrate the application of this research tool. Eight patients with Class II skeletal open bite malocclusions in the mixed dentition were treated with HPA. A control sample consisting of eight untreated children with Class II who were obtained from The Ohio State University Growth Study was used as a comparison group. Lateral cephalograms taken before and at the completion of treatment were traced, digitized, and analyzed with the conventional method and tensor analysis. The results showed that HPA had little or no effect on maxillary skeletal structures. However, reduction in growth rate was found with the skeletal triangle S-N-A, indicating a posterior tipping and torquing of the maxillary incisors. The treatment also induced additional deformation on the mandible in a downward and slightly forward direction. Together with the results from the conventional cephalometric analysis, HPA seemed to provide the vertical and rotational control of the maxilla during orthopedic Class II treatment by inhibiting the downward and forward eruptive path of the upper posterior teeth. The newly designed computer software permits rapid analysis of cephalometric data with the tensor analysis on a desktop computer. This tool may be useful in analyzing growth changes for research data.

Treatment effects of a fixed intermaxillary device to correct class II malocclusions in growing patients.

PubMed

Heinrichs, Dean A; Shammaa, Imad; Martin, Chris; Razmus, Thomas; Gunel, Erdogan; Ngan, Peter

2014-01-01

The objective of this study was to evaluate the treatment effects of Forsus™ Fatigue Resistant Device (FRD; 3M Unitek, Monrovia, CA, USA) in growing patients with Class II non-extraction malocclusions. A retrospective sample of 24 class II patients treated consecutively with the FRD followed by comprehensive orthodontic treatment was compared to a sample of untreated control subjects from the Bolton Brush Study who was matched in age, sex, and craniofacial morphology. Lateral cephalometric radiographs were taken before treatment (T1) and after removal of fixed appliances (T2). Growth changes were subtracted from the treatment changes to obtain the treatment effects of the appliance. Data were analyzed using ANOVA and a match paired t test. Significant differences were found between the treated and control groups for 12 of the 29 measured variables (Co-Gn minus Co-Apt, Wits, Is-OLp, Ii-OLp, overjet, Mi-OLp, molar relationship, overbite, Mic-ML, SNA, ANB, and Ii-ML). With 27.8 months of treatment, all patients were corrected to a class I dental arch relationship. Overjet and molar relationships were improved by an average of 4.7 and 3.1 mm, respectively. This was contributed by a 1.2 mm of restraint in forward maxillary growth, 0.7 mm of forward movement of the mandible, 1.5 mm of backward movement of the maxillary incisors, 1.3 mm forward movement of the mandibular incisors, 0.5 mm backward movement of the maxillary molars, and 1.3 mm of forward movement of the mandibular molars. The overbite was decreased by 2 mm with no significant change in the occlusal, palatal, or mandibular plane. Individual variations in response to the FRD treatment were large for most of the parameters tested. Significant differences in treatment changes between male and female subjects were found only in a few parameters measured. These results demonstrate that significant overjet and overbite corrections can be obtained with the Forsus FRD in conjunction with comprehensive orthodontic treatment.

Evaluating the Correlation between Anteroposterior and Mediolateral Compensatory Curves and their Influence on Dentoskeletal Morphology-An In vitro CBCT Study.

PubMed

Babu, K Suresh; Kumar, A Nanda; Kommi, Pradeep Babu; Krishnan, P Hari; Kumar, M Senthil; Sabapathy, R Senkutvan; Kumar, V Vijay

2017-08-01

To date, many orthodontist corrects malocclusion based on patients aesthetic concern and fails to correct the compensatory curves. This scenario is due to less insight on understanding relationship of compensatory curves and its correlation in treatment prognosis. The purpose of this study was to evaluate the correlation between the curve of Spee, curve of Monson and curve of Wilson, their influence on dentoskeletal morphology and their contribution to occlusal stability. This study included 104 non-orthodontic models. The study casts were subdivided into two groups, Group-I consist 52 non- orthodontic models with Class-I molar relationship and Group-II consist of 52 non- orthodontic models with Class-II molar relationship. Curve of Spee was measured with digital vernier caliper, curve of Monson estimated using specially made sphere (7″inch, 8″ inch and 9″inch) and curve of Wilson was evaluated using Cone Beam Computed Technology (CBCT). Mean value for curve of Spee obtained for Group I and Group II is 1.844 mm and 3.188 mm. For curve of Monson, the mean value obtained for Group I and Group-II is 7.65 inches and 7.40 inches. The mean degree obtained for the curve of Wilson for Group I and Group-II is 12.05 and 16.49. The result showed positive correlation between curve of Spee and curve of Wilson and no correlation between curve of Monson and curve of Wilson and no correlation between curve of Spee and curve of Monson. The Pearson correlation coefficient analysis from the study confirmed these results. The results showed positive correlation between curve of spee and curve of Wilson. The data found in this study can be applied clinically for Class I and Class II malocclusion patients on diagnosis and treatment planning.

25 CFR 522.10 - Individually owned class II and class III gaming operations other than those operating on...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Individually owned class II and class III gaming... GAMING COMMISSION, DEPARTMENT OF THE INTERIOR APPROVAL OF CLASS II AND CLASS III ORDINANCES AND RESOLUTIONS SUBMISSION OF GAMING ORDINANCE OR RESOLUTION § 522.10 Individually owned class II and class III...

Class II treatment in adults: comparing camouflage orthodontics, dentofacial orthopedics and orthognathic surgery--a cephalometric study to evaluate various therapeutic effects.

PubMed

Kinzinger, Gero; Frye, Linda; Diedrich, Peter

2009-01-01

It was the aim of this clinical study to compare the skeletal and dentoalveolar effects as well as those on the profile of three different treatment approaches in Class II patients (camouflage orthodontics, dentofacial orthopedics, and combined orthodontic and surgical treatment). Our study cohort consisted of 60 young adults presenting a skeletal Class II, Division 1 malocclusion: 20 patients whose overjet was reduced by camouflage following premolar extraction, 20 patients whose occlusions were corrected by placement of a fixed functional orthopedic appliance, and 20 who underwent orthognathic surgery (bilateral sagittal split osteotomy of the mandible without genioplasty). We documented the therapeutic progress using cephalometry. Each patient group achieved a reduction in overjet via their respective treatment. While no treatment-related changes in the maxillary area were assessable, the effects on the mandible differed. We observed advancement of the bony chin and an increase in mandibular length in the sagittal-diagonal dimension in the surgical and functional orthopedic groups. However, the extent of the treatment-related changes was significant only in the group of patients that had undergone orthognathic surgery. Only the surgical group presented changes in vertical relationships. Incisor repositioning as an outcome of the respective treatments differed fundamentally, with those in the surgical group revealing significant protrusion of the upper incisors. The maxillary incisors were retruded and mandibular incisors proclined in the functional orthopedic group, whereas the upper and lower incisors both retruded significantly in the extraction group. Soft-tissue remodeling bore no linear relationship to treatment-induced skeletal and dental effects. Still, orthognathic surgery led to the most marked profile changes. Treatment using fixed functional orthopedic appliances reduced the convexity of the soft-tissue profile at least moderately. Camouflage orthodontics, on the other hand, resulted in an increase in the nasolabial angle. In young adults fixed functional appliances are a treatment alternative to extraction therapy but to a lesser extent to orthognathic surgery. Because of their limited skeletal effects and minor changes in the profile they are indicated only in patients with a moderately severe Class II malocclusion. Pre-treatment proclined mandibular incisors limit the scope of indications for fixed functional appliances, as they can cause an increase in lower incisor proclination. Significant reductions in profile convexity are achievable only by combined orthodontic and surgical treatment of the malocclusion. When performing camouflage orthodontics in conjunction with maxillary premolar extractions in adults, an increase in the nasolabial angle, which is often esthetically undesirable, has to be discussed as a potential side effect and has to be taken into account when considering the different therapeutic approaches.

Malocclusions in guinea pigs, chinchillas and rabbits

PubMed Central

Legendre, Loïc F.J.

2002-01-01

The types of malocclusions encountered in rodents and lagomorphs are classified. Diagnosis, treatment, and prognosis are reviewed. Some malocclusions are curable, whereas others can only be controlled. The need to perform a complete oral examination and to find a cause for the condition is stressed, as it will seriously affect the prognosis. PMID:12001507

Study of occlusal characteristics of primary dentition and the prevalence of maloclusion in 4 to 6 years old children in India

PubMed Central

Bhayya, Deepak P; Shyagali, Tarulatha R; Dixit, Uma B; Shivaprakash

2012-01-01

Background: To assess the prevalence of malocclusion and to determine the different occlusal characteristics in primary dentition of 4 to 6 years old children in India. Materials and Methods: The target population comprised 4 to 6 years old children attending different nursery, kindergarten and primary schools of Bagalkot city. Stratified cluster random sampling procedure was executed to collect the representative sample. Each subject was assessed for various occlusal characteristics. Results: Occlusal characteristic found were flush terminal plane (52.5%), class I canine relationship (84%), maxillary developmental spaces (35.4%), primate spaces in maxilla (47.6%), mandibular crowding (4.6%), mandibular midline shift (5.6%), anterior multiple tooth crossbite (1.3%), scissors bite (0.6%), anterior open bite (1%), over bite of 0-2 mm (81.6%) and overjet of 0-2 mm (84.5%). The age wise difference for the occlusal characteristics was statistically significant. Conclusions: The data revealed that most of the children had malocclusion. This highlights the importance of identifying children who are in need of orthodontic treatment for dental health or aesthetic reasons. PMID:23559929

Superimposition of 3-dimensional cone-beam computed tomography models of growing patients

PubMed Central

Cevidanes, Lucia H. C.; Heymann, Gavin; Cornelis, Marie A.; DeClerck, Hugo J.; Tulloch, J. F. Camilla

2009-01-01

Introduction The objective of this study was to evaluate a new method for superimposition of 3-dimensional (3D) models of growing subjects. Methods Cone-beam computed tomography scans were taken before and after Class III malocclusion orthopedic treatment with miniplates. Three observers independently constructed 18 3D virtual surface models from cone-beam computed tomography scans of 3 patients. Separate 3D models were constructed for soft-tissue, cranial base, maxillary, and mandibular surfaces. The anterior cranial fossa was used to register the 3D models of before and after treatment (about 1 year of follow-up). Results Three-dimensional overlays of superimposed models and 3D color-coded displacement maps allowed visual and quantitative assessment of growth and treatment changes. The range of interobserver errors for each anatomic region was 0.4 mm for the zygomatic process of maxilla, chin, condyles, posterior border of the rami, and lower border of the mandible, and 0.5 mm for the anterior maxilla soft-tissue upper lip. Conclusions Our results suggest that this method is a valid and reproducible assessment of treatment outcomes for growing subjects. This technique can be used to identify maxillary and mandibular positional changes and bone remodeling relative to the anterior cranial fossa. PMID:19577154

Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome.

PubMed

Tran, Ngoc Hieu; Tantidhnazet, Syrina; Raocharernporn, Somchart; Kiattavornchareon, Sirichai; Pairuchvej, Verasak; Wongsirichat, Natthamet

2018-05-01

The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS. Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method. The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria. In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS.

A new palatal distractor device for bodily movement of maxillary bones by rigid self-locking miniplates and screws system.

PubMed

Cortese, Antonio; Savastano, Mauro; Cantone, Antonio; Claudio, Pier Paolo

2013-07-01

A new palatal distractor device for bodily movement of the maxillary bones after complete segmented Le Fort I osteotomy for 1-stage transversal distraction and tridimensional repositioning on 1 patient is presented. The new distractor has an intrinsic tridimensional rigidity also in the fixation system by self-locking miniplates and screws for better control of the 2 maxillary fragments during distraction. Le Fort I distraction and repositioning procedure in association with a bilateral sagittal split osteotomy were performed on 1 patient with complete solution of the cross-bite and class III malocclusion. Results of dental and cephalometric analysis performed before surgery (T1), after surgery and distraction time (T2), and 18 months after surgery and orthodontic appliance removal (T3) are reported. No complications were encountered using the new distractor device. Advantages of this device and technique are presented including improved rigidity of both distraction (jackscrew) and fixation (4 self-locking miniplates and screws) systems resulting in complete control of the position of the 2 maxillary fragments during distraction and surgery. In addition, this new device allows resuming palatal distraction in the event of cross-bite relapse without causing dental-related problems or the risks of screw slackening.

Long-term results of maxillary distraction osteogenesis in nongrowing cleft: 5-years experience using internal device.

PubMed

Hirjak, D; Reyneke, J P; Janec, J; Beno, M; Kupcova, I

2016-01-01

Patients with cleft lip and palate (CLP) related deformities frequently have maxillary hypoplasia in all dimensions. These patients usually present with class III malocclusions, retruded midfaces and narrow hard palates. The skeletal problems can be treated by means of Le Fort I maxillary procedures. Surgical and orthodontic correction of severe maxillary hypoplasia, as often seen in CLP patients, has however proved to be challenging. The magnitude of the advancement is often hampered and the post operative stability significantly affected by palatal soft tissue scarring. The slow distraction of bone and the histogenic abilities of distraction osteogenesis (DO) have made it an atractive alternative treatment option for the management of maxillary hypoplasia in these patients. This paper presents the treatment results of 15 nongrowing CLP patients with severe maxillary hypoplasia treated by means of intra oral distraction. The mean anterior distraction of the maxillas was 12.7 mm (9-15.0 mm). The long-term cephalometric and clinical evaluation after a minimum of 60 months (mean follow-up 71 months) proved to be stable. The treatment results revealed, that distraction osteogenesis in nongrowing CLP patients with severe maxillary hypoplasia proved to be a predictable and stable option (Tab. 2, Fig. 3, Ref. 26).

25 CFR 291.5 - Where must the proposal requesting Class III gaming procedures be filed?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Where must the proposal requesting Class III gaming... ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.5 Where must the proposal requesting Class III gaming procedures be filed? Any proposal requesting Class III gaming procedures must be filed with the...

Mediation and moderation effect of the big five personality traits on the relationship between self-perceived malocclusion and psychosocial impact of dental esthetics.

PubMed

Spalj, Stjepan; Novsak, Alenka; Bilobrk, Philipp; Katic, Visnja; Zrinski, Magda Trinajstic; Pavlic, Andrej

2016-05-01

To explore the mediation and moderation effects of personality traits on the relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics. The sample included 252 subjects (62% female) aged 12-39 years. Self-perceived malocclusion was estimated using the 10-point scale Aesthetic Component of the Index of Orthodontic Treatment Need. The Psychosocial Impact of Dental Aesthetics Questionnaire was used to assess the psychological impact and the Big Five Inventory for personality traits. Moderation and mediation effects were evaluated with Pearson correlations and stepwise regression analysis, respectively. Self-perceived malocclusion ranged from 1 to 8 and was the most significant predictor of psychosocial impact of dental esthetics, whose unique contribution accounted for 11%-36.4% of variability, while age and sex accounted for 1.2%-2.5%. Personality traits had no mediating effect on this relationship. The moderating effect of agreeableness was present in the relationship between self-perceived degree of malocclusion and Social Impact (SI), Psychological Impact (PI), and Aesthetic Concern (AC) (ΔR2  =  0.035, 0.020, and 0.013, respectively; P < .001), while conscientiousness affected the relationship between perception of malocclusion and SI and PI (ΔR2  =  0.018 and 0.016, respectively; P < .05). In people with lower agreeableness and conscientiousness, increasing the severity of self-perceived malocclusion leads to less increase in SI and PI. In people with lower agreeableness, the increase influences AC in a similar manner. Extraversion, neuroticism, and openness do not have a moderating effect. The relationship between self-perceived malocclusion and the psychosocial impact of dental esthetics appears to be moderated and not mediated by personality traits. Adolescents and young adults with lower agreeableness and conscientiousness seem to be less affected by the increased severity of self-perceived malocclusion, as demonstrated in reporting some psychosocial impacts.

Association between maternal education and malocclusion in Mongolian adolescents: a cross-sectional study.

PubMed

Tumurkhuu, Tsasan; Fujiwara, Takeo; Komazaki, Yuko; Kawaguchi, Yoko; Tanaka, Toshihiro; Inazawa, Johji; Ganburged, Ganjargal; Bazar, Amarsaikhan; Ogawa, Takuya; Moriyama, Keiji

2016-11-01

Malocclusion is a highly prevalent condition, affecting 20-60% of adolescents worldwide. Although its treatment is often expensive and unaffordable for disadvantaged individuals, few studies have examined the relationship between malocclusion and socioeconomic status. We investigated the prevalence of malocclusion among Mongolian adolescents and its association with maternal education in a community-based sample in Mongolia. Cross-sectional study. 2 large secondary schools with different backgrounds in Ulaanbaatar, Mongolia. Complete dental casts of 557 randomly recruited Mongolian schoolchildren aged 11-16 years were evaluated using the Dental Health Component of the Index of Orthodontic Treatment Need to dichotomise orthodontic treatment requirements. Exclusion criteria were the presence of orthodontic treatment history and absence of maternal educational status. Questionnaires were administered to caregivers to assess socioeconomic status. Poisson regression analysis was performed to examine the association between malocclusion and maternal educational status. The prevalence of malocclusion requiring orthodontic treatment among all adolescents was 35.2% (95% CI 31.2 to 39.2). In the unadjusted analysis, the prevalence ratio (PR) for malocclusion was higher (PR=1.46; 95% CI 0.96 to 2.20) among adolescents of mothers with a high educational background than among those of mothers with a low educational background. After adjusting for covariates, the PR remained significantly higher (PR=1.72; 95% CI 1.06 to 2.82) among adolescents of mothers with a high educational background. Other socioeconomic status variables, including family income and the educational level of the father, showed no association with malocclusion. These findings suggest that malocclusion requiring orthodontic treatment in adolescents is more prevalent among children of mothers with high levels of education. Further studies are needed to clarify the behavioural factors and environmental circumstance that contribute to this. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A review of the evidence supporting the aesthetic orthodontic treatment need indices.

PubMed

Borzabadi-Farahani, Ali

2012-11-01

Aesthetic improvement and psychological enhancement have been cited as justifications for orthodontic treatment. This paper reviews the evidence that relates malocclusion to psychological health and quality of life and explores whether this evidence supports the most commonly used aesthetic Orthodontic Treatment Need Indices (OTNI). The relevant cited material from the MEDLINE, Web of Science, Scopus, Cochrane databases, and scientific textbooks were used. The citation rate was confirmed by using the Google Scholar. The subjective nature of aesthetic indices and the variable perception of attractiveness between clinicians and patients, and among various cultures or countries are a few limitations of aesthetic OTNI. The available evidence of mainly cross-sectional studies on the link between malocclusion and either psychosocial well-being or quality of life is not conclusive, and sometimes contradictory, to suggest these characteristics are affected by malocclusions. Further, the long-term longitudinal studies did not suggest that people with malocclusion are disadvantaged psychologically, or their quality of life would be worse off, which challenges using aesthetic OTNI to assess the social and psychological implications of malocclusion. The subjective nature of aesthetic OTNI and the minor contributory role of malocclusion in psychosocial health or quality of life undermine using aesthetic indices to assess the likely social and psychological implications of malocclusion. Consequently, using aesthetic OTNI, as a method to quantify malocclusion remains open to debate. Various soft and hard-tissue analyses are used before formulating a treatment plan (i.e., assessment of sagittal and vertical skeletal relationships). The addition of a shortened version of these analyses to the aesthetic OTNI can be a good substitute for the aesthetic components of OTNI, if an assessment of the aesthetic aspects of malocclusion is intended. This reduces subjectivity and improves the validity of the OTNI that incorporate an aesthetic component. Copyright © 2012. Published by Elsevier Srl.

Distribution of craniomandibular disorders, occlusal factors and oral parafunctions in a paediatric population.

PubMed

Corvo, G; Tartaro, G; Giudice, A; Diomajuta, A

2003-06-01

The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in a paediatric population. The clinical study population comprised patients with TMJ disorders who were being treated in the orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid, suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal, overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant). A substantial number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism, onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most representative symptoms. The identification and recognition of factors, such as malocclusions and parafunctions, are considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the stomatognathic system.

Pendulum and modified pendulum appliances for maxillary molar distalization in Class II malocclusion - a systematic review.

PubMed

Al-Thomali, Yousef; Basha, Sakeenabi; Mohamed, Roshan Noor

2017-08-01

The main purpose of the present systematic review was to evaluate the quantitative effects of the pendulum appliance and modified pendulum appliances for maxillary molar distalization in Class II malocclusion. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus and key journals and review articles; the date of the last search was 30 January 2017. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). In total, 203 studies were identified for screening, and 25 studies were eligible. The quality assessment rated four (16%) of the study as being of strong quality and 21 (84%) of these studies as being of moderate quality. The pendulum appliances showed mean molar distalization of 2-6.4 mm, distal tipping of molars from 6.67° to 14.50° and anchorage loss with mean premolar and incisor mesial movement of 1.63-3.6 mm and 0.9-6.5 mm, respectively. The bone anchored pendulum appliances (BAPAs) showed mean molar distalization of 4.8-6.4 mm, distal tipping of molars from 9° to 11.3° and mean premolar distalization of 2.7-5.4 mm. Pendulum and modified pendulum appliances are effective in molar distalization. Pendulum appliance with K-loop modification, implant supported pendulum appliance and BAPA significantly reduced anchorage loss of the anterior teeth and distal tipping of the molar teeth.

Replacement of a first molar and 3 second molars by the mesial inclination of 4 impacted third molars in an adult with a Class II Division 1 malocclusion.

PubMed

Tomonari, Hiroshi; Yagi, Takakazu; Kuninori, Takaharu; Ikemori, Takahiro; Miyawaki, Shouichi

2015-06-01

This case report presents the successful replacement of 1 first molar and 3 second molars by the mesial inclination of 4 impacted third molars. A woman, 23 years 6 months old, had a chief complaint of crowding of her anterior teeth and linguoclination of a second molar on the left side. The panoramic radiographic images showed that the maxillary and mandibular third molars on both sides were impacted. Root resorption on the distal surfaces of the maxillary second molars was suspected. The patient was given a diagnosis of Angle Class II Division 1 malocclusion with severe crowding of the anterior teeth and 4 impacted third molars. After we extracted the treated maxillary second premolars and the second molars on both sides, the treated mandibular second premolar and the second molar on the left side, and the root canal-filled mandibular first molar on the right side, the 4 impacted third molars were uprighted and formed part of the posterior functional occlusion. The total active treatment period was 39 months. The maxillary and mandibular third molars on both sides successfully replaced the first and second molars. The replacement of a damaged molar by an impacted third molar is a useful treatment option for using sound teeth. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

25 CFR 291.13 - When do Class III gaming procedures for an Indian tribe become effective?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false When do Class III gaming procedures for an Indian tribe... ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.13 When do Class III gaming procedures for an Indian tribe become effective? Upon approval of Class III gaming procedures for the Indian tribe under either...

25 CFR 291.15 - How long do Class III gaming procedures remain in effect?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How long do Class III gaming procedures remain in effect... ENTERPRISES CLASS III GAMING PROCEDURES § 291.15 How long do Class III gaming procedures remain in effect? Class III gaming procedures remain in effect for the duration specified in the procedures or until...

25 CFR 291.14 - How can Class III gaming procedures approved by the Secretary be amended?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How can Class III gaming procedures approved by the... ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.14 How can Class III gaming procedures approved by the Secretary be amended? An Indian tribe may ask the Secretary to amend approved Class III gaming...

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children.

PubMed

López Del Valle, Lydia M; Singh, G Dave; Feliciano, Nilma; Machuca, María del Carmen

2006-03-01

Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce. The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits. The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed. The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit. It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Assessment of parental awareness about malocclusion in Shiraz, Islamic Republic of Iran.

PubMed

Danaei, S Momeni; Oshagh, M; Pajuhi, N; Ghahremani, Y; Bushehri, Ghodsi S

2011-07-01

Information empowers people to take charge of their health. The aim of this study in Shiraz, Islamic Republic of Iran was to evaluate parents' knowledge about dental malocclusion, referral routes and information sources. A random sample of 1000 7-9-year-old schoolchildren were given a questionnaire to complete at home. Questionnaires were completed by 795 parents. Knowledge about malocclusion was significantly greater in families with higher levels of education and income. Most respondents (83.5%) were aware of the importance of maintaining primary teeth to prevent malocclusion, and 25.1% thought that carious primary teeth must be extracted. Half of the parents (50.6%) did not know that spaces between primary teeth are normal. Only 28.8% of the children visited dentists for annual routine check-ups. Television (43.3%) was the most common source of dental information. The level of general public awareness about malocclusion needs to be improved.

25 CFR 522.8 - Publication of class III ordinance and approval.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 522.8 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR APPROVAL OF CLASS II AND CLASS III ORDINANCES AND RESOLUTIONS SUBMISSION OF GAMING ORDINANCE OR RESOLUTION § 522.8 Publication of class III ordinance and approval. The Chairman shall publish a class III tribal gaming...

Impact of malocclusion on the quality of life of children aged 8 to 10 years.

PubMed

Dutra, Sônia Rodrigues; Pretti, Henrique; Martins, Milene Torres; Bendo, Cristiane Baccin; Vale, Miriam Pimenta

2018-01-01

The aim of the present cross-sectional study was to assess the impact of malocclusion on the quality of life of children aged 8 to 10 years attending public elementary schools in Belo Horizonte, State of Minas Gerais, Brazil. The Brazilian version of the Child Perceptions Questionnaire 8-10 (CPQ8-10) was used to evaluate oral health-related quality of life. The children were examined for the diagnosis of malocclusion using the Dental Aesthetic Index (DAI). The data were analyzed by bivariate and multivariate descriptive statistics using Poisson regression at a 5% significance level. A total of 270 children participated in the study. Children with normal occlusion or mild malocclusion (DAI ≤ 25) were 56% less likely (95%CI: 0.258-0.758; p= 0.003) to have their quality of life affected compared with children diagnosed with extremely severe malocclusion (DAI ≥ 36). Children with a maxillary anterior overjet ≥ 3 mm had higher CPQ8-10 mean scores (19.4; SD = 17.1) than those with an overjet < 3 mm (13.6; SD = 11.7; p= 0.038). Extremely severe malocclusion and pronounced maxillary anterior overjet were associated with a negative impact on quality of life.

Prevalence of Malocclusion and its Psycho-Social Impact among 12 To 15-Year-old School Children in Lucknow City

PubMed Central

Saha, Sabyasachi; GV, Jagannatha; Narang, Ridhi; Biswas, Gautam; Sood, Poonam; Garg, Aarti; Narayan, Manu

2014-01-01

Background: Facial aesthetics affects how people are perceived by society and how they perceive themselves. Anterior malocclusion can have an impact on the overall facial appearance. Aim: The aim of the study was to assess the prevalence of malocclusion and its psycho-social impact among 12 to 15 yrs old school children in Lucknow city. Materials and Methods: The study consisted of collection of information for psychosocial assessment using a questionnaire and clinical examination of malocclusion. Data regarding psychosocial impact of dental aesthetics was collected using a Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) given by Klages et al., (2006). Results: 15.57% children belonged to the definite malocclusion category and 5.41% to the handicapped malocclusion category. The mean Dental self confidence score differed significantly among both male (p≤0.001) and female children (p≤0.001) across the age groups. The mean Social impact score did not differ significantly among both male (p≤0.31) and female children (p≤0.12) across the age groups. Conclusion: The results of the present study imply that dental aesthetics had a significant impact on the psychosocial aspects of human life irrespective of the gender. PMID:25478444

Management of a growing Skeletal Class II Patient: A Case Report.

PubMed

Sharma, Narendra Shriram

2013-01-01

Sagittal and transverse discrepancies often coexist in skeletal class II malocclusions. Orthopedic growth modification can work well in such cases, provided that the remaining pubertal growth is adequate and that the clinician can provide timely treatment to coincide with the peak growth period. The transverse discrepancy is generally corrected first, establishing a proper base for the sagittal correction to follow. For example, in a skeletal class II case with a narrow maxillary arch and retrusive mandible, maxillary expansion is performed initially to facilitate functional mandibular advancement. The present article illustrates an exception to this rule, in a case where sagittal correction was undertaken before transverse correction to make optimal use of the patient's pubertal growth spurt in first phase followed by a second phase of fixed appliance therapy during adolescence to achieve optimal results. How to cite this article: Sharma NS. Management of a growing Skeletal Class II Patient: A Case Report. Int J Clin Pediatr Dent 2013;6(1):48-54.

25 CFR 522.12 - Revocation of class III gaming.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Revocation of class III gaming. 522.12 Section 522.12 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR APPROVAL OF CLASS II AND CLASS III ORDINANCES AND RESOLUTIONS SUBMISSION OF GAMING ORDINANCE OR RESOLUTION § 522.12 Revocation of class III...

25 CFR 522.7 - Disapproval of a class III ordinance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Disapproval of a class III ordinance. 522.7 Section 522.7 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR APPROVAL OF CLASS II AND CLASS III ORDINANCES AND RESOLUTIONS SUBMISSION OF GAMING ORDINANCE OR RESOLUTION § 522.7 Disapproval of a class III...

25 CFR 291.3 - When may an Indian tribe ask the Secretary to issue Class III gaming procedures?

Code of Federal Regulations, 2010 CFR

2010-04-01

... III gaming procedures? 291.3 Section 291.3 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.3 When may an Indian tribe ask the Secretary to issue Class III gaming procedures? An Indian tribe may ask the Secretary to issue Class III...

Evaluation of the effects of malocclusion and orthodontic treatment on self-esteem in an adolescent population.

PubMed

Jung, Min-Ho

2010-08-01

The purpose of this study was to evaluate the effects of malocclusion and orthodontic treatment on adolescent self-esteem. A total of 4509 middle school students were clinically evaluated for dental crowding. Lip protrusion was also measured with a specially designed ruler. Rosenberg's self-esteem scale was used to determine each subject's level of self-esteem. The results showed that sex played a role in the relationship between self-esteem and malocclusion. For the girls, crowding of the anterior teeth had significant effects on their self-esteem; however, there was no significant difference in the boys' self-esteem. After fixed orthodontic treatment, the girls had higher self-esteem than the untreated malocclusion group. Girls with an ideal profile and good tooth alignment also showed higher self-esteem than students with crowding or protrusion. This clinical study proved that malocclusion and fixed orthodontic treatment can affect self-esteem in adolescent girls. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Association between oral habits, mouth breathing and malocclusion.

PubMed

Grippaudo, C; Paolantonio, E G; Antonini, G; Saulle, R; La Torre, G; Deli, R

2016-10-01

The ratio of bad habits, mouth breathing and malocclusion is an important issue in view of prevention and early treatment of disorders of the craniofacial growth. While bad habits can interfere with the position of the teeth and normal pattern of skeletal growth, on the other hand obstruction of the upper airway, resulting in mouth breathing, changes the pattern of craniofacial growth causing malocclusion. Our crosssectional study, carried out on 3017 children using the ROMA index, was developed to verify if there was a significant correlation between bad habits/mouth breathing and malocclusion. The results showed that an increase in the degree of the index increases the prevalence of bad habits and mouth breathing, meaning that these factors are associated with more severe malocclusions. Moreover, we found a significant association of bad habits with increased overjet and openbite, while no association was found with crossbite. Additionally, we found that mouth breathing is closely related to increased overjet, reduced overjet, anterior or posterior crossbite, openbite and displacement of contact points. Therefore, it is necessary to intervene early on these aetiological factors of malocclusion to prevent its development or worsening and, if already developed, correct it by early orthodontic treatment to promote eugnatic skeletal growth. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

Individual and contextual determinants of malocclusion in 12-year-old schoolchildren in a Brazilian city.

PubMed

Jordão, Lidia Moraes Ribeiro; Vasconcelos, Daniela Nobre; Moreira, Rafael da Silveira; Freire, Maria do Carmo Matias

2015-01-01

The aim of this study was to describe malocclusion prevalence and its association with individual and contextual factors among Brazilian 12-year-old schoolchildren. This cross-sectional study included data from an oral health survey carried out in Goiânia, Brazil (n = 2,075), and data from the files of the local health authority. The data were collected through oral clinical examinations. The Dental Aesthetic Index (DAI) was used to assess occlusion. The presence of malocclusion (DAI > 25) was used as the dependent variable. The individual independent variables consisted of adolescents' sex and race and their mothers' level of schooling. The clinical variables were caries experience and presence of adverse periodontal condition (calculus and/or gingival bleeding). The contextual variables included type of school and the location of schools in the city's health districts. The Rao-Scott test and multilevel logistic regression were performed. The prevalence of malocclusion was 40.1%. In the final model, significantly higher rates of malocclusion were found among those who attended schools located in less affluent health districts and whose mothers had fewer years of education. Rates were also higher among those presenting calculus and/or gingival bleeding. Malocclusion demonstrated a high prevalence rate and the inequalities in its distribution were determined by individual and contextual factors.

[Socio-demographic aspects related to severity of malocclusion among 12-year-old Brazilian children].

PubMed

Bauman, José Mansano; Souza, João Gabriel Silva; Bauman, Claudiana Donato; Flório, Flávia Martão

2018-03-01

The scope of this study was to characterize malocclusion in 12-year-old Brazilian children and identify associated socio-demographic aspects. It is a cross-sectional and analytical study based on an Oral Health Survey (SB Brasil 2010). A sample of 5,539 was included, among which 41% had some degree of malocclusion according to the Dental Aesthetic Index (DAI). Descriptive, bivariate and multiple multinomial logistic regression analyses were conducted. Defined malocclusion was greater among those who rated their oral health as neither satisfied/nor dissatisfied (OR 1.24; CI95%1.03-1.50) and dissatisfied (OR 1.76; CI95%1.50-2.08). Severe malocclusion was greater among children in the Southeast (OR 1.44; CI95%1.06-1.96) and South (OR 1.52; CI95%1.05-2.19), male (OR 1.24; CI95%1.03-1.48), black/brown (OR 1.39; CI95%1.14-1.69) who rated their oral health as neither satisfied/nor dissatisfied (OR 1.79; CI95%1.41-2.26) and dissatisfied (OR 2.20; CI95%1.77-2.72). Very severe malocclusion was higher among residents of capitals (OR 1.36; CI95%1.07-1.71) who evaluated their oral health as neither satisfied/nor dissatisfied (OR 1.58; CI95%1.22-2.05) and dissatisfied (OR 2.44; CI95%1.96-3.03). The prevalence of malocclusion is high among Brazilian children, the severity being associated with socio-demographic aspects.

A 57-year follow-up of occlusal changes, oral health, and attitudes toward teeth.

PubMed

Stenvik, Arild; Espeland, Lisen; Berg, Rolf E

2011-04-01

Very few studies have addressed long-term development and risks associated with untreated malocclusion. The purpose of this study was to examine changes in occlusion in a lifelong perspective and to compare oral health and attitudes toward teeth among persons with malocclusion with those having normal occlusion. In 1950 an epidemiologic survey of 2349 8-year-olds was conducted and included 4 intraoral photographs. Three selected samples with different malocclusions (deep bite, crossbite, or irregular teeth) and 1 sample with normal occlusion (a total of 183 subjects) were, 57 years later, invited for examination and an extensive interview about dental experiences and attitudes. Sixty-nine responded (38%) and constitute the subjects studied. Malocclusion remained the same or worsened except in subjects having deep bite in childhood, which in some improved and in others became worse. Crowding generally increased. Sixteen persons reported moderate or severe temporomandular joint (TMJ) problems, and of these 7 belonged to the group with crossbite in childhood. With few exceptions, the subjects in all samples had good oral hygiene, visited the dentist regularly, and had well-preserved dentitions. Mean number of missing teeth was significantly lower among those with normal occlusion compared with the malocclusion groups. Individuals with normal occlusion responded favorably to all questions related to attitudes and experiences about their teeth, while responses in the malocclusion groups varied. Persons with the particular malocclusions examined experienced more problems related to teeth later in life compared with those having normal occlusion in childhood. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Does malocclusion influence the adolescent's satisfaction with appearance? A cross-sectional study nested in a Brazilian birth cohort.

PubMed

Peres, Karen Glazer; Barros, Aluísio J D; Anselmi, Luciana; Peres, Marco Aurélio; Barros, Fernando C

2008-04-01

To test whether malocclusion had an impact on adolescents' appearance satisfaction regardless of other physical aspects. A cross-sectional study nested in a birth cohort study was carried out in Pelotas, Brazil. A random sample of 900 15-year-old adolescents was selected. WHO criteria were used to define malocclusion and a questionnaire was administered including self-reported skin colour and appearance satisfaction. Dental caries were assessed. Height and weight were measured and body mass index calculated. Data concerning gender and socioeconomic characteristics were obtained from the cohort's perinatal study. Adjusted analyses including all confounding variables investigated were performed using Poisson regression with robust variance in order to identify the potential risk factors for appearance dissatisfaction. All analyses were carried out separately by gender. The sample included 867 individuals, 54.1% men. The prevalence of moderate or severe malocclusion was 30.6% (95% CI: 26.5-34.7) among boys, and 32.8% (95% CI: 28.2-37.4) among girls (P = 0.524). Dissatisfaction with appearance was reported by 29.8% of the boys and by 46.5% of the girls (P < 0.001). A positive association between malocclusion and appearance dissatisfaction, controlling for other physical, dental caries and socioeconomic characteristics was observed only in girls [prevalence ratio = 1.4 (1.3-1.7)]. Malocclusion is a common condition and is positively associated with appearance dissatisfaction in adolescent girls. The effect of different types of malocclusion on appearance dissatisfaction should be the focus of further investigation.

[Inferring landmark displacements from changes in cephalometric angles].

PubMed

Xu, T; Baumrind, S

2001-07-01

To investigate the appropriateness of using changes in angular measurements to reflect the actually profile changes. The sample consists of 48 growing malocclusion patients, contained 24 Class I and 24 Class II subjects, treated by an experienced orthodontist using Edgewise technique. Landmark and superimpositional data were extracted from the previously prepared numerical database. Three pairs of angular and linear measures were computed by the Craniofacial Software Package. Although the associations between all three angular measures and their corresponding linear measures are statistically significant at the 0.001 level, the disagreement between these three pairs of measures are 10.4%, 22.9% and 37.5% respectively in this sample. The direction of displacement of anterior facial landmarks during growth and treatment cannot reliably be inferred merely from changes in cephalometric Angles.

Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

PubMed

Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

2016-01-01

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

Extraction of maxillary first molars improves second and third molar inclinations in Class II Division 1 malocclusion.

PubMed

Livas, Christos; Halazonetis, Demetrios J; Booij, Johan Willem; Katsaros, Christos

2011-09-01

The aim of this study was to assess the changes in inclination of the maxillary second (M2) and third (M3) molars after orthodontic treatment of Class II Division 1 malocclusion with extraction of maxillary first molars. Two groups of subjects were studied. The experimental group consisted of 37 subjects, 18 boys and 19 girls (mean age, 13.2 ± 1.62 years). The inclusion criteria were white origin, Class II Division 1 malocclusion, overjet ≥4 mm, no missing teeth or agenesis, and maxillary M3 present. All patients were treated with extraction of the maxillary first molars and the Begg technique. Standardized lateral cephalometric radiographs were taken at the start of active treatment (T1) and at least 3.7 years posttreatment (T2). The control group was drawn from the archives of the Nittedal Growth Material (Oslo University, Oslo, Norway) and included 54 untreated Class I and Class II subjects,18 boys and 36 girls (mean age, 13.4 ± 1.99 years) followed up for a minimum of 3.6 years. M2 and M3 inclinations relative to the palatal plane (PP) and functional occlusal plane (FOP) were measured and compared between groups and time periods. M2 to PP inclination improved significantly in both the control group (M2-PP at T1, 17.7° ± 5.81°, and at T2, 11.9° ± 4.61°) and the experimental group (M2-PP at T1, 26.7° ± 5.75°, and at T2, 6.9° ± 6.76°). There were also significant increases of the mesial inclination of M3 in the control group (M3-PP at T1, 30.1° ± 8.54°, and at T2, 19.6° ± 9.01°) and extraction group (M3-PP at T1, 32.2° ± 7.90°, and at T2, 12.8° ± 7.36°). By using the FOP as the reference system, no significant change in the inclination of M2 was observed in the control group, whereas, in the extraction group, although more distally inclined at T1, M2 ended up mesially inclined at T2 (M2-FOP at T1, 14.2° ± 4.62°, and at T2, -6.2° ± 6.10°; P <0.0001). M3 inclinations were similar between the groups at T1 (M3-FOP control, 17.3° ± 9.35°; M3-FOP experimental, 19.6° ± 7.37°), and these improved significantly in both groups. However, M3 uprighting was almost 4 times greater in the extraction group (M3-FOP from T2-T1, 5.6° vs 19.9°). The greatest distal inclination of M3 at T2 in the extraction group was 9.4°, a value attained by only 43% of the control group. Extraction of the maxillary first molars in Class II Division 1 patients results in significant uprighting of M2 and M3 and facilitates the normal eruption of M3. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Transversal maxillary dento-alveolar changes in patients treated with active and passive self-ligating brackets: a randomized clinical trial using CBCT-scans and digital models.

PubMed

Cattaneo, P M; Treccani, M; Carlsson, K; Thorgeirsson, T; Myrda, A; Cevidanes, L H S; Melsen, B

2011-11-01

To assess transversal tooth movements and buccal bone modeling of maxillary lateral segments achieved with active or passive self-ligating bracket systems in a randomized clinical trial. Sixty-four patients, with Class I, II, and mild Class III malocclusions, were randomly assigned to treatment with passive (Damon 3 MX) or active (In-Ovation R) SLBs. Impressions and cone-beam CT-scans were taken before (T0) and after treatment (T1). Displacement of maxillary canines, premolars and molars, and buccal alveolar bone modeling were blindly assessed. Twenty-one patients in the Damon and 20 in the In-Ovation group completed treatment according to the prescribed protocol. Eight Damon and 10 In-Ovation patients were excluded as the treatment approach had to be changed because of deviation from the recommended initial plan, while three Damon and two In-Ovation patients did not complete the treatment. Transversal expansion of the upper arch was achieved by buccal tipping in all but one patient in each group. No statistical significant difference in inter-premolar bucco-lingual inclination was found between the two groups from T0 to T1. The bone area buccal to the 2nd premolar decreased on average of 20% in the Damon and 14% in the In-Ovation group. Only few patients exhibited widening of the alveolar process. The anticipated translation and buccal bone modeling using active or passive SLBs could not be confirmed. Because of the large interindividual variation, a patient-specific analysis seems to be mandatory as individual factors like pre-treatment teeth inclination and occlusion influenced the treatment outcome of the individual patients. © 2011 Aarhus University A.

Effects of miniplate anchored and conventional Forsus Fatigue Resistant Devices in the treatment of Class II malocclusion.

PubMed

Turkkahraman, Hakan; Eliacik, Sule Kocabas; Findik, Yavuz

2016-11-01

To compare the skeletal, dentoalveolar, and soft tissue effects of the miniplate anchored Forsus Fatigue Resistant Device (FRD) and the conventional Forsus FRD in the treatment of Class II malocclusion. The study was carried out with 30 patients (10 girls, 20 boys). In the MA-Forsus group, 15 patients (2 girls, 13 boys) were treated with a miniplate anchored Forsus FRD for 9.40 ± 2.25 months. In the C-Forsus group, 15 patients (8 girls, 7 boys) were treated with a conventional Forsus FRD for 9.46 ± 0.81 months. A total of 16 measurements were calculated and statistically analyzed to find intragroup and intergroup differences. Statistically significant differences were found between the groups in IMPA, SN/Occ, SN/GoGn, overjet, overbite, and Li-S measurements (P < .05). In the C-Forsus group, a substantial amount of lower incisor protrusion was observed, whereas retrusion was found in the MA-Forsus group (P < .001). The mandible rotated backward in the MA-Forsus group, whereas it remained unchanged in the C-Forsus group (P < .05). Reductions in overjet (P < .001) and overbite were greater in the C-Forsus group (P < .05). Stimulation of mandibular growth and inhibition of maxillary growth were achieved in both treatment groups. In the C-Forsus group, a substantial amount of lower incisor protrusion was observed, whereas retrusion of lower incisors was found in the MA-Forsus group. The MA-Forsus group was found to be more advantageous as it had no dentoalveolar side effects on mandibular dentition.

The prevalence of dental anomalies in orthodontic patients at the State University of New York at Buffalo.

PubMed

Al-Amiri, Athari; Tabbaa, Sawsan; Preston, Charles Brian; Al-Jewair, Thikriat

2013-05-01

To determine the prevalence of permanent tooth anomalies in patients attending the graduate orthodontic clinic at the State University of New York at Buffalo. Charts of 496 subjects (310 females and 186 males) met the inclusion criteria for this study. The mean ages were 16 years and 3 months for the combined gender sample that received orthodontic treatment in the graduate orthodontic clinic between 2007 and 2010. Full pretreatment records (intraoral photographs, digital study models, lateral cephalograms and panoramic radiographs) were used for the assessment. Charts were examined for these anomalies: agenesis, supernumerary, impaction and delayed tooth eruption. Subjects were categorized by gender and ethnicity. The percentages of the anomalies were assessed according to type of malocclusion, gender, race, location, tooth class and region in the dental arches. Sixty-four subjects (12.9%) had at least one occurrence of delayed eruption and impaction (DEI), followed by 47 subjects (9.5%) who had at least one occurrence of agenesis, and seven (1.4%) had a supernumerary condition. Approximately 80% of the subjects had no dental anomalies. The presence of more than one anomaly was observed in 61 subjects. Twelve subjects (2.4%) had both agenesis and DEI. Agenesis tended to be more common in class II malocclusions (p=0.012). The prevalence of permanent tooth anomalies was (20.4%). The percentage occurrence of DEI was the highest (12.9%) followed by dental agenesis (9.5%) and supernumerary teeth (1.4%) in the orthodontic patients at the State University of New York at Buffalo.

Unpredictability of soft tissue changes after camouflage treatment of Class II division 1 malocclusion with maximum anterior retraction using miniscrews.

PubMed

Kim, Kayoung; Choi, Sung-Hwan; Choi, Eun-Hee; Choi, Yoon-Jeong; Hwang, Chung-Ju; Cha, Jung-Yul

2017-03-01

To compare soft and hard tissue responses based on the degree of maxillary incisor retraction using maximum anchorage in patients with Class II division 1 malocclusion. This retrospective study sample was divided into moderate retraction (<8.0 mm; n = 28) and maximum retraction (≥8.0 mm; n = 29) groups based on the amount of maxillary incisor retraction after extraction of the maxillary and mandibular first premolars for camouflage treatment. Pre- and posttreatment lateral cephalograms were analyzed. There were 2.3 mm and 3.0 mm of upper and lower lip retraction, respectively, in the moderate group; and 4.0 mm and 5.3 mm, respectively, in the maximum group. In the moderate group, the upper lip was most influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.94). The lower lip was most influenced by posterior movement of B-point (β = 0.84) and the cervical point of the mandibular incisor (β = 0.83). Prediction was difficult in the maximum group; no variable showed a significant influence on upper lip changes. The lower lip was highly influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.50), but this correlation was weak in the maximum group. Posterior movement of the cervical point of the anterior teeth is necessary for increased lip retraction. However, periodic evaluation of the lip profile is needed during maximum retraction of the anterior teeth because of limitations in predicting soft tissue responses.

Evaluation of orthognathic surgery on articular disc position and temporomandibular joint symptoms in skeletal class II patients: A Magnetic Resonance Imaging study.

PubMed

Firoozei, Gholamreza; Shahnaseri, Shirin; Momeni, Hasan; Soltani, Parisa

2017-08-01

The purpose of orthognathic surgery is to correct facial deformity and dental malocclusion and to obtain normal orofacial function. However, there are controversies of whether orthognathic surgery might have any negative influence on temporomandibular (TM) joint. The purpose of this study was to evaluate the influence of orthognathic surgery on articular disc position and temporomandibular joint symptoms of skeletal CI II patients by means of magnetic resonance imaging. For this purpose, fifteen patients with skeletal CI II malocclusion, aged 19-32 years (mean 23 years), 10 women and 5 men, from the Isfahan Department of Oral and Maxillofacial Surgery were studied. All received LeFort I and bilateral sagittal split osteotomy (BSSO) osteotomies and all patients received pre- and post-surgical orthodontic treatment. Magnetic resonance imaging was performed 1 day preoperatively and 3 month postoperatively. Descriptive statistics and Wilcoxon and Mc-Nemar tests were used for statistical analysis. P <0.05 was considered significant. Disc position ranged between 4.25 and 8.09 prior to surgery (mean=5.74±1.21). After surgery disc position range was 4.36 to 7.40 (mean=5.65±1.06). Statistical analysis proved that although TM disc tended to move anteriorly after BSSO surgery, this difference was not statistically significant ( p value<0.05). The findings of the present study revealed that orthognathic surgery does not alter the disc and condyle relationship. Therefore, it has minimal effects on intact and functional TM joint. Key words: Orthognathic surgery, skeletal class 2, magnetic resonance imaging, temporomandibular disc.

Angle Class I malocclusion treated with lower incisor extraction.

PubMed

Barbosa, Vanessa Leal Tavares

2013-01-01

In planning orthodontic cases that include extractions as an alternative to solve the problem of negative space discrepancy, the critical decision is to determine which teeth will be extracted. Several aspects must be considered, such as periodontal health, orthodontic mechanics, functional and esthetic alterations, and treatment stability. Despite controversies, extraction of teeth to solve dental crowding is a therapy that has been used for decades. Premolar extractions are the most common, but there are situations in which atypical extractions facilitate mechanics, preserve periodontal health and favor maintenance of the facial profile, which tends to unfavorably change due to facial changes with age. The extraction of a lower incisor, in selected cases, is an effective approach, and literature describes greater post-treatment stability when compared with premolar extractions. This article reports the clinical case of a patient with Angle Class I malocclusion and upper and lower anterior crowding, a balanced face and harmonious facial profile. The presence of gingival and bone recession limited large orthodontic movements. The molars and premolars were well occluded, and the discrepancy was mainly concentrated in the anterior region of the lower dental arch. The extraction of a lower incisor in the most ectopic position and with compromised periodontium, associated with interproximal stripping in the upper and lower arches, was the alternative of choice for this treatment, which restored function, providing improved periodontal health, maintained facial esthetics and allowed finishing with a stable and balanced occlusion. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements for obtaining the BBO Diplomate title.

Orthodontic treatment of a complex open-bite malocclusion with temporary anchorage devices: a case report.

PubMed

Waldman, Alexander B

2010-08-01

Orthodontic temporary anchorage devices provide a novel alternative to orthognathic surgery for the treatment of severe anterior open-bite malocclusions. These implantable devices provide skeletal anchorage for maxillary molar intrusion, allowing for mandibular autorotation and subsequent open-bite closure. This case demonstrates step-by-step treatment of a 41-year-old woman with a severe open-bite malocclusion. Detailed orthodontic mechanics are described at every stage of treatment.

25 CFR 291.12 - Who will monitor and enforce tribal compliance with the Class III gaming procedures?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Class III gaming procedures? 291.12 Section 291.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ECONOMIC ENTERPRISES CLASS III GAMING PROCEDURES § 291.12 Who will monitor and enforce tribal compliance with the Class III gaming procedures? The Indian tribe and the State may have an agreement...

49 CFR 1150.33 - Information to be contained in notice-transactions that involve creation of Class III carriers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... that involve creation of Class III carriers. 1150.33 Section 1150.33 Transportation Other Regulations.... 10901 § 1150.33 Information to be contained in notice—transactions that involve creation of Class III...: § 1150.33 Information to be contained in notice—transactions that involve creation of Class III carriers...

Shock absorption ability of laminate mouth guards in two different malocclusions using fiber Bragg grating (FBG) sensor.

PubMed

Bhalla, Ashish; Grewal, Navneet; Tiwari, Umesh; Mishra, Vandana; Mehla, Nahar Singh; Raviprakash, Suryanarain; Kapur, Pawan

2013-06-01

The majority of orofacial injuries affect the upper jaw, with the maxillary incisors being most prone to injury, often accounting for as many as 80% of all cases. Children with malocclusion in the anterior segment of the maxilla are more prone to traumatic injuries than those exhibiting normal occlusion, because most often the damaging force impacts directly against the maxillary anterior teeth. Hence, because of the difference of dissipation of the impact force because of the presence or absence of malocclusion, the mouthguard's shock absorption capacity would be influenced by certain factors. In the present study, a unique in vitro experiment utilizing fiber Bragg Grating (FBG) as distributed strain sensors was carried out to evaluate the shock absorption ability of laminate customized mouthguards in two different malocclusions compared with normal occlusion. The impact was produced using a customized pendulum device with three interchangeable impact objects on typhodont models with two different malocclusions and normal occlusion from different heights. Response of gratings was monitored using an optical spectrum analyzer. Strain induced because each impact was determined from the Bragg's wavelength shifts for each grating. For every model, 12 impact strikes were measured using three different impact objects on the two specified sites by releasing the object from two different heights. The laminated mouthguards showed significant variation in shock absorption ability when different malocclusions were compared. Hence, modifications in the original design of the laminated mouthguards should be considered for athletic competitors with malocclusion to provide adequate protection against impact. FBG sensor has shown the unique advantage of high sensitivity to strain measurement and can be used in further studies. The height of the impact is an important variable in determining the shock absorption ability of mouthguards. © 2012 John Wiley & Sons A/S.

Impact of malocclusion and dentofacial anomalies on the prevalence and severity of dental caries among adolescents.

PubMed

Feldens, Carlos Alberto; Dos Santos Dullius, Angela Isabel; Kramer, Paulo Floriani; Scapini, Annarosa; Busato, Adair Luiz Stefanello; Vargas-Ferreira, Fabiana

2015-11-01

To investigate the association between malocclusion/dentofacial anomalies and dental caries among adolescents. A cross-sectional study was conducted with 509 adolescents aged 11 to 14 years enrolled at public schools in the city of Osório in southern Brazil. Parents/caregivers answered a structured questionnaire on demographic and socioeconomic variables. A trained examiner recorded the presence of malocclusion (Dental Aesthetic Index [DAI]), traumatic dental injury, and dental caries. Data analysis involved the chi-square, Mann-Whitney, and Kruskal-Wallis tests. Poisson regression with robust variance was used for the multivariable analysis. A total of 44.8% of the adolescents had dental caries (mean DFMT  =  1.33 ± 1.84). The DAI index ranged from 15 to 77 (mean  =  29.0 ± 7.9); 43.6% of the sample had severe malocclusion and 11.6% had traumatic dental injury. The prevalence and severity of dental caries were significantly greater among adolescents with severe malocclusion. The multivariate analysis demonstrated that adolescents with severe or handicapping malocclusion had a 31% greater probability of having dental caries (prevalence ratio: 1.31; 95% CI: 1.02-1.67), independently of demographic, socioeconomic, or clinical aspects. The orthodontic characteristics associated with the occurrence and severity of caries were maxillary irregularity ≥3 mm (P  =  .021) and abnormal molar relationship (P  =  .021). Handicapping malocclusion, maxillary irregularity, and abnormal molar relationship were associated with the occurrence and severity of dental caries. The findings suggest that the prevention and treatment of these conditions can contribute to a reduction in dental caries among adolescents.

Orthodontic findings in the deciduous and early mixed dentition--inferences for a preventive strategy.

PubMed

Stahl, Franka; Grabowski, Rosemarie

2003-11-01

The aim of the present epidemiologic study was to obtain representative basic data on the frequency, extent and age-dependence of malocclusions in the deciduous and early mixed dentition. The developmental tendencies of specific malocclusions were investigated from the aspect of orthodontic prevention. The collective comprised 8,864 preschool and school-aged children, of whom 1,225 were in the deciduous dentition (mean age 4.5 years) and 7,639 in the mixed dentition (mean age 8.9 years). The orthodontic data were clinically assessed as sagittal, transversal, or vertical single-arch and occlusal findings. In addition, the malocclusions were classified according to their primary symptoms. Early infantile habits, tongue dysfunctions, speech defects and incompetent lip closure were registered separately. 57% of the children were found to have malocclusions, with the frequency rising statistically significantly in dependence on age from the deciduous to the mixed dentition (p < or = 0.001). The mean extent of excessive overjet increased significantly from the deciduous to the mixed dentition. Crossbite with mandibular midline discrepancies were observed significantly more frequently in the deciduous dentition. Although the frequency of anterior open bite underwent a significant decline from the deciduous to the mixed dentition, open bite was the malocclusion most frequently associated with dysfunction in both groups. The significant increase in traumatic deep bite in the mixed dentition indicates an unfavorable developmental tendency in this anomaly until after the eruption of the permanent incisors. The need for preventive orthodontic therapy and for the intensified application of interceptive and early treatment measures is stressed in view of the high number of malalignments and malocclusions in the deciduous and mixed dentition and the tendency for some forms of malocclusion to deteriorate as the dentition develops.

Postoperative surgical complications of lymphadenohysterocolpectomy

PubMed Central

Marin, F; Pleşca, M; Bordea, CI; Voinea, SC; Burlănescu, I; Ichim, E; Jianu, CG; Nicolăescu, RR; Teodosie, MP; Maher, K; Blidaru, A

2014-01-01

Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. Methods and results Patients were divided according to the type of surgery performed as follows: for cervical cancer – group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer. Abbreviations: PRS- Piver Rutledge-Smith, II- class II, III- class III PMID:24653760

Factors affecting smile esthetics in adults with different types of anterior overjet malocclusion

PubMed Central

Cheng, Pei-Chin

2017-01-01

Objective This study aimed to quantitatively assess the relationship of smile esthetic variables with various types of malocclusion, and identify the cephalometric factors affecting smile measurements. Methods This retrospective study included 106 patients who were treated with retention at the orthodontic department of Taipei Medical University Hospital. Hard-tissue variables were measured using lateral cephalographic tracings, and nine smile esthetic variables were measured using facial photographs. The patients were divided into three groups according to their overjet (< 0, 0–4, and > 4 mm). An analysis of variance was conducted to compare the pretreatment cephalometric variables and smile esthetic variables among the three groups. Multiple linear regression analysis was performed to identify the cephalometric factors affecting the smile measurements in each group. Results Except the upper midline and buccal corridor ratio, all of the smile measurements differed significantly among the three groups before orthodontic treatment. Some of the smile characteristics were correlated with the cephalometric measurements in different types of malocclusion. The overjet was the major factor influencing the smile pattern in all three types of malocclusion. Conclusions Smile characteristics differ between different types of malocclusion; the smile may be influenced by skeletal pattern, dental procumbency, or facial type. These findings indicate that establishment of an optimal horizontal anterior teeth relationship is the key to improving the smile characteristics in different types of malocclusion. PMID:28127537

Effects of Sabbagh Universal Spring 2 fixed functional appliance on class II/1 patients at their postpubertal-peak growth period compared with the extraction method : A randomized clinical trial.

PubMed

Hemmatpour, Siamak; Mokhtar, Ali; Rakhshan, Vahid

2017-01-01

The aim of this study was to evaluate the therapeutic effects of the Sabbagh Universal Spring 2 (SUS 2) fixed functional appliance compared to the premolar extraction method in correcting class II/1 malocclusion in patients who had passed their peak of postpubertal growth (stages 4-6 of Cervical Vertebral Maturation Index). In all, 40 class II/1 patients were randomized to receive SUS 2 application (7 males, 13 females, age 15.75 ± 1.02 years) or maxillary premolar extraction (8 males, 12 females, age 15.40 ± 0.99 years). Pre- and posttreatment digital cephalographs were traced at least twice. A paired t test was used to compare the pre- and posttreatment measurements. Treatment changes were compared using an independent samples t test (P ≤ 0.05). The extent of change was significant in the following variables: ANB, nasolabial angle, Mand1-ML, 1L-NB, anterior and posterior facial heights, N-A-Pog, 1U-NF, 6L-MP, Ar-Go, OP-HP, A-B, A-Sn, B-Sm, APDI, NAPog, AB-NPog, POr-DOP, SN-OcP, POr-OcP, Wits, 1 l-APog, 1LMeLm, S-Go:N-Me, N-ANS-Pog, Ap1LAp1u-DOP, ANS-Cond, Pog-Cond, SS-Ls, A-N-Pog, Pog-Pog', MeGoOcP, 1L-Npog, Go-Me, Go-Me:N-S, S-Me, Ls-(Sn-Pog'), Stms-Stmi, N'-Gn', N'NsPog', 6u-PTV, 1u-NA, FMIA, and IMPA. SUS 2 corrected class II/1 malocclusion of patients in the postpubertal growth period by inhibiting the maxilla's forward growth, advancing the mandible, decreasing the nasolabial and interincisal angles, proclining the incisors, increasing the facial height, and clockwise rotation of the occlusal plane. Extraction reduced the interincisal angle and protruded the lower incisors. However, it did not change the soft tissue thickness and did not cause a clockwise rotation in the occlusal plane.

Malocclusion and orthodontic treatment need of secondary school students in Nigeria according to the dental aesthetic index (DAI).

PubMed

Otuyemi, O D; Ogunyinka, A; Dosumu, O; Cons, N C; Jenny, J

1999-08-01

The aims of this study were to measure the distribution, prevalence and the severity of malocclusion and treatment need amongst randomly selected (n = 703) rural and urban Nigerian children aged 12-18 years (mean 14.0 +/- 1.84) using the dental aesthetic index (DAI), and to assess whether malocclusion was affected by age, gender and socio-economic background. Data were collected according to the method recommended by WHO. Most of the children (77.4 per cent) had a dental appearance which required no orthodontic treatment. Over 13 per cent fell into the group where treatment for malocclusion is considered to be 'elective'. However, a substantial proportion (9.2 per cent) of the population had severe to handicapping malocclusion where treatment is 'highly desirable' or 'mandatory'. There were no statistically significant differences (P > 0.05) in DAI scores between age groups, gender and socio-economic background. This study also found that Nigerian adolescents had better dental appearance and less orthodontic treatment need compared with the Caucasian and Oriental populations.

Occlusion and malocclusion in the cat: what's normal, what's not and when's the best time to intervene?

PubMed

Milella, Lisa

2015-01-01

Malocclusion affecting cats, and treatment thereof, has not been widely described in the veterinary literature, yet is a condition seen in a growing number of breeds, often causing pain and discomfort to the patient. Recognising the problem, and certainly whether it is a hereditary problem (eg, a skeletal malocclusion), is important for the longer term health of pedigree breeds. If there is a malocclusion, the mouth may be painful and a thorough occlusal assessment of the conscious patient may be difficult. Occlusal assessment should always be accompanied by a thorough oral examination and, where necessary, further investigation under general anaesthesia, including dental radiography. Recognising what is normal, and what is not, can be challenging; so, too, can be determining the correct time to intervene. This article is intended to help fill the gap in dental education regarding the range of developmental and acquired malocclusions seen in cats. Treatment options are also briefly reviewed. The guidance contained in this article is based on a combination of the published literature, the author's personal experience and that of colleagues. © ISFM and AAFP 2015.

Morphometric evaluation of condylar cartilage of growing rats in response to mandibular retractive forces.

PubMed

de Sá, Milena Peixoto Nogueira; Zanoni, Jacqueline Nelisis; de Salles, Carlos Luiz Fernandes; de Souza, Fabrício Dias; Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga

2013-01-01

The mandibular condylar surface is made up of four layers, i.e., an external layer composed of dense connective tissue, followed by a layer of undifferentiated cells, hyaline cartilage and bone. Few studies have demonstrated the behavior of the condylar cartilage when the mandible is positioned posteriorly, as in treatments for correcting functional Class III malocclusion. The aim of this study was to assess the morphologic and histological aspects of rat condyles in response to posterior positioning of the mandible. Thirty five-week-old male Wistar rats were selected and randomly divided into two groups: A control group (C) and an experimental group (E) which received devices for inducing mandibular retrusion. The animals were euthanized at time intervals of 7, 21 and 30 days after the experiment had began. For histological analysis, total condylar thickness was measured, including the proliferative, hyaline and hypertrophic layers, as well as each layer separately, totaling 30 measurements for each parameter of each animal. The greatest difference in cartilage thickness was observed in 21 days, although different levels were observed in the other periods. Group E showed an increase of 39.46% in the total layer, reflected by increases in the thickness of the hypertrophic (42.24%), hyaline (46.92%) and proliferative (17.70%) layers. Posteriorly repositioning the mandible produced a series of histological and morphological responses in the condyle, suggesting condylar and mandibular adaptation in rats.

Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome

PubMed Central

Tran, Ngoc Hieu; Tantidhnazet, Syrina; Raocharernporn, Somchart; Kiattavornchareon, Sirichai; Pairuchvej, Verasak; Wongsirichat, Natthamet

2018-01-01

Background The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS. Methods Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method. Results The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria. Conclusion In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS. PMID:29581806

Assessing bone volume for orthodontic miniplate fixation below the maxillary frontal process.

PubMed

Präger, T M; Brochhagen, H G; Mischkowski, R; Jost-Brinkmann, P-G; Müller-Hartwich, R

2014-09-01

The maxillary bone below the frontal process is used for orthodontic anchorage; indications have included skeletally anchored protraction of the maxilla for treating Class III malocclusions or the intrusion of teeth in patients with a deep bite. This study was conducted to assess the condition of bone before cortically implanting miniplates in that area of the maxilla. A total of 51 thin-sliced computed tomography scans of 51 fully-dentate adult patients (mean age 24.0 ± 8.1 years; 27 men and 24 women) obtained prior to third-molar osteotomy were evaluated. Study parameters included total bone thickness, thickness of the facial cortical plate, and width of the nasal maxillary buttress. All these parameters were measured at different vertical levels. The bone volume adjacent to the piriform aperture was most pronounced at the basal level and decreased progressively toward more cranial levels. The basal bone structure had a mean total thickness of 7.8 mm, facial cortical plate thickness of 1.9 mm, and nasal maxillary buttress width of 9.2 mm. At 16 mm cranial to the aperture base, these values fell to 5.6 mm, 1.3 mm, and 5.8 mm, respectively. These bone measurements suggest that screws 7 mm in length can be inserted at the base level of the piriform aperture and screws 5 mm long at the cranial end of the bone.

The Effect of Excipients on the Permeability of BCS Class III Compounds and Implications for Biowaivers.

PubMed

Parr, Alan; Hidalgo, Ismael J; Bode, Chris; Brown, William; Yazdanian, Mehran; Gonzalez, Mario A; Sagawa, Kazuko; Miller, Kevin; Jiang, Wenlei; Stippler, Erika S

2016-01-01

Currently, the FDA allows biowaivers for Class I (high solubility and high permeability) and Class III (high solubility and low permeability) compounds of the Biopharmaceutics Classification System (BCS). Scientific evidence should be provided to support biowaivers for BCS Class I and Class III (high solubility and low permeability) compounds. Data on the effects of excipients on drug permeability are needed to demonstrate that commonly used excipients do not affect the permeability of BCS Class III compounds, which would support the application of biowaivers to Class III compounds. This study was designed to generate such data by assessing the permeability of four BCS Class III compounds and one Class I compound in the presence and absence of five commonly used excipients. The permeability of each of the compounds was assessed, at three to five concentrations, with each excipient in two different models: Caco-2 cell monolayers, and in situ rat intestinal perfusion. No substantial increases in the permeability of any of the compounds were observed in the presence of any of the tested excipients in either of the models, with the exception of disruption of Caco-2 cell monolayer integrity by sodium lauryl sulfate at 0.1 mg/ml and higher. The results suggest that the absorption of these four BCS Class III compounds would not be greatly affected by the tested excipients. This may have implications in supporting biowaivers for BCS Class III compounds in general.

Managing malocclusion in the mixed dentition: six keys to success. Part 1.

PubMed

Fleming, Padhraig S; Johal, Ama; DiBiase, Andrew T

2008-11-01

Indications of developing malocclusion are often present in the mixed dentition.With judicious supervision and timely intervention their effects can be minimized. The general dental practitioner is ideally placed to recognize, manage and correct many such incipient problems. This first of two papers considers three keys to success involving, normal dental development, deviations from normal eruption patterns, crossbite correction and habit cessation. The appropriate management of developing malocclusion may simplify later orthodontic management or indeed make such intervention unnecessary.

The use of functional appliances in contemporary orthodontic practice.

PubMed

DiBiase, A T; Cobourne, M T; Lee, R T

2015-02-16

Functional appliances have been used for over 100 years in orthodontics to correct Class II malocclusion. During this time numerous different systems have been developed often accompanied by claims of modification and enhancement of growth. Recent clinical evidence has questioned whether they really have a lasting influence on facial growth, their skeletal effects appearing to be short term. However, despite these findings, the clinical effectiveness of these appliances is acknowledged and they can be very useful in the correction of sagittal arch discrepancies. This article will discuss the clinical use of functional appliances, the underlying evidence for their use and their limitations.

Sliding mechanics with microscrew implant anchorage.

PubMed

Park, Hyo-Sang; Kwon, Tae-Geon

2004-10-01

Three cases are illustrated. One was treated with maxillary microscrew implants, another with mandibular microscrew implants, and the third with both maxillary and mandibular microscrew implants. With the maxillary microscrew implants, the maxillary anterior teeth were retracted bodily with a slight intrusion and all the premolar extraction space was closed without loss of anchorage. Furthermore, the maxillary posterior teeth showed distal movement. The mandibular microscrew implants controlled the vertical position of the mandibular posterior teeth and played an important role in improving the facial profile. The efficacy of sliding mechanics with microscrew implant anchorage on the treatment of skeletal Class II malocclusion is also discussed.

[A novel protocol for hyperdivergent Class II surgery: innovation or breaking a taboo?].

PubMed

Garcia, Claude; Brunel, Jean-Michel

2009-06-01

The widespread distribution via Internet of images and even videos showing facial surgery has considerably contributed to our knowledge of orthodontic-surgical treatment. The never-ending increase in the number of patients receiving surgery has given us food for thought and statistics. If we are to progress further, we need to innovative in the area of surgical technique as well as in our clinical and psychological approach to patients. We have endeavoured to move forward from the idea of "straightforward" malocclusion repair to that of "morphofunctional surgery of the face" by emphasizing the esthetic and occlusal outcome.

Latent Class Analysis of Differential Item Functioning on the Peabody Picture Vocabulary Test-III

ERIC Educational Resources Information Center

Webb, Mi-young Lee; Cohen, Allan S.; Schwanenflugel, Paula J.

2008-01-01

This study investigated the use of latent class analysis for the detection of differences in item functioning on the Peabody Picture Vocabulary Test-Third Edition (PPVT-III). A two-class solution for a latent class model appeared to be defined in part by ability because Class 1 was lower in ability than Class 2 on both the PPVT-III and the…

49 CFR 572.146 - Test conditions and instrumentation.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Head acceleration—Class 1000 (2) Neck (i) Force—Class 1000 (ii) Moments—Class 600 (iii) Pendulum... acceleration—Class 1000 (ii) Spine and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv...

49 CFR 572.146 - Test conditions and instrumentation.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Head acceleration—Class 1000 (2) Neck (i) Force—Class 1000 (ii) Moments—Class 600 (iii) Pendulum... acceleration—Class 1000 (ii) Spine and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv...

49 CFR 572.146 - Test conditions and instrumentation.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Head acceleration—Class 1000 (2) Neck (i) Force—Class 1000 (ii) Moments—Class 600 (iii) Pendulum... acceleration—Class 1000 (ii) Spine and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv...

49 CFR 572.146 - Test conditions and instrumentation.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Head acceleration—Class 1000 (2) Neck (i) Force—Class 1000 (ii) Moments—Class 600 (iii) Pendulum... acceleration—Class 1000 (ii) Spine and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv...

49 CFR 572.146 - Test conditions and instrumentation.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Head acceleration—Class 1000 (2) Neck (i) Force—Class 1000 (ii) Moments—Class 600 (iii) Pendulum... acceleration—Class 1000 (ii) Spine and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv...

Surgical management of patients with a history of early Le Fort III advancement after they have attained skeletal maturity.

PubMed

Caterson, E J; Shetye, Pradip R; Grayson, Barry H; McCarthy, Joseph G

2013-10-01

The classic Le Fort III procedure was recommended in syndromic craniosynostotic children to reduce exorbitism, improve airway function, and decrease dysmorphism. This study reports on a cohort of syndromic craniosynostosis patients who have undergone early primary subcranial (classic Tessier) Le Fort III advancement and who have been followed longitudinally through skeletal maturity and beyond. In this study, the Le Fort III advancements all occurred between the ages of 3 to 5 years, with a mean age of 4.6 years. Subsequently, these early Le Fort III patients were followed throughout development with longitudinal dental, medical, radiographic, and photographic evaluations conducted through skeletal maturity and beyond. For study inclusion, the patients had to have preoperative medical photographs and cephalometric studies at 6 months and 1, 5, and 10 years postoperatively after the primary Le Fort III advancement as well as cephalometric documentation 6 months and 1 year after the secondary midface advancement after skeletal maturity. After early or primary Le Fort III advancement, there was no evidence of relapse and only minimal anterior or horizontal postoperative growth of the midface. However, there was also a return of occlusal disharmony from "anticipated" mandibular growth, approaching a maximum at skeletal maturity. The dysmorphic concave facial profile and malocclusion, and airway and ocular considerations, provided the impetus for secondary midface surgery after skeletal maturity was attained. The data demonstrate that early Le Fort III advancement performed before the age of mixed dentition does not obviate the need for a secondary advancement after skeletal maturity is reached. Therapeutic, IV.

Molar distalization with 2K appliance: one-year follow-up

PubMed Central

Tripathi, Tulika; Rai, Priyank; Singh, Navneet

2017-01-01

Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angle's Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space. PMID:28717634

Orthodontic Protocol Using Mini-Implant for Class II Treatment in Patient with Special Needs

PubMed Central

Carvalho Ferreira, Fernando Pedrin; de Paula, Eliana de Cássia Molina; Ferreira Conti, Ana Claudia de Castro; Valarelli, Danilo Pinelli; de Almeida-Pedrin, Renata Rodrigues

2016-01-01

Improving facial and dental appearance and social interaction are the main factors for special needs (SN) patients to seek orthodontic treatment. The cooperation of SN patients and their parents is crucial for treatment success. Objective. To show through a case report the satisfactory results, both functional and esthetic, in patients with intellectual disability, congenital nystagmus, and severe scoliosis. Materials Used. Pendulum device with mini-implants as anchorage unit. Results. Improvement of facial and dental esthetics, correction of Class II malocclusion, and no root resorption shown in the radiographic follow-up. Conclusion. Knowing the limitations of SN patients, having a trained team, motivating and counting on the cooperation of parents and patients, and employing quick and low-cost orthodontic therapy have been shown to be the essential factors for treatment success. PMID:27847652

Masticatory function and temporomandibular disorders in patients with dentofacial deformities.

PubMed

Abrahamsson, Cecilia

2013-01-01

About 30% of individuals in the Swedish population will at some stage during life have treatment with orthodontic appliances. In more severe cases, when orthodontic treatment is not considered sufficient enough to correct the malocclusion, the orthodontic treatment is combined with orthognathic surgery. For these cases, a satisfying jaw relation is achieved by surgically moving the maxilla and/or the mandible into a pre-planned position. Patients due to be treated with orthognathic surgery often suffer from an impaired masticatory function, symptoms from the masticatory muscles or temporomandibular joints (temporomandibular disorders), headaches as well as dissatisfaction with their facial aesthetics. Since orthognathic treatment is expensive, in many cases arduous to the patient and not without complications, it is important to assess the treatment outcome and if this is satisfying for the patients. Previous studies that have examined the outcome after orthognathic treatment have had diverging study designs and have come to different conclusions with regard to both temporomandibular disorders and masticatory function. The overall aim of this thesis was to assess and compare the frequencies of temporomandibular disorders and the masticatory function in patients with dentofacial deformities before and after orthognathic treatment. THE THESIS IS BASED ON THE FOLLOWING STUDIES: Paper I is a systematic literature review aiming to, in an evidence-based approach, answer the question whether orthognathic treatment affects the prevalence of signs and symptoms of temporomandibular disorders. The review encompasses the period from January 1966 to April 2006 and was further extended to May 2013 in the frame story of this thesis. CONCLUSIONS IN PAPER I AND THE COMPLEMENTARY SURVEY: There is insufficient scientific evidence for a decrease of sub diagnoses of temporomandibular disorders after orthognathic treatment. There is limited scientific evidence for a reduction of masticatory muscle pain on palpation after orthognathic treatment. There is insufficient scientific evidence for an effect on temporomandibular joint pain on palpation and temporomandibular joint sounds from orthognathic surgery. Further controlled, well-designed studies assessing temporomandibular disorders before and after orthognathic treatment are needed to consolidate strong evidence considering treatment outcomes. Papers II and III are studies comparing frequencies of temporomandibular disorders in patients with dentofacial deformities with a control group. The patients were referred for a combined orthodontic and orthognathic treatment to correct their malocclusion. The control group comprised individuals with normal occlusion or minor malocclusion traits not in need of orthodontic treatment. In Paper III, temporomandibular disorders were longitudinally analysed by assessing and comparing frequencies before and after orthognathic treatment. All individuals in the studies were diagnosed according to the research diagnostic criteria for temporomandibular disorders. CONCLUSIONS IN PAPERS II AND III: Patients due to be treated with orthognathic surgery had more signs and symptoms of temporomandibular disorders and a higher frequency of diagnosed temporomandibular disorders compared with the age- and gender matched control group. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, had a positive treatment outcome in respect of myofascial pain and arthralgia. After treatment the frequency of temporomandibular disorders . in the treatment group was low and at an equivalent level of that in the control group. Paper IV evaluates the self-estimated masticatory ability and the masticatory performance before and after orthognathic treatment in the same individuals as in Paper II and III. CONCLUSIONS IN PAPER IV: Masticatory ability and performance increased after orthognathic treatment. The number of occlusal contacts and severity of overall symptoms of TMD influenced both the masticatory ability and performance. Open bite had a negative effect on masticatory performance.

Teeth eruption in children with normal occlusion and malocclusion.

PubMed

Legović, Mario; Legović, Asja; Slaj, Martina; Mestrović, Senka; Lapter-Varga, Marina; Slaj, Mladen

2008-06-01

The aim of this study was to assess the differences in eruption of permanent teeth (C, P1, P2 and M2) in a group of children with and without malocclusion. A sample of 1758 children (921 boys and 837 girls), aged 8-13 was randomly selected. The subjects were grouped by chronological age (11 groups) and by presence of malocclusion. Statistically significant differences were found for both, upper and lower canines in the age group 11 (p<0.01). Statistically significant difference was found in the age group 8.5 for upper first (p<0.05), upper second premolars (p<0.01) in the age group 10, and the lower second premolars in the age group 11 (p<0.05). Premature loss of deciduous teeth caused early eruption of succedaneus permanent teeth, possibly leading to development of a malocclusion.

Frequency of rhinitis and orofacial disorders in patients with dental malocclusion

PubMed Central

Imbaud, Tamara Christine de Souza; Mallozi, Márcia Carvalho; Domingos, Vanda Beatriz Teixeira Coelho; Solé, Dirceu

2016-01-01

Abstract Objective: To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Methods: Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (São Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. Results: The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. Conclusions: The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed. PMID:26631324

Impact of malocclusion on affective/romantic relationships among young adults.

PubMed

Pithon, Matheus Melo; Dos Santos, Camila Rangel; Lima Santos, Nathalia de; Aguiar Sales Lima, Stefanni Olga; da Silva Coqueiro, Raildo; Dos Santos, Rogério Lacerda

2016-07-01

To evaluate the extent to which different types of malocclusion influence the development of affective/romantic relationships among young adults of both sexes. A cross-sectional study was conducted with 360 men and women ranging in age from 18 years to 25 years. Criteria for exclusion from the sample were the following: participants could not be married, visually impaired, or students of a higher education course in the area of health. In this study, images of young adult men and women in the same age range as that of the evaluators were used. These images were manipulated to create different types of malocclusion: diastema, open bite, crowding, gingival (or gummy) smile, little exposure of teeth. Six groups of images containing six images each were formed and consisted of two experimental images (digitally manipulated) and four control images. These images were provided to the participants, who evaluated them by means of a questionnaire and a visual analog scale. The Kruskal-Wallis, Mann-Whitney, chi-square, and Fisher exact tests were used for data analysis. All malocclusions had a negative impact on acceptance by the evaluators for the purposes of affective/romantic relationships, with crowding being the type of malocclusion that led to the highest level of rejection (P < .01). Malocclusions have a negative influence on the development of affective/romantic relationships among young adults. Individuals with good occlusion are seen in a more positive light, from the perspective of affective life.

Malocclusion and oral health-related quality of life in Brazilian school children.

PubMed

Sardenberg, Fernanda; Martins, Milene T; Bendo, Cristiane B; Pordeus, Isabela A; Paiva, Saul M; Auad, Sheyla M; Vale, Miriam P

2013-01-01

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05). Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

49 CFR 572.137 - Test conditions and instrumentation.

Code of Federal Regulations, 2011 CFR

2011-10-01

...—Class 1000 (2) Neck: (i) Forces—Class 1000 (ii) Moments—Class 600 (iii) Pendulum acceleration—Class 180... and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv) Forces—Class 1000 (v...—Class 180 (6) Femur forces and knee pendulum—Class 600 (n) Coordinate signs for instrumentation polarity...

49 CFR 572.137 - Test conditions and instrumentation.

Code of Federal Regulations, 2010 CFR

2010-10-01

...—Class 1000 (2) Neck: (i) Forces—Class 1000 (ii) Moments—Class 600 (iii) Pendulum acceleration—Class 180... and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv) Forces—Class 1000 (v...—Class 180 (6) Femur forces and knee pendulum—Class 600 (n) Coordinate signs for instrumentation polarity...

49 CFR 572.137 - Test conditions and instrumentation.

Code of Federal Regulations, 2013 CFR

2013-10-01

...—Class 1000 (2) Neck: (i) Forces—Class 1000 (ii) Moments—Class 600 (iii) Pendulum acceleration—Class 180... and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv) Forces—Class 1000 (v...—Class 180 (6) Femur forces and knee pendulum—Class 600 (n) Coordinate signs for instrumentation polarity...

49 CFR 572.137 - Test conditions and instrumentation.

Code of Federal Regulations, 2014 CFR

2014-10-01

...—Class 1000 (2) Neck: (i) Forces—Class 1000 (ii) Moments—Class 600 (iii) Pendulum acceleration—Class 180... and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv) Forces—Class 1000 (v...—Class 180 (6) Femur forces and knee pendulum—Class 600 (n) Coordinate signs for instrumentation polarity...

49 CFR 572.137 - Test conditions and instrumentation.

Code of Federal Regulations, 2012 CFR

2012-10-01

...—Class 1000 (2) Neck: (i) Forces—Class 1000 (ii) Moments—Class 600 (iii) Pendulum acceleration—Class 180... and pendulum accelerations—Class 180 (iii) Sternum deflection—Class 600 (iv) Forces—Class 1000 (v...—Class 180 (6) Femur forces and knee pendulum—Class 600 (n) Coordinate signs for instrumentation polarity...

Individual factors associated to malocclusion in adolescents.

PubMed

Rebouças, Adriana Gama; Zanin, Luciane; Ambrosano, Gláucia Maria Bovi; Flório, Flávia Martão

2017-11-01

The study aimed to identify the severity of malocclusions and associated factors among Brazilian adolescents. Data from 5,445 adolescents participating in the Brazilian Oral Health Survey (SBBrasil 2010) were evaluated, of which 4,276 were included in the study based on the inclusion criteria. The dependent variable was severe and very severe malocclusion, according to the Dental Aesthetic Index (DAI > 30). The independent variables were place of residence, macro-region, self-reported ethnicity, income, gender, schooling, access to dental care, untreated caries and front and back teeth loss due to caries. A hierarchical multiple logistical regression analysis was performed, considering the complex cluster sampling plan. Prevalence of severe/very severe malocclusions was 17.5%. After adjustments, black/brown ethnicity group (OR = 1.59, 95% CI: 1.09-2.34), lower household income (OR = 0.67, 95% CI: 0.55-0-82), front (OR = 2.32, 95% CI: 1.14-4.76) and back teeth (OR = 1.45, 95% CI: 1.14-1.84) loss due to caries were associated with the outcome. Therefore, we conclude that black/brown ethnicity, lower household income and greater number of front and back teeth loss due to caries increased the odds for severe/very severe malocclusion.

Psycho-Neurological Status in Children with Malocclusions and Muscle Pressure Habits.

PubMed

Rubleva, Irina A; Persin, Leonid S; Slabkovskaya, Anna B; Zavadenko, Nikolay N; Deregibus, Andrea; Debernardi, Cesare L

2015-01-01

Non-nutritive sucking behaviors such as finger- and tongue-sucking, tongue thrust, lips- or cheek-sucking, nail-, lip- or tongue-biting and other pressure habits represent risk factors for malocclusion. The association between psycho-neurological disorders and different types of malocclusion in children with sucking habits was long studied. During neurological examination, many children with sucking habits are diagnosed as Minimal Cerebral Dysfunction or Attention Deficit Hyperactivity Disorder (ADHD) bearers. The aim of this study is to assess the psycho-neurological status and motor disorders in children with malocclusion and normal occlusion. 135 children, aged between 8 and 12 years old, were examined, 42 children with normal occlusion and 93 children with different types of malocclusion. Besides clinical examination, all children were studied by the following psychoneurological methods: 1) Parent's Questionnaire, 2) Diagnostic interview Kiddie-Sads 3) Physical and Neurological Exam for Subtle Signs and 4) stabilometric tests. This study shows as in presence of dentofacial anomalies, pressure habits, ADHD reports significant effects on the functional state of the motor system: increases are noted in all basic parameters of statokinesiograms (crossed distance, sway area and ellipse surface), which lead to increased physiologic energy costs to maintain the vertical position of the body.

PubMed Central

Paolantonio, E.G.; Antonini, G.; Saulle, R.; La Torre, G.; Deli, R.

2016-01-01

SUMMARY The ratio of bad habits, mouth breathing and malocclusion is an important issue in view of prevention and early treatment of disorders of the craniofacial growth. While bad habits can interfere with the position of the teeth and normal pattern of skeletal growth, on the other hand obstruction of the upper airway, resulting in mouth breathing, changes the pattern of craniofacial growth causing malocclusion. Our crosssectional study, carried out on 3017 children using the ROMA index, was developed to verify if there was a significant correlation between bad habits/mouth breathing and malocclusion. The results showed that an increase in the degree of the index increases the prevalence of bad habits and mouth breathing, meaning that these factors are associated with more severe malocclusions. Moreover, we found a significant association of bad habits with increased overjet and openbite, while no association was found with crossbite. Additionally, we found that mouth breathing is closely related to increased overjet, reduced overjet, anterior or posterior crossbite, openbite and displacement of contact points. Therefore, it is necessary to intervene early on these aetiological factors of malocclusion to prevent its development or worsening and, if already developed, correct it by early orthodontic treatment to promote eugnatic skeletal growth. PMID:27958599

Pharyngeal airway effects of Herbst and skeletal anchored Forsus FRD EZ appliances.

PubMed

Celikoglu, Mevlut; Buyuk, Suleyman Kutalmis; Ekizer, Abdullah; Unal, Tuba

2016-11-01

To evaluate the skeletal and pharyngeal airway effects of skeletal anchored Forsus FRD EZ appliance using bilateral miniplates inserted on mandibular symphyses and to compare the findings with a well matched control group treated using a Herbst appliance. Thirty patients with skeletal Class II malocclusion due to mandibular retrusion were divided into two groups. Group 1 consisted of 15 patients (8 females and 7 males; mean age: 13.11 ± 1.29 years) treated using the Herbst appliance and Group 2 consisted of 15 patients (9 females and 7 males; 12.84 ± 1.27 years) treated using the skeletal anchored Forsus FRD EZ appliance. Treatment changes were assessed by means of linear, angular, and area measurements. The groups were well matched regarding to the chronological ages, gender distribution and initial cephalometric values (P > 0.05). In both groups, skeletal Class II malocclusion was corrected by decrease in SNA and increase in SNB, Co-Gn, VRL-B and VRL-Pog measurements. Those changes caused a significant correction in the maxillo-mandibular relationship. Upper and lower pharyngeal airway dimensions were increased in both group, while the increase in the lower pharyngeal dimension was found to be statistically significant in the skeletal anchored Forsus FRD EZ group (P < 0.05). Oropharyngeal area measurements significantly increased in both groups (P < 0.001 and P < 0.01, respectively). Comparison of the groups showed that both groups had similar changes with no statistically significant differences (P > 0.05). Skeletal changes produced by both appliances caused significant pharyngeal airway changes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Adult orthodontic therapy: extraction versus non-extraction.

PubMed

Baumrind, S

1998-11-01

This study addresses the problem of randomization of subjects with respect to an irreversible aspect of treatment strategy, namely, the extraction of teeth. The investigation includes both prospective and retrospective components. The data presented focus on clinician decision-making. Of the 1321 potential subjects for whom records were taken, 250 met the inclusion criteria. Of these subjects, 82 declined to participate and 20 were dropped because of difficulty in obtaining five independent evaluations of their records within a reasonable time frame. Thus, the final sample contained 148 subjects. Approximately one-third of the subjects in the sample are adult, somewhat more than half are female, and Class I malocclusions outnumber Class II malocclusions by a count of 95 to 53. Patterns of agreement and disagreement among five clinicians include: a) agreement/disagreement on the primary decision whether or not to extract: the data reveal a strong tendency towards consensus among the clinicians; b) agreement/disagreement on extraction pattern in patients in whom the clinician believes that extraction is indicated: the clinicians tended strongly to agree on extraction pattern; c) agreement/disagreement on the need for adjunctive orthognathic surgery: decisions favoring surgery were more common and more 'definite' than 'probable' in the adult cohort than in the adolescent cohort but this tendency was not as strong as had been anticipated; d) agreement/disagreement concerning Angle classification: disagreements were more common than had been anticipated; and e) differences among the individual clinicians as to their ratios of extraction/non-extraction decisions: overall, clinicians opted for extraction less frequently in the adolescent cohort than in the adult cohort (55 vs. 66%). Because the data are drawn from actual clinical experience, the conclusions involve a number of assumptions and their generalizability should be evaluated.

Three-dimensional analysis of the change in the curvature of the smiling line following orthodontic treatment in incisor class II division 1 malocclusion.

PubMed

Mah, Michael; Tan, Wei Chuan; Ong, Sim Heng; Chan, Yiong Huak; Foong, Kelvin

2014-12-01

To investigate the different effects of changes in the occlusal plane, incisors inclination, and maxillary intercanine width on the curvature of the smiling line. Records of 46 subjects (28 females and 18 males, mean age 16.6 ± 4.2 years) with incisor class II division 1 malocclusions were selected. All subjects had four premolar extractions and were treated with preadjusted edgewise appliances. Pre- and post-treatment maxillary dental digital models were virtually aligned via corresponding landmarks to the respective lateral cephalograms. Subsequent two-dimensional superimposition of the aligned cephalograms facilitated the three-dimensional superimposition of the pre- and post-treatment models. This process allowed the quantification of the curvature from a frontal perspective of the models. The change in curvature was then correlated with changes in the cephalometric inclination of the anterior occlusal plane (AOP), functional occlusal plane (FOP), maxillary central incisor (U1), and the intercanine width. Orthodontic correction in this sample resulted in the clockwise rotation of the anterior occlusal plane (5.84 degrees), reduction in proclination of the incisors (-14.39 degrees), increase in intercanine width (2.48mm), and a corresponding increase in the curvature of the smiling line (6.83 degrees). The change in curvature of the smiling line in these subjects was found to be related more significantly to the magnitude of difference in the inclination between the pre-treatment AOP and FOP than to the change in the inclination of the maxillary incisors. With orthodontic treatment, the smiling line can be correlated with cephalometric data to improve or maintain the curvature. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Objectification of Orthodontic Treatment Needs: Does the Classification of Malocclusions or a History of Orthodontic Treatment Matter?

PubMed

Kozanecka, Anna; Sarul, Michał; Kawala, Beata; Antoszewska-Smith, Joanna

2016-01-01

Orthodontic classifications make it possible to give an accurate diagnosis but do not indicate an objective orthodontic treatment need. In order to evaluate the need for treatment, it is necessary to use such indicators as the IOTN. The aim of the study was to find (i) relationships between individual diagnosis and objective recommendations for treatment and (ii) an answer to the question whether and which occlusal anomalies play an important role in the objectification of treatment needs. Two hundred three 18-year-old adolescents (104 girls, 99 boys) were examined. In order to recognize occlusal anomalies, the classifications proposed by Orlik-Grzybowska and Ackerman-Proffit were used. The occlusal anomalies were divided into three categories: belonging to both classifications, typical of OrlikGrzybowska classification and typical of Ackerman-Proffit classification. In order to determine the objective need for orthodontic treatment, the Dental Health Component (DHC) of the IOTN was used. The occurrence of the following malocclusions covered by both classifications, namely abnormal overjet, crossbite and Angle's class, had a statistically significant (p < 0.05) impact on an increase of treatment needs in the subjects (DHC > 3). As for the classification by Orlik-Grzybowska, dental malpositions and canine class significantly affected the need for orthodontic treatment, while in the case of the Ackerman-Proffit scheme, it was asymmetry and crowding. There was no statistically significant correlation between past orthodontic treatment and current orthodontic treatment need. IOTN may be affected by a greater number of occlusal anomalies than it was assumed. Orthodontic treatment received in the past slightly reduces the need for treatment in 18-year-olds.

A comparison of skeletal stability after mandibular advancement and use of two rigid internal fixation techniques.

PubMed

Blomqvist, J E; Ahlborg, G; Isaksson, S; Svartz, K

1997-06-01

Two different methods of rigid fixation were compared for postoperative stability 6 months after mandibular advancement for treatment of Class II malocclusion. Sixty (30 + 30) patients from two different oral and maxillofacial units treated for a Class II malocclusion by bilateral saggital split osteotomy (BSSO), and two different methods of internal rigid fixation were prospectively investigated. Two groups (S1, n = 15; S2, n = 15) had bicortical noncompressive screws inserted in the gonial area through a transcutaneous approach, and the other two groups (P1, n = 15; P2, n = 15) had the bone segments fixed with unicortical screws and miniplates on the lateral surface of the mandibular body. Cephalograms were taken preoperatively, 2 days postoperatively and 6 months after the operation. A computer program was used to superimpose the three cephalograms and to register the mandibular advancement and postoperative change both sagittally and vertically. These were minor differences in the advancement and postoperative changes between the four groups, but statistically no significant difference was shown in either sagittal or vertical directions. However, statistically verified differences proved that increasing age was associated with a smaller amount of postsurgical relapse. Low-angle cases (ML/NSL < 25 degrees) had a bigger amount of surgical (P = .0008) and postsurgical (P = .0195) movement compared with the patients in the high-angle group (ML/NSL < 38 degrees). Using a multiple regression test, a positive correlation was also shown between the amount of surgical advancement and the amount of postsurgical instability (P = .018). This prospective dual-center study indicates that the two different methods of internal rigid fixation after surgical advancement of the mandible by BSSO did not significantly differ from each other, and it is up to the individual operator to choose the method for internal rigid fixation.

A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial

PubMed Central

Haj-Younis, Samiha; Khattab, Tarek Z.; Hajeer, Mohammad Y.; Farah, Hassan

2016-01-01

ABSTRACT Objective: To compare speech performance and levels of oral impairment between two types of lingual brackets. Methods: A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years) with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio). Either STb (Ormco) or 7th Generation (Ormco) lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0), one week following premolar extraction prior to bracket placement (T1), within 24 hours of bracket bonding (T2), one month after (T3), and three months after (T4) bracket placement. Patients′ acceptance was assessed by means of standardized questionnaires. Results: After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. Conclusions: 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment. PMID:27653268

A comparison between two lingual orthodontic brackets in terms of speech performance and patients' acceptance in correcting Class II, Division 1 malocclusion: a randomized controlled trial.

PubMed

Haj-Younis, Samiha; Khattab, Tarek Z; Hajeer, Mohammad Y; Farah, Hassan

2016-01-01

To compare speech performance and levels of oral impairment between two types of lingual brackets. A parallel-group randomized controlled trial was carried out on patients with Class II, Division 1 malocclusion treated at the University of Hama School of Dentistry in Hama, Syria. A total of 46 participants (mean age: 22.3 ± 2.3 years) with maxillary dentoalveolar protrusion were randomly distributed into two groups with 23 patients each (1:1 allocation ratio). Either STb (Ormco) or 7th Generation (Ormco) lingual brackets were applied. Fricative sound/s/ spectrograms were analyzed directly before intervention (T0), one week following premolar extraction prior to bracket placement (T1), within 24 hours of bracket bonding (T2), one month after (T3), and three months after (T4) bracket placement. Patients' acceptance was assessed by means of standardized questionnaires. After bracket placement, significant deterioration in articulation was recorded at all assessment times in the 7th Generation group, and up to T3 in the STb group. Significant intergroup differences were detected at T2 and T3. No statistically significant differences were found between the two groups in reported tongue irritation levels, whereas chewing difficulty was significantly higher in the 7th Generation group one month after bracket placement. 7th Generation brackets have more interaction with sound production than STb ones. Although patients in both groups complained of some degree of oral impairment, STb appliances appeared to be more comfortable than the 7th Generation ones, particularly within the first month of treatment.

40 CFR 131.35 - Colville Confederated Tribes Indian Reservation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... would be limited to the extent that bacterial infections of eyes, ears, respiratory, or digestive... Creek Class I Coyote Creek Class II Deerhorn Creek Class III Dick Creek Class III Dry Creek Class I...

Asymmetric severe skeletal Class II division 1 patient with temporomandibular joint disorder treated with zygomatic anchorage devices and Ni-Ti alloy wires.

PubMed

Ishida, Takayoshi; Ono, Takashi

2014-09-01

To describe the orthodontic treatment of a nongrowing 30-year-old woman with asymmetric severe skeletal Class II malocclusions (asymmetric Angle Class II), large overjet (16 mm), large overbite (8 mm), two congenitally missing mandibular incisors (presenting a deciduous anterior tooth), and signs and symptoms of temporomandibular joint disorder (TMD). We used novel improved super-elastic Ni-Ti alloy wires (ISWs) combined with Ni-Ti alloy coil springs, power hooks, and a zygomatic implant as reinforced anchorage to provide a constant and continuous mild force to the dentition. We successfully distalized maxillary molars, premolars, and retracted anterior teeth and corrected the asymmetric Angle Class II molar relationship using this system of zygomatic anchorage in conjunction with ISWs, Ni-Ti alloy open-coil springs, and crimpable power hook. The maxillary molars were distalized, and postero-occlusal relationships were improved to achieve Class I canine and molar relationships on both sides. Intrusion of the upper molars made the mandibular plane close. Ideal overbite and overjet relationships were established. Facial esthetics were improved with decreased upper and lower lip protrusion, and no symptoms of TMD were observed after treatment. The orthodontic treatment described here is a promising anchorage technique alternative to traditional techniques to improve severe skeletal Class II with TMD.

Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population.

PubMed

Choi, Sung-Hwan; Kim, Jung-Suk; Cha, Jung-Yul; Hwang, Chung-Ju

2016-03-01

The aim of this study was to evaluate the effect of malocclusion severity on oral health-related quality of life and food intake ability in adult patients, controlling for sex, age, and the type of dental clinic visited. The sample consisted of 472 Korean patients (156 male, 316 female) with a mean age of 21.1 (SD, 8.6) years in a dental hospital and a private clinic. The correlations between the Korean version of the Oral Health Impact Profile-14 (OHIP-14K), subjective food intake ability (FIA) for 5 key foods, and Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC) were investigated. The mean IOTN-DHC and OHIP-14K scores were significantly higher for the dental hospital patients than for the private clinic patients (IOTN-DHC, P <0.001; OHIP-14K, P <0.05). Malocclusion severity was significantly higher in male than in female subjects (P <0.001). Older patients perceived their oral health-related quality of life more negatively than did the teens (P <0.001). As the severity of the malocclusion increased, oral health-related quality of life and masticatory function worsened (OHIP-14K, P <0.001; FIA, P <0.05). As the severity of the malocclusion and the age of the patients increased, oral health-related quality of life and masticatory function relatively deteriorated. This finding provides evidence that severe malocclusions are associated with lower quality of life and less masticatory efficiency in older patients. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

[Frequency of rhinitis and orofacial disorders in patients with dental malocclusion].

PubMed

Imbaud, Tamara Christine de Souza; Mallozi, Márcia Carvalho; Domingos, Vanda Beatriz Teixeira Coelho; Solé, Dirceu

2016-06-01

To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (Sao Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test (SPT) with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Epidemiology of malocclusion and orthodontic treatment need of 12-13-year-old Malaysian schoolchildren.

PubMed

Esa, R; Razak, I A; Allister, J H

2001-03-01

Data on malocclusion and orthodontic treatment need in Malaysia are limited. The purpose of this study was to evaluate malocclusion and orthodontic treatment need in a sample of 12-13-year-old schoolchildren using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and socio-demographic variables, perceptions of need for orthodontic treatment, aesthetic perception and social functioning. The sampling procedure involved a multistage, clustered and stratified random sampling. The sample comprised of 1,519 schoolchildren attending 20 secondary government and government-aided schools in urban and rural areas of Klang District in Peninsular Malaysia. There were 772 males and 747 females. Each subject was administered a questionnaire eliciting standard demographic information such as gender, parents' income and ethnic origin and questions on perception of need for orthodontic treatment and satisfaction with dental appearance and function. Intra-oral examination for occlusal status using the DAI was performed for each subject. Most subjects (62.6%) require no orthodontic treatment. Only about 7% had handicapping malocclusion that needed mandatory treatment. Malocclusion, as defined in this study, was found to be significantly associated with gender and subjects' area of residence. There were no significant differences in mean DAI scores for Malays, Chinese and Indian children. Significant associations were found between DAI scores and perception of need for orthodontic treatment, satisfaction with dental appearance and social functioning (P<0.01). The findings will be useful for the public dental service to determine priority for orthodontic treatment as part of the comprehensive care provided by the School Dental Service (SDS).

Perception of personal dental appearance in Nigerian adolescents.

PubMed

Onyeaso, Chukwudi Ochi; Sanu, Oluwatosin Oluyemi

2005-06-01

The purpose of this study was to investigate the relationship among Nigerian adolescents' awareness of malocclusion, their satisfaction with personal dental appearance, and the severity of their occlusal irregularities. The sample consisted of 577 randomly selected secondary school adolescents-306 (53%) boys and 271 (47%) girls aged 12 to 17 years (mean age, 14.73 +/- 1.12). A pretested questionnaire was used to assess the subjects' awareness of malocclusion and satisfaction with personal dental appearance; the actual severity of malocclusion was determined by using the dental aesthetic index (DAI), performed by an orthodontist in a school environment under natural illumination. Statistically significant, negative, weak correlations were found between awareness of malocclusion and satisfaction at the various DAI scores as follows: < or =25 (r = -0.3774, P < .001), 26 to 30 (r = -0.4305, P < .001), 31 to 35 (r = -0.5137, P < .001), and > or =36 (r = -0.5104, P < .001). Analysis of variance (ANOVA) did not show a significant value of any of the 3 factors. Multivariate analysis with age as the covariate did not show a significant effect. Also, the association between socioeconomic status and the variables was not significant ( P > .05). Generally, no statistically significant sex differences were found in relation to the DAI scores, awareness, or satisfaction ( P > .05). Significant, negative, weak correlations were found between Nigerian adolescents' awareness of malocclusion and satisfaction with personal dental appearance at the various severity levels of malocclusion. It would be worthwhile to assess such a relationship with the index of orthodontic treatment need in the Nigerian population.