The Effects of Intrusion of Anterior Teeth by Skeletal Anchorage in Deep Bite Patients; A Systematic Review and Meta-Analysis.

BACKGROUND: Deep bite is known as one of the most common malocclusions, and its treatment and retention are often challenging. The use of mini-screws has been suggested as an ideal method for the intrusion of incisors in deep-bite patients. Still, there are conflicting reports regarding the superiority of this method compared to other common treatments. AIM: The aim of this systematic review and meta-analysis was to evaluate the effects of the intrusion of anterior teeth by skeletal anchorage in deep bite patients. METHODS: From the beginning to 15 September 2022, articles on the topic of interest were searched in electronic databases including PubMed, Web of Science, Scopus, EMBASE, and Cochrane's CENTRAL. Additionally, a hand search for pertinent studies and a search of the grey literature were carried out. After the selection of eligible studies, data extraction was performed using piloted forms. Inverse-variance random-effects meta-analyses were used to combine the outcome measures of dental indices, skeletal cephalometric indices, and dental cephalometric indices. RESULTS: A total of 15 studies (6 RCT; 9 CCT) were included in the systematic review and 14 were used in the meta-analyses. The differences in overbite changes (MD = -0.45, p = 0.04), true incisor intrusion [u1-pp] (MD = -0.62, p = 0.003) and molar extrusion [u6-pp] (MD = -0.40, p = 0.01) were statistically significant and TADs showed better treatment results than other intrusion methods (segmented intrusion arch, utility arch, J hook headgear). No significant differences regarding overjet, molar and incisor tipping, and skeletal indices between mini-screw and other intrusion methods could be found. CONCLUSION: The use of mini-screws leads to lower overbite and higher true intrusion (about 0.45 and 0.62 mm, respectively) compared to the use of other methods for intruding upper incisors. Furthermore, the effect of TAD on extrusion of molar teeth is less (by 0.4 mm) than other methods.

Do We Vary from Caucasians! Cephalometric Analysis for Orthognathic Surgery in Chhattisgarhi Population.

Aim: The aim of this study is to deduce the cephalometric norms for orthognathic surgery in Chhattisgarh population by comparing with the analysis given by Burstone et al. for hard tissue and Legan and Burstone for soft tissue. Materials and Methods: Lateral cephalograms of 70 subjects (35 male and 35 female) aged between 18 and 25 years having class I malocclusion, acceptable facial profile were recorded and traced for the analysis and interpretation using landmarks and values given by Burstone's analysis were obtained and further comparison was done for the values obtained for the Chhattisgarh population with that of Caucasians. Results: Findings of our study were statistically significant as considerable skeletal differences were found between men and women of Chhattisgarh origin compared to Caucasian origin. Many contrasting findings were discovered in our study group from that of the Caucasian population with respect to the maxillo-mandibular relation, vertical hard tissues parameters. Less differences were found in horizontal hard tissue parameters and dental parameters among the two study populations. Conclusion: The differences found must be kept in consideration during analysis of cephalogram for orthognathic surgeries. Values obtained can be considered to assess deformities and surgical planning to achieve optimal results for Chhattisgarh population. Clinical Significance: The understanding of normal human adult's facial measurements are important to assess craniofacial dimensions and facial deformities and to monitor postoperative results in orthognathic surgeries. Cephalometric norms can be a beneficial abet to clinicians in ascertaining the patient abnormalities. Norms define the ideal cephalometric measurements for patients based on factors such as age, sex, size and race. It has become apparent over years that significant variations do occur among and between the individuals of different racial origins.

Effects on root axes and resorption of simultaneous intrusion and retraction of maxillary central and lateral incisors using mini-implant supported three-piece burstone base arch: A prospective observational study.

OBJECTIVE: Prospective morphometric evaluation of the positional changes and root resorption of maxillary central and lateral incisors undergoing simultaneous intrusion and retraction (SIR) using mini-implant supported 3-piece Burstone base arch. MATERIALS AND METHODS: Bracket head type mini-implants were inserted between the maxillary second premolar and first permanent molar. After maxillary canine retraction, SIR of maxillary incisors was begun using mini-implant supported 3-piece Burstone arch. A segmental CBCT was taken before and after SIR of the maxillary four incisors. Data collected were analysed using Paired t test, ANOVA test, independent sample t test and Pearson's correlation test. RESULTS: Sixteen patients of 17.9±1.94 years mean age with class II division 1 malocclusion, deep bite≥4mm and overjet 5-8mm were selected. All mini-implants showed good stability during treatment with no looseness. Increasing the vertical end of the anterior segment up to 10mm led to controlled tipping and partial bodily retraction of the maxillary central and lateral incisors. The centre of resistance (CRe) of the four maxillary incisors was retracted 2.38±0.77mm and intruded 2.76±1.0mm with a mean change in axial inclination of 9.76±3.45°. The mean amount of root resorption of the four incisors was 1.29±0.59mm over a mean period of 6.2 months. CONCLUSIONS: The mini-implant supported 3-piece Burstone base arch had a pronounced effect on SIR of flared maxillary incisors with clinically insignificant amount of root resorption.

Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms.

Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in Taiwan, (2) compare this 3D norm dataset with the two-dimensional (2D) Burstone norms from Caucasian and Singaporean Chinese populations, and (3) apply these 3D norms to assess the outcome of a computer-aided simulation of orthognathic surgery. Three-dimensional Burstone cephalometric analysis was performed on 3D digital craniofacial image models generated from cone-beam computed tomography datasets of 60 adult Taiwanese Chinese individuals with normal occlusion and balanced facial profile. Three-dimensional Burstone analysis was performed on 3D image datasets from patients with skeletal Class III pattern (n = 30) with prior computer-aided simulation. Three-dimensional Burstone cephalometric measurements showed that Taiwanese Chinese males had significantly (p < 0.05) larger anterior and posterior facial heights, maxillary length, and mandibular ramus height than females, with no significant (p > 0.05) difference for facial soft-tissue parameters. The 3D norm dataset revealed Taiwanese Chinese-specific facial characteristics, with Taiwanese presenting (p < 0.05) a more convex profile, protrusive maxillary apical bases, protruding mandible, protruding upper and lower lips, and a shorter maxillary length and lower facial height than Caucasians. Taiwanese had significantly (p < 0.05) larger maxillary projection, vertical height ratio, lower face throat angle, nasolabial angle, and upper lip protrusion than Singaporean Chinese. No significant (p > 0.05) difference was observed between 3D norms and computer-aided simulation-derived 3D patient images for horizontal skeletal, vertical skeletal, and dental measurements, with the exception of two dental parameters (p < 0.05). This study contributes to literature by providing gender- and ethnic-specific 3D Burstone cephalometric norms, which can assist in the multidisciplinary-based delivery of orthodontic surgical care for Taiwanese Chinese individuals worldwide, including orthodontic management, computer-assisted simulation, and outcome assessment.

Effect of Oral Submucous Fibrosis on Jaw Dimensions.

OBJECTIVE: The disuse of the jaws owing to the restricted movement of the mandible in advanced cases of oral submucous fibrosis (OSMF) may have an effect on the morphologic features of the jaw bones. The purpose of the present study was to determine the jaw bone measurements in patients with OSMF and to compare the measurements in normal subjects and Caucasian norms. METHODS: The lateral cephalograms of 59 subjects (43 males and 16 females) with OSMF and 44 normal subjects (23 males and 21 females) in the age group of 18-45 years were collected. The jaw measurements were performed using Burstone analysis, and the relevant linear measurements of jaw sizes included were N-A, N-B, N-ANS, ANS-PNS, ANS-Gn, Ar-Go, and Pg-Go. The sex-wise comparison was performed using unpaired t-test, and measurements were compared with other studies using Z test. RESULTS: In the present study, sex-wise comparison was found to be significant with greater jaw measurements in males than in females in patients with OSMF. Overall, the measurements were less or equal in patients with OSMF than in normal subjects except for N-ANS and Pg-Go. When study measurements were compared with Burstone measurements, differences were significant with greater and less measurements. CONCLUSION: Overall, the jaw measurements were less or equal in patients with OSMF than in normal subjects except for mandibular body length and middle third facial height that may need further evaluation.

Legan-burstone soft tissue profile values in a Circassian adult sample.

OBJECTIVE: To determine the mean soft tissue facial profile for Circassian adults as determined by Legan-Burstone cephalometric analysis. MATERIALS AND METHODS: 71 lateral cephalometric radiographs for nongrowing Circassian adults with normal occlusion were traced and accurately measured. RESULTS: With regard to facial form analysis, Circassian adults showed higher facial convexity angle, retruded mandible, and obtuse lower face-throat angle. When compared with lip form norms, Circassians showed increased nasolabial angle, deeper mentolabial sulcus, and increased maxillary incisor exposure. Comparison between men and women showed that mentolabial sulcus depth was significantly increased in Circassian men compared with Circassian women. CONCLUSION: The results of this study showed that soft tissue facial profiles for Circassians and Caucasians are different in certain values. Such differences should be taken into account when formulating a treatment plan for Circassian patients seeking orthodontic treatment and orthognathic surgery.

An Approach with Hybrid Segmental Mechanics.

Present case report provides an insight into the hybrid segmental mechanics with treatment of 13-year-old male, considering the side effects of sole continuous arch wire sliding mechanics. Patient was diagnosed as a case of skeletal class I jaw relationship, low mandibular plane angle, class II molar relation on right and class I molar relation on left side, anterior cross bite, crowding of 12mm in upper, 5mm in lower arch. He also had proclined upper and lower anteriors by 2mm, convex profile and incompetent lips. Total treatment duration was 20 months, during which segmental canine retraction was performed with TMA (Titanium, Molybdenum, Aluminum) 'T' loop retraction spring followed by consolidation of spaces with continuous arch mechanics. Most of the treatment objectives were met with good intraoral and facial results within reasonable framework of time. This approach used traditional twin brackets, which offered the versatility to use continuous arch-wire mechanics, segmental mechanics and hybrid sectional mechanics.

A study to evaluate cephalometric hard tissue profile of Tamil population for orthognathic surgery.

The primary aim of this study is to compare, the cephalometric hard tissue profile values and analysis between Tamil and Caucasian population. The study also aims to create a better understanding in the facial proportions of Tamil Nadu population and to have better diagnosis and treatment planning for orthognathic surgery for Tamil population in Tamil Nadu.

"Are we similar to caucasians": orthognathic surgery for north indians.

PRIMARY AIM: To establish the cephalometric standards for hard and soft tissues of the facial skeleton for north Indian population. METHODS: The sample comprised of lateral cephalograms taken in natural head position of 100 participants (50 men, 50 women). The cephalograms were traced, analyzed and interpreted using the landmarks and values given by Burstone's analysis for hard tissue and Legan and Burstone analysis for soft tissue respectively. The Student's t test, standard deviation and mean deviation were calculated to compare between the groups. RESULTS: Statistically significant results were found in various parameters between intra and inter group comparison. CONCLUSION: The results obtained in the north Indian population can be used as cephalometric norms for orthognathic surgery.

Establishment of Cephalometric Norms for the South Indian (Karnataka) Population Based on Burstone's Analysis.

UNLABELLED: PRIMARY AIM: Variability is characteristic of different faces and facial types, and normative data based on one population group does not represent all. Hence, this study was undertaken to establish skeletal cephalometric norms for the South Indian (Karnataka) population utilizing the norms laid by Burstones's analysis for Caucasians. METHODS: The sample comprised of lateral cephalograms taken in natural head position of 100 participants (50 men, 50 women). The cephalograms were traced, analyzed and interpreted using the landmarks and values given by Burstone's analysis (Cephalometric analysis for Orthognathic surgery). The student's t test, standard deviation and mean deviation were calculated to compare between two groups. RESULTS: Statistically significant skeletal differences were found between men and women of the South Indian origin in comparison to Caucasian origin. Men had decreased facial divergence, anterior maxillary dental height and proclined upper incisors. Women had marginally increased cranial base, increased midfacial height and proclined upper incisors. CONCLUSION: Statistically significant differences were found between South Indian men and women when compared with Caucasians in certain key parameters. These differences need to be considered when analyzing the cephalogram for orthognathic surgeries. The values derived from this study may be considered to make the deformity assessment and plan surgery to get optimal results for people of south Indian origin conclusive results can be derived after conducting a study with an eager sample size.