Orthodontic plate for management of obstructive sleep apnoea in infants with Pierre Robin sequence: experience and protocol in Hong Kong.

OBJECTIVE: To present the application of the pre-epiglottic baton plate (PEBP) in infants with Pierre Robin sequence (PRS) in the Southern Chinese population (Hong Kong) and to present the diagnosis and management protocol of these infants in our centre. DESIGN: Retrospective case series of three patients with PRS. SETTING: Neonatal Intensive Care Unit in Kwong Wah Hospital and Craniofacial Orthodontic Centre in United Christian Hospital, Hong Kong. PARTICIPANTS: Three new-born infants (two girls, one boy) with PRS and upper airway obstruction due to glossoptosis. METHODS: A protocol for the diagnosis and management of these infants in the Southern Chinese population (Hong Kong) was presented. The three patients received nasal high-flow oxygen and/or continuous positive airway pressure (CPAP) as first-line respiratory support, followed by PEBP for 3-5 months. A two-stage approach was undertaken to ensure accurate positioning of the PEBP. RESULTS: All three infants had improvement in clinical signs, symptoms and polysomnography upon discharge. PEBP and other respiratory aids were weaned off at 3-6 months. CONCLUSIONS: The PEBP, combined with other respiratory support, is a useful modality in the treatment of obstructive sleep apnoea in infants with PRS.

Management of Severe Class II Malocclusion With Sequential Fixed Functional and Orthodontic Appliances: A Case for MOrthRCSEd Examination.

Fixed functional appliance is an effective way of treating skeletal Class II malocclusion in children and adolescents. The following case report documented a 13-year-old boy with 15 mm overjet treated by a phase I 12-month growth modification therapy using Herbst appliance with Hyrax palatal expander and high pull headgear in a stepwise mandibular advancement protocol followed by a phase II pre-adjusted edgewise appliance therapy. It is one of the cases submitted for the Membership of Orthodontics Examination of the Royal College of Surgeons of Edinburgh.

Angular photogrammetric analysis of the soft tissue profile in 12-year-old southern Chinese.

INTRODUCTION: To quantify average angular measurements that define the soft tissue profiles of 12-year-old southern Chinese and to determine gender differences. MATERIALS AND METHODS: A random population sample of 514 12-year-old children was recruited (about 10% of a Hong Kong Chinese birth cohort). Photographs were taken in natural head posture and 12 soft tissue landmarks were located on the photos to measure 12 angular measurements using ImageJ (V1.45s) for Windows. Approximately 10% of photographs were reanalyzed and method error was calculated. Angular norm values for the 12 parameters were determined and gender differences were assessed using 2 sample T-test with 95% confidence interval. RESULTS: The response rate was 54.1% (278/514). Norm values for the 12 angular measurements were generated. The greatest variability was found for the nasolabial (Cm-Sn-Ls) and labiomental (Li-Sm-Pg) angles. Gender differences were found in 4 angular parameters: vertical nasal angle (N-Prn/TV) (p < 0.05), cervicomental angle (G-Pg/C-Me) (p < 0.001), facial convexity angle (G-Sn-Pg) (p < 0.01) and total facial convexity angle (G-Prn-Pg)(p < 0.01). CONCLUSION: Norm values for 12 angular measurements among 12-year-old southern Chinese children were provided and some variability noted. Gender differences were apparent in several angular measurements. This study has implications in developing norm values for southern Chinese and for comparison with other ethnic groups.

Diagnosis and management of root resorption by erupting canines using cone-beam computed tomography and fixed palatal appliance: a case report.

INTRODUCTION: Resorption of the root of the maxillary incisors during ectopic eruption of the maxillary canines is not an uncommon phenomenon, and must be considered in all patients with seriously diverging eruption of the maxillary canines. CASE PRESENTATION: We report on the diagnosis and treatment of a 10-year-old Chinese boy with severe crowding and risk of root resorptions caused by impacted canines in the upper arch and reverse overjet. With the aid of cone-beam computed tomography, the upper right canine crown of our patient was positioned in close proximity to the right lateral incisor while the left canine crown was hitting the root apex of the left lateral incisor. To avoid any progress of root resorption, use of an upper fixed palatal appliance with torquing spring to move the root of lateral incisors away from the canines, plus extraction of upper primary first molars, was selected as an interceptive treatment. CONCLUSIONS: Careful planning is crucial to avoid any complication through orthodontic treatment and to reduce the treatment time and cost.

Repair of a defect following the removal of an impacted maxillary canine by orthodontic tooth movement: a case report.

This case report describes a 13-year-old boy with alveolar bony defect resulted from surgical removal of impacted upper canine transposed in the anterior region. The boy had a normal occlusion with malposition of upper central and lateral incisors. The treatment objectives were to align teeth, close spaces by mesial movement of the buccal segments in the upper jaw to repair bone loss. Fixed appliance with palatal root torque was used for the mesial movements, levelling, and alignment of teeth.Orthodontic tooth movement consisted of a sequence of root movement in a direction to increase the thickness of the labial cortical plate of bone, could ensure healthier periodontium. A healthier periodontium prior to space closure ensured repair of alveolar bony defect after surgical intervention. Orthodontic tooth movement should be added to our armamentarium for the repair of alveolar bony defect.

Orthodontic tooth movement enhancing bony apposition in alveolar bony defect: a case report.

INTRODUCTION: Prevalence of complications from orthognathic surgery is relatively low but if it happens it is vital to manage the post complication bony defect appropriately. CASE PRESENTATION: This case report describes a 20-year-old gentleman who suffered from a complication from a bimaxillary orthognathic surgery. A bone grafting was carried out to repair the bony defect from the surgery but it was unsuccessful. A non-invasive technique employing the use of very light orthodontic force with a laceback stainless steel ligature is described and a successful space closure with an improvement in the periodontal condition and bone apposition has been shown. CONCLUSION: This technique can be considered if orthodontic tooth movement is needed across a deficient alveolar ridge.

Orthodontic traction of impacted canine using magnet: a case report.

A 15 year and 1 month old Chinese female with palatally impacted upper left canine was successfully treated with an upper removable appliance with a magnet incorporated to provide orthodontic traction force. This case report indicates the possibility of using magnetic force as a safe, effective and comfortable way for orthodontic traction.