RESUMO
A 24-year-old man presented with a severe skeletal class III malocclusion, associated with an anterior and posterior crossbite in the left side, upper and lower lip eversion, skeletal asymmetry, midline discrepancy, diastemas in the maxillary and mandibular dental arches, and agenesis of maxillary lateral incisors and canines with retained deciduous teeth. Treatment was performed with the use of the Win Lingual System. When the 0.016 × 0.022-inch NiTi archiwire was applied, the deciduous teeth were extracted and replaced with temporary crowns connected to the appliance. After the aligning, leveling, and diastema closure phases, a modified Le Fort II osteotomy, a mandibular setback with a bilateral sagittal split osteotomy and a genioplasty were performed. Implants were placed in the canine site through a flapless guided surgery, and cantilevered temporary bridges were delivered. Final prosthetic rehabilitation included veneers for the central incisors and zirconia-ceramic cantilevered bridges for the canine and lateral incisors. After 36 months of active treatment, the patient showed an Angle Class I molar and canine relationship and an ideal overbite and overjet. His profile had improved, lips were competent, and gingival levels were acceptable. The lateral radiograph and cephalometric analysis showed a good balance of the skeletal pattern, a good profile of the soft tissue, and proper inclinations of the maxillary and mandibular incisors in relation to maxilla and mandible. After 2 years of follow-up, the patient had a pleasant smile and no relapse, or joint or muscular pain.
Assuntos
Anodontia/complicações , Má Oclusão Classe III de Angle/terapia , Desenho de Aparelho Ortodôntico/instrumentação , Desenho de Aparelho Ortodôntico/métodos , Aparelhos Ortodônticos , Adulto , Cefalometria , Dente Canino , Implantação Dentária Endóssea , Implantes Dentários , Diastema/cirurgia , Diastema/terapia , Estética Dentária , Humanos , Incisivo , Lábio , Masculino , Má Oclusão Classe I de Angle/complicações , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/reabilitação , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Modelos Dentários , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Braquetes Ortodônticos , Fios Ortodônticos , Osteotomia , Sobremordida/terapia , Radiografia Panorâmica , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto JovemRESUMO
OBJECTIVE: To assess changes in the tongue and hyoid bone positions and airway dimensions after maxillary protraction using lateral cephalograms. METHODS: Lateral cephalograms were obtained before (C0) and after (C1) an observation period for untreated children with skeletal Class I malocclusion and before (T0), immediately after (T1), and one year after (T2) maxillary protraction in children with skeletal Class III malocclusion. Cephalometric measurements were compared between the time points in both patient groups. RESULTS: Immediately after maxillary protraction, the tongue moved superiorly and the nasopharyngeal and superior oropharyngeal airway dimensions increased. No significant changes in the middle or inferior oropharyngeal airway dimensions or in the hyoid bone position were noted after treatment. CONCLUSIONS: Maxillary protraction improved tongue posture and modified the nasopharyngeal and superior oropharyngeal airway dimensions in patients with skeletal Class III malocclusion. Consequently, maxillary protraction may restore the intra- and extraoral balance and improve respiratory function.
Assuntos
Cefalometria/métodos , Osso Hioide/patologia , Má Oclusão Classe III de Angle/patologia , Má Oclusão Classe III de Angle/reabilitação , Má Oclusão Classe I de Angle/patologia , Má Oclusão Classe I de Angle/reabilitação , Maxila , Faringe/patologia , Língua/patologia , Tração/métodos , Criança , Aparelhos de Tração Extrabucal , Feminino , Humanos , Masculino , Má Oclusão Classe I de Angle/diagnóstico , Má Oclusão Classe III de Angle/diagnóstico , Fatores de Tempo , Tração/instrumentaçãoRESUMO
In a case report the stomatognathic rehabilitation of a patient with class III malocclusion and mandibular bilateral interdental gaps from the diagnosis and treatment planning through to the stepwise realization of the orthodontic, surgical and prosthetic treatment is presented. Explicit information about the proposed treatment, risks and the prospective outcome beforehand ensured the patients compliance during the extensive procedure.
Assuntos
Anodontia/reabilitação , Implantes Dentários , Comunicação Interdisciplinar , Colaboração Intersetorial , Má Oclusão Classe III de Angle/reabilitação , Ortodontia Corretiva , Adulto , Anodontia/diagnóstico por imagem , Terapia Combinada , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/reabilitação , Feminino , Humanos , Má Oclusão Classe III de Angle/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica , Extração DentáriaRESUMO
CASE REPORT: This report describes the oral rehabilitation of a young boy with severe oligodontia of primary dentition and complete anodontia of permanent dentition, treated by complete maxillary and partial mandibular removable dentures. Since the determination of a proper occlusal vertical dimension in paediatric patients is often difficult, treatment was achieved by means of a multidisciplinary approach involving conventional prosthodontic principles combined with cephalometric analysis and growth prediction. After a follow-up of two years a second lateral cephalogram was taken to evaluate the developmental changes in craniofacial morphology and the superimpositions method was performed, showing an improvement of both sagittal and vertical relationship between basal bones. In this case, the early prosthetic treatment resulted in enhanced aesthetics and masticatory function as well as skeletal growth changes.
Assuntos
Anodontia/reabilitação , Cefalometria/métodos , Planejamento de Dentadura , Dimensão Vertical , Criança , Queixo/patologia , Prótese Total Superior , Prótese Parcial Removível , Seguimentos , Humanos , Registro da Relação Maxilomandibular/métodos , Lábio/patologia , Masculino , Má Oclusão Classe III de Angle/reabilitação , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Desenvolvimento Maxilofacial/fisiologia , Nariz/patologia , Equipe de Assistência ao Paciente , RotaçãoRESUMO
To treat a patient with anterior crossbite, the clinician should first assess if it is a genuine class III or a pseudo-class III malocclusion. Cephalometric analysis is important; however, registering a patient's centric relation (CR) is simple, quick, and costless and can play a decisive role in a differential diagnosis for this type of patient profile. This clinical report depicts a patient clinically diagnosed as class III. After mandible manipulation in CR, it was noted that the patient in question was a pseudo-class III. The treatment was based on the pseudo-class III diagnosis. Therefore, the patient was rehabilitated by occlusal adjustments and conventional and implant-supported prostheses and without the need for invasive orthognathic surgery.
Assuntos
Relação Central , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão/diagnóstico , Cefalometria , Humanos , Masculino , Má Oclusão/fisiopatologia , Má Oclusão/reabilitação , Má Oclusão Classe III de Angle/fisiopatologia , Má Oclusão Classe III de Angle/reabilitação , Mandíbula/fisiopatologia , Maxila/fisiopatologia , Pessoa de Meia-IdadeRESUMO
En estos artículos los autores presentan una nueva línea de instrumentos de precisión usados en el procedimiento de laboratorio para la preparación de modelos set-up, corrección de modelos set-up y cirugía de modelos de acuerdo con el plan de tratamiento ortodóncico y quirúrgico. Se describen en este artículo el Set-Up Model Maker (SUM), el Occlusal Plane Reference (OPR) y el Surgical Model Accuracy Device (SMAD), y se explica su utilización a través del tratamiento de un caso clínico con clase III esquelética y mordida abierta...
In these articles the authors introduce a new line of precision instruments used in the laboratory procedure for set-up models preparation, set-up models correction and model surgery according to the orthodontic and surgery treatment plan. The Set-Up Model Maker (SUM), the Occlusal Plane Reference (OPR) and the Surgical Model Accuracy Device (SMAD) are described in this article, and its use is explained through the case report of a treatment of a skeletal class III case with open bite...
Assuntos
Humanos , Feminino , Adulto Jovem , Má Oclusão Classe III de Angle/reabilitação , Má Oclusão Classe III de Angle/terapia , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Equipamentos Odontológicos , Equipamentos de LaboratórioRESUMO
The aim of this article is to describe a successful clinical protocol for prosthodontic rehabilitation of a patient with a skeletal Class III malocclusion using a fixed-detachable maxillary prosthesis supported by 6 implants and the MK1 attachment system. The patient was followed up for 8 years. A 46-year-old edentulous woman with a skeletal Class III malocclusion expressed dissatisfaction with her old existing maxillary denture from an esthetic point of view and frustration regarding its function. A fixed-detachable maxillary prosthesis using the MK1 attachment system was made. The patient was followed up clinically and radiographically for 8 years. No bone loss, fracture of prosthetic components, or fracture of the prosthesis was detected in that period. A fixed detachable maxillary prosthesis using the MK1 attachment system is a treatment option for patients with Class III malocclusions who opt not to undergo orthognathic surgery.
Assuntos
Prótese Dentária Fixada por Implante , Prótese Total Superior , Revestimento de Dentadura , Má Oclusão Classe III de Angle/reabilitação , Implantes Dentários , Planejamento de Dentadura , Estética Dentária , Feminino , Seguimentos , Humanos , Arcada Edêntula/reabilitação , Pessoa de Meia-Idade , Osseointegração/fisiologia , Planejamento de Assistência ao PacienteRESUMO
The paper presents clinical case of 63 years old edentulous patient with slight class III malocclusion. For 15 years he was using inadequately fabricated dentures causing forced severe class III malocclusion. Forced progeny was corrected by newly fabricated dentures which restored normal orofacial function and facial harmony.
Assuntos
Planejamento de Prótese Dentária , Prótese Parcial Removível , Má Oclusão Classe III de Angle/etiologia , Má Oclusão Classe III de Angle/reabilitação , Perda de Dente/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Modelos DentáriosRESUMO
Acromegaly is a condition which results from an excess of growth hormone produced by the pituitary gland after epiphyseal plate closure at puberty. The most common cause of acromegaly is a benign pituitary adenoma. Acromegaly is characterised by enlargement of the hands, feet, nose and ears; expansion of the skull and pronounced brow protrusion. From an oral standpoint, the most relevant symptoms are mandibular protrusion, spacing of the lower teeth and macroglossia. A 46 year-old patient was referred to University Dental School and Hospital by her General Dental Practitioner. The patient had been diagnosed with acromegaly and was receiving medical care from a consultant endocrinologist. The patient was partially dentate with only her lower anterior dentition remaining. She was wearing a complete upper denture but was unable to function effectively due to a lack of occlusal support. Treatment comprised non-surgical periodontal management, construction of upper and lower removable prostheses in a class III relationship and composite restorations on the remaining lower teeth.
Assuntos
Acromegalia/complicações , Reabilitação Bucal/métodos , Resinas Compostas/química , Assistência Odontológica para Doentes Crônicos , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Planejamento de Dentadura , Prótese Total Superior , Prótese Parcial Removível , Feminino , Humanos , Arcada Edêntula/reabilitação , Arcada Parcialmente Edêntula/reabilitação , Má Oclusão Classe III de Angle/reabilitação , Mandíbula/patologia , Maxila/patologia , Pessoa de Meia-Idade , Doenças Periodontais/terapiaRESUMO
The article presents the results of planning and comprehensive treatment of a patient with class III malocclusion complicated by partial teeth absence. Split osteotomy of the mandible improved the relationship of dental arches facilitating complete oral restorative rehabilitation with adequate functional load distribution and esthetic harmony.
Assuntos
Má Oclusão Classe III de Angle/cirurgia , Arco Dental/anatomia & histologia , Prótese Dentária , Estética Dentária , Feminino , Humanos , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/reabilitação , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Pessoa de Meia-Idade , Osteotomia , Radiografia Panorâmica , Resultado do TratamentoAssuntos
Planejamento de Prótese Dentária , Má Oclusão Classe III de Angle/cirurgia , Osteotomia Maxilar/métodos , Reabilitação Bucal , Cimentação/métodos , Coroas , Articuladores Dentários , Técnica de Moldagem Odontológica , Porcelana Dentária/química , Feminino , Humanos , Registro da Relação Maxilomandibular/instrumentação , Má Oclusão Classe III de Angle/reabilitação , Planejamento de Assistência ao Paciente , Prognatismo/reabilitação , Prognatismo/cirurgia , Preparo Prostodôntico do Dente/métodosRESUMO
The rehabilitation of the atrophic maxilla by means of implant-supported prostheses cannot always be achieved with fixed prostheses because of anatomic, esthetic, or economic issues, so for some patients the treatment of choice is a removable prosthesis. This article analyzes a new design for implant-supported overdentures with horizontal or faciolingual insertion. Its retention system is based on frictional forces or stepped interlocking horizontal surfaces and is appropriate for patients with skeletal Class II or III relationships with severe maxillary atrophies. The design facilitates implant-prosthetic hygiene and improved esthetics in patients with nonparallel implants by hiding abutment screws.
Assuntos
Prótese Dentária Fixada por Implante , Planejamento de Dentadura , Prótese Total Superior , Revestimento de Dentadura , Atrofia , Projeto do Implante Dentário-Pivô , Retenção de Dentadura/instrumentação , Retenção de Dentadura/métodos , Estética Dentária , Fricção , Humanos , Má Oclusão Classe II de Angle/reabilitação , Má Oclusão Classe III de Angle/reabilitação , Maxila/patologia , Higiene BucalRESUMO
The present paper describes the design features, potential indications and a clinical application of a newly designed device for jaw motion rehabilitation, the Spring-Bite. This device is characterized by a first class lever mechanism, which allows performing passive jaw motion rehabilitation at constant load without an active participation by the patient. Spring-Bite was developed for the management of temporomandibular joint (TMJ) hypomobility and its application may be much useful in the post-operatory phases of TMJ or orthognathic surgeries as well as in patients with reduced muscular force.
Assuntos
Má Oclusão Classe III de Angle/cirurgia , Aparelhos Ortodônticos , Transtornos da Articulação Temporomandibular/reabilitação , Humanos , Masculino , Má Oclusão Classe III de Angle/complicações , Má Oclusão Classe III de Angle/reabilitação , Músculos da Mastigação/fisiopatologia , Desenho de Aparelho Ortodôntico , Osteotomia de Le Fort , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/cirurgia , Trismo/reabilitação , Adulto JovemRESUMO
To prove the efficiency of dental implantation in complex treatment of patients with class III malocclusion and partial teeth loss. Nine patients aged 18-35 years with class III malocclusion and partial teeth loss were included in the study. All patients received two-step treatment involving orthodontic correction with two-step implantation and provisional restorations placement followed by orthognatic surgery procedure. The patients were followed-up for three years with no recurrent malocclusion or implant failure revealed, thus proving dental implantation to be useful tool in complex oral rehabilitation of patients with class III malocclusion and partial teeth loss.
Assuntos
Implantação Dentária Endóssea/métodos , Má Oclusão Classe III de Angle/reabilitação , Perda de Dente/reabilitação , Adolescente , Adulto , Implantes Dentários , Humanos , Masculino , Má Oclusão Classe III de Angle/complicações , Má Oclusão Classe III de Angle/cirurgia , Osteotomia de Le Fort , Perda de Dente/complicações , Resultado do Tratamento , Adulto JovemRESUMO
The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included.
Assuntos
Má Oclusão Classe III de Angle/terapia , Ortodontia Interceptora/métodos , Planejamento de Assistência ao Paciente , Qualidade de Vida , Cefalometria/métodos , Pré-Escolar , Eficiência , Estética , Aparelhos de Tração Extrabucal , Músculos Faciais/fisiopatologia , Feminino , Seguimentos , Humanos , Lábio/fisiopatologia , Linfangioma Cístico/complicações , Macroglossia/complicações , Má Oclusão Classe III de Angle/psicologia , Má Oclusão Classe III de Angle/reabilitação , Mastigação/fisiologia , Desenvolvimento Maxilofacial/fisiologia , Mordida Aberta/psicologia , Mordida Aberta/reabilitação , Mordida Aberta/terapia , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Prognóstico , Hábitos Linguais/terapia , Neoplasias da Língua/complicações , Resultado do TratamentoRESUMO
Anteroposterior (AP) deficiencies present a restorative treatment challenge. Complex, multidisciplinary planning is necessary for the success of the treatment. This clinical report describes an approach to managing a complex complete oral rehabilitation of an edentulous patient with skeletal transverse and AP deficiencies with a history of facial trauma to the left zygomaticomaxillary complex. This was further complicated by a hopeless remaining dentition and pneumatization of the maxillary sinuses. Treatment included initial bony augmentation of the vertically and horizontally deficient maxilla, dental implant placement, provisional restoration in a Class III malocclusion with bilateral posterior crossbite, and Le Fort I osteotomy with transverse widening and advancement to correct the skeletal deficiency. Definitive restoration was accomplished with implant-supported fixed prostheses that provided ideal facial balance and occlusion.
Assuntos
Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Má Oclusão Classe III de Angle/reabilitação , Boca Edêntula/reabilitação , Osteotomia de Le Fort/métodos , Técnica de Expansão Palatina , Perda do Osso Alveolar/reabilitação , Processo Alveolar/inervação , Implantes Dentários , Feminino , Humanos , Ílio/transplante , Maxila/cirurgia , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Cavidade Nasal/anatomia & histologiaRESUMO
OBJECTIVES: The lingual dysfunctions play a considerable role in the pathogenesis of dentoskeletal dysmorphisms. The treatment of dento-maxillofacial dysgnathia implies a functional rehabilitation to re-harmonize the stomatognathic system. This study aims to demonstrate the importance of a rehabilitation protocol of functional orofacial parameters at the end of a surgical-orthodontic treatment in order to achieve long-term success. MATERIALS AND METHODS: After orthognathic surgery, facial expression exercises and jaw exercises are prescribed to promote the recovery of neuromuscular function. At the end of treatment, a sample of 30 dysgnathic patients underwent a functional evaluation of the orofacial district to identify any lingual or articulatory dysfunctions. The information gathered led to an individual re-education program that consisted of an active myofunctional-logopedic approach integrated with appliances used as retention. RESULTS: 19 patients needed myofunctional therapy to re-educate deglutition and tongue posture. Articulatory disorders were found in 7 patients originally suffering from Class III and/or open-bite skeletal disharmony; 5 of these completed rehabilitation with speech therapy. After rehabilitation the functional parameters were completely normalized in 12 patients; in 5 cases, partial improvements were obtained, while in 2 cases the therapy was ineffective. CONCLUSIONS: In a patient undergoing post-surgical reconsolidation of his/her functional equilibrium even an uncontrolled speech defect may lead to an instable result. Only through an interdisciplinary approach it is possible to intercept and re-educate all the functions that are not compliant with the structural changes and to eliminate a tendency to relapse of the dysgnathia.
Assuntos
Má Oclusão/reabilitação , Terapia Miofuncional/métodos , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fonoterapia/métodos , Adolescente , Adulto , Transtornos da Articulação/reabilitação , Transtornos de Deglutição/reabilitação , Terapia por Exercício/instrumentação , Terapia por Exercício/métodos , Músculos Faciais/inervação , Músculos Faciais/fisiologia , Feminino , Humanos , Lábio/fisiologia , Masculino , Má Oclusão/cirurgia , Má Oclusão Classe II de Angle/reabilitação , Má Oclusão Classe II de Angle/cirurgia , Má Oclusão Classe III de Angle/reabilitação , Má Oclusão Classe III de Angle/cirurgia , Exercícios de Alongamento Muscular/métodos , Terapia Miofuncional/instrumentação , Junção Neuromuscular/fisiologia , Mordida Aberta/reabilitação , Mordida Aberta/cirurgia , Desenho de Aparelho Ortodôntico , Equipe de Assistência ao Paciente , Amplitude de Movimento Articular/fisiologia , Língua/fisiologia , Hábitos Linguais/terapia , Resultado do Tratamento , Adulto JovemRESUMO
AIM: The aim of this retrospective clinical study was to evaluate dental arch, skeletal, dentoalveolar, and soft tissue profile changes following treatment of Class III malocclusion by means of the Function Regulator (FR-3) appliance. SUBJECTS AND METHODS: The study sample consisted of 14 growing patients (seven boys and seven girls) with a mean age of 9.7 +/- 1.1 years presenting Class III malocclusion. They were treated with an FR-3 appliance exclusively for a period of 2.4 +/- 0.6 years. Dental casts and lateral cephalometric radiographs were obtained immediately before initiation and after completion of treatment with the FR-3 appliance. Thirteen variables were used for the dental cast analysis and 61 variables for the cephalometric analysis. The paired t-test was utilized to evaluate the presence of significant changes (p < 0.05). RESULTS: The evaluation of the dental casts revealed that there was a significant increase in intermolar, interpremolar, and intercanine width of the maxilla and of palatal height after treatment. Concerning the mandible, an increase in intermolar and intercanine width and a decrease in lower arch depth were observed. Cephalometric evaluation revealed a significant decrease in SNB angle and an increase in ANB angle, overjet, facial convexity, nose prominence, and lower soft tissue face height. There was an increase in upper lip thickness and a decrease in lower lip convexity observed after treatment. CONCLUSIONS: The results of this study confirm a favorable functional and esthetic maxillary and mandibular position following treatment by means of the function regulator (FR-3) appliance.
Assuntos
Arco Dental/diagnóstico por imagem , Arco Dental/patologia , Face/diagnóstico por imagem , Face/patologia , Má Oclusão Classe III de Angle/reabilitação , Aparelhos Ortodônticos Funcionais , Cefalometria , Criança , Técnica de Fundição Odontológica , Feminino , Humanos , Masculino , Prognóstico , Radiografia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Facioscapulohumeral muscular dystrophy syndrome (FSHD) is a rare hereditary myopathy characterized by muscle atrophy and weakness, particularly in the face and upper arms. Patients may also exhibit dental malocclusions. This article presents the prosthodontic treatment for an 18-year old male with FSHD.