Postural Assessment in Class III Patients Before Orthognathic Surgery.

PURPOSE: To determine the postural characteristics of patients with Class III dentofacial deformities before orthognathic surgery by photogrammetry using SAPO postural assessment software. MATERIALS AND METHODS: This was a cross-sectional study. Eligible participants were adult patients who had an indication for orthognathic surgery to correct skeletal Class III dentofacial deformities and were undergoing orthodontic preparation for surgery. Patients were recruited at the outpatient clinic for dentofacial deformities of the authors' institution from March to November 2015. Postural assessment was performed by photogrammetry based on anterior, posterior, and lateral images, which were analyzed using SAPO software. RESULTS: The sample consisted of 40 patients with a mean age of 28.7 years; 55% were men. Postural changes were found in most anatomic structures, and the main changes were anterior displacement of the center of gravity (sagittal plane asymmetry, 43.77%) and a tendency to left lateral deviation (frontal plane asymmetry, -3.89%). The anterior view showed a pattern of head tilt to the left (measured value minus reference value [Δ], -0.22), elevation of the left acromion (Δ, 2.31), elevation of the right anterior superior iliac spine (Δ, -0.56), right knee with genu varum (Δ, 1.25), and left knee with genu valgum (Δ, -1.55). The posterior view displayed scapular asymmetry with abduction of the right scapula (Δ, 7.54) and valgus foot deformity (Δright, 8.35; Δleft, 11.60). The lateral view depicted decreased cervical lordosis (Δright, 22.63; Δleft, 19.98), pelvic anteversion (Δright, -0.56; Δleft, -0.26), and genu flexum at the right (Δ, 6.85) and left (Δ, 4.40) knees. Twenty-seven patients (67.5%) reported temporomandibular joint pain. CONCLUSIONS: Postural assessment by photogrammetry showed that most anatomic structures were outside the normal range in patients with skeletal Class III dentofacial deformities before orthognathic surgery. These results suggest that dentofacial abnormalities can lead to postural disorders in this population.

Effects of Craniofacial Morphology on Nasal Respiratory Function and Upper Airway Morphology.

BACKGROUND: Craniofacial skeletal patterns change after orthognathic surgery. The present study aimed to investigate the effects of different craniofacial patterns on nasal respiratory function and the upper airway. METHODS: Forty-seven healthy subjects were selected and divided into 3 groups according to their mandibular position. Sixteen were in the skeletal Class I group, 15 were in the skeletal Class II group, and 16 were in the skeletal Class III group. Cone beam computed tomography was performed, and nasal airflow and nasal resistance were measured. Differences in nasal respiratory functions and upper airway were compared among the groups. A correlation analysis was conducted for nasal respiratory function, upper airway, and skeletal patterns. RESULTS: There were significant differences among the 3 groups regarding dominant-side nasal inspiratory capacity (P = 0.001), bilateral nasal inspiratory capacity (P = 0.005), nasal partitioning ratio-inspiration (P = 0.007), and velopharyngeal minimum cross-sectional area (P = 0.029). The values were significantly higher for the skeletal Class III group than the skeletal Class I and II groups. A correlation analysis showed that the nasal partitioning ratio and nasal airway resistance were mostly negatively correlated with SNA, but the upper airway volume and cross-sectional area were positively correlated with SNB and negatively correlated with ANB. The dominant-side nasal expiratory capacity was mainly negatively correlated with the mean velopharyngeal cross-sectional area (r = -0.324, P = 0.026), mean glossopharyngeal cross-sectional area (Glosso-A mean) (r = -0.293, P = 0.046), and mean total airway cross-sectional area (Total-A mean) (r = -0.307, P = 0.036). CONCLUSION: Craniofacial skeletal morphology may affect nasal respiratory function and the upper airway.

Skeletal and dental effects of Class III orthopaedic treatment: a systematic review and meta-analysis.

To summarise the skeletal, dental and soft tissue effects of orthopaedic treatment on growing skeletal class III patients compared with a concurrent untreated similar control group and to evaluate whether the design of the primary studies may affect the results. A literature search was performed up to the end of February 2016. No restrictions were applied concerning language and appliances. Once the quality score was assessed, a meta-analysis was performed for the appliances used in more than three studies. A moderator analysis for study design was performed. The level of evidence was evaluated by means of the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool. The search resulted in 21 papers. The quality of most of the studies was medium. Each study reported skeletal sagittal improvement and overjet correction. Fourteen studies reported a significant increase in lower facial height. Follow-up data showed slight relapses in about 15% of patients. Meta-analyses were performed for the facemask and chin cup. The two appliances were efficient for correcting the sagittal discrepancy, increasing the divergence. In the analysis for study design, the retrospective studies showed a more efficient appliance than RCTs for 6 of 13 variables. The level of evidence was between very low and moderate. There is very low to low evidence that orthopaedic treatment is effective in the correction of Class III skeletal discrepancies and moderate evidence for the correction of the overjet. A common side effect is mandibular clockwise rotation in older subjects.

Relationships among nasal resistance, adenoids, tonsils, and tongue posture and maxillofacial form in Class II and Class III children.

INTRODUCTION: The purpose of this study was to clarify the relationships between upper airway factors (nasal resistance, adenoids, tonsils, and tongue posture) and maxillofacial forms in Class II and III children. METHODS: Sixty-four subjects (mean age, 9.3 years) with malocclusion were divided into Class II and Class III groups by ANB angles. Nasal resistance was calculated using computational fluid dynamics from cone-beam computed tomography data. Adenoids, tonsils, and tongue posture were evaluated in the cone-beam computed tomography images. The groups were compared using Mann-Whitney U tests and Student t tests. The Spearman rank correlations test assessed the relationships between the upper airway factors and maxillofacial form. RESULTS: Nasal resistance of the Class II group was significantly larger than that of the Class III group (P = 0.005). Nasal resistance of the Class II group was significantly correlated with inferior tongue posture (P <0.001) and negatively correlated with intermolar width (P = 0.028). Tonsil size of the Class III group was significantly correlated with anterior tongue posture (P <0.001) and mandibular incisor anterior position (P = 0.007). Anterior tongue posture of the Class III group was significantly correlated with mandibular protrusion. CONCLUSIONS: The relationships of upper airway factors differ between Class II and Class III children.

Understanding interactions among cephalometrics variables during growth in untreated Class III subjects.

OBJECTIVE: The aim of the present study was to apply a computational method commonly used in data mining discipline, classification trees (CTs), to evaluate the growth features in untreated Class III subjects. MATERIALS AND METHODS: CT was applied to data from 91 untreated Class III subjects (48 females and 43 males) and compared with the results of discriminant analysis (DA). For all subjects, lateral cephalograms were available at T1 (mean age 10.4 ± 2.0 years) and at T2 (mean age 15.4 ± 1.9 years). A cephalometric analysis comprising 11 variables was performed. The subjects were divided into two subgroups, unfavourable ('Bad') and favourable ('Good') growers, according to the quality of the skeletal growth rate in comparison with the normal craniofacial growth. RESULTS: CTs showed that the most informative attribute for the prediction of favourable/unfavourable skeletal growth was the SNA angle. Subjects with SNA values lower than 79.1 degrees showed a risk of 94 per cent of growing unfavourably. DA was able to select palatal plane to mandibular plane angle as predictors. DA, however, showed a statistically significant higher rate of misclassification when compared with CTs (40.7 per cent versus 12.1 per cent, binomial exact test: odds ratio = 6.20; P < 0.0001). CONCLUSIONS: CTs provided a valid measure of elucidating the effective contribution of craniofacial characteristics in predicting favourable/unfavourable growth in untreated Class III subjects.

Evaluation of Chewing Movement in Skeletal Class III Patients with Orthognathic Treatment.

The objective of this study was to clarify the influence of improvement in morphology on chewing movement in patients with skeletal reversed occlusion following orthognathic treatment. A total of 10 patients with skeletal class III reversed occlusion undergoing orthognathic treatment were included in the study. A number of parameters, including chewing rhythm, maximum opening and closing velocities, and opening distance during chewing of gum, were measured in a pre- (Pre) and post-treatment (Post) group. The laterality and stability of the measured items were then compared between the two groups and with those in another group of subjects with normal occlusion (Control). Laterality of chewing movement was greater in the Pre group than in the Control group, and significant differences were noted in all parameters, apart from closing Vmax and opening distance. No significant difference was noted in any parameter between the Post and Control groups. The coefficient of variation was significantly higher in the Pre group than in the Control group, apart from for opening phase. All parameters showed a significant decrease in the Post group compared with in the Pre group, yielding a stable chewing movement. Comparison of the Post and Control groups revealed no significant difference in any of the parameters, apart from in the occluding phase. These findings suggest that orthognathic treatment of skeletal class III malocclusion improves chewing movement to levels close to those in subjects with normal occlusion.

Computational Fluid Dynamic Study of Nasal Respiratory Function Before and After Bimaxillary Orthognathic Surgery With Bone Trimming at the Inferior Edge of the Pyriform Aperture.

PURPOSE: This study aimed to evaluate the influence of maxillary impaction orthognathic surgery on nasal respiratory function and the efficacy of bone trimming at the inferior edge of the pyriform aperture. MATERIALS AND METHODS: The participants were 10 patients (3 male and 7 female patients) with mandibular prognathism who underwent bimaxillary orthognathic surgery with maxillary impaction. The surgical procedures performed were Le Fort I osteotomy with bone trimming at the inferior edge of the pyriform aperture and bilateral sagittal split osteotomy. Three-dimensional models of the nasal cavity were reconstructed from preoperative and postoperative computed tomography images. Furthermore, we remodeled the nasal valve region based on the postoperative models by adding a 1-mm and 2-mm stenosis to investigate the effects of bone trimming at the inferior edge of the pyriform aperture on the pressure effort. The 3-dimensional models were simulated with computational fluid dynamics, and the results of the pressure effort and the cross-sectional area (CSA) were compared for the anterior, middle, and posterior parts of the nasal cavity. The Wilcoxon signed rank test and Spearman rank correlation coefficients were used for statistical comparisons (P < .05). RESULTS: In the preoperative and postoperative models, there were considerable correlations between the CSA and the pressure effort in each part of the nasal cavity. The postoperative pressure effort showed a tendency to decrease and the CSA showed a tendency to increase in each part of the nasal cavity. In four 2-mm stenosis models, the pressure effort in the anterior nasal cavity was larger than the preoperative pressure effort and the CSA of the anterior nasal cavity was smaller than the preoperative CSA. CONCLUSIONS: Bone trimming at the inferior edge of the pyriform aperture appears to be useful for avoiding nasal respiratory complications with maxillary impaction.

Effect of malocclusion severity on oral health-related quality of life and food intake ability in a Korean population.

INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Three-dimensional surgical changes of mandibular proximal segments affect outcome of jaw motion analysis.

PURPOSE: Displacement of the mandibular proximal segments is inevitable in surgical correction of the asymmetric mandible. The aim of the present study was to assess the outcomes of jaw motion analysis (JMA) in relation to the changes in the mandibular proximal segments after orthognathic surgery (OGS). PATIENTS AND METHODS: The present retrospective cohort study investigated the surgical changes using the cone-beam computed tomography records and the mandibular function with JMA and a temporomandibular joint (TMJ) examination. The predictor variables were the 3-dimensional (3D) changes in the proximal segments on the deviated and nondeviated sides. The outcome variables were the JMA data obtained 6 months after OGS. The Pearson correlation test was performed to assess the relationship between the surgical changes and the outcome of JMA. RESULTS: Twenty-one adult patients with skeletal Class III malocclusion and mandibular deviation greater than 4 mm were included in the present study. The change of the ramus axis to the coronal plane on the deviated side correlated negatively with the laterotrusive movement of the mandible toward the deviated side (r = -0.452, P < .05). The changes in the distance from the condyles to the midsagittal plane and the angulation of the ramus axis to midsagittal plane on the nondeviated side correlated negatively with the condyle range of retrusion on both sides. However, the increase in the angulation of the ramus axis to the midsagittal plane on the nondeviated side correlated positively with the angle of the horizontal condylar movement in laterotrusion on the deviated side (r = 0.458, P < .05). CONCLUSIONS: 3D model visualization enabled us to clearly detect the changes in the proximal segments after OGS. A relationship between the condylar range of motion and skeletal changes in the proximal segments in patients with Class III malocclusion was observed, mainly on the deviated side of the mandible.

Comparison of the soft and hard tissue effects of two different protraction mechanisms in class III patients: a randomized clinical trial.

OBJECTIVE: The objective of the present study is to test the null hypotheses that there were no significant differences for hard and soft tissue changes induced by mini maxillary protractor (MMP) and face mask and rapid maxillary expansion (FM/RME). MATERIALS AND METHODS: Thirty-two patients who met the criteria were randomly divided into two groups: 16 patients (males/females 7/9) in the MMP group and 16 patients (males/females 6/10) in the FM/RME group. The patients in both groups were instructed to wear the appliances for at least 20 h per day until a 2-mm positive overjet was achieved. Hard and soft tissue profile changes observed by MMP and FM/RME were compared using paired and Student's t tests. RESULTS: Class III malocclusion and negative overjet were improved by means of skeletal changes in conjunction with upper incisor proclination and lower incisor retroclination in both groups. Maxilla and surrounding soft tissues (SNA, Ls-E, and Ls-PMV) were significantly moved anteriorly with less rotation of the palatal plane in the MMP group. Mandibular incisors were found to be more retrusive in the FM/RME group (p = 0.024). CONCLUSION: Both groups showed similar effects except more anterior movement of the maxilla and surrounding soft tissues with less rotation of the palatal plane and retrusion of lower incisors in the MMP group. CLINICAL RELEVANCE: This is the first study to compare the soft and hard tissue changes induced by MMP appliance with a conventional FM /RME.

Speech Articulatory Characteristics of Individuals With Dentofacial Deformity.

PURPOSE: To analyze the speech articulatory characteristics of individuals with dentofacial deformities (DFD) and assess differences compared to individuals with dentofacial balance. METHODS: Sixty individuals participated, being 30 presenting DFD (19 with class III and 11 class II skeletal malocclusion, 18 women and 12 men, age group 18-40 years) and 30 individuals from a control group matched for gender and age. The assessment of the diadochokinesis (DDK) was evaluated using the emissions /pa/, /ta/, /ka/, /pataka/, and /i/. RESULTS: The individuals with DFD produced fewer emissions per second: at syllable "ka" and sequence "pataka" for the total of individuals; syllable "pa" and sequence "pataka" for women, individuals with class II and class III malocclusion. The parameters related to the irregularity of the cycles were higher for the group with DFD than for the control, as well as emission of the syllable "pa" for the total of individuals, group of class III malocclusion and women, during production of the syllables "ta" and "ka" for all individuals and group of class III and during emission of the vowel "ï" for women. CONCLUSIONS: Differences regarding speed and stability of oral and laryngeal DDK were found among individuals with DFD compared with the control group.

Influence of surgical orthodontic treatment on masticatory function in skeletal Class III patients.

Skeletal Class III patients exhibit malocclusion characterised by Angle Class III and anterior crossbite, and their occlusion shows total or partially lateral crossbite of the posterior teeth. Most patients exhibit lower bite force and muscle activity than non-affected subjects. While orthognathic surgery may help improve masticatory function in these patients, its effects have not been fully elucidated. The aims of the study were to evaluate jaw movement and the electromyographic (EMG) activity of masticatory muscles before and after orthognathic treatment in skeletal Class III patients in comparison with control subjects with normal occlusion. Jaw movement variables and EMG data were recorded in 14 female patients with skeletal Class III malocclusion and 15 female controls with good occlusion. Significant changes in jaw movement, from a chopping to a grinding pattern, were observed after orthognathic treatment (closing angle P < 0.01; cycle width P < 0.01), rendering jaw movement in the patient group similar to that of the control group. However, the grinding pattern in the patient group was not as broad as that of controls. The activity indexes, indicating the relative contributions of the masseter and temporalis muscles (where a negative value corresponds to relatively more temporalis activity and vice versa) changed from negative to positive after treatment (P < 0.05), becoming similar to those of control subjects. Our findings suggest that orthognathic treatment in skeletal Class III patients improves the masticatory chewing pattern and muscle activity. However, the chewing pattern remains incomplete compared with controls.

Occlusal rehabilitation of pseudo-class III patient.

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.

Forecasting craniofacial growth in individuals with class III malocclusion by computational modelling.

AIM: To develop a mathematical model that adequately represented the pattern of craniofacial growth in class III subject consistently, with the goal of using this information to make growth predictions that could be amenable to longitudinal verification and clinical use. MATERIALS AND METHODS: A combination of computational techniques (i.e. Fuzzy clustering and Network analysis) was applied to cephalometric data derived from 429 untreated growing female patients with class III malocclusion to visualize craniofacial growth dynamics and correlations. Four age groups of subjects were examined individually: from 7 to 9 years of age, from 10 to 12 years, from 13 to 14 years, and from 15 to 17 years. RESULTS: The connections between pathway components of class III craniofacial growth can be visualized from Network profiles. Fuzzy clustering analysis was able to define further growth patterns and coherences of the traditionally reported dentoskeletal characteristics of this structural imbalance. Craniofacial growth can be visualized as a biological, space-constraint-based optimization process; the prediction of individual growth trajectories depends on the rate of membership to a specific 'winner' cluster, i.e. on a specific individual growth strategy. The reliability of the information thus gained was tested to forecast craniofacial growth of 28 untreated female class III subjects followed longitudinally. CONCLUSION: The combination of Fuzzy clustering and Network algorithms allowed the development of principles for combining multiple auxological cephalometric features into a joint global model and to predict the individual risk of the facial pattern imbalance during growth.

The inadequacy of the Y-axis of growth (SNGn) for the vertical pattern assessment in patients with sagittal discrepancies.

AIM: The aim of this cephalometric study was to evaluate the influence of the sagittal skeletal pattern on the 'Y-axis of growth' measurement in patients with different malocclusions. MATERIALS AND METHODS: Lateral head films from 59 patients (mean age 16y 7m, ranging from 11 to 25 years) were selected after a subjective analysis of 1630 cases. Sample was grouped as follows: Group 1 - class I facial pattern; group 2 - class II facial pattern; and Group 3 - class III facial pattern. Two angular measurements, SNGoGn and SNGn, were taken in order to determine skeletal vertical facial pattern. A logistic regression with errors distributed according to a binomial distribution was used to test the influence of the sagittal relationship (Class I, II, III facial patterns) on vertical diagnostic measurement congruence (SNGoGn and SNGn). RESULTS: RESULTS show that the probability of congruence between the patterns SNGn and SNGoGn was relatively high (70%) for group 1, but for groups II (46%) and III (37%) this congruence was relatively low. CONCLUSION: The use of SNGn appears to be inappropriate to determine the vertical facial skeletal pattern of patients, due to Gn point shifting throughout sagittal discrepancies. Clinical Significance: Facial pattern determined by SNGn must be considered carefully, especially when severe sagittal discrepancies are present.

Timing of Class III treatment with unfavorable growth pattern.

When treating youngpatients with Class III malocclusion, factors such as timing and an accurate prediction of growth of the mandible are very important. Even though early interceptive treatment of Class III might often be successful, clinicians should be careful to not initiate early treatment with premolar extractions which will compromise the success of orthognathic surgery later due to mandibular prognathism. This case report presents an adolescent female patient who developed a severe Class III skeletal discrepancy during growth and was treated with surgery after her growth had finished.

Relationship between bite force, occlusal contact area, and three-dimensional facial soft tissue in dentofacial deformities.

PURPOSE: This study aimed to investigate three-dimensional facial soft tissue dimensions, maximum bite force (MBF), and occlusal contact area in patients with DFD. In addition, we analyzed the relationship between MBF and the three-dimensional facial measurements. METHODS: Thirty-two patients with skeletal Class III DFD and 20 patients with Class II DFD underwent a soft tissue evaluation using surface laser scanning, as well as MBF and occlusal contact area assessments. The DFD groups were compared with each other and with 25 healthy subjects. RESULTS: Significant morphological differences were found in the transversal, vertical, and anteroposterior dimensions between Class II DFD and Class III DFD. Both DFD groups presented an increased linear distance of chin height, which was strongly related with decreased MBF magnitude. The DFD groups exhibited lower MBF and occlusal contact area, with no significant differences between Class II and Class III DFD. CONCLUSION: The presence of DFD affected 3D measurements of facial soft tissue, causing variations beyond normal limits, lower MBF, and occlusal contact area in both Class II and Class III DFD patients. The vertical dimension might have influenced the lower MBF magnitude in the studied skeletal deformities.

Effect of dentofacial deformity on maximum isometric tongue strength.

The objective of this study was to determine whether dentofacial deformities (class II and class III) influence maximum isometric tongue strength compared with a group without deformities. A total of 126 adult patients participated in the study. Of these, 45 had a class II diagnosis (14 men and 31 women) and 81 a class III diagnosis (35 men and 46 women), all of them with indication of orthognathic surgery. Fifty adult volunteers (17 men and 33 women) with no changes in dental occlusion (class I) and with no clinical signs of dysfunction of the temporomandibular joint represented the control group. Tongue strength (in N) was measured with a dynamometer. The maximum strength of the anterior portion was determined with the instrument positioned on the retroincisor region and the maximum strength of the dorsum with the instrument positioned in the region of the hard palate. Data were analysed statistically by analysis of variance (anova) and by the Pearson correlation test. No significant difference (P > 0·05) in tongue strength in the anterior or dorsal region was observed between the groups with dentofacial deformities or between these groups and the control. The tongue strength of the anterior and dorsal regions was not influenced by the dentofacial deformity.

Evaluation of the closest speaking space in different dental and skeletal occlusions.

STATEMENT OF PROBLEM: The closest speaking space (CSS) together with the vertical overlap of anterior teeth during the production of the /s/ sound have not been previously investigated with respect to differences in dental and skeletal orthodontic classifications. PURPOSE: The purpose of this study was to investigate the CSS in dental and skeletal occlusions and to analyze the cause and effect relationship of the CSS and the amount of the vertical overlap of anterior teeth. MATERIAL AND METHODS: Poly vinylsiloxane interocclusal registration material was placed bilaterally onto the occlusal surfaces of premolar and molar teeth of 155 native Turkish speaking adolescent and young adult dentate participants, who were then asked to pronounce the word seyis. The thinnest point between the maxillary and mandibular teeth was recorded in millimeters as the CSS. The occlusion of each participant was classified according to the Angle dental and Steiner skeletal classifications. The differences in CSS values within each classification were statistically analyzed with the Kruskal-Wallis test, and the correlation between the CSS and the vertical overlap was statistically analyzed with the Spearman Rho Correlation tests (P<.05). RESULTS: The differences in the CSS were only significant between Angle Class II division 2 and Class III groups (P=.034), while the differences in the CSS between skeletal classes were not significant. The correlation between the amount of CSS and the amount of vertical overlap was not significant. CONCLUSIONS: The results showed that regardless of dental and skeletal occlusions, average CSS values could be used to determine the occlusal vertical dimension of prosthetic restorations.

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

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.