Evaluation of occlusal function during orthognathic therapy : A prospective clinical trial using a digital registration method.

OBJECTIVES: Reduced occlusal function is a main characteristic of orthognathic patients. The present study aimed to investigate the extent of therapy-induced functional improvements in occlusal function using a digital diagnostic method. METHODS: This prospective clinical study included 41 orthognathic patients (24 women and 17 men, median age 27.26 ± 8.2 years) and 10 control patients (5 women and 5 men, median age 29.8 ± 13.5 years) with neutral skeletal and dental configurations. The patients were divided into classes I, II and III based on their cephalometry. Digital occlusal registrations in habitual occlusion in an upright sitting position were taken before (T1) and after (T2) therapy using the T­Scan Novus (Tekscan, South Boston, MA, USA) application. RESULTS: Class II and III patients showed a significantly less efficient occlusal pattern than the untreated controls regarding total antagonism (p < 0.001), time of occlusion (p = 0.004), occlusal asymmetry (p = 0.001), anterior antagonism (p < 0.001) and posterior antagonism (p < 0.001). After therapy, the occlusal pattern increased in both therapy groups, where class III patients became indistinguishable from the controls, and class II patients differed only in posterior antagonism (p = 0.035). CONCLUSIONS: The digital occlusal registration method proved to be a useful diagnostic tool and provided new insights into therapeutic effects in orthognathic patients. By precisely adjusting the occlusal function, masticatory performance improved significantly. CLINICAL RELEVANCE: Severe malocclusion leads to a significantly lower masticatory performance for patients, which can be improved by orthognathic therapy and captured by digital occlusal registration.

Desmoid fibromatosis in the pharyngeal wall: A case report and literature review.

Desmoid fibromatosis (DF) is one of the rarest locally aggressive growing benign tumor entities. We present an overview of the literature and a rare clinical case of a 22-year-old female patient, who was diagnosed with aggressive DF in the left pharyngeal wall at the age of 4 years old.

Orthodontic incisor decompensation in orthognathic therapy-success and efficiency in three dimensions.

OBJECTIVES: Sufficient dental decompensation is crucial for treatment success in combined orthodontic-surgical treatment. The study's objective was to determine the treatment success and efficiency in sagittal, vertical, and transversal decompensation. METHODS: This longitudinal, observational study enrolled 52 adult patients, who underwent orthodontic-surgical treatment. Incisor inclinations and positions as well as skeletal changes were assessed pre-treatment (T1), pre-surgical (T2), and post-surgical (T3) by lateral cephalograms and CBCT scans. RESULTS: Incisor decompensation was insufficient in all three dimensions. Sagittal: treatment efficiency did not differ between class II and III patients. Vertical: patients with open bite demonstrated pre-surgical bite deepening and insufficient surgical reduction of the maxillomandibular plane angle. Transversal: Dental midline deviations were not adapted to the skeletal asymmetry so that menton deviations were not properly corrected. CONCLUSIONS: Incisor decompensation was not as successful as requested in all three dimensions and the treatment ideal was seldom achieved. CLINICAL RELEVANCE: To improve the skeletal outcome, the orthodontist has to treat the patient with the desired surgical movements in mind and should critically evaluate the pre-surgical incisor decompensation before referral to the surgical team.