How Similar are the Dentoskeletal Characteristics of Class III Double-Jaw Surgery Patients with Ideal Post-Treatment Profiles and Class I Subjects?

Objective: To define the dental and skeletal characteristics of Class III surgery patients with ideal final soft-tissue profiles, and to compare them with those of Class I subjects. Also, to show how soft-tissues respond to surgical jaw movements and contribute to the outcome. Methods: This short-term, retrospective study was conducted using pre-treatment (T0), pre-surgery (T1), and post-treatment (T2) records of 50 double-jaw Class III surgery patients who presented with ideal cephalometric characteristics in sagittal (Holdaway and soft-tissue convexity angles) and vertical dimensions (GoGn. SN angle and upper-to-lower face harmony) at the end of treatment, and 50 control subjects. Results: At T2, the horizontal distance between the vertical reference plane (a perpendicular plane to the horizontal reference plane that is angulated 7° clockwise to the SN plane) and hard-tissue A, B and Pog points, lower lip, soft-tissue B, and pogonion points were greater, Wits appraisal was more negative, U1.PP was higher, IMPA was lower, and soft-tissue chin (Pog-Pog') was thicker in Group 1 when compared to Group 2 (p<0.05). Moreover, upper lip and subnasal (A-A') thicknesses were decreased, and chin thickness (Pog-Pog') was increased significantly (p<0.05). Conclusion: Dentoskeletal characteristics of an ideally-treated Class III surgery patient differed from a Class I subject concerning a protrusive maxilla and soft-tissue pogonion, and incisors that were not fully-decompensated. Soft-tissues hindered the actual surgical correction to 66% and 73% in the mid- and lower-faces, respectively.

An unusual case of invasive cervical resorption after piezosurgery-assisted en masse retraction.

A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.

Assessing the influence of chin prominence on profile esthetics: A survey study.

PURPOSE: The aim of this survey study was to assess the influence of chin prominence on the perception of profile esthetics between genders by orthodontists, oral and maxillofacial surgeons (OMF), plastic surgeons, orthognathic patients and laypersons. MATERIALS AND METHODS: A total of 731 observers participated in this study. Profile photographs of one female and one male showing ideal soft tissue values, skeletal class 1 relationship, and normodivergent facial type were modified with photo editing program (Adobe Photoshop CC software), so that the chin was moved posteriorly up to 10 mm and anteriorly up to 8 mm at 2-mm intervals. Participants were asked to rate 11 female and 11 male profile images and to assess whether surgery was needed. RESULTS: Within the limits of this study, ideal, slightly concave and slightly convex profiles for females, and ideal and slightly concave profiles for males were found more acceptable. Surgery was desired for 50.9% of retrusive profiles and 57.3% of protrusive profiles. Female participants had a higher rate of desire for surgery than male participants, and clinicians desired surgery significantly less than others. Desire for surgery started from 4 mm in males and females for all groups, from -6 mm in orthodontists and OMFs, from -4 mm in other groups in females, and from -6 mm in males for all groups. CONCLUSION: Clinicians tend to operate more pronounced cases when compared to laypeople. A significantly higher rate of surgery was desired for protrusive chin profiles, and female participants had a higher desire for surgery.

Osseous outgrowth on the buccal maxilla associated with piezosurgery-assisted en-masse retraction: A case series.

Piezoelectric surgery is a novel surgical approach used in orthodontic treatment for rapid tooth movement. This paper presents a case series wherein osseous outgrowths were observed in response to piezosurgery-assisted en-masse retraction. Sixteen patients requiring upper premolar extractions were treated with miniscrew-supported en-masse retraction and received minimally invasive decortication via piezosurgery. Computed tomography (CT) of the maxillary anterior region was performed to investigate the nature of the outgrowths. In 8 of the 16 patients, hemispheric or disc-shaped osseous outgrowths were observed on the sites where piezosurgery was performed during retraction. CT images revealed that these outgrowths were alveolar bone. This case series presents a previously unreported osseous response to piezosurgery-assisted tooth movement during orthodontic treatment. The response is mostly transient and is observed in 50% of the treated patients, suggesting a bone turnover that can be assessed clinically and radiographically.

Efficiency of piezosurgery technique in miniscrew supported en-masse retraction: a single-centre, randomized controlled trial.

BACKGROUND: Piezoelectric surgery is a newly introduced technique for rapid tooth movement. However, the efficiency of this technique has not been investigated on en-masse retraction cases yet. OBJECTIVE: To investigate the efficiency of piezosurgery technique in accelerating miniscrew supported en-masse retraction and study the biological tissue response. In addition, to show if this technique induces a difference in dental, skeletal and soft tissue changes on lateral cephalograms, and in canine and molar rotations, besides intercanine and intermolar widths on dental casts. DESIGN, SETTING, PARTICIPANTS: We conducted a randomized, single-centred, parallel-group, controlled trial, requiring upper right and left first premolar extractions on 30 patients above the minimum age of 14 years at the beginning of retraction. INTERVENTIONS: Piezosurgery-assisted versus conventional en-masse retraction anchored from miniscrews placed between second premolars and first molars, bilaterally. OUTCOMES: The main outcome was the en-masse retraction rate. Secondary outcomes were gingival crevicular fluid (GCF) volume and GCF content of receptor activator of nuclear factor κß ligand (RANKL), changes regarding cephalometric and dental cast variables, and miniscrew success rates. RANDOMIZATION: Accomplished with opaque, sealed envelopes. BLINDING: Applicable for data assessment only. RECRUITMENT: Commenced in February 2013 and ended in October 2014. RESULTS: Thirty-one patients were included in the study and divided into 2 groups of piezosurgery (n = 16) and control (n = 15). After 9.3 months of follow-up, no statistically significant difference was observed between groups for neither retraction rates (P = 0.958) nor GCF parameters (P > 0.05). Changes in lateral cephalometric and dental cast variables, and miniscrew success rates did not show significant differences either. CONCLUSION: Based on the results of this study, piezosurgery technique was found to be ineffective in accelerating en-masse retraction, and promoting a difference in the studied GCF parameters, skeletal and dental variables. REGISTRATION: The trial was not registered. PROTOCOL: The full protocol of this PhD thesis study can be accessed from tez.yok.gov.tr. FUNDING: This work was supported by Baskent University Research Fund. No conflict of interest was declared.