Surgical-orthodontic treatment of Class III malocclusion with agenesis of lateral incisor and unerupted canine.

INTRODUCTION: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch. METHODS: The presurgical orthodontic treatment was performed with extraction of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the postsurgical orthodontic treatment was finished. RESULTS: The Class III malocclusion was treated establishing occlusal and facial normal standards.

Surgical-orthodontic treatment of Class III malocclusion with agenesis of lateral incisor and unerupted canine

INTRODUCTION: Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch. METHODS: The pre-surgical orthodontic treatment was performed with extractions of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the post-surgical orthodontic treatment was finished. RESULTS: The Class III malocclusion was treated establishing occlusal and facial normal standards.

INTRODUÇÃO: o presente trabalho apresenta um tratamento ortodôntico-cirúrgico realizado em paciente portadora de má oclusão de Classe III esquelética com crescimento mandibular, protrusão dentária superior e inferior, trespasse horizontal de -3,0mm, trespasse vertical de -1,0mm, ausência congênita do dente 22, dentes 13 e supranumerários inclusos, dente 12 com forma conoide e parcialmente irrompido em supraversão, retenção prolongada do dente 53, tendência ao crescimento vertical da face e assimetria facial. A discrepância na arcada superior era de -2,0mm, e na inferior era de -5,0mm. MÉTODOS: o tratamento ortodôntico pré-cirúrgico foi realizado com extrações dos dentes 35 e 45. Na arcada superior foram extraídos os dentes 53, 12 e supranumerário, para efetuar o tracionamento do canino incluso. Os espaços das extrações inferiores foram fechados com mesialização do segmento posterior. Após o alinhamento e nivelamento dos dentes, foram avaliados por meio de modelos de estudo o fechamento dos espaços das extrações e o posicionamento correto dos dentes nas bases ósseas, a intercuspidação correta das arcadas dentárias, com molares e caninos em Classe I de Angle, linhas medianas coincidentes, trespasse horizontal e trespasse vertical normais e torques ideais. A paciente foi encaminhada para realização de cirurgia ortognática e, em seguida, o tratamento ortodôntico pós-cirúrgico foi finalizado. RESULTADOS: a má oclusão de Classe III foi corrigida, estabelecendo padrões oclusais e faciais normais.

Influence of adenotonsillectomy on hard palate dimensions.

OBJECTIVE: To evaluate hard palate width and height in mouth-breathing children pre- and post-adenotonsillectomy. METHODS: We evaluated 44 children in the 3-6 year age bracket, using dental study casts in order to determine palatal height, intercanine width, and intermolar width. The children were divided into two groups: nasal breathing (n=15) and mouth breathing (n=29). The children in the latter group underwent adenotonsillectomy. The study casts were obtained prior to adenotonsillectomy, designated time point 1 (T1), at 13 months after adenotonsillectomy (T2), and at 28 months after adenotonsillectomy (T3). Similar periods of observation were obtained for nasal breathing children. RESULTS: At T1, there was a significantly lower intercanine width in mouth breathing children; intermolar width and palate height were similar between groups. After surgery, there was a significant increase in all the analyzed parameters in both groups, probably due to facial growth. Instead, the increase in intercanine width was substantially more prominent in mouth breathing children than in nasal breathing children, and the former difference failed in significance after the procedure. CONCLUSIONS: There were no significant differences between the nasal-breathing and mouth-breathing children in terms of intermolar width and palatal height prior to or after tonsillectomy. Although intercanine width was initially narrower in the mouth-breathing children, it showed normalization after the surgical procedure. These results confirm that the restoration of nasal breathing is central to proper occlusal development.

Má oclusão de Classe II com apinhamento: tratamento sem extrações dentárias / Class II maloclusion with crowding: treatment without dental extractions

O presente artigo ilustra um tratamento ortodôntico sem extrações para correção de uma má oclusão de Classe II com apinhamento. As características dessa má oclusão incluíam incisivos superiores protruídos, incisivos inferiores retruídos, sobressaliência de 7mm, sobremordida profunda e tendência de crescimento vertical. O tratamento ortodôntico, sem extrações dentárias consistiu de expansão ortopédica da maxila com expansor tipo Haas, placa labioativa associada à mecânica de classe III, para inclinação distal dos molares inferiores, e aparelho extrabucal de tração combinada, para distalização dos molares superiores.