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1.
Cureus ; 16(3): e55473, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38571844

RESUMEN

Cleft lip and palate (CLP) is a prevalent congenital craniofacial deformity that can be unilateral or bilateral. This case report highlights the interdisciplinary approach to managing a 24-year-old male with unilateral CLP (UCLP), emphasizing the complexity of associated dental and skeletal challenges. The patient had undergone multiple surgeries, including lip closure at three months, palate repair at seven years, and alveolar bone grafting at 12 years. Clinical assessments revealed a retruded maxilla, an absence of lateral incisors, and scars from previous surgeries. Radiographic evaluations indicated a Class III skeletal pattern and confirmed the presence of a cleft on the left side. Orthodontic treatment commenced with maxillary arch alignment, followed by Le Fort I surgery to address maxillary retrusion, correct skeletal malocclusion, and close the alveolar cleft space. The post-surgical phase involved orthodontic adjustments, crossbite correction, and alignment of the mandibular arch. Despite the discontinuation of treatment due to the patient's relocation, the interdisciplinary collaboration achieved significant improvements, including a corrected facial profile, maxillary advancement, closure of the cleft space, and enhanced dental alignment. The patient's confidence and functionality were positively impacted. This case underscores the importance of a coordinated interdisciplinary approach to addressing the multifaceted challenges associated with UCLP, aiming to optimize both aesthetic and functional outcomes for improved patient well-being.

2.
Cureus ; 16(3): e55798, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38586693

RESUMEN

The transverse dimension, often overlooked in orthodontics, plays a crucial role in malocclusions, affecting not only occlusion in that dimension but also sagittal and vertical dimensions. Posterior crossbites, indicative of transverse maxillary issues, are commonly addressed through palatal expansion. This case report explores the clinical insights into addressing a constricted maxillary arch in Angle's Class II malocclusion using a nickel-titanium (NiTi) expander. The NiTi expander provides constant and optimal expansion forces by incorporating a temperature-activated NiTi alloy. A 16-year-old male with irregularly placed teeth, high palatal vault, and posterior crossbite underwent treatment involving NiTi expander usage for maxillary expansion. The case presentation details the patient's journey, starting with upper arch bonding and expansion, then lower arch bonding, and concluding with complete leveling and alignment without extractions. The presented case demonstrates successful correction of a constricted maxillary arch, specifically in the canine and molar regions, utilizing the NiTi expander. The observed increase in intermolar width aligns with previous studies, showcasing the effectiveness of slow maxillary expansion. This article contributes valuable clinical insights into addressing transverse maxillary issues, emphasizing the importance of careful consideration in choosing the appropriate expansion method for optimal results.

3.
Cureus ; 16(2): e55036, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38550417

RESUMEN

Twin Block, a functional orthodontic appliance, has a major impact on the dentoalveolar structures with limited skeletal effects. In specific clinical scenarios, particularly in growing patients such as class II division 1 where the mandible is retropositioned, these appliances can effectively address the malocclusions. Patient compliance plays a crucial role in the success of these appliances, which also streamline subsequent phases of fixed appliance treatment. In the current case report, a Twin Block appliance followed by a Quad Block was given to a 12-year-old boy to refine the occlusion. The design and treatment outcomes of the appliance are discussed in this case study.

4.
Cureus ; 16(1): e53056, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38410302

RESUMEN

Supernumerary molars are an uncommon anomaly that can occur in the maxillofacial complex, referring to the presence of additional teeth in the dental arch. This condition is often associated with several rare disorders such as Gardner's syndrome, Cleidocranial dysplasia, Ehler-Danlos syndrome, and Down syndrome However, it is seldom observed in non-syndromic associations. They occur more frequently in the maxilla than in the mandible. This research represents a unique case study that explores unerupted paramolar and parapremolar follicles coexisting in both the maxillary and mandibular arches of a 17-year-old male patient. The discovery of these follicles was fortuitous, as the patient exhibited no symptoms during the initial orthopantomogram scan. Despite the absence of noticeable symptoms, vigilant monitoring and observation were employed over time. Subsequently, a substantial shift in the approach to management occurred with the integration of surgical and orthodontic methodologies, guided eruption strategies, and a collaborative, multidisciplinary effort.

5.
Cureus ; 16(1): e51582, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38313909

RESUMEN

Permanent maxillary central incisor impaction is generally a rare phenomenon. Because the anterior teeth have a huge impact on a patient's facial aesthetics, missing anterior teeth are of major concern to patients who seek orthodontic treatment. However, correcting this type of malocclusion poses a challenge to the orthodontist. This case report of a 16-year-old male patient with an impacted maxillary right central incisor takes us through a series of events that are necessary to treat this type of malocclusion. The presenting case also had an impacted supernumerary tooth which was the primary cause for permanent tooth impaction. A combined treatment approach is usually needed to manage this type of case involving both the orthodontist and the surgeon.

6.
Cureus ; 16(1): e51611, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38313948

RESUMEN

This case study offers a rare and difficult condition involving the impaction of teeth 11, 12, and 13, providing a severe dental challenge. A thorough examination was performed on the patient, which included clinical evaluations and radiographic examinations. Because the impacted teeth were causing discomfort and functional impairment, a multidisciplinary approach was required, which included surgical exposure followed by traction forces to level and align the impacted teeth. The abstract emphasizes the case's complexity, digging into the diagnosis process and the establishment of a personalized treatment strategy. The complexities of handling many impacted teeth are explored in length, including surgical intervention, orthodontic considerations, and postoperative care.

7.
Cureus ; 16(1): e52643, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38380192

RESUMEN

Cleft lip and palate (CLP) represent a multifaceted congenital deformity encompassing skeletal, dental, and functional discrepancies. This case report presents the management of a 13-year-old female with bilateral CLP, focusing on the challenges associated with permanent dentition and retained deciduous teeth. The patient's history included prior lip and palate repair surgeries, leading to poor aesthetics and functional concerns. A multidisciplinary approach involving orthodontics, oral surgery, and prosthodontics was implemented. Clinical examinations revealed dental abnormalities, oro-nasal fistula, and skeletal discrepancies, necessitating a comprehensive treatment plan. The orthodontic intervention aimed at aligning the dentition, followed by surgical closure of the oro-nasal fistula and alveolar bone grafting (ABG) to facilitate permanent canine eruption. Prosthetic replacement of missing maxillary lateral incisors was accomplished, enhancing aesthetics with minimal invasiveness. Results demonstrated significant improvements in profile, dental alignment, and functional stability. Cephalometric and dental parameter analyses confirmed the corrections and enhancements achieved, affirming the success of the multidisciplinary treatment. This case report emphasizes the importance of a collaborative multidisciplinary approach in effectively addressing the complexities of bilateral CLP in patients with permanent dentition and retained deciduous teeth. The comprehensive treatment strategy rectified dental and skeletal issues and positively impacted the patient's overall well-being and self-confidence.

8.
Cureus ; 15(12): e51024, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38264393

RESUMEN

Cleidocranial dysplasia (CCD) is a rare genetic disorder that causes cranial and skeletal abnormalities. This case report presents a comprehensive analysis of a rare instance of CCD, highlighting its clinical manifestations through an orthodontic lens shedding light on the challenges and complexities associated with managing this uncommon condition. The patient, an 18-year-old female, presented with a variety of symptoms, including delayed eruption of permanent teeth, abnormal facial features, and prominent cranial abnormalities. Multiple teeth in both the arches were missing including over-retention of primary teeth. Features of cleidocranial dysplasia were evident in her facial appearance. Treatment of CCD requires a multifaceted approach, often involving orthodontic interventions, dental extractions, and corrective surgeries to address cranial deformities and other skeletal anomalies. The report emphasizes the importance of multidisciplinary collaboration in diagnosing and managing such cases, shedding light on the distinctive features of CCD and their implications for orthodontic treatment on what kind of best treatment can be given to these patients. This case serves as a reminder of the importance of raising awareness about rare genetic disorders like CCD, as early diagnosis and intervention can significantly improve the patient's quality of life. Furthermore, it underscores the significance of a collaborative and holistic healthcare approach in managing such complex conditions. It emphasizes the need for continued research, awareness, and support for individuals affected by such conditions.

9.
Cureus ; 15(12): e51177, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38283527

RESUMEN

Probiotic therapy represents a novel concept in dentistry. The microbial nature of dental plaque can be altered, or the probiotic strategy can efficiently inhibit oral pathogens. Probiotics are dietary supplements that are vital for boosting immunity as they include beneficial bacteria and yeast. In dentistry and medicine, the interest in probiotics, prebiotics, and synbiotics is increasing. By forming a biofilm and assisting in preventing dental cavities, probiotics play a crucial role in dentistry and significantly impact immunity. Prebiotics are non-digestible dietary supplements that enhance health by increasing the quantity and activity of beneficial bacteria such as Lactobacilli and Bifidobacteria. It has been demonstrated that prebiotics, in addition to probiotics, can help treat oral diseases. They promote the growth and activity of beneficial organisms while inhibiting potentially harmful bacteria's growth and activity. Synbiotics are dietary supplements that combine probiotics and prebiotics, believed to work in tandem through a process known as synergism. Studies have indicated that synbiotics, or a combination of probiotics with a prebiotic, may have greater efficacy than either supplement alone.

10.
J Contemp Dent Pract ; 24(8): 582-586, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38193182

RESUMEN

AIM: To evaluate the changes in the intraoral dynamic space with myofunctional therapy in skeletal class II division 1 malocclusion using three-dimensional digital volume tomography (3D-DVT). MATERIALS AND METHODS: The study type is observational and the duration of intervention was 3 years. Dental casts obtained from 20 samples of 11-14 years age-group were collected and 3D-DVT scans were performed prior to and after the myofunctional therapy. The parameters depicting the arch perimeter, arch width, arch length, arch shape, and arch volume on dental cast were used in the study using several linear and volumetric measurements. All parameters were compared before and after myofunctional therapy using t-test. RESULTS: The Intraoral volume before myofunctional therapy (T0) was 5.59 mL and after myofunctional therapy (T1), it was 7.22 mL. Significant changes were seen in intraoral volume, arch perimeter, arch length, and intercanine and intermolar arch width and the arch shape. Linear and volumetric measurements were increased after myofunctional therapy. CONCLUSION: Myofunctional appliances lead to an expansion in the anteroposterior and sagittal direction thus increasing the Donders space and leading to proper formation of dental arches and proper positioning of the teeth. CLINICAL SIGNIFICANCE: Myofunctional therapy is an effective method of increasing arch width, length, and volume. This therapy can be used in routine practices in young children with constricted arch and improvement in facial esthetic.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Maloclusión Clase II de Angle , Niño , Preescolar , Humanos , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Terapia Miofuncional , Proyectos de Investigación
11.
Cureus ; 15(12): e50858, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38249225

RESUMEN

Corticotomy-assisted orthodontics is an emerging technique that combines orthodontic treatment with selective alveolar corticotomy to accelerate tooth movement and optimize treatment outcomes. This case report presents the successful application of corticotomy-assisted orthodontics in the management of a complex malocclusion. Following a comprehensive orthodontic assessment and treatment planning, corticotomy-assisted orthodontics was selected as the treatment approach. The surgical procedure involved selective alveolar corticotomy in the affected regions, followed by initiation of orthodontic mechanics. The case was closely monitored at regular intervals, and treatment progress was assessed using clinical examination and radiographs. The combined approach led to significantly accelerated tooth movement, a reduction in treatment time, and improved patient satisfaction. This case report underscores the potential benefits of corticotomy-assisted orthodontics in complex cases, providing clinicians with valuable insights into its successful application and the considerations involved in treatment planning and execution. Further research and long-term follow-up are warranted to elucidate the long-term stability and outcomes of this approach.

12.
Cureus ; 14(11): e31746, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36569664

RESUMEN

Introduction Cleft of the lip and/or the palate is commonly inherited defect which involves cleft of lip and palate. Maxillary second molar inclination has been studied in various malocclusion. Every abnormality in body is compensated to some extend by compensation. Our objectives were to evaluate maxillary second molar inclination in Angle's Class I, Class III malocclusion, and unilateral cleft lip and palate (UCLP) patients in transverse plane and to compare variation in maxillary second molar inclination in Angle's Class I, Class III malocclusion, and UCLP cases buccopalatally in transverse plane. Material and method Model of 45 subjects were analyzed. The maxillary second molar inclination was measured using aid of protractor fixed on the surveyor. Axis under consideration was the axis along the long axis of the central fossa of maxillary second molar. Various standardization regarding measurement of second molar inclination were set. The maxillary second molar inclination was compared among 3 groups Angle's Class I, Class III malocclusion, and UCLP cases. Results Data was analyzed using one-way analysis of variance (ANOVA) and post-hoc Tukey test. There was a significant difference between inclination of maxillary second molar when Angle's Class I malocclusion was compared with Angle's Class III malocclusion and UCLP cases (p = 0.003 and p = 0.011, respectively). There was not a significant difference between Angle's Class III malocclusion and UCLP cases (p = 0.87). Conclusion Amongst Class III patients and UCLP patients the inclination of maxillary second molar had greater buccal inclination. Maxillary second molar correction would alleviate the effect of deleterious force on periodontium and bone generated by malpositioned teeth.

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