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1.
Braz Oral Res ; 34: e003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022222

RESUMEN

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Asunto(s)
Estética Dental , Cara/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Extracción Dental/métodos , Adolescente , Análisis de Varianza , Diente Premolar/cirugía , Cefalometría , Niño , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Ortodoncistas , Percepción , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
2.
Am J Orthod Dentofacial Orthop ; 156(2): 248-256.e2, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375235

RESUMEN

INTRODUCTION: The treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion. METHODS: Pretreatment cephalograms of 306 patients (131 men, 175 women; overall ages 18-45 years) were evaluated. Four groups were constructed. Three groups had increased overbite (>4.5 mm): group 1 (n = 96) skeletal Class I (ANB = 0.5°-4°), group 2 (n = 85) skeletal Class II (ANB >4.5°) with Class II/1; and group 3 (n = 79) skeletal Class II with Class II/2 malocclusion. Group 4 as a control (n = 46) skeletal Class I normal overbite. Dental and skeletal characteristics of the groups were compared by sex. For statistical evaluations, analysis of variance followed by Tukey post hoc, Mann-Whitney U, and Kruskall-Wallis tests were used. Additionally correlation coefficients between overbite and skeletal/dental parameters were calculated. RESULTS: Between sexes, with regard to skeletal parameters, the men had greater values in millimetric measurements, and the women had higher SN/GoGn values. Maxillary/mandibular molar heights and the mandibular incisor heights were higher in men. In group 1, decreased lower anterior facial height (LAFH), retrusive mandibular incisors, and increased interincisal degree were determined. The maxillary molars were intrusive, whereas the vertical position of the mandibular molars and incisors in both jaws were normal. In group 2, retrognathic mandible, increased LAFH and mandibular plane angle, extrusive maxillary/mandibular incisors, protrusive mandibular incisors, and decreased interincisal degree were found. In group 3, decreased LAFH, increased interincisal degree, and retrusive incisors in both jaws were determined. There were significant negative correlations between SN/GoGN, palatal plane, and overbite in group 2 and between ANS-SN and overbite in group 3, and positive correlation between interinsical angle and overbite in all increased overbite groups. CONCLUSIONS: Dental morphology seems to be the main factor of increased overbite. Differences between groups were related primarily to inclinations and vertical positions of the incisors, rather than molar positions.


Asunto(s)
Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Sobremordida/epidemiología , Sobremordida/patología , Adolescente , Adulto , Análisis de Varianza , Puntos Anatómicos de Referencia , Cefalometría , Femenino , Humanos , Incisivo/patología , Masculino , Maloclusión de Angle Clase III/patología , Mandíbula/patología , Maxilar/patología , Persona de Mediana Edad , Diente Molar/patología , Retrognatismo/patología , Factores Sexuales , Turquia , Adulto Joven
3.
Am J Orthod Dentofacial Orthop ; 156(2): 266-274, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375237

RESUMEN

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Maloclusión/terapia , Técnica de Expansión Palatina , Técnicas de Movimiento Dental/métodos , Cefalometría , Modelos Dentales , Oclusión Dental , Estudios de Seguimiento , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Maloclusión/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/cirugía , Maloclusión de Angle Clase II/terapia , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase III/terapia , Maxilar/anomalías , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Aparatos Ortodóncicos , Soportes Ortodóncicos , Alambres para Ortodoncia , Paladar (Hueso)/cirugía , Planificación de Atención al Paciente , Estudios Prospectivos , Resultado del Tratamiento
4.
Int. j. morphol ; 37(2): 744-751, June 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1002288

RESUMEN

During development, bony changes in the palate are reflected in the palatal rugae. Therefore, we hypothesized that the palatal dimensions (PD) influence the shape and number of palatal rugae (PR). The objectives were to record the palatal rugae characteristics (PRC) and palatal dimensions (intercanine distance (ICD), intermolar distance (IMD), palatal height (PH) and palatal area (PA) in Classes I, II and III malocclusion patients and investigate their interrelationship, and statistically examine the possibility of predicting PRC with the PD. Four hundred eighty-one pre-orthodontic study casts of healthy patients with normal palate anatomy were grouped as Classes I, II and III and scanned using 3D cast scanner. The PRC, ICD, IMD, PH, and PA were recorded digitally using 3D enabled software. The data was statistically analyzed. A strong statistically significant difference was observed between PA and number of straight and wavy rugae. ICD and the number of straight rugae were also related. A weak correlation exists between malocclusion classes and PA. The remaining rugae characteristics did not exhibit any relation with palatal dimensions. PA is positively related to the number of straight rugae and negatively related to the number of wavy rugae. Bigger palates have more straight rugae and less number of wavy rugae. A weak correlation between PA and Angle's class I malocclusion exists. We also propose that PA has a developmental association with the number and shape of PR.


Durante el desarrollo, los cambios óseos en el paladar se reflejan en las rugas palatinas. Por lo tanto, planteamos la hipótesis de que las dimensiones palatinas influyen en la forma y el número de las rugas palatinas. Los objetivos fueron registrar las características de las rugas palatinas y las dimensiones palatales (distancia intercanina, distancia intermolar, altura palatina y área palatina) en pacientes con maloclusión de clases I, II y III e investigar su interrelación, y examinar estadísticamente la posibilidad de predecir las características de las rugas palatinas con las dimensiones palatinas. Cuatrocientos ochenta y un estudios pre-ortodónticos de pacientes sanos con anatomía normal del paladar se agruparon como Clases I, II y III y se escanearon con un escáner de emisión 3D. La distancia intercanina, distancia inter molar, altura palatina y área palatina se registraron digitalmente utilizando el software 3D. Los datos se analizaron estadísticamente. Se observó una diferencia estadísticamente significativa entre la altura palatina y el número de rugas rectas y onduladas. Se registró también la distancia intercanina y el número de rugas rectas. Existe una correlación débil entre las clases de maloclusión y la altura palatina. Las características restantes de las rugas palatinas no mostraron ninguna relación con las dimensiones palatinas. El área palatina está relacionada positivamente con el número de rugas rectas y negativamente relacionada con el número de rugas onduladas. Los paladares más grandes tienen más rugas rectas y menor cantidad de rugas onduladas. Existe una correlación débil entre el área palatina y la clase I de maloclusión de Angle. También proponemos que el área palatina tiene una asociación de desarrollo con el número y la forma de rugas palatinas.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Adulto Joven , Paladar Duro/patología , Maloclusión/patología , Estudios Transversales , Estudio Observacional , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología
5.
J Craniomaxillofac Surg ; 47(3): 400-405, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30691943

RESUMEN

PURPOSE: The purpose of this study was to examine changes in masseter and medial pterygoid muscles, ramus, condyle and occlusal force after bi-maxillary surgery in class II and III patients. SUBJECTS AND METHODS: The subjects were 42 patients (84 sides) who underwent sagittal split ramus osteotomy with Le Fort I osteotomy (21 class II cases: mandibular advancement and 21 class III cases: mandibular setback). The cross-sectional measurements of the masseter and medial pterygoid muscles, ramus and condyle were measured in horizontal plane images by computed tomography (CT), before and 1 year after the operation. Occlusal force and contact area were also recorded before and 1 year after the operation. RESULTS: Preoperatively, class II was significantly larger than class III in masseter width (P = 0.0068), masseter area (P < 0.0001) and medial pterygoid length (P < 0.0001). However, class II was significantly smaller than class III in medial pterygoid width (P < 0.0001). After 1 year, class II was significantly smaller than class III in masseter length (P = 0.0017). Class II was still larger than class III in medial pterygoid area after 1 year (P = 0.0343). Class II was significantly larger than class III in condylar angle pre-operatively (P < 0.0001) and after 1 year (P = 0.0006). After 1 year, class II decreased significantly more than class III in condylar thickness (P = 0.0020), condylar width (P < 0.0001) and condylar area (P < 0.0001). CONCLUSION: This study suggested that changes in the cross-sectional measurements of masseter and medial pterygoid muscles and the condyle differed between class II and class III patients, although occlusal force did not significantly change 1 year after surgery in both groups.


Asunto(s)
Fuerza de la Mordida , Mandíbula/anatomía & histología , Músculo Masetero/anatomía & histología , Maxilar/cirugía , Músculos Pterigoideos/anatomía & histología , Cefalometría , Femenino , Humanos , Imagenología Tridimensional , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/fisiopatología , Maloclusión de Angle Clase II/cirugía , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/fisiopatología , Maloclusión de Angle Clase III/cirugía , Avance Mandibular , Músculo Masetero/fisiología , Osteotomía Le Fort , Osteotomía Sagital de Rama Mandibular , Músculos Pterigoideos/fisiología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
6.
Eur J Orthod ; 41(1): 21-28, 2019 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-29617755

RESUMEN

Background: Increased awareness on the role of oral functions in the aetiology of Class II deformities has led to the wide spread of myofunctional training appliances as easy and possibly effective treatment for children with Class II malocclusion but their efficacy is yet to be proven. Objectives: To evaluate soft- and hard-tissue changes following 12 months of Class II division 1 treatment in growing patients with a conventional functional appliance (a modified Activator) versus a myofunctional Trainer system (T4K®). Setting and sample population: Department of Orthodontics, Dental School. Participants, study design, and methods: Sixty Class II division 1 children (8-12 years old) were recruited from primary schools and were distributed randomly into two equal groups. Randomization was based on a computer-generated sequence of random numbers. Data analysis included: the Activator group (28 patients, mean age = 10.6 ± 1.3 years); the T4K® group (26 patients, mean age = 10.3 ± 1.4 years). Skeletal, dentoalveolar, and soft tissues changes were assessed using standardized lateral cephalograms collected before and after 12 months of treatment. No blinding was applied in this trial. Results: Improvement in the Class II skeletal and dentofacial characteristics were significantly greater in the Activator group when compared with the T4K® group. The improvement was evident in a significant decrease in the skeletal angle ANB with Activator (x¯ = -1.89 ± 1.12) compared to T4K® (x¯ = -0.9 ± 1.01) (P = 0.01), a significant greater increase in the facial convexity angle with Activator (x¯ = 2.61 ± 3.71) more than T4K® (x¯ = 0.2 ± 2.51) (P = 0.04), and a significant reduction in the overjet (x¯ = -3.0 ± 2.3 mm) compared to (x¯ = -1.5 ± 1.9 mm; P = 0.01) with Activator versus T4k®, respectively (P = 0.001). Limitations: This study was a short-term study (12-month follow-up). Conclusions: The results of the current study indicated that the Activator was more effective than the T4K® in treating Class II division 1 growing patients. Registration: The trial was not registered in any major database of clinical trials. Protocol: The protocol was not published before the commencement of the trial but can be given upon request.


Asunto(s)
Aparatos Activadores , Maloclusión de Angle Clase II/terapia , Terapia Miofuncional/métodos , Ortodoncia Correctiva/instrumentación , Cefalometría/métodos , Niño , Cara/patología , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/patología , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Resultado del Tratamiento
7.
Cranio ; 37(4): 264-271, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29359644

RESUMEN

Objective: To evaluate whether osseous changes of the temporomandibular joint (TMJ) condyle affect backward rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption (ICR). Methods: Twenty Japanese women with Class II malocclusion with ICR (ICR group) and 24 women with Class II malocclusion without ICR (non-ICR group) were examined. Pre-treatment panoramic radiographs were used to measure condylar ratios. Pre-treatment lateral cephalograms were used to evaluate maxillofacial morphology. Results: The ICR group had a significantly smaller condylar ratio, greater backward rotation of the ramus, less labially inclined upper incisors, and a steeper occlusal plane. The increased backward rotation of the ramus in the ICR group was significantly associated with a smaller condylar ratio. Conclusion: Angle Class II patients with ICR had shorter condylar height attributable to osseous changes of the TMJ condyle, and the shorter condylar height may affect subsequent backward rotation of the ramus.


Asunto(s)
Resorción Ósea/patología , Resorción Ósea/fisiopatología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/fisiopatología , Cóndilo Mandibular/patología , Cóndilo Mandibular/fisiopatología , Rotación , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/patología , Articulación Temporomandibular/fisiopatología , Adulto , Resorción Ósea/diagnóstico por imagen , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Cóndilo Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Adulto Joven
8.
Orthod Craniofac Res ; 22(1): 9-15, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30421852

RESUMEN

OBJECTIVES: To clarify the associations among tongue volume, hyoid position, airway volume and maxillofacial form using cone beam computed tomography (CBCT) data for children with Class-I, Class-II and Class-III malocclusion. SETTING AND SAMPLE POPULATION: Sixty children (mean age, 9.2 years) divided into Class-I, Class-II and Class-III malocclusion groups according to the A-nasion-B angle. MATERIAL AND METHODS: Cone beam computed tomography was used for three-dimensional reconstruction of the maxillofacial region and airway. The hyoid position and the tongue, airway and oral cavity volumes were evaluated. Upper airway ventilation status was calculated using computational fluid dynamics. The groups were compared using analysis of variance and Kruskal-Wallis tests; relationships among the parameters were assessed using Pearson's and Spearman's rank correlation tests. RESULTS: The tongue volume was larger in Class-III patients (50.63 cm3 ) than in Class-I patients (44.24 cm3 ; P < 0.05). The hyoid position was lower (49.44 cm), and anatomical balance (AB; tongue volume/oral cavity volume; 85.06%) was greater in Class-II patients than in Class-I patients (46.06 cm, 80.57%, respectively; P < 0.05 for both). The hyoid height showed a positive correlation with AB (r = 0.614; P < 0.001). CONCLUSIONS: Children with Class-III malocclusion have large tongue volumes and small AB; the reverse is true for children with Class-II malocclusion. The hyoid position is closely associated with AB in children with malocclusion.


Asunto(s)
Hueso Hioides/patología , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Nasofaringe/patología , Lengua/patología , Niño , Tomografía Computarizada de Haz Cónico , Cara/diagnóstico por imagen , Cara/patología , Femenino , Humanos , Hueso Hioides/diagnóstico por imagen , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Maxilar/patología , Nasofaringe/diagnóstico por imagen , Estudios Retrospectivos , Lengua/diagnóstico por imagen
9.
Pain Res Manag ; 2018: 4286796, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30410638

RESUMEN

Aim: To assess changes in the craniocervical structure and in hyoid bone position in skeletal Class II subjects with and without temporomandibular disorders (TMD). Materials and Methods: The cephalometric analysis of 59 subjects with skeletal Class II was evaluated and compared. The measurements considered were ANB as a parameter of Class II and C0-C1 distance, C1-C2 distance, craniocervical angle, and hyoid bone position for the cervical spine analysis. Patients were divided into patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson's and Spearman's correlation analysis, with p value <0,005, were performed. Results: C0-C1 and C1-C2 distance values and hyoid bone position resulted within the normal range in the majority of patients examined. Craniocervical angle was altered in 33 patients. The reduction of this angle with the increase of the ANB value resulted to be statistically significant in group A, according to Pearson's correlation index. No other data were statistically significant. Conclusions: The significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of craniocervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (groups A and B). The presence of TMD as a key factor of changes in neck posture could explain the different result between the two groups about the relationship between ANB and craniocervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the craniocervical space or to temporomandibular joint retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture could be the result of a compensatory/antalgic mechanism in response to TMD.


Asunto(s)
Vértebras Cervicales/patología , Hueso Hioides/patología , Maloclusión de Angle Clase II/complicaciones , Maloclusión de Angle Clase II/patología , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/patología , Cefalometría , Femenino , Humanos , Masculino , Estadísticas no Paramétricas
10.
Am J Orthod Dentofacial Orthop ; 154(4): 477-486, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30268258

RESUMEN

INTRODUCTION: In this study, we aimed to determine the effect of maxillary and mandibular posterior space discrepancies and third molar angulations on the overbite. METHODS: Pretreatment lateral cephalograms of 131 subjects were analyzed. The sample included 83 open-bite and 48 deepbite subjects. A multiple regression analysis was used to evaluate the influence of maxillary and mandibular posterior space discrepancies and third molar angulations (predictor variables) on overbite. Correlations between posterior space discrepancy and third molar angulation, and correlations between predictor variables and dental angulation and height of posterior teeth and incisors were evaluated with the Pearson correlation coefficient. Subgroups with accentuated negative overbite and deepbite (27 open-bite, 37 deepbite) were compared with t tests. RESULTS: The multiple linear regression analysis showed a positive association of the mesial angulation of the mandibular third molar with overbite. Posterior space discrepancy was negatively associated with posterior teeth mesial angulation and dentoalveolar height. However, these associations were weak, with no clinically significant implications. The deepbite subgroup showed significantly greater mesial angulation of the mandibular third molars than did the open-bite subgroup. CONCLUSIONS: There was no clinically significant effect of posterior space discrepancies and third molar angulations on overbite and dental angulation and height of posterior teeth and incisors.


Asunto(s)
Incisivo/anatomía & histología , Maloclusión de Angle Clase II/patología , Tercer Molar/anatomía & histología , Sobremordida , Diente Impactado/complicaciones , Adolescente , Puntos Anatómicos de Referencia , Brasil , Niño , Arco Dental/patología , Femenino , Humanos , Incisivo/patología , Modelos Lineales , Masculino , Mandíbula , Maxilar , Tercer Molar/diagnóstico por imagen , Mordida Abierta , Erupción Dental , Diente Impactado/patología
11.
Angle Orthod ; 88(6): 757-764, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30004786

RESUMEN

OBJECTIVES:: The purpose of this three-dimensional (3D) study was to assess retrospectively the middle cranial fossa and central skull base of patients treated with the Herbst appliance (HA). MATERIALS AND METHODS:: 3D surface virtual models of 40 Class II, division 1 malocclusion patients were generated from cone-beam computed tomography (CBCT) acquired before treatment (T0) and after 8 months of HA treatment (T1). T0 and T1 3D models were superimposed volumetrically at the anterior cranial fossa. Twenty subjects who had been treated with the Herbst appliance (HAG) were compared to 20 subjects who were not treated orthopedically. The latter group served as a comparison control group (CG). Quantitative assessments of the location and directional changes were made with linear and angular measurements between anatomical landmarks. Qualitative assessments of the spatial behavior of the middle cranial fossa and central skull base relative to the anterior cranial fossa were displayed graphically for visualization with color maps and semitransparent overlays. Non-parametric tests were performed to compare the between the HAG and CG. RESULTS:: Point-to-point linear measurements and skeletal rotation (pitch, roll, and yaw) changes were very small along the observational period and were not significantly different between HAG and CG. Visual analysis of color maps and overlays confirmed that no changes in the cranial base were associated with HA. CONCLUSIONS:: HA therapy did not produce clinically significant changes in the middle cranial fossa and central skull base.


Asunto(s)
Fosa Craneal Media/diagnóstico por imagen , Aparatos Ortodóncicos Funcionales , Base del Cráneo/diagnóstico por imagen , Adolescente , Estudios de Casos y Controles , Niño , Tomografía Computarizada de Haz Cónico , Fosa Craneal Media/anatomía & histología , Fosa Craneal Media/patología , Humanos , Imagenología Tridimensional , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Aparatos Ortodóncicos Funcionales/efectos adversos , Base del Cráneo/anatomía & histología , Base del Cráneo/patología
12.
J Contemp Dent Pract ; 19(6): 712-718, 2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-29959301

RESUMEN

AIM: The study was conducted to assess facial asymmetry in various dental malocclusions and to determine asymmetry in lower, mid, and upper face and jaws using posteroanterior cephalometric analysis. MATERIALS AND METHODS: Overall, 120 posteroanterior cepha-lograms were taken of individuals between 12 and 25 years of both sexes, and were divided into four groups: Angle's class I excellent occlusion, Angle's class I malocclusion, Angle's class II malocclusion, and Angle's class III malocclusion. These cepha-lograms were traced and Grummon's analysis was performed. RESULTS: In Angle's class I occlusion and Angle's class II malocclusion, the results obtained showed asymmetry present in the upper face. Correlation was found between occlusion, maloc-clusion, and facial asymmetry. CONCLUSION: Facial asymmetry was found in all dental occlusions whether excellent or malocclusion group, with maximum asymmetry having upward trend toward upper face starting from lower. CLINICAL SIGNIFICANCE: For the success of the orthodontic treatments in various types of malocclusion and to determine the facial asymmetry, posteroanterior view can be very helpful, as it gives additional information which can be utilized to augment treatment planning and improve prognosis in terms of relapse prevention.


Asunto(s)
Asimetría Facial/diagnóstico , Maloclusión/patología , Adolescente , Adulto , Cefalometría , Niño , Cara/patología , Asimetría Facial/patología , Femenino , Humanos , Maxilares/patología , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología , Adulto Joven
13.
BMC Oral Health ; 18(1): 109, 2018 06 19.
Artículo en Inglés | MEDLINE | ID: mdl-29921259

RESUMEN

BACKGROUNDS: The occlusal registration of virtual models taken by intraoral scanners sometimes shows patterns which seem much different from the patients' occlusion. Therefore, this study aims to evaluate the accuracy of virtual occlusion by comparing virtual occlusal contact area with actual occlusal contact area using a plaster model in vitro. METHODS: Plaster dental models, 24 sets of Class I models and 20 sets of Class II models, were divided into a Molar, Premolar, and Anterior group. The occlusal contact areas calculated by the Prescale method and the virtual occlusion by scanning method were compared, and the ratio of the molar and incisor area were compared in order to find any particular tendencies. RESULTS: There was no significant difference between the Prescale results and the scanner results in both the molar and premolar groups (p = 0.083 and 0.053, respectively). On the other hand, there was a significant difference between the Prescale and the scanner results in the anterior group with the scanner results presenting overestimation of the occlusal contact points (p < 0.05). In Molars group, the regression analysis shows that the two variables express linear correlation and has a linear equation with a slope of 0.917. R2 is 0.930. Groups of Premolars and Anteriors had a week linear relationship and greater dispersion. CONCLUSIONS: Difference between the actual and virtual occlusion revealed in the anterior portion, where overestimation was observed in the virtual model obtained from the scanning method. Nevertheless, molar and premolar areas showed relatively accurate occlusal contact area in the virtual model.


Asunto(s)
Modelos Dentales , Oclusión Dental , Imagenología Tridimensional , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase I/patología , Adulto , Humanos , Técnicas In Vitro , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase II/diagnóstico por imagen , Interfaz Usuario-Computador
14.
Angle Orthod ; 88(6): 830-840, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29717632

RESUMEN

This case report demonstrates the treatment of a skeletal Class II high-angle adult patient with bimaxillary protrusion, angle Class I occlusion, and crowded anterior teeth. A ribbon-wise arch wire and a customized lingual appliance with anterior vertical slots were used to achieve proper torque control of the maxillary anterior teeth. An orthodontic anchor screw and a palatal bar were used for vertical control to avoid increasing the Frankfort-mandibular plane angle (FMA) by maxillary molar extrusion. Through the combined use of the ribbon-wise customized lingual appliance, palatal bar, and orthodontic anchor screw, vertical control and an excellent treatment result were achieved without the vertical and horizontal bowing effects peculiar to conventional lingual treatment.


Asunto(s)
Tornillos Óseos , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia , Femenino , Humanos , Maloclusión de Angle Clase II/patología , Maxilar/patología , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Soportes Ortodóncicos , Alambres para Ortodoncia , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Adulto Joven
15.
Angle Orthod ; 88(5): 552-559, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29809053

RESUMEN

OBJECTIVES: The aim of this study was to assess three-dimensionally the upper airway changes following functional appliance treatment in growing Class II patients. MATERIALS AND METHODS: Pre-and post-treatment Cone beam computed tomography scans of 20 patients (age range: 9 to 12; mean: 11.4 ± 1.0 years) were retrieved from the list of patients previously treated with functional appliances in the Postgraduate Clinic at the Section of Orthodontics, Aarhus University, Denmark. Total and partial volumes of the upper airway (ie, lower nasopharynx, velopharynx, and oropharynx) were calculated. To rule out the effect of growth, the changes in the functional appliance group were compared to an age-matched Class I group of 18 patients (age range: 8 to 14; mean: 11.8 ± 1.4 years). RESULTS: In the functional appliance group, all the partial and total volumes were significantly larger at the end of treatment when compared to the start of treatment ( P < .003). On the other hand, when comparing the changes for the total and partial volumes of the upper airway in the functional appliance group with the Class I group, a statistical difference was seen only for the oropharynx ( P = .022) and total volume ( P = .025), with the functional appliance group showing a larger volume increment. CONCLUSIONS: An increase in the upper airway volume was found after treatment with functional appliances. This difference was mainly related to the changes at the oropharynx level, which differed significantly from what was observed in the Class I group.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Avance Mandibular , Aparatos Ortodóncicos Funcionales , Faringe/patología , Adolescente , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Hipofaringe/diagnóstico por imagen , Hipofaringe/patología , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Avance Mandibular/métodos , Orofaringe/diagnóstico por imagen , Orofaringe/patología , Faringe/diagnóstico por imagen , Estudios Retrospectivos
16.
Int J Esthet Dent ; 13(2): 208-219, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29687099

RESUMEN

AIM: To compare the esthetic perception of different observer groups of 14 photos of two patients with Class II, division 1 malocclusion with severe mandibular retrusion. MATERIALS AND METHODS: A sample of 441 participants, of which 191 were laypeople, was obtained through a snowball sampling method. Fourteen photos of two children with Class II, division 1 malocclusion with severe mandibular retrusion were used, before and after orthodontic treatment (OT), with advance genioplasty simulation. For the evaluation of esthetic perception, the photos were rated using a numerical scale from 0 (very unesthetic) to 10 (extremely esthetic). RESULTS: Despite a parallelism of opinions, there were statistically significant differences (P < 0.05) in the assessments made by the different observer groups. Laypeople tended to attribute higher values (statistically significant difference of P < 0.05) compared to the other observer groups, with the exception of the girl's lateral profile and smile photos before OT (P > 0.05). Although they did not agree on all the photos, the other groups expressed similar scores between them. Pretreatment photos obtained the lowest scores, and those with advance genioplasty simulation obtained the highest. CONCLUSIONS: Mandibular retrusion has a strong impact on the perception of facial attractiveness. The esthetics of the lateral profile in children with severe mandibular retrusion is improved by OT. As a rule, laypeople tend to assign higher ratings.


Asunto(s)
Actitud Frente a la Salud , Estética Dental , Maloclusión de Angle Clase II/patología , Retrognatismo/patología , Adulto , Estudios Transversales , Cara/anatomía & histología , Femenino , Humanos , Masculino
17.
Angle Orthod ; 88(5): 530-537, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29667470

RESUMEN

OBJECTIVES: The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. MATERIALS AND METHODS: Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. RESULTS: Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = -1.925°, P < .0001; FH-NA = -3.042°, P < .0001; linear measurement A-point to Vertical Reference = -3.859 mm, P < .0001) and reduction of the ANB angle (-1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. CONCLUSIONS: One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.


Asunto(s)
Aparatos de Tracción Extraoral , Maloclusión de Angle Clase II/terapia , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Estudios de Casos y Controles , Cefalometría , Niño , Humanos , Masculino , Maloclusión de Angle Clase II/patología , Ortodoncia Correctiva/instrumentación
18.
J Orofac Orthop ; 79(3): 147-156, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29663035

RESUMEN

OBJECTIVE: Purpose of this prospective study was to evaluate the skeletal and dentoalveolar effects of a fixed functional appliance, the Austro Repositioner, in dolicho- and brachyfacial skeletal Class II patients. MATERIAL AND METHODS: In all, 20 dolicho- and 25 brachyfacial consecutive patients treated with the Austro Repositioner were compared with untreated controls (20 dolicho- and 20 brachyfacial patients) with the same initial dentoskeletal features. Lateral cephalograms were acquired before and 1.0±0.2 year after therapy. RESULTS: Significant improvements in skeletal Class II relationships were observed in both groups. The ANB angle decreased (3.56° in dolicho- and 3.13° in brachyfacial patients, P < 0.001) due to changes localized exclusively in the mandible, the SNB angle increased to 3.20° in dolicho- and 3.02° in brachyfacial patients, and the total mandibular length (Co-Pg) increased to 6.47 mm in dolicho- and 5.78 mm in brachyfacial patients (P < 0.001). A favorable guidance of vertical pattern was also achieved in both groups, and no significant changes were observed in the upper and lower incisors in both groups. CONCLUSIONS: The Austro Repositioner was effective for short-term treatment of skeletal Class II malocclusion resulting from the retrusion of the mandible in both dolicho- and brachyfacial patients.


Asunto(s)
Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/terapia , Mandíbula/anatomía & histología , Aparatos Ortodóncicos Fijos , Aparatos Ortodóncicos Funcionales , Niño , Femenino , Humanos , Masculino , Proyectos Piloto , Estudios Prospectivos
19.
Eur J Orthod ; 40(6): 583-591, 2018 11 30.
Artículo en Inglés | MEDLINE | ID: mdl-29617758

RESUMEN

Objective: To test whether early headgear (HG) treatment and space conditions in the dental arch affect the eruption pathway of the maxillary canines in young children with mixed dentition. Subjects and methods: Data from two randomized controlled trials studying the effects of early HG treatment were pooled, yielding a study sample comprising 99 children (38 girls and 61 boys, mean age 7.6 years) with Angle Class II occlusion. Fifty-one children were treated with HG and 48 children served as an untreated control group (CG). Digital 3D models and panoramic radiographs were taken before (T0) and after (T1) treatment, and changes in the maxillary canine eruption angle and interdental spaces were measured at T0 and T1. A paired samples t-test was used to assess changes in maxillary canine angulation, and an independent samples t-test was used to evaluate the effect of HG treatment on spacing in the dental arch. Associations between intra-arch space conditions and changes in maxillary canine angulation were estimated with linear regression models. Results: The eruption pattern of the permanent canine was significantly more vertical in the HG group than in the CG. The linear regression models showed a statistically significant association among the intercanine distance, crowding in the anterior part of the maxilla, and changes in the maxillary canine eruption angle. The maxillary canine eruption pattern changed significantly more to a vertical direction in spaced dental arches than in crowded dental arches in the HG group. Conclusion: This study shows that early HG treatment in children with Angle Class II occlusion may change the eruption pattern of permanent maxillary canines to a more vertical direction. This change appears to be related to space conditions in the maxillary arch, especially in the intercanine region, with more effect in children with spaced dental arches than in children with crowded dental arches.


Asunto(s)
Diente Canino/crecimiento & desarrollo , Aparatos de Tracción Extraoral , Maloclusión de Angle Clase II/terapia , Erupción Dental , Niño , Diente Canino/diagnóstico por imagen , Diente Canino/patología , Arco Dental/diagnóstico por imagen , Arco Dental/patología , Dentición Mixta , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/patología , Maxilar/diagnóstico por imagen , Maxilar/patología , Radiografía Panorámica , Ensayos Clínicos Controlados Aleatorios como Asunto
20.
BMC Oral Health ; 18(1): 45, 2018 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-29548316

RESUMEN

BACKGROUND: The purpose of this study was to determine and compare the shapes, sizes, and bridging of the sella turcica in patients with different skeletal patterns and genders. METHODS: It was a cross-sectional comparative study. The samples were divided into three groups according to the skeletal pattern viz. Class I, Class II and Class III, and each group consisted of 40 samples (20 males and 20 females). The lateral cephalograms were traced and the sella turcica was assessed for its size, shape, and bridging. RESULTS: The mean length, anteroposterior diameter and depth of sella turcica were 8.13 ± 2.03 mm, 9.60 ± 1.43 mm and 6.40 ± 1.21 mm respectively. The mean length of sella turcica was 7.91 ± 1.52 mm in Class I, 7.32 ± 1.62 mm in Class II and 9.16 ± .2.42 in Class III skeletal pattern; anteroposterior diameter was 9.30 ± 1.02 mm in Class I, 9.15 ± 1.28 mm in Class II and 10.35 ± 1.64 mm in Class III skeletal pattern; and the depth was 6.40 ± 0.92 mm in Class I, 6.07 ± 1.01 mm in Class II and 6.74 ± .1.54 mm in Class III skeletal pattern. There were significant differences in length and anteroposterior diameter and sella turcica between Class I, Class II and Class III skeletal patterns (p = 0.01), (p = 0.01) respectively. There was no significant difference in size of sella turcica between different genders and age groups. Sixty percent of the patients studied had normal Sella morphology. Partial Sella turcica bridging and Sella turcica bridging was seen in this study in 23.33% and 11.67% of patients respectively. CONCLUSION: Sixty percent of the patients had normal sella turcica. There were significant differences in lengths and anteroposterior diameters among Class I, Class II and Class III patients. The larger size was present in skeletal Class III patients.


Asunto(s)
Maloclusión/patología , Silla Turca/patología , Adolescente , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/patología , Radiografía , Silla Turca/diagnóstico por imagen , Factores Sexuales , Adulto Joven
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