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1.
Am J Orthod Dentofacial Orthop ; 159(2): 175-183.e3, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33390311

RESUMEN

INTRODUCTION: The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS: The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS: The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS: The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.


Asunto(s)
Maloclusión de Angle Clase III , Procedimientos Quirúrgicos Ortognáticos , Adulto , Cefalometría , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/cirugía , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Reproducibilidad de los Resultados
2.
J Craniomaxillofac Surg ; 49(2): 146-153, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33423893

RESUMEN

The aim of this study was to evaluate volumetric changes of the posterior airway space (PAS) following bimaxillary surgery using a high oblique sagittal split osteotomy (HSSO) of the mandibular ramus. The cone beam CTs of Class II and Class III patients taken before (T0) and 6-12 months after surgery (T1) were analyzed using 3D software (Mimics® Innovation Suite 18.0). The PAS was divided into three segments (superior, middle, inferior) by three planes parallel to the Frankfurt horizontal plane intersecting at the posterior nasal spine, the velum palatinum and the epiglottis. Total (TPAS) and partial volumes (SPAS = superior, MPAS = middle, IPAS = inferior) were calculated. For the 25 Class II patients, a highly significant increase (p<0.001) of the total, middle and inferior airway space (TPAS: +33.6%, MPAS: +43.1%, IPAS: +55.9%) was found, while the increase of the upper airway space was statistically not significant (+5.4%, p = 0.074). For the 28 Class III patients, the total, middle and inferior airway space increased statistically insignificantly (TPAS: +4.6%, p = 0.265, MPAS: +2.7%, p = 0.387, IPAS: +2.8%, p = 0.495), while the increase of the upper airway space was statistically significant (+9.7%, p = 0.010). Bimaxillary orthognathic surgery using the HSSO technique led to a significant increase of PAS for Class II patients and could conserve the PAS for Class III patients.


Asunto(s)
Maloclusión de Angle Clase III , Procedimientos Quirúrgicos Ortognáticos , Cefalometría , Tomografía Computarizada de Haz Cónico , Humanos , Maloclusión de Angle Clase III/cirugía , Osteotomía Le Fort , Osteotomía Sagital de Rama Mandibular , Faringe/diagnóstico por imagen
3.
Angle Orthod ; 90(3): 330-338, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378440

RESUMEN

OBJECTIVES: To evaluate the presence of dehiscences and changes in alveolar bone height and width in the area of the mandibular central incisors pre- and post-orthodontic treatment. MATERIALS AND METHODS: In 60 skeletal Class II patients, cone-beam computed tomographic (CBCT) images were obtained and the patients were divided into four groups based on the presence of dehiscences at pre- and post-orthodontic treatment. The alveolar bone height and width were measured on CBCT in cross section along the long axis of the teeth. Lateral cephalograms were analyzed. RESULTS: The changes in L1-NB and IMPA appeared to be correlated with vertical bone loss and dehiscence. Alveolar bone height appeared to follow a segmented relationship with these two variables, with changes below a threshold (L1-NB = 0.71 mm, IMPA = 3.02°) having relatively minimal or no effect on bone loss but with changes beyond the threshold correlated with extensive bone loss. Similarly, increases in L1-NB or IMPA correlated with decreases in alveolar bone width (L1-NB: -0.25 mm/mm, IMPA: -0.07 mm/°) and increased the probability of developing dehiscences, with an estimated 50% probability of vertical bone loss at a L1-NB change of 2.00 mm or, equivalently, an IMPA change of 8.02° was estimated. CONCLUSIONS: When treating skeletal Class II patients, the limits of incisor proclination/protraction are less than previously thought. To prevent undesired periodontal outcomes, careful three-dimensional diagnosis is advisable. Furthermore, when excessive protrusion and/or proclination is planned, additional treatment modalities, including orthognathic surgery, tooth extraction, and corticotomy with bone graft, should be considered.


Asunto(s)
Incisivo , Maloclusión de Angle Clase III , Proceso Alveolar/diagnóstico por imagen , Cefalometría , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo/diagnóstico por imagen , Mandíbula/diagnóstico por imagen
4.
Angle Orthod ; 90(5): 715-722, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378484

RESUMEN

OBJECTIVES: To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). RESULTS: All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). CONCLUSIONS: Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.


Asunto(s)
Maloclusión de Angle Clase III , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Cefalometría , Tomografía Computarizada de Haz Cónico , Humanos , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/cirugía , Mandíbula , Seno Maxilar , Faringe/diagnóstico por imagen
5.
Angle Orthod ; 90(6): 851-856, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378513

RESUMEN

OBJECTIVE: To compare second molar angulation to the occlusal plane with cephalometric measurements corresponding to AP skeletal discrepancy. MATERIALS AND METHODS: 72 patients' pre-orthodontic records were analyzed. A plane was constructed along the cusps of the upper second molar and measured to a proxy for the occlusal plane. The angle between the planes was measured. ANB, Wits appraisal, U1-SN, IMPA, A-B perpendicular to Frankfort, and overjet were measured on the patients' cephalograms. Generalized additive mixed model analysis was performed to analyze the relationship between the second molar angulation and the cephalometric measurements. RESULTS: All six cephalometric measurements showed a significant relationship with the second molar angulation, with Class III patients having a larger angle than Class II and I patients. CONCLUSIONS: Class III patients have upper second molars that are significantly tipped from the occlusal plane. The second molars require special attention for correction prior to orthognathic surgery for Class III patients in order to avoid deleterious effects from the malpositioned teeth.


Asunto(s)
Maloclusión de Angle Clase III , Maloclusión de Angle Clase II , Cefalometría , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen
6.
Eur J Paediatr Dent ; 21(4): 262-270, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33337900

RESUMEN

AIM: The use of maxillary protraction appliances (MPAs) and Facemask (FM), with or without a rapid maxillary expansion (RME), have become a routine orthopaedic treatment procedure for the treatment of Class III in growing individuals; several authors have suggested that maxillary protraction could have a positive impact on airway dimensions. The purpose of this systematic review and meta-analysis was to assess the efficacy of maxillary protraction appliances (MPAs), with or without a rapid maxillary expansion (RME), on airway dimensions in children in mixed or early permanent dentition. MATERIALS AND METHODS: An electronic search was performed on PubMed, Medline, Scopus, The Cochrane Library, EMBASE and the System for Information on Grey Literature in Europe until November 30th, 2019. The Newcastle-Ottawa (NOS) scale was used to assess the studies' quality. Review Manager 5.3 (provided by the Cochrane Collaboration) was used to synthesize the effects on airway dimensions. RESULTS: After full text assessment, 8 studies were included in the qualitative and quantitative synthesis. NOS scores ranged 6 to 9 indicating high quality. The effects of two therapeutic protocols were compared, treatment with MPAs only (113 subjects treated - 65 controls) and the treatment with MPAs + RME (137 subjects treated- 87 controls). The MPAs only treatment group displayed a significantly increase in nasopharyngeal airway dimension at PNS-AD1 (random: mean difference, 1.39 mm, 95% CI, 0.32 mm, 2.47 mm, p= 0.01) and at PNS-AD2 (random: mean difference, 1.70 mm, 95% CI, 1.14 mm, 2.26 mm, p= 0.00001). No statistically significant changes were found post treatment in MPAs + RME treatment groups at PNS-AD1 (P= 0.15), PNS-AD2 (P= 0.17), McNamara's upper pharynx (MPAs + RME P= 0.05, MPAs P= 0.99) and McNamara lower pharynx (MPAs + RME P= 0.25, MPAs P= 0.40). CONCLUSION: MPAs only treatment can increase the pharyngeal thickness after treatment both at PNS-A1 and PNS-AD2. MPA+ RME had no effect on sagittal widths compared with controls, but the effect on the transverse dimension could not be assessed.


Asunto(s)
Maloclusión de Angle Clase III , Técnica de Expansión Palatina , Cefalometría , Niño , Europa (Continente) , Aparatos de Tracción Extraoral , Humanos , Maxilar
7.
Angle Orthod ; 90(4): 607-618, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378502

RESUMEN

When considering camouflage orthodontic treatment for Class III malocclusion with skeletal facial asymmetry, it is crucial to preserve the favorable compensated posterior occlusion. Once the inclination of the compensated occlusion is changed during orthodontic treatment, unstable occlusion, such as crossbite or scissor bite may occur. A 23-year-old female patient had anterior spacing with Class III malocclusion and a mandibular asymmetry. A nonsurgical approach was adopted. The treatment objectives were to establish a Class I molar relationship with compensated inclination of the posterior dentition and to correct the midline deviation. To achieve these goals, the computer-aided design/computer-aided manufacturing (CAD/CAM) orthodontic system plus customized brackets was applied, and miniscrews were used to distalize the left mandibular dentition for midline correction. The results suggested that the CAD/CAM-based customized brackets can be efficiently used in camouflage treatment to achieve a correct final occlusion.


Asunto(s)
Asimetría Facial , Maloclusión de Angle Clase III , Adulto , Cefalometría , Diseño Asistido por Computadora , Asimetría Facial/diagnóstico por imagen , Asimetría Facial/terapia , Femenino , Humanos , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/terapia , Mandíbula , Adulto Joven
8.
Angle Orthod ; 90(4): 548-555, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378504

RESUMEN

OBJECTIVES: To evaluate intersegmental displacement during long-term follow-up after bilateral sagittal split osteotomy (BSSO) by mandibular body area superimposition. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 23 patients ages 18-37 years with class III malocclusion before orthognathic surgery were obtained. A three-dimensional (3D) CBCT examination was performed at four stages: surgery (T0), 6 months after surgery (T1), 1 year after surgery (T2), and long-term follow-up (6.1 ± 2.1 years, T3). The CBCT datasets were superimposed on the symphyseal area and the lower part of the distal segment of the mandible between T0 and the other time points (T1, T2, and T3). The reference points (both condyle, coronoid, and sigmoid) were estimated by the CBCT analyzed program. RESULTS: The coronoid, condylion, and sigmoid showed changes within 6 months after surgery, but there was no significant change in the intersegmental displacement between 6 months and 6 years after surgery. The distances between the left and right coronoid, condylion, and sigmoid from T0 to T3 were noted. CONCLUSIONS: The change in intersegmental displacement between T0 and T3 affecting relapse after orthognathic surgery was not significantly different. This suggests that the mandible itself may have a stable morphology during the follow-up period.


Asunto(s)
Maloclusión de Angle Clase III , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Estudios de Seguimiento , Humanos , Imagenología Tridimensional , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/cirugía , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Osteotomía Sagital de Rama Mandibular , Estudios Retrospectivos , Adulto Joven
9.
Dental Press J Orthod ; 25(5): 57-65, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206830

RESUMEN

INTRODUCTION: Supervising the development of occlusion, managing problems during the transition from mixed to permanent dentition, as well as controlling environmental factors that contribute to establishing malocclusion, are important actions to achieve a Class I occlusion with facial balance. Among these problems, the malocclusions associated with dysfunctions such as mouth breathing or obstructive sleep apnea syndrome (OSAS), atypical swallowing and abnormal tongue position, open bites, crossbites and maxillomandibular discrepancies, and especially the Class III malocclusion can be listed. OBJECTIVE: The purpose of this article is to present and discuss the main aspects relevant to the benefits of performing the treatment of Class III malocclusion in patients with growth.


Asunto(s)
Maloclusión de Angle Clase III , Maloclusión , Dentición Mixta , Dentición Permanente , Humanos , Maloclusión/terapia , Maloclusión de Angle Clase III/terapia , Respiración por la Boca
10.
Am J Orthod Dentofacial Orthop ; 158(5): e63-e72, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33131569

RESUMEN

INTRODUCTION: This study aimed to assess the stability of compensatory treatment of Class III malocclusion in permanent dentition. METHODS: Thirty-six patients (21 women and 15 men; mean age, 20 years) with Class III malocclusion were subjected to the compensatory treatment of permanent dentition and followed up for at least 3 years after orthodontic treatment (T3). Multivariate Poisson regression was performed to assess the influence of clinical, cephalometric, and dental cast variables at the beginning (T1) and the end of treatment on the stability of Class III malocclusion. RESULTS: Overjet changed from -0.25 mm (-3 to 0.5 mm) at T1 to 1.4 mm (1-2.5 mm) at the end of treatment and 0.8 mm (0-1.5 mm) at T3. Clinical relapse (overjet <1 mm and/or canine Class III relations) was observed in 11 patients (30.6%). Patients treated with extraction of mandibular premolars (risk ratio [RR] = 2.13 × 10-07, P <0.001), with better orthodontic end outcomes (RR = 1.16, P = 0.009) and which had lower maxillary incisor inclination at T1 (RR = 1.08, P = 0.035) showed a lower risk of relapse. Demographic (sex, age), clinical (length of treatment and posttreatment, number of treatment phases, time of Class III elastics), cephalometric (SNA, SNB, ANB, Wits appraisal, SNGoGn, IMPA), and dental cast (peer assessment rating index and arch dimensions) variables were not significantly associated with clinical relapse at T3. CONCLUSIONS: The stability of compensatory treatment of Class III malocclusion in permanent dentition is multifactorial, with few predictive variables. Patients treated with extraction and better orthodontic finishing had a lower risk of relapse, whereas larger maxillary incisor inclination at baseline increased the risk of relapse.


Asunto(s)
Maloclusión de Angle Clase III , Sobremordida , Adulto , Cefalometría , Dentición Permanente , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/terapia , Mandíbula , Maxilar , Resultado del Tratamiento , Adulto Joven
11.
Am J Orthod Dentofacial Orthop ; 158(6): 878-888, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33129633

RESUMEN

The demand for fast and invisible treatment options for adults has grown. Treatment protocols involving clear aligners in association with alveolar corticotomy have been developed in response to this demand. Alveolar corticotomy surgery can accelerate orthodontic tooth movement, but good clinical follow-up is crucial and can become cumbersome as the frequency of aligner changes accelerates. Clinical monitoring with patient-managed software can be of assistance in such cases. We present the ortho-surgical treatment of a healthy 21-year-old woman with Class III malocclusion who was treated with corticotomy-accelerated presurgical decompensation and clear aligners, followed by mandibular sagittal split osteotomy. Alveolar corticotomy surgery was performed and the aligners were changed every 4 days. Clinical follow-up of aligner-mediated tooth movement was managed with a patient-managed smartphone application, allowing early interception and correction of minute orthodontic movement errors. Such errors would have been difficult to detect considering the rapidity of aligner change when accelerated by alveolar corticotomy. Clinical follow-up with a patient-managed smartphone application could thus allow for better and easier management of corticotomy-accelerated clear aligner orthodontic treatment.


Asunto(s)
Maloclusión de Angle Clase III , Aparatos Ortodóncicos Removibles , Adulto , Femenino , Estudios de Seguimiento , Humanos , Osteotomía Mandibular , Técnicas de Movimiento Dental , Adulto Joven
12.
Orthod Fr ; 91(1-2): 145-165, 2020 06 01.
Artículo en Francés | MEDLINE | ID: mdl-33146129

RESUMEN

Class III dysmorphia, classically distributed in hereditary or functional etiology, have often multifactorial causes. Breaking the dysmorpho-dysfunctional cascade with early treatment may seem to be an essential alternative to give growth a new orientation. Whether the treatments are preventive, interceptive with or without an appliance, orthodontic or surgical (early, first-line or late), this takes more account of the clinical form than of age. The authors, through clinical cases, will develop their therapeutic approach, based on clinical common sense. Waiting to act at the right time is essential to set up treatments based on proven therapies.


Asunto(s)
Maloclusión de Angle Clase III , Humanos , Maloclusión de Angle Clase III/diagnóstico , Maloclusión de Angle Clase III/terapia
13.
Orthod Fr ; 91(3): 239-248, 2020 10 01.
Artículo en Francés | MEDLINE | ID: mdl-33146618

RESUMEN

The aim of our study was to evaluate the effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures and to describe the correlation between the skeletal changes and the sagittal airway dimension associated with tongue, soft palate, and hyoid bone position in skeletal Class III children. A total of 40 patients with Class III malocclusions were evaluated by the use of lateral cephalograms. Pretreatment and posttreatment cephalometric radiographs were analyzed; linear and angular measurements were performed by the same orthodontist. The effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures were evaluated by Student's T test and the correlation between treatment changes in craniofacial morphology and those in upper airway, tongue, soft palate, and hyoid position was evaluated by Pearson's correlation test. A significant increase in maxillary forward growth, inhibition of mandibular forward growth, and clockwise rotation of the mandible were observed. The statistical analysis revealed that maxillary growth had a significant positive effect on the superior upper airway sagittal dimension. The nasopharyngeal airway dimensions can be improved in the short term with maxillary protraction in skeletal Class III children.


Asunto(s)
Aparatos de Tracción Extraoral , Maloclusión de Angle Clase III , Cefalometría , Niño , Humanos , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/terapia , Mandíbula , Maxilar/diagnóstico por imagen , Faringe/diagnóstico por imagen
14.
Am J Orthod Dentofacial Orthop ; 158(6): 799-806, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33010979

RESUMEN

INTRODUCTION: Patients and parents want shorter treatment times, but it is unclear whether they would compromise outcome quality to shorten treatment. The purpose of this study was to compare orthodontists' and parents' perceptions of finished occlusion and their willingness to extend treatment time to achieve improved outcomes. The effects of elapsed treatment time and patient compliance were also investigated. METHODS: Parallel surveys for orthodontists (n = 1000) and parents (n = 750) displayed simulated treatment outcomes of well-aligned teeth with occlusions in 1 mm increments from 3 mm Class III to 3 mm Class II. Participants rated their preferences on a visual analogue scale (VAS; 0-100) and specified whether they would extend treatment, and for how long, to improve the occlusion. RESULTS: Two hundred thirty-three orthodontists (23%) and 243 parents (32%) responded. Despite differences between the scores given (P < 0.0001), both groups rated Class I occlusion most acceptable (mean VAS = 93.9 and 80.7, respectively) and 3 mm Class III malocclusion least acceptable (mean VAS = 25.9 and 40.9, respectively). Parents were willing to extend treatment more often and for a greater time than orthodontists to improve results (P < 0.0001). In addition, parents were less willing to terminate treatment early (P < 0.05). Both groups perceived existing outcomes as more acceptable if the patient was noncompliant (P < 0.05), but elapsed time in treatment had no significant effect on ratings. CONCLUSIONS: For outcomes with well-aligned teeth, orthodontists and parents agreed on what the most and least acceptable occlusal relationships were. To achieve better outcomes, parents were willing to extend treatment duration more often and for a greater time than were orthodontists. In addition, parents were less willing than orthodontists to terminate treatment early.


Asunto(s)
Maloclusión de Angle Clase III , Ortodoncia , Actitud del Personal de Salud , Oclusión Dental , Humanos , Ortodoncistas , Padres
15.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(5): 519-524, 2020 Oct 01.
Artículo en Chino | MEDLINE | ID: mdl-33085235

RESUMEN

OBJECTIVE: To investigate the effect of bilateral sagittal split ramus osteotomy (BSSRO) on temporomandibular joint (TMJ) symptom and condylar position in patients with skeletal class Ⅲ malocclusion treated with orthodontic-orthognathic surgical treatment. METHODS: Twenty-four patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment were included in the study. Their cone-beam computed tomography scans and TMJ symptom were evaluated, and their Helkimo index before BSSRO, 1 month after BSSRO, and 12 months after BSSRO was recorded. The maximum diameter of the horizontal and coronal sections, short axis diameters, neck width, height, joint space widths at different angles (45°, 90°, and 135°) of the condylar joint, bilateral condylar spacing, and different condylar angles (horizontal angle, vertical angle, and stress angle) in three dimensions were measured. Then, the changes in TMJ symptom and bone structure at different periods were analyzed. RESULTS: The Helkimo index was anamnestic (Ai) or dysfunctional (Di) levels 0 or 1 before and after BSSRO, and no difference in Helkimo index was observed. The horizontal angle and joint space widths at 45° and 90° increased whereas the joint space width at 135° decreased at 1 month after BSSRO compared with before BSSRO (P<0.05). Except for the increase in condylar horizontal angle (P<0.05), no significant difference in other measurement items was noted (P>0.05) 12 month after BSSRO. CONCLUSIONS: BSSRO would not have a remarkable effect on the TMJ symptom and condylar position of patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment procedure and whose Helkimo index ranked Ai0, Ai1, Di0, and Di1.


Asunto(s)
Maloclusión de Angle Clase III , Osteotomía Sagital de Rama Mandibular , Tomografía Computarizada de Haz Cónico , Humanos , Maloclusión de Angle Clase III/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/cirugía , Articulación Temporomandibular/diagnóstico por imagen
17.
Dental Press J Orthod ; 25(4): 24-32, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965384

RESUMEN

OBJECTIVE: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. METHODS: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). RESULTS: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. CONCLUSIONS: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.


Asunto(s)
Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase II , Sobremordida , Cefalometría , Humanos , Mandíbula/diagnóstico por imagen , Estudios Retrospectivos , Resultado del Tratamiento
20.
Prog Orthod ; 21(1): 30, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-32856183

RESUMEN

BACKGROUND: The volumetric ratio of the tongue to the oral cavity has been recognized to be one of the important factors for the maintenance of stable occlusion. Oral cavity capacity is changed after orthognathic surgery in patients with mandibular prognathism; however, the volumetric changes of the oral cavity including the tongue before and after surgery have not been analyzed. The purpose of this study was to evaluate the morphological and volumetric changes of the tongue and oral cavity following orthognathic surgery using a newly developed vinyl polysiloxane impression method. MATERIALS AND METHODS: The study was performed in fifteen subjects who underwent surgical orthognathic treatment. Impressions of the tongue together with the oral cavity were obtained before orthognathic surgery and 1, 3, and 6 months after orthognathic surgery. These impression patterns were scanned using cone-beam computed tomography (CT), and three-dimensional (3D) images of the oral cavity including the tongue, and the upper and lower dental arches were reconstructed. The morphological and volumetric changes in the oral cavity capacity and the tongue volume were examined. RESULTS: The volume of the tongue with the volume of the oral cavity decreased after orthognathic surgery. There was a correlation between the decrease in the oral cavity capacity and tongue volume. The volumetric ratio of the tongue to the oral cavity seems to be maintained before and after orthognathic surgery. CONCLUSION: VPS method, free from radiation exposure, may be useful for investigating the morphological and volumetric changes of the tongue and oral cavity, which may possibly influence the stability of the dental arch and occlusion during surgical orthodontic treatment.


Asunto(s)
Maloclusión de Angle Clase III , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Prognatismo , Tomografía Computarizada de Haz Cónico , Humanos , Imagenología Tridimensional , Boca
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