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1.
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
2.
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
3.
Am J Orthod Dentofacial Orthop ; 156(1): 104-112.e3, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256822

RESUMEN

INTRODUCTION: Mandibular prognathism (MP) is subject to major polygenic influence and segregates within families in autosomal dominance with variable expressivity and incomplete penetrance. We aimed to identify the inheritance pattern and genes and loci involved in the development of MP in Mediterranean families and to evaluate the dentoskeletal characteristics of affected individuals. METHODS: Fifty-one eastern Mediterranean families with individuals affected by MP were identified. Data and biospecimens were collected from 14 of the families, including clinical examination, lateral cephalography (on subjects with Class III malocclusion), and 5 mL blood drawn from consenting affected and nonaffected relatives. Next-generation sequencing (NGS) was performed on 8 families (7 Lebanese, 1 Lebanese/Syrian), including large numbers of affected individuals over many generations and severe conditions, with the use of whole-exome sequencing. RESULTS: Most pedigrees suggested autosomal-dominant inheritance with an equal number of affected male and female individuals. Affected individuals had macrognathic and prognathic mandibles with dentoalveolar compensation. Genetic screening did not correspond with previously reported MP-linked genes, but yielded 3 novel genes (C1orf167, NBPF8, NBPF9) on chromosome 1 potentially responsible for mandibular development and macrognathism. CONCLUSIONS: In this first genetic study with the use of NGS on the largest reported number of families with MP, novel genes (C1orf167, NBPF8, NBPF9) were associated with familial MP in the eastern Mediterranean population.


Asunto(s)
Estudios de Asociación Genética , Predisposición Genética a la Enfermedad/genética , Maloclusión de Angle Clase III/genética , Prognatismo/genética , Adulto , Grupo de Ascendencia Continental Asiática , Cefalometría , Cromosomas Humanos Par 1/genética , Femenino , Genoma Humano , Humanos , Líbano , Masculino , Maloclusión de Angle Clase III/sangre , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Persona de Mediana Edad , Linaje , Prognatismo/sangre , Prognatismo/diagnóstico por imagen , Prognatismo/patología , Análisis de Secuencia de ADN , Siria , Adulto Joven
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.
Medicine (Baltimore) ; 98(22): e15830, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31145325

RESUMEN

The purpose of this study was to evaluate the change in three-dimensional morphology and clinical symptoms of temporomandibular joint (TMJ) in class III dentofacial deformity patients postoperatively for 6 months after sagittal split ramus osteotomy (SSRO).Seventeen patients with skeletal Class III malocclusion and 10 asymptomatic volunteers (classified as Control group) were recruited for the study and underwent cone-beam computed tomography scanning. The geometries of the maxilla and mandible were reconstructed using MIMICS (Materialise, Leuven, Belgium). The morphologic measurements of the patients' TMJs were done before surgery and at 6-month follow-up - named as Pre and Post groups, respectively.The joint spaces (medial joint space, superior joint space, lateral joint space, anterior joint space, and posterior joint space) of the Control group were significantly greater than those of the Pre and Post groups (P < .05), and SSRO did not significantly change the TMJ morphology parameters. Five patients were found to have preoperative temporomandibular disorder (TMD) symptoms, and 3 of them were relieved at 6 months after surgery. Postoperative TMD symptom was observed in 1 patient without preoperative TMD symptom.SSRO did not markedly alter the TMJ morphology of the patients with mandibular prognathism. The effects of SSRO on TMD symptoms should be related to the type of deformity.


Asunto(s)
Maloclusión de Angle Clase III/cirugía , Osteotomía Sagital de Rama Mandibular/métodos , Adulto , Bélgica , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Maloclusión de Angle Clase III/complicaciones , Maloclusión de Angle Clase III/patología , Articulación Temporomandibular/anatomía & histología , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/patología , Adulto Joven
6.
Am J Orthod Dentofacial Orthop ; 155(4): 509-522, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30935606

RESUMEN

OBJECTIVE: Our aim was to describe hard- and soft-tissue asymmetry in people who have a skeletal Class III malocclusion, and to compare with those without asymmetry. We also performed a regional analysis of a possible correlation between facial soft- and hard-tissue asymmetries. METHODS: This retrospective study was performed with the use of the computed tomographic scans of 60 subjects. The skeletal Class III subjects were categorized into 2 subgroups: soft-tissue menton deviation ≤4 mm (n = 20) versus >4 mm (n = 20). The Class III groups were compared with a Class I symmetry group (n = 20). Hard and soft tissues were segmented into different morphologic areas and deviation calculated. Pearson correlation coefficients were obtained, and 1-way analysis of variance was conducted for statistical analysis. RESULTS: The highest deviation in the hard tissues of the Class III asymmetry group was in the corpus region (5.55 ± 3.05 mm), with the second highest in the angulus region (4.70 ± 2.43 mm). The highest average deviation in the soft tissues was seen in the lower cheek (7.04 ± 3.46 mm). In the different study groups, the amounts of asymmetry measured in anatomic structures on the mandible were found to be highly correlated between neighboring structures. CONCLUSIONS: Clinically and statistically significant differences were found in the anatomic regions located in the middle and lower thirds of the face. There was a medium or high correlation between condyle, coronoid process, ramus, and angulus regions. A low level of correlation was observed between middle face and mandibular asymmetries in hard-tissue upper cheek and lower cheek regions were correlated with different mandibular regions.


Asunto(s)
Asimetría Facial/patología , Maloclusión de Angle Clase III/patología , Adulto , Estudios de Casos y Controles , Mejilla/patología , Femenino , Humanos , Labio/patología , Masculino , Mandíbula/patología , Cóndilo Mandibular/patología , Maxilar/patología , Hueso Nasal/patología , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
7.
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
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.
Cranio ; 37(4): 214-222, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29327661

RESUMEN

OBJECTIVE: To assess changes in the tongue and hyoid bone positions and airway dimensions after maxillary protraction using lateral cephalograms. METHODS: Lateral cephalograms were obtained before (C0) and after (C1) an observation period for untreated children with skeletal Class I malocclusion and before (T0), immediately after (T1), and one year after (T2) maxillary protraction in children with skeletal Class III malocclusion. Cephalometric measurements were compared between the time points in both patient groups. RESULTS: Immediately after maxillary protraction, the tongue moved superiorly and the nasopharyngeal and superior oropharyngeal airway dimensions increased. No significant changes in the middle or inferior oropharyngeal airway dimensions or in the hyoid bone position were noted after treatment. CONCLUSIONS: Maxillary protraction improved tongue posture and modified the nasopharyngeal and superior oropharyngeal airway dimensions in patients with skeletal Class III malocclusion. Consequently, maxillary protraction may restore the intra- and extraoral balance and improve respiratory function.


Asunto(s)
Cefalometría/métodos , Hueso Hioides/patología , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/rehabilitación , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase I/rehabilitación , Maxilar , Faringe/patología , Lengua/patología , Tracción/métodos , Niño , Aparatos de Tracción Extraoral , Femenino , Humanos , Masculino , Maloclusión de Angle Clase I/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Factores de Tiempo , Tracción/instrumentación
10.
J Craniomaxillofac Surg ; 46(12): 2103-2107, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30420148

RESUMEN

PURPOSE: The purpose of this study was to examine the relationship between occlusal force and condylar morphology in class II and III after sagittal split ramus osteotomy (SSRO) with Le Fort I osteotomy. MATERIALS AND METHODS: The subjects were 42 female patients who underwent bi-maxillary surgery, and were divided into 2 groups (21 class II and 21 class III cases). They were selected randomly from among patients that underwent surgery from 2012 to 2017. Condylar height, ramus height, ramus inclination and condylar square were assessed by computed tomography (CT), preoperatively and 1 year postoperatively. Occlusal contact area and occlusal force were measured pre- and 1, 3, 6 and 12 months post-operative. RESULTS: Condylar height and ramus height of the class II advancement cases decrease more significantly than those of class III. There were no significant differences in time-course changes of occlusal force and area between the class II and III. In the class II cases, occlusal force at 1 and 3 months was significantly lower than the preoperative value (P = 0.0009, P = 0.0002). On the other hand, in class III, occlusal force at 1, 3 and 6 months (P = 0.0038, P = 0.0031, P = 0.0283) was significantly lower than the preoperative value. CONCLUSION: This study suggested that occlusal force of the class II advancement cases reached the pre-operative level earlier than that of the class III setback cases, even though condylar height decreased after surgery in the class II cases. However, a correlation between occlusal force change and condylar height reduction after surgery could not be found.


Asunto(s)
Fuerza de la Mordida , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase II/cirugía , Cóndilo Mandibular/patología , Osteotomía Maxilar , Osteotomía Sagital de Rama Mandibular , Articulación Temporomandibular/patología , Adolescente , Adulto , Cefalometría , Femenino , Humanos , Imagen por Resonancia Magnética , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Cóndilo Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Osteotomía Le Fort , Estudios Retrospectivos , Articulación Temporomandibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
11.
Prog Orthod ; 19(1): 28, 2018 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-30069814

RESUMEN

BACKGROUND: One of the most controversial issues in treatment planning of class III malocclusion patients is the choice between orthodontic camouflage and orthognathic surgery. Our aim was to delineate diagnostic measures in borderline class III cases for choosing proper treatment. METHODS: The pretreatment lateral cephalograms of 65 patients exhibiting moderate skeletal class III were analyzed. The camouflage group comprised of 36 patients with the mean age of 23.5 (SD 4.8), and the surgery group comprised of 29 patients with the mean age of 24.8 years (SD 3.1). The camouflage treatment consisted of flaring of the upper incisors and retraction of the lower incisors, and the surgical group was corrected by setback of the mandible, maxillary advancement, or bimaxillary surgery. Mann-Whitney U test was used to compare the variables between the two groups. Stepwise discriminant analysis was applied to identify the dentoskeletal variables that best separate the groups. RESULTS: Holdaway H angle and Wits appraisal were able to differentiate between the patients suitable for orthodontic camouflage or surgical treatment. Cases with a Holdaway angle greater than 10.3° and Wits appraisal greater than - 5.8 mm would be treated successfully by camouflage, while those with a Holdaway angle of less than 10.3° and with Wits appraisal less than - 5.8 mm can be treated surgically. Based on this model, 81.5% of our patients were properly classified. CONCLUSIONS: Holdaway H angle and Wits appraisal can be used as a critical diagnostic parameter for determining the treatment modality in class III borderline cases.


Asunto(s)
Maloclusión de Angle Clase III/terapia , Cefalometría , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/diagnóstico , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos , Estudios Retrospectivos , Adulto Joven
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.
J Craniomaxillofac Surg ; 46(8): 1336-1342, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29859817

RESUMEN

PURPOSE: Maxillary downgraft (MD) and mandibular setback (MS) are problematic procedures in terms of postoperative stability. While the amount of intraoperative clockwise rotation (CWR) of the proximal segment (PS) after MS combined with MD has a positive correlation with the amount of MD, mandibular relapse after MS with MD in relation to intraoperative CWR of the PS has not been reported. Moreover, the effect of mandibular relapse on maxillary stability after MS with MD remains unclear. The purpose of this study is to evaluate mandibular and maxillary stability after MS with MD in relation to intraoperative CWR of the PS and amount of MD. MATERIALS AND METHODS: The study included 57 patients who underwent bimaxillary orthognathic surgery. Patients were classified into two groups according to whether MD was performed or not performed: Group I had 2 mm or more MD; and Group II had less than 2 mm MD including vertical impaction or no vertical changes. The amount of surgical movement and postoperative relapse were cephalometrically evaluated and statistically analyzed. RESULTS: There was no significant difference in MS between Groups I and II, however, the vertical movement of the maxilla was different significantly (p < 0.001). In Group I, the intraoperative CWR and postoperative CCWR of the PS was greater than that of Group II (p = 0.010; p < 0.001, respectively). Consequently, the anterior relapse of the mandible was greater in Group I than in Group II despite the same amount of MS in Groups I and II. In Group I, with direct bone contact using Le Fort I inclined osteotomy, vertical relapse at point A showed no statistical correlation with anterior relapse at point B, while the vertical and horizontal dental relapse at U1 showed significant correlations with anterior relapse at point B (r = -0.403, p = 0.030; r = 0.581, p < 0.001, respectively). CONCLUSION: For more stable results, Le Fort I inclined osteotomy is recommended to obtain direct bone contact when moving the maxilla inferiorly. The PS must also be fixed while maintaining vertical bone step to prevent CWR.


Asunto(s)
Mandíbula/cirugía , Maxilar/cirugía , Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Mandíbula/patología , Maxilar/patología , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/efectos adversos , Complicaciones Posoperatorias/etiología , Recurrencia , Adulto Joven
14.
Int. j. morphol ; 36(2): 430-434, jun. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-954132

RESUMEN

The objective of the study was to investigate the morphological changes of skeletal class III malocclusion in mixed dentition with light force protraction combined activities. Randomly selected 30 cases of orthodontics in Shanxi Medical University orthodontics patients (ages: 6-10 years) of the lateral cephalograms. Using the oral maxillary casting type of pre-traction device, according to the condition of maxillary dentition to select the corresponding activities of the movable expansion appliance, each side of the force of about 150-200 g, requiring patients to wear 10-12 hours a day, the appliance should be removed after reaching normal occlusion. The correlation cephalometric profile of the cranial lateral radiographs before and after orthodontic treatment was measured. All patients with skeletal class III malocclusion were improved, concave type became direct type, measurements SNA, ANB, A-Ptm, MP-SN, ANS-Me/N-Me increased, maxillary advancement and reconstruction are more obvious; mandible rotates clockwise; the increase of lip inclination of anterior teeth compensatory changes, lower anterior tooth inclination changes smaller; upper lip forward, nasolabial angle decreased, improved appearance significantly. Light force protraction combined activities can make the mixed dentition of skeletal class III malocclusion in patients with significant improvement in profile appearance.


El objetivo de este estudio fue investigar los cambios morfológicos de la maloclusión clase esquelética III, en la dentición mixta, con actividades combinadas de protracción de la fuerza ligera. Se seleccionaron aleatoriamente 30 casos de ortodoncia en pacientes de ortodoncia de la Universidad Médica de Shanxi (edades: 6-10 años) a partir de cefalogramas laterales, utilizando el tipo de dispositivo de pretracción de vaciado maxilar oral, de acuerdo con la condición de la dentición maxilar para seleccionar las actividades correspondientes del dispositivo de expansión móvil, cada lado con fuerza de alrededor de 150-200 g, requiriendo que los pacientes los utilizaran de 10 a 12 horas al día. El dispositivo debía ser retirado después de alcanzar la oclusión normal. Se midió el perfil cefalométrico de correlación de las radiografías laterales craneales, antes y después del tratamiento ortodóncico. Se observó mejoramiento en todos los pacientes con maloclusión de clase esquelética. Las mediciones SNA, ANB, APtm, MP-SN, ANS-Me / N-Me aumentaron, el avance y la reconstrucción maxilar fueron los cambios más significativos; la mandíbula giró en el sentido de las agujas del reloj, se observó un aumento de la inclinación labial de los dientes anteriores. Fue reducida la inclinación anterior del diente inferior, el ángulo nasolabial disminuyó y en general mejoró significativamente la apariencia. Las actividades combinadas de protrusión de la fuerza radiante pueden llevar a una mejora signficativa en el perfil de pacientes con dentición mixta de maloclusión clase III.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Técnica de Expansión Palatina , Dentición Mixta , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/terapia , Cefalometría , Aparatos de Tracción Extraoral
15.
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
16.
J Craniomaxillofac Surg ; 46(4): 679-687, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29545032

RESUMEN

PURPOSE: The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy. SUBJECTS AND METHODS: The subjects were 46 patients (92 joints) who underwent bi-maxillary surgery. The TMJ disc position was assessed by magnetic resonance imaging (MRI) and the anterior, superior, posterior, medial and lateral joint spaces were assessed by computed tomography (CT), preoperatively and at 1 week and 1 year postoperative. The 92 joints were divided into 2 groups, namely class II (n = 46 joints), and class III (n = 46 joints) (an advanced group vs a setback group). Next, the 92 joints were divided into 2 groups comprising 36 joints with anterior disc displacement joint (ADD group) and 56 joints without (non-ADD group). Time-course changes in the measurements were compared statistically between the advanced and setback groups, and between the ADD and non-ADD groups. RESULTS: There were no significant differences between the advance group and setback group regarding time-course change in all the joint spaces. However, there were significant differences between the ADD group and non-ADD group regarding time-course change in the medial, anterior, superior and posterior joint spaces (P < 0.05). CONCLUSION: This study suggested that ADD could affect the time-course change in TMJ space and condylar position after bi-maxillary osteotomy.


Asunto(s)
Avance Mandibular/efectos adversos , Osteotomía Le Fort/efectos adversos , Articulación Temporomandibular/patología , Adolescente , Adulto , Cefalometría , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/cirugía , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Persona de Mediana Edad , Articulación Temporomandibular/diagnóstico por imagen , Factores de Tiempo , Tomografía Computarizada por Rayos X , Adulto Joven
17.
Am J Orthod Dentofacial Orthop ; 153(2): 262-268, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29407504

RESUMEN

INTRODUCTION: The purpose of this study was to describe the skeletal and dentoalveolar changes in a group of growing skeletal Class III patients treated with hybrid rapid palatal expansion and facemask. METHODS: Twenty-eight growing patients with skeletal Class III malocclusion were treated using a rapid maxillary expander with hybrid anchorage according to the ALT-Ramec protocol (SKAR III; E.P.), followed by 4 months of facemask therapy. Palatal miniscrew placement was accomplished via digital planning and the construction of a high-precision, individualized surgical guide. Pretreatment and posttreatment cephalometric tracings were analyzed, comparing dental and skeletal measurements. RESULTS: Point A advanced by a mean of 3.4 mm with respect to the reference plane Vert-T. The mandibular plane rotated clockwise, improving the ANB (+3.41°) and the Wits appraisal (+4.92 mm). The maxillary molar had slight extrusion (0.42 mm) and mesialization (0.87 mm). CONCLUSIONS: The use of a hybrid-anchorage expander followed by 4 months of facemask treatment improves the skeletal Class III relationship with minimal dental effects, even in older patients (mean age, 11 years 4 months, ± 2.5 years).


Asunto(s)
Proceso Alveolar/patología , Aparatos de Tracción Extraoral , Maxilares/patología , Maloclusión de Angle Clase III/terapia , Técnica de Expansión Palatina , Factores de Edad , Cefalometría , Niño , Terapia Combinada , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Técnica de Expansión Palatina/instrumentación , Radiografía Dental
18.
Angle Orthod ; 88(2): 151-156, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29257705

RESUMEN

OBJECTIVES: The present study aimed to compare the amount of incisal tooth wear in the maxillary central incisors of patients with skeletal Class III malocclusion and anterior crossbite receiving one-phase or two-phase treatment. The hypothesis was that tooth wear would differ according to treatment modalities. MATERIALS AND METHODS: Maxillary dental casts obtained before (T1) and after (T2) orthodontic treatment were divided into three groups. Group I consisted of casts from 21 patients (7 males, 14 females; mean age 9.8 years) who received two-phase treatment (maxillary protraction followed by fixed appliance therapy). Group II comprised casts from 37 patients who underwent orthodontic camouflage treatment for crossbite, subdivided according to age. Group IIa consisted of casts from 15 adolescents (8 males, 7 females; mean age 13.5 years), and group IIb consisted of casts from 22 adults (13 males, 9 females; mean age 24.5 years). Maxillary dental casts obtained at T1 and T2 were scanned. For each pair of digital images, T2 was superimposed on T1 using the best-fit method. Tooth wear was quantified and compared among groups. RESULTS: Significantly less tooth wear was observed in group I compared to groups IIa and IIb, but no difference was found between groups IIa and IIb. Spearman correlation analysis revealed no significant correlation between tooth wear and age, treatment duration, or craniofacial morphology. CONCLUSIONS: Despite the long duration of early treatment, it caused less wear of the maxillary central incisors than did orthodontic camouflage treatment.


Asunto(s)
Incisivo/patología , Maloclusión de Angle Clase III/terapia , Ortodoncia Correctiva/efectos adversos , Desgaste de los Dientes/etiología , Adolescente , Factores de Edad , Niño , Técnica de Colado Dental , Modelos Dentales , Aparatos de Tracción Extraoral/efectos adversos , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/patología , Aparatos Ortodóncicos Fijos/efectos adversos , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Desgaste de los Dientes/patología , Adulto Joven
19.
Angle Orthod ; 88(2): 195-201, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29215300

RESUMEN

OBJECTIVES: To evaluate prevalence, distribution, and sexual dimorphism of dental anomalies (DA) among different skeletal malocclusions (SM) and growth patterns (GP) under the hypothesis that specific clinical patterns exist and may indicate common etiological roots. MATERIALS AND METHODS: A total of 1047 orthodontic records of patients older than 8 years were evaluated. The SN-GoGn angle was used to classify GP (hypodivergent, normal, and hyperdivergent), and the ANB angle was used to verify SM (Angle Classes I, II, and III). These assessments were done from lateral cephalometric radiographs. DA were diagnosed using panoramic radiographs by one calibrated investigator. Odds ratios, chi-square, and Student's t-tests were used. RESULTS: Of the subjects, 56.7% were female, with mean age of 16.41 (±10.61) years. The prevalence of DA was 15.7%. Impaction and tooth agenesis were the most prevalent DA, with relative frequencies of 14.4% and 9.7%, respectively. DA were most prevalent in Class III SM (80.8%) and in hypodivergent GP (82.5%), although this was not statistically significant. Tooth agenesis ( P < .01) and microdontia ( P = .025) were significantly more common among hypodivergent GP and Class III SM, respectively. CONCLUSIONS: The results of this study support the idea that DA are preferentially associated with certain patterns of malocclusion.


Asunto(s)
Maloclusión/etiología , Anomalías Dentarias/complicaciones , Adolescente , Adulto , Cefalometría , Niño , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Maloclusión de Angle Clase I/etiología , Maloclusión de Angle Clase I/patología , Maloclusión de Angle Clase II/etiología , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase III/etiología , Maloclusión de Angle Clase III/patología , Radiografía Dental , Radiografía Panorámica , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/patología , Diente Impactado/complicaciones , Diente Impactado/patología , Adulto Joven
20.
Angle Orthod ; 88(1): 91-99, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29072859

RESUMEN

OBJECTIVES: To investigate the association between the periodontal soft tissue, alveolar bone and dental parameters surrounding the incisors at baseline in patients with skeletal Class III malocclusion. MATERIALS AND METHODS: The study sample comprised 154 teeth from 28 patients with skeletal Class III malocclusion (19 men and 9 women, 21.15 ± 4.02 years). Periodontal soft tissue examination and hard tissue measurements with cone-beam computed tomography (CBCT) were performed. Factor analysis was used to reduce the CBCT variables, and correlation analysis between the hard tissue factors and soft tissue parameters was performed. Differences in hard tissue parameters between thick and thin gingival types were evaluated. RESULTS: CBCT measurements were reduced to three hard tissue factors: lingual plate, coronal-buccal plate, and apical-buccal plate. Keratinized gingiva width and thickness were positively correlated with the coronal-buccal plate factor and negatively correlated with the apical-buccal plate factor. In the thin gingival biotype, mandibular incisors were more proclined, and the apical part of the buccal alveolar plate and the coronal part of lingual alveolar plate were thicker than in the thick gingival biotype. CONCLUSIONS: In the anterior teeth in cases of skeletal Class III malocclusion, hard tissue structures on the buccal side can be grouped based on coronal and apical factors that are significantly correlated with keratinized gingival width and thickness. Thick and thin gingival biotypes exhibited differences in tooth inclination and alveolar plate thickness with regard to the mandibular incisors.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Encía/diagnóstico por imagen , Encía/patología , Incisivo/diagnóstico por imagen , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Cefalometría , Análisis Factorial , Femenino , Humanos , Masculino , Adulto Joven
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