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1.
Am J Orthod Dentofacial Orthop ; 157(3): 408-421, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32115119

RESUMEN

Anterior open bite malocclusion is generally associated with several causes. This case report describes the 2-phase treatment of a 13-year-old boy with a Class III malocclusion, severe anterior open bite, and bilateral posterior crossbite treated without surgical intervention. An orthopedic approach was performed in phase 1 with a hyrax-type palatal expander, followed by maxillary protraction with a facemask for a 10-month period to promote the correction of transverse and sagittal deviations. In phase 2, a comprehensive orthodontic approach using fixed preadjusted appliances associated with intermaxillary elastics was performed. These approaches, combined with good patient compliance, established a functional and esthetic occlusal relationship, normal overjet and overbite, and a well-balanced facial appearance. The 4.5-year follow-up indicated that treatment results were stable.


Asunto(s)
Maloclusión de Angle Clase III , Mordida Abierta , Técnica de Expansión Palatina , Adolescente , Cefalometría , Estética Dental , Humanos , Masculino , Maloclusión de Angle Clase III/terapia
2.
Rev. ADM ; 77(1): 41-45, ene.-feb. 2020. ilus
Artículo en Español | LILACS | ID: biblio-1088066

RESUMEN

Introducción: La maloclusión clase III es considerada como severa y en la mayoría de los pacientes la etiología suele estar combinada entre componentes esqueléticos y dentoalveolares. Las posibilidades terapéuticas dependerán de la edad biológica del paciente y del tipo de maloclusión. Conforme va aumentando la edad del paciente va menguando la capacidad de crecimiento y se va asentando la relación de clase III esquelética. Las maloclusiones de clase III esqueléticas se pueden corregir mediante extracciones dentales y cirugía ortognática. Caso clínico: Paciente masculino de 13 años de edad con protrusión mandibular, discrepancia óseo dentaria negativa, convexidad facial disminuida y clase III dental y esqueletal. Resultados: Se resolvió la discrepancia óseo dentaria negativa del paciente, se logró la clase I Molar y canina con una sobremordida adecuada (AU)


Introduction: Class III malocclusion is considered severe and in most patients the etiology is usually combined between skeletal and dentoalveolar components. The therapeutic possibilities depend on the biological age of the patient and the type of malocclusion. As it increases the age of the patient wanes growth capacity and Will settled the relationship skeletal class III. The skeletal class III malocclusion can be corrected by tooth extractions and orthognathic surgery. Case report: Male patient 13 years old with mandibular protrusion, negative tooth bone discrepancy, decreased facial convexity and dental and skeletal class III. Results: Dental patient refusal bone discrepancy was resolved, I molar and canine class and adequate overbite was achieved (AU)


Asunto(s)
Humanos , Masculino , Adolescente , Técnica de Expansión Palatina , Aparatos de Tracción Extraoral , Aparatos Ortodóncicos Fijos , Maloclusión de Angle Clase III/terapia , Planificación de Atención al Paciente , Extracción Dental , Cierre del Espacio Ortodóncico
3.
Am J Orthod Dentofacial Orthop ; 156(6): 858-869, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784020

RESUMEN

A 19-year-old woman with a skeletal Class III pattern, anterior and posterior crossbites, and a low mandibular plane angle was treated with nonextraction camouflage treatment. The total active treatment time was 17 months. After treatment, her occlusion, smile esthetics, and soft tissue profile were significantly improved.


Asunto(s)
Oclusión Dental , Maloclusión de Angle Clase III , Ortodoncia Correctiva , Cefalometría , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase III/terapia , Sonrisa , Adulto Joven
4.
Rom J Morphol Embryol ; 60(2): 605-615, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31658335

RESUMEN

Face mask (FM) therapy used for maxillary protraction improves the facial profile in patients with Class III malocclusion. The aim of this study was to compare the sagittal morphological changes of the maxilla through three different therapeutic approaches, respectively using removable appliances (RA), rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME), each of them in combination with the FM therapy in growing and non-growing patients. The sample, consisting of 42 orthodontic patients aged 7-21, was divided into four groups, according to their age. The first group of patients, aged 6-9 (RA + FM group), received treatment with RA in combination with FM, the second group of patients, aged 10-13 (RME + FM pubertal group), received treatment with RME in combination with FM, the third group of patients, aged 14-16 (RME + FM postpubertal group), received treatment with RME and FM, and the fourth group of patients, aged 17-21 (SARME + FM group), underwent SARME in combination with FM. To assess the sagittal skeletal changes of the maxilla, the sella-nasion-A point (SNA) and A point-nasion-B point (ANB) angles were measured at the beginning and after the FM therapy. The differences in the evolution of the SNA angle between the groups were statistically significant (p<0.001). Post-hoc analysis showed that patients aged 6-9 had the highest evolution, statistically higher than patients aged 14-16 (p=0.007) or patients aged 17-21 (p<0.001). The evolution of the SNA angle was significantly higher in patients aged 10-13, in comparison to patients aged 17-21 (p<0.001). The efficiency of the FM therapy alone or associated with RME depends on patients' growing period. In non-growing patients, the FM therapy is efficient when associated with SARME.


Asunto(s)
Maloclusión de Angle Clase III/terapia , Diseño de Aparato Ortodóncico/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven
5.
Am J Orthod Dentofacial Orthop ; 156(4): 453-463, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582117

RESUMEN

INTRODUCTION: Extraction of one mandibular incisor in adolescents and adults can simplify orthodontic treatment in 2 major circumstances: (1) severe crowding of the mandibular but not the maxillary incisors, and (2) mild anterior crossbite with good alignment in both arches. Despite its potential advantages, this method has had limited use in most practices. There have been 3 major objections: (1) the possibility of unsightly black triangles because of loss of interdental papilla height, (2) a possible tooth size discrepancy that would affect occlusal relationships, and (3) patient concerns about a visible extraction site. All 3 objections now can be overcome. METHODS: For 37 consecutively treated single-incisor-extraction patients, preparation of the extraction site for the tooth to be extracted was done by tipping it lingually while simultaneously closing the space in front of it. Treatment outcomes and the effect of age at the time of treatment were evaluated. RESULTS: In patients below age 20, this approach eliminated post-treatment black triangles and almost eliminated partial loss of the interdental papilla. It reduced the previously reported prevalence of these problems in patients aged 20-40 years and did not seem to be helpful in those aged over 40 years. This positive effect was achieved because of maintenance of alveolar crest height that supports the interdental papillae. Tooth size discrepancy caused by incisor extraction was largely compensated by the different labio-lingual orientation of maxillary and mandibular anterior teeth. The extraction space quickly disappeared during extraction site preparation. CONCLUSIONS: The new procedure of extraction site preparation described in this paper offers more favorable outcomes for post-treatment prevalence of black triangles in younger patients but shows limited efficacy in older patients. Camouflage of a mild skeletal Class III problem is the major indication for this extraction pattern. About 3% of Icelandic orthodontic patients appear to be good candidates for this treatment, and this finding should be reasonably generalizable to other populations of European descent.


Asunto(s)
Incisivo/cirugía , Mandíbula/cirugía , Extracción Dental/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Anciano , Cefalometría/métodos , Niño , Estética Dental , Femenino , Humanos , Islandia , Incisivo/diagnóstico por imagen , Masculino , Maloclusión de Angle Clase III/terapia , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Fotograbar , Resultado del Tratamiento
6.
Am J Orthod Dentofacial Orthop ; 156(4): 512-521.e6, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582123

RESUMEN

INTRODUCTION: This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS: Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS: This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS: Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.


Asunto(s)
Anodoncia/terapia , Diente Canino , Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase I/terapia , Métodos de Anclaje en Ortodoncia/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Cefalometría , Niño , Terapia Combinada , Estética Dental , Aparatos de Tracción Extraoral , Femenino , Humanos , Masculino , Técnica de Expansión Palatina , Estudios Prospectivos , Resultado del Tratamiento , Escala Visual Analógica , Adulto Joven
7.
Am J Orthod Dentofacial Orthop ; 156(3): 383-390, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474268

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the height growth of Class I and III orthodontic patients according to the Fishman skeletal maturation index (SMI) and to compare it with that of a general population. METHODS: The study sample included 81 Class I and 71 Class III adolescents who had height measurements and hand-wrist radiographs taken annually and categorized according to SMI. Height completion rate, residual height, height increase per sequential SMI stage, and height velocity were analyzed. Sex differences were evaluated and comparisons between Class I and Class III groups were made. In addition, the height of orthodontic patients was indirectly compared with that of the general population. RESULTS: In boys and girls, height completion rate was >90% at SMI 6, residual height was fewer than 10 cm at SMI 7, and height increase per sequential SMI stage was greatest from SMI 6 to SMI 7. Height velocity was greatest from SMI 5 to SMI 6 in boys and from SMI 4 to SMI 5 in girls. CONCLUSIONS: There was no significant difference in body height parameters for all SMI stages between Class I and Class III adolescents. Adolescents who had orthodontic treatment were not shorter in stature at growth completion compared with the general population.


Asunto(s)
Estatura , Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva , Adolescente , Determinación de la Edad por el Esqueleto , Desarrollo Óseo , Niño , Femenino , Gráficos de Crecimiento , Mano/diagnóstico por imagen , Mano/crecimiento & desarrollo , Huesos de la Mano/diagnóstico por imagen , Huesos de la Mano/crecimiento & desarrollo , Humanos , Estudios Longitudinales , Masculino , Radiografía , República de Corea , Estudios Retrospectivos , Factores Sexuales , Muñeca/diagnóstico por imagen , Muñeca/crecimiento & desarrollo
8.
Am J Orthod Dentofacial Orthop ; 156(3): 401-411, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474270

RESUMEN

A 24-year-old man presented with a severe skeletal class III malocclusion, associated with an anterior and posterior crossbite in the left side, upper and lower lip eversion, skeletal asymmetry, midline discrepancy, diastemas in the maxillary and mandibular dental arches, and agenesis of maxillary lateral incisors and canines with retained deciduous teeth. Treatment was performed with the use of the Win Lingual System. When the 0.016 × 0.022-inch NiTi archiwire was applied, the deciduous teeth were extracted and replaced with temporary crowns connected to the appliance. After the aligning, leveling, and diastema closure phases, a modified Le Fort II osteotomy, a mandibular setback with a bilateral sagittal split osteotomy and a genioplasty were performed. Implants were placed in the canine site through a flapless guided surgery, and cantilevered temporary bridges were delivered. Final prosthetic rehabilitation included veneers for the central incisors and zirconia-ceramic cantilevered bridges for the canine and lateral incisors. After 36 months of active treatment, the patient showed an Angle Class I molar and canine relationship and an ideal overbite and overjet. His profile had improved, lips were competent, and gingival levels were acceptable. The lateral radiograph and cephalometric analysis showed a good balance of the skeletal pattern, a good profile of the soft tissue, and proper inclinations of the maxillary and mandibular incisors in relation to maxilla and mandible. After 2 years of follow-up, the patient had a pleasant smile and no relapse, or joint or muscular pain.


Asunto(s)
Anodoncia/complicaciones , Maloclusión de Angle Clase III/terapia , Diseño de Aparato Ortodóncico/instrumentación , Diseño de Aparato Ortodóncico/métodos , Aparatos Ortodóncicos , Adulto , Cefalometría , Diente Canino , Implantación Dental Endoósea , Implantes Dentales , Modelos Dentales , Diastema/cirugía , Diastema/terapia , Estética Dental , Humanos , Incisivo , Labio , Masculino , Maloclusión de Angle Clase I/complicaciones , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/rehabilitación , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Soportes Ortodóncicos , Alambres para Ortodoncia , Osteotomía , Sobremordida/terapia , Radiografía Panorámica , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto Joven
9.
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
10.
Shanghai Kou Qiang Yi Xue ; 28(2): 218-224, 2019.
Artículo en Chino | MEDLINE | ID: mdl-31384913

RESUMEN

PURPOSE: This study was to evaluate the upper airway changes in patients with skeletal Class Ⅲ maxillary retrognathia after rapid maxillary expansion and protraction. METHODS: An electronic search in PubMed, Cochrane Library, Embase, CNKI, CBM, VIP and Wanfang was performed until March 1st, 2018. According to the inclusion and exclusion criteria, two investigators respectively reviewed the literature and selected eligible studies, then assessed the risks of bias and extracted the data of the included studies. The extracted data were quantitatively analyzed with Revman 5.3 software. RESULTS: A total of 12 studies were included for meta-analysis. The results showed that, after treatment the nasopharyngeal volum(P<0.05) increased significantly. However, no statistically significant differences in oropharyngeal volume(P>0.05) and hypopharyneal volume (P>0.05) existed. The nasopharyngeal airway dimensions had increased significantly with the following measurements: PNS-ad1 (P<0.05), PNS-ad2(P<0.05). However, no statistically significant differences in lower pharynx dimension existed with the following measurements: MPS(P>0.05), IPS(P>0.05). CONCLUSIONS: Rapid maxillary expansion and protraction can increase nasopharyngeal volume and sagittal airway dimensions in skeletal Class Ⅲ subjects with maxillary retrusion. It may be suggested that rapid maxillary expansion and protraction have the potential to reduce the risk of obstructive sleep apnea syndrome in children with maxillary retrusion by enlarging airway space.


Asunto(s)
Maloclusión de Angle Clase III , Técnica de Expansión Palatina , Retrognatismo , Cefalometría , Niño , Aparatos de Tracción Extraoral , Humanos , Maloclusión de Angle Clase III/terapia , Maxilar , Retrognatismo/terapia
11.
Int J Pediatr Otorhinolaryngol ; 125: 159-163, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31323354

RESUMEN

BACKGROUND: Treatment of Class III malocclusion is related to redirecting the growth of mandible, which may have an impact on the pharyngeal airway. OBJECTIVE: To evaluate and compare the treatment effect of Reverse Twin-Block (RTB) and Reverse Pull Face Mask (RPFM) on Pharyngeal Airway Space (PAS) in early and late mixed dentition Class III samples. METHODS: Ninety-five mixed dentition Malay children with Class III malocclusion were included in this study. Data consists of 190 pre- and post-treatment lateral cephalograms of early (8-9 years) and late (10-11 years) mixed dentition Class III samples. forty-nine samples were under RTB and forty-six samples were under RPFM. Treatment changes were evaluated by McNamara airway analysis and changes in tongue and hyoid bone position. RESULTS: Both upper and lower pharyngeal airway width were increased after treatment with RTB and RPFM ruling out the chance of airway constriction. There was also posterior positioning of the tongue and hyoid bone indicating mandibular retrusion. No significant treatment changes were found on the Pharyngeal Airway Space by the factor age, gender or type of appliance. CONCLUSIONS: Both RTB and RPFM increased the Pharyngeal Airway Space and produced similar treatment effect. As age does not affect the treatment outcome significantly, treatment can be delayed until late mixed dentition stage.


Asunto(s)
Dentición Mixta , Maloclusión de Angle Clase III/terapia , Aparatos Ortodóncicos , Retrognatismo/terapia , Adolescente , Cefalometría , Niño , Estudios Transversales , Femenino , Humanos , Hueso Hioides , Malasia , Masculino , Mandíbula , Faringe , Lengua , Resultado del Tratamiento
12.
Clin Ter ; 170(3): e168-e173, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31173044

RESUMEN

OBJECTIVES: To show the orthodontic treatment in a 8-year-old patient affected by Ectodermal Dysplasia (hypohidrotic type) and presenting multiple agenesiae, contraction of the maxilla and skeletal Class III malocclusion. STUDY DESIGN: Because of both oligodontia of primary and secondary dentition and no good retention and anchoring, a hybrid modified rapid palatal expander (RPE) was used. It presented dental anchoring with two bands on first upper molars and skeletal anchoring with two miniscrews in the anterior palate. The project included the use of a CBTC for the bone examination and precise silicon dental impression for the insertion of miniscrews. RESULTS: The procedure was successful and the patient solved the expansion in few days, so RPE has been embedded throughout 6 months in order to develop the bone at the median suture. CONCLUSIONS: This case report can be considered as a valid example for approaching patients affected by Ectodermal Dysplasia with multiple agenesiae and palatal contraction because of the difficult retention.


Asunto(s)
Displasia Ectodérmica/terapia , Maloclusión de Angle Clase III/terapia , Técnica de Expansión Palatina , Niño , Humanos , Masculino , Maxilar/anomalías , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Paladar (Hueso)/anomalías
13.
J Craniofac Surg ; 30(6): e544-e547, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30939558

RESUMEN

This case report introduces a treatment in mandibular prognathism correction by combining the surgery-first (SF) approach and clear aligners. An intraoral scanner (TRIOS 3, 3Shape, Copenhagen, Denmark) and a virtual setup program (OrthoAnalyzer, 3Shape) were used for treatment simulation. All clear aligners were fabricated using a 3-dimensional printer. The total treatment was completed within 3 months after surgery. An immediate improvement of the facial profile was obtained using the SF approach, and rapid and esthetic tooth movement was achieved using clear aligners. This case report demonstrated that the combination of the SF approach and clear aligners could be a patient-oriented surgical-orthodontic treatment method.


Asunto(s)
Maloclusión de Angle Clase III/cirugía , Prognatismo/cirugía , Humanos , Masculino , Maloclusión de Angle Clase III/terapia , Aparatos Ortodóncicos Removibles , Procedimientos Quirúrgicos Ortognáticos , Impresión Tridimensional , Prognatismo/terapia , Técnicas de Movimiento Dental/métodos , Adulto Joven
14.
Am J Orthod Dentofacial Orthop ; 155(3): 388-397, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30826042

RESUMEN

INTRODUCTION: The aim of this finite element study was to analyze and clarify the mechanics of tooth movement patterns for total distalization of the mandibular dentition based on force angulation. METHODS: Long-term orthodontic movement of the mandibular dentition was simulated by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. RESULTS: Displacement of each tooth was caused by movement of the whole dentition, elastic deflection of the archwire, and clearance gap between the archwire and bracket slot. The whole dentition was rotated clockwise or counterclockwise when the line of action of the force passed below or above the center of resistance. Elastic deflection of the archwire induced a lingual tipping of the anterior teeth. It became larger when increasing the magnitude of angulation. The archwire could be rotated within the clearance gap between the archwire and the bracket slot, and thereby the teeth tipped. CONCLUSIONS: Mechanics of total mandibular distalization was clarified. Selective use of force angulation with a careful biomechanical understanding can achieve proper distalization of the whole mandibular dentition.


Asunto(s)
Análisis de Elementos Finitos , Maloclusión de Angle Clase III/terapia , Mandíbula/fisiología , Técnicas de Movimiento Dental , Proceso Alveolar/fisiología , Fenómenos Biomecánicos , Módulo de Elasticidad , Humanos , Soportes Ortodóncicos , Alambres para Ortodoncia , Ligamento Periodontal/fisiología
15.
Am J Orthod Dentofacial Orthop ; 155(3): 398-410, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30826043

RESUMEN

This case report describes the induced ankylosis of the primary canines for use as absolute anchorage for maxillary protraction. The patient was a young boy with Class III malocclusion and cleft soft palate. The final occlusion was esthetic, functional, healthy, and stable 4 years after treatment.


Asunto(s)
Fisura del Paladar/cirugía , Diente Canino , Maloclusión de Angle Clase III/terapia , Métodos de Anclaje en Ortodoncia , Ortodoncia Correctiva/métodos , Paladar Blando/anomalías , Anquilosis del Diente , Cefalometría , Niño , Humanos , Masculino , Maloclusión de Angle Clase III/diagnóstico por imagen , Paladar Blando/cirugía , Radiografía Panorámica
16.
J Craniofac Surg ; 30(4): 1004-1008, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30817506

RESUMEN

OBJECTIVE: The aim of this study was to analyze the displacement in 3D direction of some craniofacial bones with the rapid maxillary expansion in Angle class III malocclusion. METHOD: Thirteen Angle class III patients (mean age: 12.4 ±â€Š1.7 years; 7 males, 6 females) using rapid maxillary expansion as part of their orthodontic treatment were selected and computed tomography scans were taken before and after expansion. The 3D models were reconstructed using the Mimics software and the maxillary, zygomata, nasal bones were separated. With 3D models correction and registration, the displacements in the 3D directions of partial craniofacial bones were measured. Quantitative variables were analyzed by using SPSS19.0 and a t value less than 0.05 was considered statistically significant. RESULTS: Measurement results showed that rapid maxillary expansion produced significant displacement in both sides of the maxillary, zygomata, and nasal bones. In the width of the midline palatine suture, the anterior nasal spine point was expanded a mean 4.18 mm (range 2.42 mm-5.68 mm, Pleft = 0.007, Pright = 0.014) and the posterior nasal spine point was expanded a mean 2.14 mm (range 1.96 mm-2.43 mm, Pleft < 0.001, Pright = 0.002). In the width of the maxillary in coronal plane, the Spr point was expanded a mean 4.86 mm (range 3.34 mm-6.22 mm, Pleft = 0.004, Pright = 0.008) followed by the A point expanded a mean 4.47 mm (range 2.87 mm-5.97 mm, Pleft = 0.005, Pright = 0.010). The bilateral maxillary moved to both sides and the points of the front maxillary anterior nasal spine and A moved forwards and downwards. In the width of the zygomata, the Zm point was expanded 2.18 mm (range 1.87 mm-2.41 mm, Pleft = 0.001, Pright = 0.002) on average and moved backwards, the retral and upper points of the zygomata Za and Mz also moved backwards. The points Zm, Za, and O all moved upwards. The external lateral side of the nasal bone expanded to both sides, the Ipa point was expanded a mean 2.04 mm (range 1.11 mm-2.46 mm, Pleft = 0.008, Pright = 0.019) and the centre of the nasal bone moved backwards and downwards. CONCLUSION: With rapid maxillary expansion, the increasement of width in the maxillary affected the position of the zygomata and nasal bones in the 3D directions, caused changes in facial appearance.


Asunto(s)
Huesos Faciales/anatomía & histología , Maloclusión de Angle Clase III/terapia , Modelos Anatómicos , Técnica de Expansión Palatina , Adolescente , Cefalometría , Niño , Simulación por Computador , Huesos Faciales/diagnóstico por imagen , Femenino , Humanos , Masculino , Cráneo/anatomía & histología , Programas Informáticos , Tomografía Computarizada Espiral
17.
J Orofac Orthop ; 80(1): 9-16, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30413832

RESUMEN

OBJECTIVES: Aim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class 2 and Class 3 deformities. METHODS: A total of 58 miniplates applied to 29 growing patients were evaluated. The first group comprised 24 symphyseal miniplates applied to 12 patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34 symphyseal miniplates applied to 17 patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate-screw anchorage system were evaluated. RESULTS: The overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2 miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups. CONCLUSIONS: Symphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class 2 deformity correction. However, the success rates regarding the two treatment modalities were comparable.


Asunto(s)
Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia , Aparatos Ortodóncicos Fijos , Placas Óseas , Niño , Femenino , Humanos , Masculino , Métodos de Anclaje en Ortodoncia/efectos adversos , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Aparatos Ortodóncicos Fijos/efectos adversos , Estudios Retrospectivos , Resultado del Tratamiento
18.
Clin Oral Investig ; 23(5): 2429-2441, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30306334

RESUMEN

OBJECTIVE: This prospective controlled study evaluated the effect of bone-anchored maxillary protraction therapy in cleft children with Class III malocclusion using CBCT-derived 3D surface models. MATERIALS AND SUBJECTS: Eighteen cleft patients between 10 and 12 years old were included. Intermaxillary elastics were worn after the placement of four zygoma bone plates for 18 months. Uniquely, three age-matched untreated groups including both cleft subjects and non-cleft subjects with Class III malocclusion served as controls. Profile photos and CBCT scans for each patient were taken before (T0) and 18 months after the protraction (T1). 3D measurements were made on CBCT surface models from the treatment group using tomographic color mapping method. Cephalometric measurements were made on lateral cephalogram reconstructed from the CBCT scans and were compared with those obtained from the control groups. RESULTS: Two thirds of the treatment subjects showed improved lip projection towards more convex facial profile. The most significant skeletal changes on 3D surface models were observed at the zygomatic regions (mean 1.5-mm forward, downward, and outward displacement) and at the maxillary complex (mean 1.5-mm forward displacement). Compared with the control groups, the treatment subjects showed significant increase in the SNA and ANB angles, increased Wits appraisal, a more forward movement of point A and overjet improvement (p < 0.05). CONCLUSIONS: BAMP in cleft patients gives a significant forward displacement of the zygomaxillairy complex in favor of the Class III treatment. CLINICAL RELEVANCE: This treatment method shows clearly favorable outcome in cleft patients after 1.5 years of BAMP.


Asunto(s)
Labio Leporino/terapia , Fisura del Paladar/terapia , Modelos Dentales , Maloclusión de Angle Clase III/terapia , Métodos de Anclaje en Ortodoncia/métodos , Cefalometría , Niño , Femenino , Humanos , Masculino , Maxilar , Técnica de Expansión Palatina , Estudios Prospectivos
19.
Am J Orthod Dentofacial Orthop ; 155(1): 117-126, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30591155

RESUMEN

This case report describes the successful camouflage treatment to correct a moderate skeletal Class III malocclusion in a 19-year-old male cleft-palate patient. Early closure of the palate produced palatal scar tissue that inhibited midfacial growth, causing maxillary arch deficiency, severe maxillary crowding, and anterior and posterior crossbites. Combined surgical-orthodontic therapy would have been the preferred treatment of choice; however, the patient declined this option because of surgical risks and costs. Therefore, nonextraction camouflage treatment using a passive self-ligating bracket system was used. Treatment aims including expansion of the maxillary arch and correction of the anterior and posterior crossbites were achieved without the use of an additional maxillary arch expander or other auxiliary appliances. This treatment resulted in satisfying facial esthetics and a normal dental occlusion.


Asunto(s)
Maloclusión de Angle Clase III/terapia , Aparatos Ortodóncicos Fijos , Técnica de Expansión Palatina/instrumentación , Cefalometría , Fisura del Paladar/complicaciones , Fisura del Paladar/cirugía , Estética Dental , Humanos , Masculino , Maloclusión de Angle Clase III/etiología , Diseño de Aparato Ortodóncico , Radiografía Panorámica , Adulto Joven
20.
Int Orthod ; 16(4): 665-675, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30385293

RESUMEN

INTRODUCTION: Different treatment protocols have been implemented for management of Class III malocclusion with aim of achieving ideal occlusal goals. The aim of current study was to compare the efficiency of Class III treatment with mandibular 2-premolar extraction and mandibular molar distalization protocol. METHODS: This retrospective cross sectional study was conducted on pre-treatment and post-treatment dental casts of 60 orthodontic patients who had Class III malocclusion and were treated with a mandibular dentition distalization and mandibular 2-premolars extraction protocol. The study was conducted at orthodontic departments of Dental Section, Faisalabad Medical University/Punjab Medical College and de'Montmorency College of Dentistry, Pakistan. The sample was classified into 2 groups. Group A consisted of 30 patients (20 females, 10 males) (mean age, 18.02years) treated with distalization protocol and Group B consisted of 30 patients (18 females, 12 males) (mean age, 18.97years) treated with mandibular 2-premolars extraction protocol. To compare the efficiency of the treatment protocol in each group, the initial and final occlusal results were assessed on dental models using PAR index while treatment efficiency was assessed using a treatment efficiency index (TX). The groups were compared with t and Mann-Whitney tests. RESULTS: There were no significant differences in the initial age, treatment time, treatment efficiency and any occlusal feature between the groups. CONCLUSION: Treatment efficiency of Class III malocclusions with mandibular 2-premolar extractions or mandibular dentition distalization protocol is similar.


Asunto(s)
Diente Premolar/cirugía , Maloclusión de Angle Clase III/terapia , Extracción Dental , Técnicas de Movimiento Dental/métodos , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Maloclusión de Angle Clase III/cirugía , Ortodoncia Interceptiva/métodos , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
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