Gastroesophageal reflux symptoms in adults with skeletal Class III malocclusion examined by questionnaires.

INTRODUCTION: Patients with masticatory dysfunction have a higher incidence of gastrointestinal disorders including gastroesophageal reflux disease (GERD). Masticatory function is significantly lower in patients with skeletal Class III malocclusion than in those with normal occlusion. However, GERD symptoms in patients with skeletal Class III malocclusion are still unknown. The purpose of this study was to examine GERD symptoms and masticatory functions in patients with skeletal Class III malocclusion. METHODS: Nineteen adult patients with severe skeletal Class III malocclusion (Class III group) and 20 adults with normal occlusion (control group) participated in this study. The results of the Carlsson-Dent self-administered questionnaire (QUEST) and the frequency scale for the symptoms of GERD (FSSG) were compared between the 2 groups, along with occlusal contact area, maximal voluntary bite force, and salivary flow rate. RESULTS: The QUEST and FSSG scores were significantly higher in the Class III group. Occlusal contact area and maximal voluntary bite force were significantly smaller in the Class III group. There was no significant difference in the salivary flow rates between the groups. CONCLUSIONS: GERD symptoms were observed more often in patients with skeletal Class III malocclusion than in normal subjects as determined by the questionnaires.

Orthodontic treatment combined with mandibular distraction osteogenesis and changes in stomatognathic function.

We performed an orthodontic treatment combined with mandibular distraction osteogenesis in a 15-year-old patient who wanted a correction of a chin deficiency and a protruding upper lip. The patient had an Angle Class II division 1 malocclusion with mandibular retrusion, a low mandibular plane angle, and scissors bite. First, a quad-helix appliance was applied to the mandibular dentition to correct the scissors bite in the bilateral premolar region. Later, a preadjusted edgewise appliance was applied to the maxillary and mandibular teeth. After 3 days, a mandibular distraction osteogenesis was performed. During and after the distraction, the open bite between the upper and lower dental arches was corrected using up and down elastics. The total treatment time with the edgewise appliance was 14 months. A skeletal Class I apical base relationship, good facial profile, and optimum intercuspation of the teeth were achieved with the treatment. The jaw-movement pattern on the frontal view did not change during gum chewing. However, the maximum gap without pain increased. The electromyographic (EMG) activity of the masseter and anterior temporalis muscles, and maximum occlusal force increased. The present case report suggests that an orthodontic treatment combined with mandibular distraction osteogenesis in a patient with mandibular retrusion in the late growth period might be effective for improving stomatognathic function.