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1.
Am J Orthod Dentofacial Orthop ; 158(3): 426-442, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862937

RESUMO

Progressive improvements in digital technology and surgical techniques have synergized the speed, predictability, and favorable outcomes for patients undergoing surgical-orthodontic treatment with handicapping dentofacial deformities. This case report will demonstrate the management of a patient with severe mandibular hypoplasia, condylar hypoplasia, and mandibular asymmetry. The dentofacial deformity, and consequently, the unaesthetic facial appearance, led to psychosocial stress, symptoms of excessive daytime sleepiness, and functional limitations, especially related to mandibular movements. A modified surgery-first approach was used, which was successfully performed using computer-assisted surgical planning. Postsurgical orthodontics was accomplished with the aid of temporary skeletal anchorage mini-plates. An additional alloplastic enhancement of the chin addressed the severe microgenia, which the osseous advancement could not achieve. This resulted in a total advancement of the pogonion by 26 mm yielding a remarkable improvement in the patient's facial esthetics. Furthermore, a considerable improvement in mandibular function and reduction in daytime sleepiness occurred. The severe malocclusion with a discrepancy index value of 47 was treated to a successful final occlusion in 21 months of treatment time.


Assuntos
Assimetria Facial , Má Oclusão , Queixo , Estética Dentária , Humanos , Mandíbula
4.
Case Rep Dent ; 2018: 3542792, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29721340

RESUMO

This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

5.
Korean J Orthod ; 48(2): 125-130, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29564222

RESUMO

Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.

8.
J Istanb Univ Fac Dent ; 51(3 Suppl 1): S90-S101, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29354313

RESUMO

Purpose: The objective of this systematic review was to compare the antero-posterior, vertical and angular changes of maxillary incisors with conventional anchorage control techniques and mini-implant based space closure methods. Materials and Methods: The electronic databases Pubmed, Scopus, ISI Web of knowledge, Cochrane Library and Open Grey were searched for potentially eligible studies using a set of predetermined keywords. Full texts meeting the inclusion criteria as well as their references were manually searched. The primary outcome data (linear, angular, and vertical maxillary incisor changes) and secondary outcome data (overbite changes, soft tissue changes, biomechanical factors, root resorption and treatment duration) were extracted from the selected articles and entered into spreadsheets based on the type of anchorage used. The methodological quality of each study was assessed. Results: Six studies met the inclusion criteria. The amount of incisor retraction was greater with buccally placed mini-implants than conventional anchorage techniques. The incisor retraction with indirect anchorage from palatal mini-implants was less when compared with buccally placed mini-implants. Incisor intrusion occurred with buccal mini-implants, whereas extrusion was seen with conventional anchorage. Limited data on the biomechanical variables or adverse effects such as root resorption were reported in these studies. Conclusion: More RCT's that take in to account relevant biomechanical variables and employ three-dimensional quantification of tooth movements are required to provide information on incisor changes during space closure.

9.
Am J Orthod Dentofacial Orthop ; 150(2): 339-51, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27476368

RESUMO

Transmigrated mandibular canines increase the treatment complexity in terms of both anchorage and biomechanical planning. Additionally, a Class II malocclusion with a deep overbite and associated dental anomalies such as hypodontia can further increase the treatment complexity and the overall treatment time. This case report describes the successful interdisciplinary treatment of a patient, aged 12.5 years, with transmigrated and severely impacted mandibular canines and congenitally missing mandibular second premolars. The transmigrated mandibular right canine was extracted, and a maxillary second premolar was autotransplanted to the missing mandibular right second premolar site with the aid of a stereolithographic donor tooth replica fabricated with 3-dimensional cone-beam computed tomography and a rapid prototyping technique. Furthermore, the autotransplanted tooth was protracted by 4 to 5 mm to close the space caused by the extraction of the mandibular right canine. The impacted mandibular left canine was orthodontically guided into its normal position in the arch. Good esthetic outcome and functional occlusion were achieved.


Assuntos
Anodontia/terapia , Dente Pré-Molar/anormalidades , Dente Pré-Molar/transplante , Dente Canino/anormalidades , Dente Impactado/cirurgia , Anodontia/diagnóstico por imagem , Autoenxertos , Dente Pré-Molar/diagnóstico por imagem , Cefalometria , Criança , Dente Canino/diagnóstico por imagem , Modelos Dentários , Feminino , Humanos , Mandíbula/anormalidades , Mandíbula/diagnóstico por imagem , Maxila , Radiografia Panorâmica , Técnicas de Movimentação Dentária , Dente Impactado/diagnóstico por imagem
11.
Angle Orthod ; 86(1): 32-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25978684

RESUMO

OBJECTIVE: To quantify the effects of tip-back mechanics on the maxillary first molars and incisors. MATERIALS AND METHODS: Sixteen subjects with Class II end-on malocclusion were treated with an intrusion arch to achieve distalization of the maxillary molar through tip-back mechanics. Lateral cephalograms were taken prior to molar tip-back (T1), after molar tip-back (T2), and after molar root uprighting (T3). Data were analyzed using the Friedman's and Wilcoxon signed rank tests to evaluate differences in time points (P ≤ .016). RESULTS: The maxillary first molar distalized 1.53 mm (P = .001) with 6.65° (P = .001) of distal tipping and 0.86 mm (P = .001) of extrusion at T2. Minor relapse of the first molar (mesial direction) was seen at T3. The maxillary incisors flared labially 0.4 mm, and the incisor root apex moved palatally 1.19 mm (P = .005) at T2. At T3, the incisor root apex moved palatally 1.5 mm (P = .003) from T1. An angular change from T1 of 3.31° (P = .008) and 3.53° (P = .014) was seen at T2 and T3, respectively, as a result of palatal root movement of the maxillary incisors. CONCLUSIONS: A significant amount of distalization of maxillary molars was attained at the crown level with tip-back mechanics. Palatal root angulation change was significant in the incisors with minimal anteroposterior movement of the incisal edge.


Assuntos
Dentição , Má Oclusão de Angle Classe II/terapia , Técnicas de Movimentação Dentária , Cefalometria , Humanos , Incisivo , Maxila , Dente Molar , Estudos Prospectivos
12.
Am J Orthod Dentofacial Orthop ; 148(6): 1054-66, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26672712

RESUMO

Recent innovations in technology and techniques in both surgical and orthodontic fields can be integrated, especially when treating subjects with facial asymmetry. In this article, we present a treatment method consisting of 3-dimensional computer-aided surgical and orthodontic planning, which was implemented with the orthognathic surgery-first approach. Virtual surgical planning, fabrication of surgical splints using the computer-aided design/computer-aided manufacturing technique, and prediction of final orthodontic occlusion using virtual planning with robotically assisted customized archwires were integrated for this patient. Excellent esthetic and occlusal outcomes were obtained in a short period of 5.5 months.


Assuntos
Assimetria Facial/cirurgia , Imageamento Tridimensional/métodos , Côndilo Mandibular/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Planejamento de Assistência ao Paciente , Cirurgia Assistida por Computador/métodos , Cefalometria/métodos , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Assimetria Facial/terapia , Feminino , Humanos , Hiperplasia , Desenho de Aparelho Ortodôntico , Fios Ortodônticos , Osteotomia de Le Fort/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Fotografação/métodos , Robótica , Contenções , Resultado do Tratamento , Interface Usuário-Computador , Adulto Jovem
14.
Prog Orthod ; 16: 31, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26373730

RESUMO

BACKGROUND: The purpose of this pilot study was to evaluate the failure rates of mini-implants placed in the infrazygomatic region and to evaluate factors that affect their stability. METHODS: A retrospective cohort study of 30 consecutive patients (55 mini-implants) who had infrazygomatic mini-implants at a University Clinic were evaluated for failure rates. Patient, mini-implant, orthodontic, surgical, and mini-implant maintenance factors were evaluated by univariate logistic regression models for association to failure rates. RESULTS: A 21.8 % failure rate of mini-implants placed in the infazygomatic region was observed. None of the predictor variables were significantly associated with higher or lower odds for failed implants. CONCLUSIONS: Failure rates for infrazygomatic mini-implants were slightly higher than those reported in other maxilla-mandibular osseous locations. No predictor variables were found to be associated to the failure rates.


Assuntos
Implantes Dentários , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Adolescente , Adulto , Criança , Estudos de Coortes , Falha de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Miniaturização , Higiene Bucal , Extrusão Ortodôntica/instrumentação , Projetos Piloto , Estudos Retrospectivos , Estresse Mecânico , Técnicas de Movimentação Dentária/instrumentação , Adulto Jovem , Zigoma
15.
Prog Orthod ; 16: 29, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26359126

RESUMO

BACKGROUND: The aim of this study was to evaluate treatment duration and number of appointments in orthognathic surgery using the surgery-first approach (SFA) and to evaluate the factors associated to these outcomes. METHODS: This was a retrospective chart review of consecutively treated patients with SFA at a University clinic and a private practice setting. Treatment duration, number of appointment, and factors associated to this duration such as patient demographics, type of surgery, use of 3D planning, and treatment center among others were evaluated. Multivariable linear regression models were used to examine the simultaneous association between all predictor variables and outcomes. RESULTS: Median treatment duration for patients undergoing SFA was 9.6 months [6.1 (25 % percentile); 13.4 (75 % percentile)] with a median number of 13.8 appointments [9 (25 % percentile); 17 (75 % percentile)]. Transverse maxillary expansion was associated with longer treatment duration and number of appointments. There was also a significant difference in number of appointments between the two treatment centers. CONCLUSIONS: SFA significantly reduces treatment duration in orthognathic surgery. Transverse expansion is associated with longer treatment duration and number of appointments.


Assuntos
Agendamento de Consultas , Procedimentos Cirúrgicos Ortognáticos/métodos , Estudos de Coortes , Desenho Assistido por Computador , Assimetria Facial/cirurgia , Assimetria Facial/terapia , Feminino , Seguimentos , Previsões , Humanos , Imageamento Tridimensional/métodos , Masculino , Má Oclusão de Angle Classe III/cirurgia , Má Oclusão de Angle Classe III/terapia , Ortodontia Corretiva/métodos , Técnica de Expansão Palatina , Planejamento de Assistência ao Paciente , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Interface Usuário-Computador , Adulto Jovem
17.
Eur J Orthod ; 36(3): 245-54, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22045693

RESUMO

The purpose of this study was to compare the activation and deactivation forces generated during first-order archwire deflections when different sizes and types of NiTi wires are paired with conventional and self-ligating brackets (SLBs) and to evaluate the rotational control between these same archwire and bracket combinations. Four maxillary premolar SLBs (Damon 3MX, SmartClip, Carriere, and In-Ovation R) and one conventional twin bracket (Victory) were paired with seven archwires [0.014, 0.016, 0.018, 0.016 × 0.022 Ultra Therm (thermal A f 80-90°F), 0.016, 0.018 SPEED Supercable, and 0.017 × 0.025 Turbo]. A cantilever test design was used and 10 trials per bracket/archwire combination were performed. Load/deflection data were captured over 4 mm fi rst-order archwire deflections. Forces generated were compared across all bracket/archwire combinations. Among thermal archwires, for a given deflection, forces increased with increasing archwire size. Supercable archwires displayed less force than their same size thermal counterparts. The Turbo archwire generated force values in between those of 0.016 and 0.018 thermal archwires. Rotational control improved with increasing wire dimensions and for a given archwire size. Rotational control among brackets generally ranked as follows: In-Ovation R > SmartClip > Carriere and Damon 3MX.


Assuntos
Braquetes Ortodônticos , Fios Ortodônticos , Fenômenos Biomecânicos , Fricção , Humanos , Desenho de Aparelho Ortodôntico , Rotação
18.
Am J Orthod Dentofacial Orthop ; 144(5): 748-58, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24182591

RESUMO

Virtual 3-dimensional planning in orthognathic surgery allows for a detailed visualization and analysis of skeletal and dental deformities, especially in patients with asymmetries. This approach also eliminates conventional stone model surgery through computer-aided fabrication of surgical stents. This article presents a new approach with 3-dimensional cone-beam computed tomography-based treatment planning for the surgical correction of facial asymmetry in conjunction with the surgery first approach. Good esthetic and occlusal outcomes were obtained for 2 patients after orthognathic surgery and orthodontic treatment with a short total treatment time.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Assimetria Facial/cirurgia , Imageamento Tridimensional/métodos , Procedimentos Cirúrgicos Ortognáticos/instrumentação , Planejamento de Assistência ao Paciente , Interface Usuário-Computador , Adulto , Cefalometria/métodos , Desenho Assistido por Computador , Oclusão Dentária , Estética Dentária , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão de Angle Classe II/cirurgia , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe III/cirurgia , Má Oclusão de Angle Classe III/terapia , Maxila/anormalidades , Mordida Aberta/cirurgia , Mordida Aberta/terapia , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteotomia de Le Fort/instrumentação , Osteotomia de Le Fort/métodos , Osteotomia Sagital do Ramo Mandibular/instrumentação , Osteotomia Sagital do Ramo Mandibular/métodos , Prognatismo/cirurgia , Prognatismo/terapia , Retrognatismo/cirurgia , Retrognatismo/terapia , Contenções , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto Jovem
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