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1.
Bull Tokyo Dent Coll ; 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34776475

RESUMO

Repositioning of the jaw in orthognathic treatment generates changes in the soft tissues of the maxillofacial region, with consequent changes in the airway. The purpose of this study was to determine how type of orthognathic surgical procedure affected the 3-dimensional morphology of the upper airway. Forty patients were divided into the following 2 groups according to the type of surgical procedure used: a horseshoe osteotomy (HS) group (20 patients, comprising 11 men and 9 women; average age 24.3±4.5 years) who underwent bimaxillary surgery; and a LeFort I osteotomy (LF) group (20 patients, comprising 8 men and 12 women; average age 22.5±4.6 years) who also underwent bimaxillary surgery. Cephalometric measurements were taken and 3-dimensional pharyngeal morphology evaluated in each group. The amounts of maxilla rotation, posterior maxilla impaction, and mandibular setback all revealed a significantly larger value in the HS group. Evaluation of pharyngeal volume revealed a significant decrease in the upper pharyngeal segment in the LF group. A significant decrease in the lower pharyngeal segment was observed in both groups. Differences were noted in postoperative pharyngeal morphology between the two groups. The results of this study suggest that HS has less effect on the upper pharyngeal segment, regardless of the amount of posterior maxilla impaction.

2.
Bull Tokyo Dent Coll ; 62(3): 181-192, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34393142

RESUMO

Aggressive periodontitis mostly affects young people, causing rapid destruction of periodontal tissue and loss of supporting alveolar bone. The destruction of periodontal tissue induces pathological tooth movement, resulting in various types of malocclusion such as crowding or spacing in the dentition. This report describes orthodontic treatment for malocclusion due to generalized aggressive periodontitis. The patient was a 31-year-old woman who presented with the chief complaint of displacement in the anterior teeth. An oral examination revealed pathological tooth mobility throughout the entire oral cavity due to severe loss of periodontal support. Many gaps in the displaced maxillary anterior teeth and crowding in the mandibular anterior teeth were also observed. The goal of subsequent treatment was to achieve ideal overjet and overbite by aligning the teeth and closing the spaces via non-extraction orthodontic treatment with stripping. The periodontal disease was managed by a periodontist who provided guidance on oral hygiene and periodontal disease control throughout the course of orthodontic treatment. Appropriate occlusion and a good oral environment were achieved. The condition of the periodontal tissue stabilized during and after orthodontic treatment, and favourable occlusal stability was observed at the 2-year follow-up examination.


Assuntos
Periodontite Agressiva , Má Oclusão Classe II de Angle , Má Oclusão , Adolescente , Adulto , Periodontite Agressiva/terapia , Oclusão Dentária , Feminino , Humanos , Má Oclusão/terapia , Técnicas de Movimentação Dentária
3.
Bull Tokyo Dent Coll ; 62(1): 27-39, 2021 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-33583878

RESUMO

Aggressive periodontitis during adolescence has a poor prognosis due to rapid alveolar bone resorption. Few studies have investigated long-term follow-up after surgical orthodontic treatment performed in conjunction with that for invasive periodontitis. Here, we report a case of mandibular prognathism accompanied by generalized aggressive periodontitis and crowding. A 31-year-old woman was referred to our department for treatment of masticatory dysfunction due to reverse overjet. The patient exhibited a class III molar relationship, protrusion of the ANB of -6.0°, and severe maxillary crowding. Initial periodontal examination revealed deep periodontal pockets and extensive inflammation. Mandibular prognathism accompanied by generalized aggressive periodontitis and crowding was diagnosed. Therefore, it was necessary to adopt an interdisciplinary approach involving surgical, orthodontic, and periodontal treatment. Prior to commencement of orthodontic treatment, plaque control, scaling, and root planing of all teeth were performed by a periodontist to suppress inflammation and reduce probing depth. During pre-surgical orthodontic treatment, the maxillary first premolars were extracted to reduce crowding of the maxillary incisors. To correct the mandibular prognathism, the mandible was repositioned by sagittal split ramus osteotomy. Proper occlusion of the incisors and maximum intercuspation were achieved by post-surgical orthodontic treatment. After completion of active orthodontic treatment, acceleration of inflammation was observed together with aggravated resorption of the alveolar bone surrounding the molars. However, reduction of probing depth and inflammation were observed after scaling and root planing. The surgical-orthodontic treatment time was 1 year and 11 months, which was followed by a 2-year retention period. There was no tooth loss due to periodontitis, and an overall satisfactory outcome was achieved.


Assuntos
Periodontite Agressiva , Má Oclusão Classe III de Angle , Má Oclusão , Prognatismo , Adulto , Feminino , Seguimentos , Humanos , Má Oclusão Classe III de Angle/cirurgia , Mandíbula , Prognatismo/cirurgia
4.
Bull Tokyo Dent Coll ; 61(4): 255-264, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177271

RESUMO

This case report describes the unusual choice of extraction of maxillary incisors with short roots as part of an orthodontic treatment plan. The patient was a 20-year-old woman referred to our department in whom the diagnosis was maxillary protrusion and open bite. Both of the maxillary central incisors had short roots. Two treatment options were considered. The first involved extraction of the 4 first premolars with the aim of improving dentoalveolar protrusion and crowding. If preservation of the central incisors subsequently became difficult due to root resorption, prosthetic options were to be considered. The second treatment option involved extraction of the maxillary central incisors with short roots and the mandibular first premolars. The second treatment option was selected as survival of the central incisors following orthodontic movement was uncertain and the patient also wanted to minimize the risk of future extractions and the use of prosthetics. Active treatment was performed over a span of 31 months, and circumferential type retainers were used on both arches for retention. For such treatment to be successful, careful diagnosis and orthodontic treatment planning must be taken to ensure the anterior dental esthetics are properly restored.


Assuntos
Má Oclusão , Mordida Aberta , Reabsorção da Raiz , Adulto , Feminino , Humanos , Incisivo , Maxila , Mordida Aberta/terapia , Técnicas de Movimentação Dentária , Adulto Jovem
5.
Bull Tokyo Dent Coll ; 61(4): 213-219, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177272

RESUMO

The aim of this study was to investigate 3-dimensional (3D) airway volume in patients with unilateral cleft lip and palate (UCLP) using computed tomography (CT). The study population comprised 15 UCLP patients (UCLP group) scheduled to receive alveolar bone grafts and 15 with impacted teeth (control group). The clinical requirements for a CT scan were met in both groups. Measurements were recorded from 3D reconstructions of Digital Imaging and Communications in Medicine data obtained from the CT images. Airway volume, cross-sectional area, and linear and angular measurements were recorded. Airway volume and cross-sectional area showed no significant difference between the two groups. The narrowest section of the airway in the UCLP group was tighter than that in the control group, however (p=0.017). The results of this study suggest that this difference in the measurements of the narrowest section of the airway is involved in the particular maxillofacial morphology found in UCLP patients.


Assuntos
Fenda Labial , Fissura Palatina , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Humanos , Imageamento Tridimensional , Faringe/diagnóstico por imagem
6.
Bull Tokyo Dent Coll ; 61(4): 243-253, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177274

RESUMO

This report describes a patient with severe high angle class II malocclusion and mandibular retrusion in whom surgical orthodontic treatment to prevent an increase in ramus height resulted in a significant improvement in esthetics and long-term stability. The patient was a woman aged 30 years 5 months who presented with the chief complaint of maxillary protrusion. She had a convex facial type, a chin button on lip sealing, and a gummy smile. Cephalometric analysis revealed a normal maxilla anterior-posterior position, but significant mandibular retrusion with pronounced clockwise rotation. The anterior maxillary tooth axis was standard, but labially inclined in the mandible. Based on these findings, the diagnosis was skeletal class II high angle malocclusion and mandibular retrusion. The proposed treatment plan comprised 2-jaw surgery with premolar extraction. Le Fort I osteotomy, in particular, was planned in the maxilla to move the ANS upward by 3.0 mm and the PNS downward by 3.0 mm. Sagittal split ramus osteotomy (SSRO) was planned to adjust the mandible and move the mandible forward by 10.0 mm. To prevent postoperative relapse, the short lingual split method was used in performing the SSRO. The mandible was split to minimize stretching of the median pterygoid muscle. Postoperatively, the ANS, PNS, and pogonion showed movement of 2.0 mm upward, 3.0 mm downward, and 8.0 mm forward, respectively. Additionally, lip closure was now natural, and the gummy smile had markedly improved. At 6 years postoperatively, there has been no change skeletally or dentally. Follow-up is being continued to monitor further progress.


Assuntos
Má Oclusão Classe III de Angle , Má Oclusão Classe II de Angle , Retrognatismo , Adulto , Cefalometria , Estética Dentária , Feminino , Humanos , Má Oclusão Classe II de Angle/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Osteotomia de Le Fort
7.
Bone ; 141: 115582, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32795676

RESUMO

Non-coding RNAs (ncRNAs) comprise a major portion of transcripts and serve an essential role in biological processes. Although the importance of major transcriptomes in osteogenesis has been extensively studied, the function of ncRNAs in human osteogenesis remains unclear. Previously, we developed hiPSCs from patients with cleidocranial dysplasia (CCD) caused by runt-related transcription factor 2 (RUNX2) haploinsufficiency. To gain insight into ncRNAs in osteogenesis, we surveyed differential ncRNA expression profiling and promoter differences of RUNX2 using patient-specific iPSCs and cap analysis gene expression (CAGE) technology to define the promoter landscape. Revertant iPSCs (Rev1 iPSCs) edited by CRISPR/Cas9 system to harbor mutation-corrected RUNX2 exhibited increased proximal promoter expression of RUNX2, while CCD iPSCs did not. We identified 2271 ncRNA genes with altered expression levels before and after differentiation, 31 of which showed at least 20-fold higher expression in Rev1 iPSCs. Bioinformatic analysis also categorized AC007392.3, LINC00379, RP11-122D10.1, and RP11-90J7.2 as enhancer regulatory regions, and HOXA-AS2, MIR219-2, and RP11-834C11.3 as dyadic regulatory regions of these ncRNAs. In addition, two miRNAs, termed MIR199A2 and MIR152, were found to have high enrichment of osteogenic-related terms. Upon further examination of the role of MIR152 on osteoblast differentiation, we found that MIR152 knockdown induced upregulation of ALP and COL1A1 in Saos-2 cells. Thus, ncRNAs were found to regulate the osteogenic differentiation potentials of hiPSCs that are used for bone regeneration and repair owing to their differentiation potentials. These data allow understanding ncRNA profiles of hiPSCs during osteogenesis.


Assuntos
Displasia Cleidocraniana , Células-Tronco Pluripotentes Induzidas , MicroRNAs , Diferenciação Celular/genética , Displasia Cleidocraniana/genética , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Expressão Gênica , Humanos , Osteoblastos , Osteogênese/genética
8.
Plast Reconstr Surg Glob Open ; 8(4): e2761, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32440429

RESUMO

Background: Hemifacial microsomia (HFM) is a congenital disorder characterized by facial asymmetry, but no midline reference has been established for evaluating facial morphology in patients with HFM. The purpose of this study was to develop a 3-dimensional coordinate system unaffected by the deformity of the external acoustic aperture or orbital circumference and to quantitatively evaluate craniofacial morphology in such patients. Methods: We quantitatively evaluated craniofacial morphology using 3-dimensional measurements with the skull base as a reference. Using computed tomography data from 15 patients with HFM and 15 controls, a coordinate system was created for each patient, and left-right differences between measurement points were compared. Results: When mandibular deformity was severe, the deformity of the posterior part of the palatine bone and lateral part of the orbit increased, but this trend was not evident for other measurement points. Thus, craniofacial deformity in HFM was not always related to mandibular deformity. Moreover, no difference was evident in the position of the hypoglossal canal between controls and patients with HFM. Conclusions: Quantitative assessments are possible using the coordinate system devised in this study, irrespective of the severity of HFM. The degree of mandibular deformity detailed in the Pruzansky classification was associated with the superoinferior deformity of the posterior part of the palatine bone and anteroposterior deformity of the lateral part of the orbit.

9.
Bull Tokyo Dent Coll ; 60(2): 139-149, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-30971679

RESUMO

Here, we report retention following surgical orthodontic treatment in a patient with vertical maxillary excess associated with temporomandibular joint osteoarthritis (TMJOA) and marked mandibular retrusion. The patient was a man aged 20 years 10 months who presented with the chief complaint of maxillary protrusion. The facial profile was of the convex type due to marked mandibular retrusion. In addition, the patient had a gummy smile. Intraoral findings revealed a Class II molar relation, +11 mm overjet, and 0 mm overbite. Mandibular dentition arch length discrepancy showed crowding of -2 mm, and the maxillary dentition showed a spaced arch of +5 mm. Panoramic radiographs confirmed flattening of the condylar head and proliferation of the bone margin. Cephalometric analysis of the skeletal pattern revealed that, horizontally, the maxilla was anterior and the mandible posterior; vertically, a dolichofacial pattern was noted. The anterior maxillary tooth axis was standard, but the anterior mandibular tooth axis showed labial inclination. Based on these findings, skeletal maxillary protrusion associated with TMJOA was diagnosed. Surgical orthodontic treatment comprised bilateral mandibular first premolar extraction with two-jaw surgery and genioplasty. Orthodontic treatment was performed with a multibracket system using a 0.22-slot pre-adjusted edgewise appliance. At 2 years and 11 months after initiation of treatment, the maxilla was transposed 6 mm upwards by orthognathic surgery and the mandible 17 mm anteriorly and 5 mm upwards by counterclockwise rotation. At 3 years and 10 months, the Pogonion was moved 6 mm anteriorly by genioplasty. At 4 years, orthodontic treatment was concluded on confirming satisfactory occlusion and improvement in facial features. At 2 years after completion of treatment, occlusion and the maxillofacial morphology remain stable, with almost no relapse. In addition, no temporomandibular joint disorder symptoms have occurred. Careful comprehensive follow-up observation will be continued.


Assuntos
Má Oclusão Classe II de Angle , Procedimentos de Ancoragem Ortodôntica , Osteoartrite , Retrognatismo , Adulto , Dente Pré-Molar , Cefalometria , Humanos , Masculino , Mandíbula , Maxila , Articulação Temporomandibular , Técnicas de Movimentação Dentária , Adulto Jovem
10.
Bull Tokyo Dent Coll ; 59(1): 1-14, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29563357

RESUMO

Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (p<0.01), and between at pre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (p<0.05, p<0.01). A significant correlation was observed between a negative change in overjet and worsening OQLQ scores at the pre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results indicate that morphologic change influences OHRQL in patients undergoing surgical orthodontic treatment not only after surgery, but also during pre-surgical orthodontic treatment.


Assuntos
Má Oclusão Classe III de Angle/terapia , Ortodontia Corretiva , Procedimentos Cirúrgicos Ortognáticos , Qualidade de Vida , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
11.
Bull Tokyo Dent Coll ; 59(1): 43-51, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29563361

RESUMO

Here, we report a case of dental implant treatment involving computer-assisted surgery for bilateral agenesis of the maxillary lateral incisors. The patient was a 39-year-old woman with the chief complaint of functional and esthetic disturbance due to maxillary and mandibular malocclusion. The treatment plan comprised non-extraction comprehensive orthodontic treatment and prosthodontic treatment for space due to the absence of bilateral maxillary lateral incisors. A preliminary examination revealed that the mesiodistal spaces left by the absent bilateral maxillary lateral incisors were too narrow for implant placement (right, 5.49 mm; left, 5.51 mm). Additional orthodontic treatment increased these spaces to approximately 6 mm, the minimum required for implant placement if risk of damage to the adjacent teeth due to inaccuracies in directionality of drilling is to be avoided. For dental implant treatment with computer-assisted surgery, preoperative planning/simulation was performed using Simplant® ver.12 software and a toothsupported surgical template fabricated using stereolithography. Two narrow-diameter implants were placed in a two-stage procedure. It was confirmed that there was sufficient distance between the implant fixtures and the roots of the adjacent teeth, together with no exposure of alveolar bone. Following a 4-month non-loading period, second-stage surgery and provisional restoration with a temporary screw-retained implant crown were performed. Cement-retained superstructures made of customized zirconia abutment and a zirconia-bonded ceramic crown were fitted as the final restoration. At 5 years after implant surgery, there were no complications, including inflammation of the peri-implant soft tissue and resorption of peri-implant bone. Computer-assisted implant surgery is useful in avoiding complications in bilateral agenesis of the maxillary lateral incisors when only a narrow mesiodistal space is available for implant placement.


Assuntos
Anodontia/cirurgia , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Incisivo/anormalidades , Cirurgia Assistida por Computador , Adulto , Anodontia/patologia , Feminino , Humanos , Maxila
12.
Bull Tokyo Dent Coll ; 58(4): 259-267, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29269721

RESUMO

We performed orthodontic treatment, fitted prostheses, and provided restorative treatment in a patient with Bloch-Sulzberger syndrome and cleft lip and palate during the early mixed dentition period. We report the case after a subsequent 6-year retention phase including the period of pubertal growth. A girl aged 8 years 4 months visited our hospital with the chief complaint of crowding of the anterior teeth and anterior crossbite. She had bilateral cleft lip, alveolus, and palate; a Class II molar relationship; winging of both the maxillary bilateral central incisors; and spacing in the mandibular anterior teeth arches. Anterior crossbite comprised 0 mm overbite and -1 mm overjet. The crown diameter was at least one standard deviation smaller than normal in both the deciduous and permanent teeth, and the crowns were slightly peg-shaped. Panoramic radiograph confirmed congenital absence of 21 permanent teeth. Cephalometric analysis revealed poor growth of the maxilla, downward growth of the mandible, and lingual inclination of the maxillary central incisors. The diagnosis was skeletal anterior crossbite with cleft lip, alveolus, and palate, accompanied by hypodontia. Orthodontic treatment comprised an edgewise appliance and an expansion arch to improve crowding and anterior crossbite. The appliance was removed 2 years after treatment initiation, followed by crown restorations of the maxillary central incisors and mandibular deciduous anterior teeth. A metal retainer was then fitted to the maxillary dentition. She was subsequently placed in a 6-year retention phase including pubertal growth, during which occlusal stability and esthetics were maintained.


Assuntos
Fenda Labial/terapia , Fissura Palatina/terapia , Ortodontia Corretiva , Criança , Fenda Labial/complicações , Fissura Palatina/complicações , Feminino , Humanos , Incontinência Pigmentar/complicações
13.
J Orthod ; 41(4): 275-84, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24812100

RESUMO

OBJECTIVE: This study aimed to investigate the reason for high failure rates of mini-screws during orthodontic treatment. We hypothesized that decreasing the length of the mini-screw outside the bone relative to the length inside the bone (outside/inside length ratio) and equalising it to the tooth crown/root ratio would lead to increased stability of the mini-screw against lateral loading when assessed using finite element analysis. METHODS: We analysed stress distribution of mini-screws in the cortical and trabecular bone and von Mises stress levels when a 2-N force was applied to the head of four mini-screws of 6, 8, 10 and 12 mm in length. The direction of the force was perpendicular to the major axis of the screws. RESULTS: Stress levels of screws in cortical bone increased in proportion to the length of mini-screws outside the bone. The length of mini-screws inside the bone did not affect stress levels in the cortical bone. CONCLUSIONS: The results of this finite element analysis indicate that to stabilize the mini-screw, controlling the screw length outside the bone is more important than controlling the outside/inside length ratio.


Assuntos
Processo Alveolar/fisiologia , Parafusos Ósseos , Análise de Elementos Finitos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Adolescente , Adulto , Fenômenos Biomecânicos , Densidade Óssea/fisiologia , Simulação por Computador , Materiais Dentários/química , Módulo de Elasticidade , Humanos , Imageamento Tridimensional/métodos , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Estresse Mecânico , Propriedades de Superfície , Titânio/química , Coroa do Dente/anatomia & histologia , Raiz Dentária/anatomia & histologia , Adulto Jovem
14.
Bull Tokyo Dent Coll ; 55(1): 39-47, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24717929

RESUMO

While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.


Assuntos
Assimetria Facial/diagnóstico , Côndilo Mandibular/patologia , Neoplasias Mandibulares/diagnóstico , Osteoma/diagnóstico , Equipe de Assistência ao Paciente , Cefalometria/métodos , Assimetria Facial/terapia , Feminino , Humanos , Má Oclusão Classe III de Angle/diagnóstico , Má Oclusão Classe III de Angle/terapia , Côndilo Mandibular/cirurgia , Neoplasias Mandibulares/cirurgia , Pessoa de Meia-Idade , Osteoma/cirurgia , Prognatismo/diagnóstico , Prognatismo/terapia , Amplitude de Movimento Articular/fisiologia , Tomografia Computadorizada por Raios X/métodos , Técnicas de Movimentação Dentária/métodos
15.
Bull Tokyo Dent Coll ; 52(1): 39-46, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21467780

RESUMO

Brodie bite is a comparatively rare type of malocclusion found in primary and mixed dentition. It not only adversely affects chewing and muscle functions, but also impairs normal growth and development of the mandible. This report describes the therapeutic results of a patient with bilateral Brodie bite in early mixed dentition after using a bonded constriction quad-helix appliance. The patient, a boy aged 9 years and 2 months, first visited our hospital after occlusal abnormality in the molar region was detected at a local dental clinic. Case analysis resulted in a diagnosis of bilateral Brodie bite with slight mandibular retrognathism. Treatment objectives were to reduce the arch width of the maxillary dentition and expand the mandibular arch in order to establish and stabilize molar occlusion and to achieve a Class I molar relation and appropriate overbite and overjet. Treatment comprised covering the occlusal surface of the maxillary molars with resin and attaching a bonded constriction quad-helix appliance joined with a 0.040-inch quad-helix wire. A bi-helix appliance was also fixed to the mandibular dentition. Brodie bite visibly improved after 5 months. Cervical headgear was then fitted and the patient observed until eruption of the permanent dentition was complete. Class I molar relation was achieved after 2 years and 6 months, although spacing remained in the maxillary and mandibular dentitions. Treatment of bilateral Brodie bite in mixed dentition by means of a bonded constriction quad-helix appliance attached to the maxillary dentition enabled effective bite opening and reduction in the width of maxillary arch independent of the patient's cooperation, providing good therapeutic outcome in a short time period.


Assuntos
Má Oclusão Classe II de Angle/terapia , Aparelhos Ortodônticos , Técnica de Expansão Palatina/instrumentação , Cefalometria , Criança , Dentição Mista , Humanos , Masculino
16.
Bull Tokyo Dent Coll ; 51(3): 151-63, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20877162

RESUMO

The aim of this retrospective study was to determine factors that might cause complications in use of temporary anchorage devices (TADs) for orthodontic anchorage. We investigated 904 TADs in 455 patients. Clinical diagnoses requiring orthodontic treatment were malocclusion, jaw deformity, various syndromes, cleft lip and palate and impacted teeth. All patients underwent surgery at Tokyo Dental College Chiba Hospital between November 2000 and June 2009. Three kinds of titanium screw of different diameter and length were used: self-drilling mini-screws (Dual Top Autoscrew® and OSAS®), pre-drilling micro-screws (K1 system®) and palatal screws (PIAS®). Mini-plates fixed with 2 or 3 screws (SAS system®) were also used for skeletal anchorage. Patients were aged between 8 and 68 years (25.7±9.8 years). A total of 460 screw-type and 444 plate-type TADs were used. These comprised the following: mini-plates, 444; self-drilling mini-screws, 225; pre-drilling micro-screws, 83; and palatal screws, 152. Each type of implant had a high success rate of over about 90%. Failure rates were as follows: micro-screws, 7%; mini-screws, 6%; palatal implants, 11%; and mini-plates, 6%. Inflammation rate occurring in soft tissue surrounding TADs was follows: plate-type, 7.6%; mini-screws, 1.3%; micro-screws, 0%; and palatal implants, 2.5%. Inflammation frequencies depended on degree of mucosal penetration. Granulation rate in soft tissue surrounding TADs occurred as follows: micro-screws, 5.7%; self-drilling mini-screws, 0%; palatal screws, 0.6%; plate-type, 0.9%. Both plate- and screwtype orthodontic implants showed excellent clinical performance.


Assuntos
Procedimentos de Ancoragem Ortodôntica/instrumentação , Aparelhos Ortodônticos , Adolescente , Adulto , Idoso , Processo Alveolar/cirurgia , Placas Ósseas , Parafusos Ósseos , Criança , Falha de Equipamento , Feminino , Humanos , Inflamação/etiologia , Anormalidades Maxilomandibulares/terapia , Masculino , Má Oclusão/terapia , Pessoa de Meia-Idade , Miniaturização , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos/efeitos adversos , Palato Duro/cirurgia , Estudos Retrospectivos , Dente Impactado/terapia , Resultado do Tratamento , Adulto Jovem
17.
Bull Tokyo Dent Coll ; 48(1): 19-26, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17721063

RESUMO

Clarifying the genetic factors involved in maxillofacial growth and development is very important in orthodontic treatment planning and prognosis. However, few dental studies have examined multiple births. The present orthodontic evaluation was conducted using orthodontic data from a set of quadruplets. Orthodontic evaluation was performed on a set of quadruplets (1 girl and 3 boys) aged 9 years and 7 months at the initial visit. Although all 4 children weighed only about 1,400 g each at birth, height and body weight subsequently normalized. Mean skeletal age of the quadruplets was 10 years and 2 months, about 6 months ahead of their calendar age. In all 4 children, facial profile was mostly symmetrical and convex. Intraoral findings showed a Hellman's dental age of IIIA, together with spacing of the upper anterior teeth. Both overbite and overjet were 5-7 mm, and mesial step of the terminal plane was noted. Model analysis showed that tooth materials were on the large side, while arch width was narrow. Cephalometric analysis revealed that the ANB of the first- and fourth-born children was 6 degrees , and skeletal maxillary protrusion due to mandibular retrusion was diagnosed. The second- and thirdborn children exhibited no marked skeletal abnormalities.


Assuntos
Cefalometria/métodos , Má Oclusão/patologia , Odontometria/métodos , Quadrigêmeos , Determinação da Idade pelo Esqueleto , Criança , Feminino , Humanos , Masculino , Desenvolvimento Maxilofacial/fisiologia
18.
Bull Tokyo Dent Coll ; 48(4): 171-6, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18360103

RESUMO

The objective of the present study was to investigate frontal morphological asymmetry in the mandibular molar region in terms of tooth axis and skeletal structures using vertical MPR sections in jaw deformity accompanied by facial asymmetry. Subjects consisted of 15 patients with jaw deformity accompanied by facial asymmetry aged 17.4 years to 37.8 years. There were four men and eleven women. Based on X-ray computed tomography (CT) scans, DICOM viewer software was used to prepare multiplanar reconstruction (MPR) sections. The mandible was then positioned on a reference plane based on the menton and left and right gonions, and a vertical MPR section passing through the mesial root of the first mandibular molar was prepared. The following measurements were made on both the shifted and non-shifted sides: maximum buccolingual width of the mandibular body; height of the mandibular body; inclination angle of the mandibular body; degree of buccal protrusion of the mandibular body; and inclination angle of the buccolingual tooth axis of the first molar. Furthermore, degree of median deviation in the menton was measured using frontal cephalograms. Differences in morphological parameters between the shifted and non-shifted sides were assessed. Furthermore, the relationship between median deviation and asymmetry were statistically analyzed. There was no significant asymmetry in the maximum buccolingual width of the mandibular body, the height of the mandibular body or the degree of buccal protrusion of the mandibular body. However, when compared to the shifted side, the inclination angle of the buccolingual tooth axis of the first molar for the non-shifted side was significantly greater. There was a relatively strong correlation between median deviation and inclination angle of the mandibular body. The above findings clarified that, in orthognathic surgery for jaw deformity accompanied by facial asymmetry, actively improving asymmetry in the buccolingual inclination of the tooth axis of the molar region during presurgical orthodontic treatment is important in achieving favorable post-treatment occlusal stability and facial symmetry.


Assuntos
Assimetria Facial/patologia , Processamento de Imagem Assistida por Computador/métodos , Mandíbula/anormalidades , Dente Molar/patologia , Adolescente , Adulto , Processo Alveolar/patologia , Cefalometria/métodos , Queixo/patologia , Arco Dental/patologia , Feminino , Humanos , Masculino , Mandíbula/patologia , Odontometria/métodos , Tomografia Computadorizada por Raios X/métodos
19.
Bull Tokyo Dent Coll ; 47(1): 25-31, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16924156

RESUMO

Surgical orthodontic treatment and dental implant therapy were performed on a man (aged 18 years 8 months) with mandibular prognathism and seven congenitally missing teeth: upper canines, first and second premolars and lower right second premolar. After 17 months of preoperative orthodontic treatment at age 20 years 1 month, sagittal split ramus osteotomy was performed using the remaining upper deciduous teeth as an anchor for intermaxillary fixation. In postoperative orthodontic treatment, the remaining deciduous teeth were extracted, and fixture installation was performed. The entire therapy required 4 years to complete (age 22 years 8 months). After completion of orthodontic treatment, superstructures were put in place. This patient had many dental problems, so multidisciplinary care was performed in conjunction with other departments to improve oral function and facial esthetics.


Assuntos
Anodontia/complicações , Má Oclusão/etiologia , Mandíbula/anormalidades , Procedimentos Cirúrgicos Bucais , Ortodontia Corretiva/métodos , Prognatismo/complicações , Adolescente , Anodontia/terapia , Implantação Dentária Endo-Óssea , Humanos , Masculino , Má Oclusão/terapia , Mandíbula/cirurgia , Equipe de Assistência ao Paciente , Prognatismo/cirurgia , Extração Dentária , Dente Decíduo/cirurgia
20.
Bull Tokyo Dent Coll ; 45(3): 165-72, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15779459

RESUMO

The interalveolar septum between the upper first molar and the second premolar of the separated human maxillary bone was three-dimensionally observed by micro CT to evaluate the appropriate mini-screw type implant placement position by considering the relationship between the tooth roots and the maxillary sinus. After taking micro CTs of 5 human maxillary bones, horizontally sectioned images of the interalveolar septum area 2, 4, 6, 8, 10, and 12 mm deep from the crest of the alveolar ridge were reconstructed by three-dimensional reconstruction software. The bucco-lingual and mesio-distal lengths and area in each sectioned interalveolar septum were measured using digital image measurement software. Using the results, the interalveolar septum area between the upper first molar and the second premolar approximately 6-8 mm deep from the alveolar crest in the tooth root apical direction was determined to be the safest position for mini-screw implantation. Furthermore, lateral implantation from the palatal side was deduced to be the safest approach.


Assuntos
Parafusos Ósseos , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Processo Alveolar/diagnóstico por imagem , Dente Pré-Molar/diagnóstico por imagem , Cefalometria , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Masculino , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Palato/diagnóstico por imagem , Ápice Dentário/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
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