Nonextraction anterior open bite treatment with distalization and intrusion.

This case report describes successful orthodontic retreatment for vertical control with nonextraction orthodontic therapy. A 31-year-old woman complained of anterior open bite and crowding. She had slightly protrusive lips but wanted to correct her malocclusion without extraction. Two palatal temporary skeletal anchorage devices were used for the distalization of the maxillary arch along with posterior intrusion. Mandibular distalization was performed with Class III elastics. The duration of active treatment was 22 months. The plain and efficient mechanics used contributed to the effective distalization of both arches, the intrusion of the maxillary posterior teeth, and favorable profile changes. The results were still stable at the five-year follow-up period.

Caracterización de madres de pacientes con exposición perinatal al Virus de Inmunodeficiencia Humana

La mayor incidencia de la infección por el virus de inmunodeficiencia humana (VIH) en mujeres ha tenido un impacto directo en la transmisión vertical, situación que puede ser evitada con un adecuado control prenatal. Objetivo: Determinar características demográficas, epidemiológicas y obstétricas de madres de pacientes con exposición perinatal al VIH. Métodos: Se realizó un estudio retrospectivo, observacional, transversal y analítico. Se incluyeron madres con infección por VIH de transmisión horizontal, cuyos hijos con exposición perinatal, nacidos entre 2001 y 2020, fueron atendidos en la Unidad VIH del Hospital de Niños "J.M. de los Ríos" (Caracas-Venezuela). La información fue obtenida de la Base de Datos Interna. Las madres fueron agrupadas según la década de nacimiento del hijo (2001-2010 o 2011-2020). El análisis estadístico incluyó la prueba de Chi cuadrado. Resultados: Se estudiaron 805 madres. La edad promedio al nacer fue 26,4 años; el 8,6 % (n=69/803) era adolescente. El control prenatal fue inadecuado o inexistente en 59,7 % (n=463/776). La identificación de la infección materna fue obtenida durante o después del nacimiento en 36,4 % (n=280/769), con diferencias entre décadas: 26,7 % en la primera y 42,5 % en la segunda (p<0,01). En el 90,4 % (n=253/280) de este grupo el diagnóstico se obtuvo posterior al nacimiento. Conclusiones: La edad promedio de las madres fue 26,4 años. Aproximadamente 50 % tuvo control prenatal inadecuado o inexistente. Alrededor de un tercio obtuvo el diagnóstico después del embarazo, con significativo mayor porcentaje en la segunda década. Sólo en 1/10 madres de este grupo, la infección fue identificada al nacimiento.

The higher incidence of human immunodeficiency virus (HIV) infection in women has had a direct impact on vertical transmission, situation that can be avoided with an adequate prenatal control. Objective: To determine demographic, epidemiological, and obstetric characteristics of mothers of children with perinatal exposure to HIV. Methods: A retrospective, observational, cross-sectional and analytical study was carried out. It was included mothers, with horizontally transmitted HIV infection, whose children with perinatal exposure, born between 2001 and 2020, were treated at the HIV Unit of the Children's Hospital "J.M. de los Ríos" (Caracas-Venezuela). The information was obtained from the Unit Internal Database. The mothers were grouped according to the decade of her child's birth (2001-2010 or 2011-2020). Chi square test was performed for statistical analysis. Results: A total of 805 mothers were studied. The average age at birth was 26.4 years; 8.6 % (n=69/803) were adolescents. Prenatal care was inadequate or non-existent in 59.7 % (n=463/776). Identification of maternal infection was obtained during or after birth in 36.4 % (n=280/769), with differences between decades: 26.7 % in the first and 42.5 % in the second (p<0.01). In 90.4 % (n=253/280) of this group, the diagnosis was obtained after birth. Conclusions: The average age of the mothers was 26.4 years. Approximately 50 % had inadequate or nonexistent prenatal care. About a third were diagnosed after pregnancy, with a significantly higher percentage in the second decade. In only 1/10 mothers of this group the infection was identified at birth.

Effects of orthodontic camouflage treatment vs orthodontic-orthognathic surgical treatment on condylar stability in Class II hyperdivergent patients with severe temporomandibular joint osteoarthrosis: a retrospective observational study.

OBJECTIVES: To investigate the differences in profile changes and stability of the condyles between orthodontic camouflage treatment assisted by vertical control and that accomplished via orthognathic surgery in Class II hyperdivergent patients with TMJ osteoarthrosis (TMJOA). MATERIALS AND METHODS: This study included 27 Class II hyperdivergent TMJOA patients (54 condyles) who received orthodontic camouflage treatment (13 patients) or orthognathic surgery (14 patients) Cone-beam computerized tomography (CBCT) scans were taken before treatment (T1) and 1 year after treatment (T2). Cephalometric and TMJ measurement analyses were conducted to evaluate the change in profile and condyles from T1 to T2 using independent samples t-test and paired t-test. Three-dimensional (3D) deviation analysis was also performed to evaluate the stability of condyles from T1 to T2. RESULTS: Both groups showed significant profile improvement from T1 to T2. The changes in Z angle and ANB angle were larger in the surgical group than in the orthodontic group. Condylar width, length, and height remained stable after treatment in the orthodontic group (P > .05), while they reduced by 0.67 ± 0.85 mm, 1.14 ± 1.10 mm, and 1.07 ± 1.34 mm, respectively, in the surgical group (P < .05). Superior, posterior, medial, and lateral joint spaces were significantly reduced in the orthodontic group (P < .05). 3D deviations intuitively showed that condylar bone in the orthodontic group was more stable than that in the surgical group. CONCLUSIONS: For Class II hyperdivergent patients with severe TMJOA, orthodontic camouflage treatment with vertical control can effectively maintain the stability of condyles while significantly improving the profile. Surgical treatment yields a better profile but may increase the risk of condyle resorption.

Effectiveness of micro-implant in vertical control during orthodontic extraction treatment in class II adults and adolescents after pubertal growth peak: a systematic review and meta-analysis.

OBJECTIVE: To compare the effectiveness of micro-implant (MI) and conventional anchorage (CA) in vertical control during orthodontic extraction treatment of class II adults and adolescents after pubertal growth peak. MATERIALS AND METHODS: Literature search was conducted through Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine (CBM), and other sources, from inception to December 2021. Randomized clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Mean differences (MDs) with 95% confidence intervals (CIs) were conducted. A meta-analysis concerning change of mandibular plane, vertical change of upper and lower molar, change of occlusal plane, SNB, chin position, and profile was carried out. RESULTS: A total of 10,669 records were identified in the database search, and 19 studies (10 RCTs and 9 CCTs) were included in the final analysis. Compared with CA, MI significantly decreased mandibular plane angle and intruded upper molars. No significant difference was found in vertical change of lower molars, occlusal plane, SNB, chin position, and profile. CONCLUSION: MI seems to be more effective than CA in vertical control during orthodontic extraction treatment of class II adults and adolescents after pubertal growth peak. CLINICAL RELEVANCE: MI should be given priority when considering the vertical control of class II patients, which is beneficial to the counterclockwise rotation of mandible or at least prevention of deterioration of the profile.

The effect of orthodontic vertical control on the changes in the upper airway size and tongue and hyoid position in adult patients with hyperdivergent skeletal class II.

BACKGROUND: At present, there are still controversies about the influence of orthodontic treatment on the size of upper airway and the position of hyoid bone. We investigated the effect of orthodontic vertical control therapy on the size of the upper airway and position of the tongue and hyoid bone in adult patients with hyperdivergent skeletal Class II. METHODS: Overall, 15 adults with hyperdivergent skeletal Class II and normal occlusion, respectively, were selected as the experimental and control groups. The angle and line of the craniofacial structure, upper airway, hyoid bone position and three-dimensional (3D) upper airway indexes were measured using the Uceph 4.2.1 standard version and Mimics 21.0 software, respectively. The paired t-test, Wilcoxon symbol rank test, t-test of two independent samples, two independent sample nonparametric tests, Mann-Whitney U test, Pearson correlation analysis, the Univariate linear regression analysis and Multiple linear regression analysis were performed. RESULTS: After treatment, the S-Go/N-Me (%) and the MP-SN and XiPm-SN angles were significantly different (P < 0.01). The U-MPW and PAS significantly increased (P < 0.05), sagittal diameter L2 increased significantly, and transverse diameter L2 decreased significantly (P < 0.01). Although no significant correlation was observed between the vertical change in the jaw and that in U-MPW and PAS, the sagittal diameter L2 showed a significant correlation (P < 0.05). The Multiple linear regression analysis showed that there was a significant negative correlation between the variables MP-SN and sagittal diameter L2 and positive correlation between S-Go/N-Me(%) and H-MP (P < 0.05). Furthermore, significant differences between the Hv (P < 0.01) and sagittal diameter L1(P < 0.05) were observed before and after treatment. CONCLUSIONS: After the orthodontic vertical control therapy in patients with hyperdivergent skeletal Class II, the upper airway only underwent adaptive changes during treatment without substantial size changes, the position of tongue body and hyoid bone did not change significantly. Furthermore, compared with normal occlusion, the velopharyngeal segment airway of patients with hyperdivergent skeletal Class II remains narrow and long after treatment.

Vertical Control of a Severe Hyperdivergent Skeletal Class II Malocclusion with Steep Posterior Occlusal Plane in a Camouflage Case.

Severe hyperdivergent skeletal Class II malocclusion may be ideally treated with orthognathic surgery in adult patients. Here, we report a camouflage treatment of a 23-year-old female patient. She was diagnosed with a skeletal Class II malocclusion with extreme high mandibular plane angle, retrusive mandible, steep posterior occlusal plane, anterior open bite, and severe overjet. The treatment plan included extraction of all second premolars and intrusion of the maxillary anterior teeth and mandibular posterior teeth using miniscrews. These contributed to an effective counterclockwise rotation of the mandible, decreased lower face height, and improvement in anterior overbite. This case report shows a vertical control strategy on severe hyperdivergent skeletal Class II malocclusions, which achieves well-controlled sagittal and vertical dimensions and a favorable facial appearance. The treatment and retention results were well balanced and aesthetically pleasing.

[Efficacy of vertical control by using mini-implant anchorage in maxillary posterior buccal area for Angle class â ¡ extraction patients].

OBJECTIVE: To investigate the efficacy of vertical control by using conventional mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients. METHODS: Twenty-eight Angle class Ⅱ patients [9 males, 19 females, and age (22.6±2.8) years] were selected in this study. All of these patients were treated by using straight wire appliance with 4 premolars extraction and 2 mini-implant anchorage in maxillary posterior buccal area. In this study, the self-control method was used to measure and analyze the lateral radiographs taken before and after orthodontic treatment in each case, the main cephalometric analysis items were related to vertical changes. The digitized lateral radiographs were imported into Dolphin Imaging Software (version 11.5: Dolphin Imaging and Management Solutions, Chatsworth, California, USA), and marked points were traced. Each marked point was confirmed by two orthodontists. The same orthodontist performed measurement on the lateral radiographs over a period of time. All measurement items were required to be measured 3 times, and the average value was taken as the final measurement result. RESULTS: Analysis of the cephalometric radiographs showed that, for vertical measurements after treatment, the differences of the following measurements were highly statistically significant (P < 0.001): SN-MP decreased by (1.40±1.45) degrees on average, FMA decreased by (1.58±1.32) degrees on average, the back-to-front height ratio (S-Go/N-Me) decreased by 1.42%±1.43% on average, Y-axis angle decreased by (1.03±0.99) degrees on average, face angle increases by (1.37±1.05) degree on average; The following measurements were statistically significant (P < 0.05): the average depression of the upper molars was (0.68±1.40) mm, and the average depression of the upper anterior teeth was (1.07±1.55) mm. The outcomes indicated that there was a certain degree of upper molar depression after the treatment, which produced a certain degree of counterclockwise rotation of the mandibular plane, resulting in a positive effect on the improvement of the profile. CONCLUSION: The conventional micro-implant anchorage in maxillary posterior buccal area has a certain vertical control ability, and can give rise to a certain counterclockwise rotation of the mandible, which would improve the profile of Angle Class Ⅱ patients.

Effects of long-term use of the lower lingual arch from 8.5 years to 13.2 years.

OBJECTIVES: To investigate the effects of long-term use of the lower lingual arch (LLA) on the sagittal and vertical positions of the permanent lower incisors and first molars. MATERIALS AND METHODS: The sample consisted of 98 patients who were treated with an LLA (LLA group) and 39 patients who were treated without an LLA (no-LLA group). The positional changes of the lower incisors and first molars were analyzed after performing mandibular structural superimpositions on lateral cephalometric radiographs taken before treatment (T1) and at the end of LLA therapy (T2). The mean ages at T1 and T2 were 8.5 years and 13.2 years, respectively. Study casts were analyzed to quantify arch dimensional changes. RESULTS: Mesial movement of the lower molar cusp was similar between the LLA and no-LLA groups, but the vertical position was slightly greater at T2 in the LLA group. In the LLA group, there was a molar tip-back effect, and the lower incisors were proclined 4.2° more than in the no-LLA group. Arch perimeter decreased 3.6 ± 2.6 mm without an LLA and 0.97 ± 3.7 mm with an LLA. Intercanine and intermolar widths both increased about 1 mm more with an LLA (P < .0001). CONCLUSIONS: The LLA does not seem to restrict mesial movement and vertical eruption of the lower incisors and molars in the long term. The LLA effectively preserves the arch perimeter at the expense of a slight lower incisor proclination.

Efficacy of vertical control by using mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients / 北京大学学报(医学版)

OBJECTIVE@#To investigate the efficacy of vertical control by using conventional mini-implant anchorage in maxillary posterior buccal area for Angle class Ⅱ extraction patients.@*METHODS@#Twenty-eight Angle class Ⅱ patients [9 males, 19 females, and age (22.6±2.8) years] were selected in this study. All of these patients were treated by using straight wire appliance with 4 premolars extraction and 2 mini-implant anchorage in maxillary posterior buccal area. In this study, the self-control method was used to measure and analyze the lateral radiographs taken before and after orthodontic treatment in each case, the main cephalometric analysis items were related to vertical changes. The digitized lateral radiographs were imported into Dolphin Imaging Software (version 11.5: Dolphin Imaging and Management Solutions, Chatsworth, California, USA), and marked points were traced. Each marked point was confirmed by two orthodontists. The same orthodontist performed measurement on the lateral radiographs over a period of time. All measurement items were required to be measured 3 times, and the average value was taken as the final measurement result.@*RESULTS@#Analysis of the cephalometric radiographs showed that, for vertical measurements after treatment, the differences of the following measurements were highly statistically significant (P < 0.001): SN-MP decreased by (1.40±1.45) degrees on average, FMA decreased by (1.58±1.32) degrees on average, the back-to-front height ratio (S-Go/N-Me) decreased by 1.42%±1.43% on average, Y-axis angle decreased by (1.03±0.99) degrees on average, face angle increases by (1.37±1.05) degree on average; The following measurements were statistically significant (P < 0.05): the average depression of the upper molars was (0.68±1.40) mm, and the average depression of the upper anterior teeth was (1.07±1.55) mm. The outcomes indicated that there was a certain degree of upper molar depression after the treatment, which produced a certain degree of counterclockwise rotation of the mandibular plane, resulting in a positive effect on the improvement of the profile.@*CONCLUSION@#The conventional micro-implant anchorage in maxillary posterior buccal area has a certain vertical control ability, and can give rise to a certain counterclockwise rotation of the mandible, which would improve the profile of Angle Class Ⅱ patients.

Considerations for vertical control with microimplants in a idiopathic condylar resorption patient: A case report.

Idiopathic condylar resorption (ICR) is a rare, destructive temporomandibular joint disease characterised by progressive resorption of the condyles. This case report presents a record of an orthodontically treated patient with ICR with favourable posttreatment remodelling of the condyles. An 18-year-old woman sought treatment for ICR. A severe Class II high-angle facial pattern with resorption of bilateral condyles was evident. The treatment plan was determined after careful examination of condylar radiographs and comprised forward rotation of the mandible through full-arch intrusion with microimplants after extraction of the four premolars. The treatment was completed in 35 months, and the patient was noted to have a straight profile, good interdigitation and slightly increased condylar volume. Two years after retention, the condyles were stable, and the patient's profile and occlusion remained acceptable despite a mild relapse of the mandibular position. ICR was successfully corrected with orthodontic treatment. Counter-clockwise mechanics applied during the ICR remission period not only improved facial aesthetics but were also suitable for condylar unloading.

Microtornillos como método de control vertical en desprogramación muscular / Vertical control with miniscrews in muscular deprogramming treatment

Una de las consecuencias de la desprogramación neuromuscular es la rotación mandibular en sentido horario, evidenciando el punto prematuro de contacto y aumentando la dimensión vertical del paciente. En pacientes clase II con componente vertical, es un problema realizar este tipo de tratamiento, ya que por lo general este efecto de posterorrotación mandibular hace el perfil más convexo, y en algunos casos genera mordida abierta anterior, la cual se debe corregir posteriormente con el tratamiento de ortodoncia, cirugía o prótesis, lo que alarga el tiempo total de tratamiento por la necesidad de control vertical. El presente caso se trata de una mujer de 45 años de edad, dolicofacial, con tendencia a mordida abierta, mordida dual, sobremordida vertical y horizontal disminuidas, motivo de consulta dolor articular, el cual no le permite continuar con sus labores diarias, el tratamiento realizado fue desprogramación neuromuscular con un guarda oclusal inferior con el propósito de aliviar sintomatología articular y control vertical con microtornillos palatinos previo a tratamiento ortodóncico (AU)

One of the effects of the neuromuscular deprogramming treatment is the mandibular clockwise rotation, making the light premature occlusal contact more evident and increasing the patient vertical dimension. In Class II patients with vertical component is difficult to treat them due to profile worsening as an effect of the clockwise rotation creating in some patient's anterior open bite, this has to be corrected later in treatment with orthodontic intrusion, surgery or prosthodontic treatment, increasing the total time of treatment with the vertical control necessity. This case report is a 45 years old patient, dolichofacial, with anterior open bite tendency, dual bite, decreased overjet and overbite, her chief complaint was temporomandibular joint dysfunction which dont allow her to do her daily duties, the treatment for her was neuromuscular deprogramming splint for the temporomandibular joint pain, and vertical control with temporary anchorage devices (miniscrews) before the orthodontic treatment (AU)

Efecto del entrenamiento muscular masticatorio en el desarrollo del patrón vertical facial en niños: revisión narrativa / Training effect of the masticatory muscles in the development of the vertical facial pattern in children: narrative review

RESUMEN: Introducción: El patrón de crecimiento facial se establece antes de la aparición del primer molar permanente. Un exceso de crecimiento vertical facial, corresponde a individuos de cara larga, con ángulos goniacos abiertos, alturas faciales inferiores aumentadas y músculos masticatorios de menor área transversal. Esto se asocia a presentar mordida abierta anterior, mordida cruzada, clase II esquelético, entre otros. El entrenamiento muscular masticatorio podría controlar el excesivo crecimiento vertical, generando fuerzas opuestas que favorezcan un crecimiento horizontal. Objetivo: Describir el efecto del entrenamiento muscular masticatorio en el desarrollo del patrón vertical facial en niños. Método: Se realizó una revisión narrativa mediante búsqueda electrónica en las bases de datos PubMed, EBSCO, Scopus, Cochrane, Trip Database y Epistemonikos. Se utilizaron las palabras clave: "músculos masticatorios", "maseteros", "temporales", "masticación", "ejercicio", "entrenamiento", "crecimiento vertical", "patrón vertical", "dolicofacial", "control vertical". Los términos MeSH: "músculos masticatorios", "ejercicio". Resultados: Se seleccionaron 15 artículos de los cuales 9 son ensayos clínicos, 4 son reportes de caso y 2 son estudios observacionales transversales. Conclusiones: El entrenamiento muscular masticatorio tiene efectos positivos, favoreciendo un mayor crecimiento horizontal en niños con patrón vertical. No obstante, faltan estudios y ensayos clínicos para establecer y cuantificar los cambios morfológicos generados por el entrenamiento muscular.

ABSTRACT: Background: The pattern of facial growth is established before the eruption of the first permanent molar. An excess of vertical facial growth corresponds to individuals with long faces, open gonial angles, higher inferior facial heights and smaller masticatory muscles associated with different dental anomalies like anterior open bite, Brodie bite, skeletal class II and others. The masticatory muscle training could control the excessive growth in the vertical dimension, making opposing forces that will favor the horizontal growth in the patient. Objective: Describe the effect of the masticatory muscle training in the development of the vertical pattern in children. Method: A narrative review was done by an electronic research in PubMed, EBSCO, Scopus, Cochrane, Trip Database y Epistemonikos. The following key words were used: "masticatory muscles", "masseter", "temporalis", "mastication", "chewing", "exercise", "training", "vertical growth", "vertical pattern", "dolichofacial", "vertical control". The MeSH terms: "masticatory muscles", "exercise". Results: Fifteen articles were selected, 9 of them were clinical trials, 4 were case reports and 2 were observational studies. Conclusions: The literature review shows that the masticatory muscle training has positive effects, favoring the horizontal growth in children with vertical facial pattern. Nevertheless, there is a lack of studies and clinical trials, that could help us to establish and quantify the morphological changes made by the masticatory muscle training.

Control vertical mediante bite block en relación céntrica / Vertical control through bite block in centric relation

Paciente femenina de ocho años y cuatro meses, con patrón esquelético de clase II severa y overjet de 10 mm, fue tratada con Bite-Block Céntrico como método de control vertical. Después de cinco meses de terapia con aparatología fija de primera fase se logró control vertical y reducción de las desviaciones de la clase esquelética. Posteriormente se continuó con tratamiento activo durante 18 meses, se dio de alta de la primera fase cuando los objetivos del tratamiento como alineación, nivelación, overbite y overjet fueron adecuados. Los registros postratamiento demostraron una buena estabilidad articular, oclusión funcional y una mejora en la estética facial. El montaje en céntrica postratamiento demuestra estabilidad condilar con el uso de Bite-Block Céntrico como método de control vertical (AU)

Female patient of eight years and four months, with skeletal pattern of severe class II and 10 mm overjet, was treated with Bite-Block Centric as a vertical control method. After five months of therapy with fixed appliances of the first phase, vertical control and reduction of the deviations of the skeletal class were achieved. Subsequently continued with active treatment for 18 months, was discharged from the first phase when the treatment objectives such as alignment, leveling, overbite and overjet appropriate. Post-treatment records showed good joint stability, functional occlusion and an improvement in facial aesthetics. The posttreatment centric assembly demonstrates condylar stability with the use of Centric Bite-Block as a vertical control method (AU)

Cephalometric comparison of adult anterior open bite treatment using clear aligners and fixed appliances.

OBJECTIVES: To compare fixed appliances and clear aligner therapy in correcting anterior open bite and in controlling the vertical dimension in adult patients with hyperdivergent skeletal patterns. MATERIALS AND METHODS: In this retrospective study, two treatment groups of adult (≥18 years old) hyperdivergent patients (mandibular plane angles of ≥38°) with anterior open bites were included: 17 fixed appliance patients and 36 clear aligner patients. Thirteen cephalometric measurements representing the vertical dimension were reported for each group. A two-sample t-test was used to assess differences in changes in mandibular plane angle and overbite between the two treatment groups. RESULTS: There were no statistical differences found in the magnitude of overbite correction and the changes in any of the cephalometric measurements for vertical control. The clear aligner group showed a slightly greater amount of lower incisor extrusion ( P = .009). The main mechanism of open bite correction was similar between the two treatment groups and was accomplished through retroclination of the upper and lower incisors while maintaining the vertical position of the upper and lower molars. CONCLUSIONS: Cephalometric comparison of anterior open bite correction and changes in the mandibular plane angle associated with use of clear aligners and fixed appliances did not demonstrate statistically significant differences in adult hyperdivergent patients.

Evaluation of Long-term Stability of Vertical Control in Hyperdivergent Patients Treated with Temporary Anchorage Devices.

This study aims to evaluate the long-term stability of vertical control in hyperdivergent patients treated with temporary anchorage devices. The sample included 20 hyperdivergent patients without anterior open bite. The temporary anchorage devices were used to intrude the upper incisor and molars for vertical control. Lateral cephalograms were established prior to treatment, immediately after treatment, and during retention. The upper molars and incisors were intruded by 1.33 mm and 1.41 mm after treatment (P<0.05). U6-PP increased by 0.11 mm and 0.23 mm during the first and second stages of retention (P>0.05). U1-PP was found to possess a significant extrusion of 1.2 mm during the first stage (P<0.05), which increased by 0.68 mm during the second stage (P>0.05). The mandibular plane angle (MP-SN) decreased by 2.58 degrees following treatment, and underwent a relapse of 0.51 degree and 0.42 degree during the first and second stages of retention respectively (P>0.05). No significant soft tissue changes occurred, with the exception of increased upper lip length during the second stage (P<0.05). Maxillary anterior and posterior intrusions, counter clockwise rotation of the mandibular plane, and improved profiles can be successfully achieved following treatment with vertical control. During the first stage of retention (less than three years), intruded molars and incisors both exhibited some extrusion, and molars had better long-term stability than incisors. During the second stage of retention (three to six years), the therapeutic effects appeared stable, with the exception of some increase in upper lip length. Rotated mandibular plane remained stable during the entire retention period.

Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect.

This case report demonstrates the treatment of a skeletal Class II high-angle adult patient with bimaxillary protrusion, angle Class I occlusion, and crowded anterior teeth. A ribbon-wise arch wire and a customized lingual appliance with anterior vertical slots were used to achieve proper torque control of the maxillary anterior teeth. An orthodontic anchor screw and a palatal bar were used for vertical control to avoid increasing the Frankfort-mandibular plane angle (FMA) by maxillary molar extrusion. Through the combined use of the ribbon-wise customized lingual appliance, palatal bar, and orthodontic anchor screw, vertical control and an excellent treatment result were achieved without the vertical and horizontal bowing effects peculiar to conventional lingual treatment.

Exploring the administrative mechanism of China's Paired Assistance to Disaster Affected Areas programme.

The Paired Assistance to Disaster Affected Areas (PADAA) programme is a mutual aid initiative with Chinese characteristics, which speeded up the process of restoring and reconstructing regions affected by the Wenchuan earthquake on 12 May 2008. The PADAA is an efficient instrument for catastrophe recovery, yet it remains a mysterious mechanism to many members of disaster management communities. This paper aims to lift the veil on it by assessing its origins and evolution. It draws on the multi-level moderated competition model to explain how the PADAA functions within the Chinese administrative system. The country's top-down political system allows the central authority to mandate provincial and local governments from more economically developed regions to assist devastated areas with post-disaster reconstruction. The practices of local accountability complement vertical control by giving leaders from donor regions strong incentives to accomplish assigned reconstruction tasks, resulting in intense competition between them.

Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case.

In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.

The effects of the vertical holding appliance in the extraction treatment of patients with hyperdivergence / 实用口腔医学杂志

Objective:To observe the effects of the vertical holding appliance (VHA) in the extraction treatment of patients with hyperdivergence.Methods:40 hyperdivergent patients orthodonticly treated by 4 first premolar extraction with(VHA group) and without VHA(control group) (n =20) respectively.Cephalometric radiographs were taken before and after orthodontic treatment and measured digitally by Winceph 8.06 software.Results:After treatment,the L6-MP,S-Go,N-Me,ANS-Me increased in the VHA group(P ＜ 0.05).The MP-SN,Y-axis,U1-PP,U6-PP,L6-MP,S-Go,N-ANS,N-Me,ANS-Me,ANS-Me/N-Me increased and the S-Go/N-Me decreased in the control group(P ＜0.05).The changes of the MP-SN,Y-axis,U6-PP,L6-MP,N-Me,ANS-Me,ANS-Me/N-Me,S-Go/N-Me were smaller in the VHA group than those in the control group (P ＜ 0.05).Conclusion:VHA is effective in the control of the height of molars in the extraction treatment of patients with hyperdivergence.

Nonsurgical correction of a severe anterior deep overbite accompanied by a gummy smile and posterior scissor bite using a miniscrew-assisted straight-wire technique in an adult high-angle case / 대한치과교정학회지

In the present report, we describe the successful use of miniscrews to achieve vertical control in combination with the conventional sliding MBT™ straight-wire technique for the treatment of a 26-year-old Chinese woman with a very high mandibular plane angle, deep overbite, retrognathic mandible with backward rotation, prognathic maxilla, and gummy smile. The patient exhibited skeletal Class II malocclusion. Orthodontic miniscrews were placed in the maxillary anterior and posterior segments to provide rigid anchorage and vertical control through intrusion of the incisors and molars. Intrusion and torque control of the maxillary incisors relieved the deep overbite and corrected the gummy smile, while intrusion of the maxillary molars aided in counterclockwise rotation of the mandibular plane, which consequently resulted in an improved facial profile. After 3.5 years of retention, we observed a stable, well-aligned dentition with ideal intercuspation and more harmonious facial contours. Thus, we were able to achieve a satisfactory occlusion, a significantly improved facial profile, and an attractive smile for this patient. The findings from this case suggest that nonsurgical correction using miniscrew anchorage is an effective approach for camouflage treatment of high-angle cases with skeletal Class II malocclusion.