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1.
J Appl Oral Sci ; 28: e20190364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348442

RESUMO

Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.


Assuntos
Má Oclusão de Angle Classe II/terapia , Dente Molar/fisiopatologia , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Técnicas de Movimentação Dentária/instrumentação , Adolescente , Análise de Variância , Cefalometria , Criança , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/fisiopatologia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
2.
Am J Orthod Dentofacial Orthop ; 157(3): 329-339, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115111

RESUMO

INTRODUCTION: The purpose of this study was to comparatively evaluate the effects of Twin-block (TB) appliance and sagittal-guidance Twin-block (SGTB) appliance on alveolar bone around mandibular incisors in growing patients with Class II Division 1 malocclusion, using cone-beam computed tomography. METHODS: The sample consisted of 25 growing patients with Class II Division 1 malocclusion (14 boys and 11 girls, mean age 11.92 ± 1.62 years) and was randomly distributed into the TB group (n = 13) and the SGTB group (n = 12). The treatment duration was 11.56 ± 1.73 months. Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were taken in both groups. Height, thickness at apex level, and volume of the alveolar bone around mandibular left central incisors were measured respectively on labial and lingual side, using Mimics software (version 19.0; Materialise, Leuven, Belgium). Based on the stable structures, 3-dimensional (3D) registrations of T1 and T2 models were taken to measure the sagittal displacement of incisors. Intragroup comparisons were evaluated by paired-samples t tests and Wilcoxon tests. Independent-samples t tests and Mann-Whitney U tests were used for intergroup comparisons. RESULTS: In both groups, alveolar bone height and volume on the labial side of the incisors significantly decreased after treatment (P <0.05). Lingual alveolar bone height, lingual and total alveolar bone volume, labial, lingual and total alveolar bone thickness showed no significant difference between T1 and T2 (P >0.05). In both groups the incisors tipped labially and drifted to the labial side. Compared with the TB group, less labial alveolar bone loss, less incisor proclination and crown edge drift were found in the SGTB group (P <0.05). CONCLUSIONS: Labial alveolar bone loss around mandibular incisors was observed after both types of appliances treatment in growing patients with Class II Division 1 malocclusion. Less labial alveolar bone loss, less incisor proclination, and crown edge drift were found in the SGTB group than in the TB group during treatment.


Assuntos
Perda do Osso Alveolar , Má Oclusão de Angle Classe II , Aparelhos Ortodônticos , Adolescente , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Coroa do Dente
3.
Rev. ADM ; 77(1): 37-40, ene.-feb. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1088035

RESUMO

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)


Assuntos
Humanos , Feminino , Criança , Dimensão Vertical , Relação Central , Aparelhos Ortodônticos Fixos , Planejamento de Assistência ao Paciente , Cefalometria , Oclusão Dentária Central , Má Oclusão de Angle Classe II/terapia
4.
Am J Orthod Dentofacial Orthop ; 157(2): 205-211, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32005472

RESUMO

INTRODUCTION: This study aimed to determine the volumetric effects on the upper airways of growing patients with Class II malocclusion treated with the Herbst appliance (HA). METHODS: Volumetric measurements of the upper airways of 42 skeletal Class II malocclusion patients (mean age: 13.8 ± 1.2 years; ranging from 12.0 to 16.9 years) were assessed using cone-beam computed tomography scans acquired before treatment (T0) and approximately 1 year later (T1). The sample comprised a Herbst appliance group (HA group [HAG]; n = 24), and a comparison group (comparison group [CG]; n = 18) of orthodontic patients who had received dental treatments other than mandibular advancement with dentofacial orthopedics. RESULTS: In CG, nasopharynx and oropharynx volumes decreased slightly during the observation period (9% and 3%, respectively), whereas the nasal cavity volume increased significantly (12%; P = 0.046). In HAG, there was an increase in the volume of all regions (nasal cavity, 5.5%; nasopharynx, 11.7%; and oropharynx, 29.7%). However, only the oropharynx showed a statistically significant increase (P = 0.003), presenting significant volumetric changes along the time (T1-T0) in HAG. CONCLUSION: Mandibular advancement with the HA significantly increased the volume of the oropharynx, but no significant volumetric modifications were observed in the nasal cavity and nasopharynx.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Má Oclusão de Angle Classe II , Aparelhos Ortodônticos Funcionais , Adolescente , Cefalometria , Criança , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula , Avanço Mandibular , Orofaringe
5.
Am J Orthod Dentofacial Orthop ; 157(2): 245-258, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32005477

RESUMO

INTRODUCTION: An adolescent girl, aged 12 years 11 months, was evaluated for orthodontic treatment. Her chief complaints included a difficulty with keeping her lips passively closed and excessive gingival exposure upon smiling. Her treatment plan included (1) restriction of maxillary growth with cervical headgear, (2) extraction of the maxillary first premolars to reduce the maxillary protrusion and the mandibular second premolars to facilitate Class II dental correction, and (3) management of maxillary incisor intrusion via anchoring with mini-implants. When indicated, even in the absence of large space discrepancies, extractions can be beneficial to the patient. The final results showed an attractive smile, passive lip seal, and a more esthetic and balanced facial profile. Retention records confirmed the stability of the treatment. The 5-year follow-up visit revealed that the treatment results were quite stable.


Assuntos
Implantes Dentários , Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Adolescente , Dente Pré-Molar , Cefalometria , Criança , Estética Dentária , Feminino , Humanos , Incisivo , Má Oclusão de Angle Classe II/terapia , Maxila , Técnicas de Movimentação Dentária
6.
Braz Oral Res ; 34: e003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32022222

RESUMO

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Assuntos
Estética Dentária , Face/patologia , Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe II/terapia , Extração Dentária/métodos , Adolescente , Análise de Variância , Dente Pré-Molar/cirurgia , Cefalometria , Criança , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/métodos , Ortodontistas , Percepção , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento
7.
J Craniofac Surg ; 31(1): 172-177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31842074

RESUMO

This retrospective research aimed to highlight the changes of occlusal plane in Class II hyperdivergent subjects that received cervical headgear treatment and compared them to untreated controls in order to evaluate the occlusal changes that might be connected to a potential mandibular rotation.The sample of this investigation was represented by 20 hyperdivergent Class II subjects (10 males, 10 females; mean age 8.54) corrected by using cervical headgear (treated group) and 21 Class II patients (11 males, 10 females; mean age 8.41) hyperdivergent who had no therapy (control group). Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for both groups; cephalometric analysis was used in order to seek the modifications between time points and between groups.Means and standard deviation have been computed for both groups. In order to confront the modification between the time points within the same group the Wilcoxon test was applied. The Mann-Whitney U test was applied to confront the dissimilarities between groups at T2.As a result of the Class II correction by using the cervical headgear treatment the occlusal plane was lowered and flattened compared to T1 and to the control group; the upper molars showed extrusion to the palatal plane, there was a significant forward rotation of mandible and the vertical dimension was not significantly modified. Downward and backward displacement of the upper jaw occurred.


Assuntos
Dimensão Vertical , Cefalometria , Criança , Feminino , Cabeça , Humanos , Masculino , Má Oclusão de Angle Classe II/terapia , Pescoço , Estudos Retrospectivos , Rotação , Estatísticas não Paramétricas , Técnicas de Movimentação Dentária/métodos
8.
Am J Orthod Dentofacial Orthop ; 156(6): 832-839, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31784017

RESUMO

INTRODUCTION: The purpose of this study was to evaluate skeletal, dentoalveolar, and soft tissue changes at 3 years posttreatment in patients with Class II Division 1 malocclusion treated with modified C-palatal plates (MCPPs). METHODS: The sample consisted of 69 lateral cephalograms of 23 patients Class II Division 1 malocclusion (9 men, 14 women; average age, 20.1 years) who underwent bilateral distalization of their maxillary dentition. The lateral cephalograms were taken immediately before the placement of the MCPPs (T1); at the end of orthodontic fixed appliance therapy (T2); and at the posttreatment observation period (3 years posttreatment; T3). Twenty-three variables were measured. Repeated measures ANOVA followed by post hoc analysis using Bonferroni test was used to identify significant differences between time points. RESULTS: Maxillary first molars showed a distal movement of 3.44 ± 1.08 mm (P <0.001) distal crown tipping of 2.35° ± 6.74°, and intrusion of 1.42 ± 1.12 mm from T1 to T2. However, from T2 to T3, there was an average of 0.41 ± 0.25 mm of mesial movement, 0.50 ± 0.46 mm of extrusion, and insignificant mesial crown tipping (0.92° ± 2.46°; P = 0.06). The nasolabial angle increased 9.36° ± 6.04° from T1 to T2 (P <0.001) but then decreased 1.55° ± 1.54° from T2 to T3. CONCLUSIONS: MCPPs are a viable treatment option for maxillary total arch distalization with minimal changes in treatment effects 3 years posttreatment.


Assuntos
Má Oclusão de Angle Classe II , Técnicas de Movimentação Dentária , Cefalometria , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe II/terapia , Maxila , Dente Molar , Desenho de Aparelho Ortodôntico , Adulto Jovem
9.
Rev. Ateneo Argent. Odontol ; 61(2): 13-25, nov. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1095251

RESUMO

Los desórdenes respiratorios del sueño (DRS) y, principalmente, roncopatías y apneas obstructivas afectan aproximadamente al 7% de los pacientes ortodóncicos. Los DRS no solo son importantes por la cantidad de pacientes afectados, sino por la gravedad de los posibles efectos secundarios a nivel de la salud general del paciente. La obstrucción de las vías aéreas superiores (VAS) provoca alteraciones del crecimiento y deformaciones craneofaciales importantes, por lo que el tratamiento temprano y la prevención de la respiración oral es muy importante.El papel del ortodoncista es muy importante en el diagnóstico y en el tratamiento de los DRS, pero también en su prevención, realizando tratamientos que aumenten la dimensión y la permeabilidad de las VAS. El protocolo de exploración interdisciplinar en niños y adolescentes y la cefalometría de vías aéreas son importantes en el diagnóstico y deben ser tenidos en cuenta en el plan de tratamiento. Pero las pruebas más significativas, el CBCT de vías aéreas y la polisomnografía no son pruebas rutinarias por la dificultad logística y el precio de estas pruebas. En este artículo también se recomiendan los tratamientos de ortodoncia más indicados en estos casos y que tienden al aumento de la dimensión de las VAS (AU)


Sleep breathing disorders (SBD) and in the first place, roncopathy and obstructive apnea, affect approximately 7% of orthodontic patients. The SBD are not only important for the number of affected patients, but also for the severity of the possible side effects at the level of general health of a patient. The upper air ways (UAW) obstruction provokes important alterations in growth and craniofacial deformations, and this is why the early treatment and prevention of mouth breathing are very important. The role of an orthodontist in diagnosis and treatment of SBD is very important, but it is also in its prevention, carrying out the treatments which increase the dimension and permeability of UAW. The protocol of interdisciplinary examination.In children and adolescents and the air ways cephalometry analysis have an important role in diagnosis and they should be taken into account in treatment planning. But the most important tests, the air ways CBCT and polysomnography, are not routine tests due to the complicated logistics and their cost. In this article, the orthodontic treatments most indicated in these cases are recommended, because they tend to increase the UAW dimension (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Ortodontia Preventiva , Síndromes da Apneia do Sono/prevenção & controle , Síndromes da Apneia do Sono/terapia , Síndromes da Apneia do Sono/diagnóstico por imagem , Ronco/terapia , Transtornos Intrínsecos do Sono , Dentição Mista , Planejamento de Assistência ao Paciente , Polissonografia , Obstrução das Vias Respiratórias/prevenção & controle , Aparelhos de Tração Extrabucal , Tomografia Computadorizada de Feixe Cônico Espiral , Má Oclusão de Angle Classe II/terapia
10.
Rev. Ateneo Argent. Odontol ; 61(2): 26-35, nov. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1095288

RESUMO

¿Qué es la estética? Es más que un concepto frívolo. Tiene que ver con la armonía facial, la autoestima, la autoimagen, la percepción de belleza. Es un concepto que involucra al individuo en su totalidad, en su ser, que va más allá de frivolidad estética. Muchos pacientes que vienen a la consulta no expresan inicialmente su real demanda. Expresan problemas funcionales, pero su real preocupación, en la mayor parte de los casos, es estética. Pueden manifestar que no pueden comer bien, masticar un alimento o que no respiran bien o sesean, pero su motivación principal es estética y tiene que ver con su propia autoestima. Las funciones de respiración, deglución, fonación, masticación, oclusión deben estar entre los objetivos a conservarse o restituirse por parte del especialista, pero el tratamiento sería un fracaso si no atendemos la demanda, a veces no bien explicitada, por el paciente y que responde a su profunda necesidad real. Para la OMS, la salud puede definirse como el estado completo de bienestar físico, mental y social. Nuestro objetivo, como agentes de salud, será poder satisfacer la demanda explícita o encubierta con la mayor estética y la mayor funcionalidad (AU)


What is aesthetics? It is more than a frivolous concept. It has to do with facial harmony, self-esteem, self-image, the perception of beauty. It is a concept, which involves the individual as a whole, in his being, which goes beyond aesthetic frivolity. Many patients who come to the office do not initially express their real demand. They express functional problems, but their real concern, in most cases, is aesthetic. They may state that they cannot eat well, chew a food or that they do not breathe well or sedate, but their main motivation is aesthetic and has to do with their own self-esteem. The functions of breathing, swallowing, phonation, chewing, occlusion should be among the objectives to be retained or restored by the specialist, but the treatment would be a failure if we do not meet the demand sometimes not well explained by the patient and responding to their Deep real need. For WHO, health can be defined as the complete state of physical, mental and social well-being. Our goal, as health agents, will be to be able to meet the explicit or covert demand with the greatest aesthetics and functionality (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Assistência Odontológica Integral , Estética Dentária , Cirurgia Ortognática , Ortodontia Corretiva , Equipe de Assistência ao Paciente , Autoimagem , Beleza , Cefalometria , Nível de Saúde , Dentição Mista , Assimetria Facial/terapia , Má Oclusão de Angle Classe II/terapia
11.
Am J Orthod Dentofacial Orthop ; 156(4): 545-554, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582126

RESUMO

This case report describes the combined use of a myofunctional Trainer for Braces and fixed appliances to treat a 10-year-old girl with a Class II Division 1 malocclusion that featured severe maxillary incisor protrusion, a large overjet, and a V-shaped maxillary arch. She had a convex profile with an underdeveloped mandible. The superiority of myofunctional training in the case was to eliminate mouth breathing and lip sucking habits, train the oral musculature, stimulate mandibular growth, and make braces work more efficiently. The posttreatment facial photographs show improvement in the facial profile. Proper occlusion and facial balance were created, which were quite stable as demonstrated by the patient's 4-year follow-up records.


Assuntos
Má Oclusão de Angle Classe II/terapia , Terapia Miofuncional/métodos , Aparelhos Ortodônticos Fixos , Cefalometria , Criança , Terapia Combinada , Técnica de Fundição Odontológica , Estética Dentária , Feminino , Humanos , Fotografação
12.
Am J Orthod Dentofacial Orthop ; 156(4): 555-565, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582127

RESUMO

A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.


Assuntos
Reabsorção Óssea/complicações , Reabsorção Óssea/terapia , Má Oclusão de Angle Classe II/terapia , Côndilo Mandibular/patologia , Doenças Mandibulares/patologia , Doenças Mandibulares/terapia , Mordida Aberta/etiologia , Mordida Aberta/terapia , Ortodontia Corretiva/métodos , Transtornos da Articulação Temporomandibular/terapia , Reabsorção Óssea/diagnóstico por imagem , Cefalometria , Criança , Terapia Combinada , Estética Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Mordida Aberta/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Resultado do Tratamento
13.
Am J Orthod Dentofacial Orthop ; 156(3): 375-382, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474267

RESUMO

INTRODUCTION: The aim of this work was to compare the skeletal and dental outcomes of 1- versus 2-phase treatment in Class II subjects with difficult-to-treat high-angle severe Class II malocclusions. METHODS: The sample of 120 cases was collected from the private offices of 3 experienced clinicians. The following selection criteria were used: (1) ANB ≥6°, (2) SN-GoGn ≥37° or mandibular plane to Frankfort horizontal plane ≥30°; and (3) overjet ≥6 mm. Patients were classified into either the early or the late treatment group according to dental age (early Tx: ≥5 primary teeth; late Tx: otherwise). Thirty-four angular, linear, and proportional measurements were determined for each patient. Statistical significance was assessed with the use of a 2-tailed t test, analysis of covariance test, and chi-square test. RESULTS: The results showed that early 2-phase treatment for severe Class II high-angle patients offered no skeletal anteroposterior advantages over late 1-phase treatment. Severe high-angle Class II patients also showed similar dental anteroposterior outcomes with the use of both approaches. Vertically there was a higher frequency of increased mandibular plane angles and extrusion of upper incisors and lower molars in the late treatment group. CONCLUSIONS: Early 2-phase treatment for severe Class II high-angle patients offered no skeletal or dental advantage over late 1-phase treatment.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva/métodos , Adolescente , Cefalometria/métodos , Criança , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Maxila , Dente Molar , Sobremordida/terapia , Fatores de Tempo , Resultado do Tratamento
14.
Am J Orthod Dentofacial Orthop ; 156(3): 383-390, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474268

RESUMO

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


Assuntos
Estatura , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva , Adolescente , Determinação da Idade pelo Esqueleto , Desenvolvimento Ósseo , Criança , Feminino , Gráficos de Crescimento , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Humanos , Estudos Longitudinais , Masculino , Radiografia , República da Coreia , Estudos Retrospectivos , Fatores Sexuais , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento
15.
PLoS One ; 14(9): e0221624, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490945

RESUMO

OBJECTIVE: To assess the cephalometric skeletal and soft-tissue of functional appliances in treated versus untreated Class II subjects in the long-term (primarily at the end of growth, secondarily at least 3 years after retention). SEARCH METHODS: Unrestricted electronic search of 24 databases and additional manual searches up to March 2018. SELECTION CRITERIA: Randomised and non-randomised controlled trials reporting on cephalometric skeletal and soft-tissue measurements of Class II patients (aged 16 years or under) treated with functional appliances, worn alone or in combination with multi-bracket therapy, compared to untreated Class II subjects. DATA COLLECTION AND ANALYSIS: Mean differences (MDs) and 95% confidence intervals (95% CIs) were calculated with the random-effects model. Data were analysed at 2 primary time points (above 18 years of age, at the end of growth according to the Cervical Vertebral Maturation method) and a secondary time point (at least 3 years after retention). The risk of bias and quality of evidence were assessed according to the ROBINS tool and GRADE system, respectively. RESULTS: Eight non-randomised studies published in 12 papers were included. Functional appliances produced a significant improvement of the maxillo-mandibular relationship, at almost all time points (Wits appraisal at the end of growth, MD -3.52 mm, 95% CI -5.11 to -1.93, P < 0.0001). The greatest increase in mandibular length was recorded in patients aged 18 years and above (Co-Gn, MD 3.20 mm, 95% CI 1.32 to 5.08, P = 0.0009), although the improvement of the mandibular projection was negligible or not significant. The quality of evidence was 'very low' for most of the outcomes at both primary time points. CONCLUSIONS: Functional appliances may be effective in correcting skeletal Class II malocclusion in the long-term, however the quality of the evidence was very low and the clinical significance was limited. SYSTEMATIC REVIEW REGISTRATION: CRD42018092139.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia/instrumentação , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
16.
Am J Orthod Dentofacial Orthop ; 156(2): 266-274, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375237

RESUMO

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.


Assuntos
Aumento do Rebordo Alveolar/métodos , Má Oclusão/terapia , Técnica de Expansão Palatina , Técnicas de Movimentação Dentária/métodos , Cefalometria , Modelos Dentários , Oclusão Dentária , Seguimentos , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/patologia , Má Oclusão/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe II/cirurgia , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/patologia , Má Oclusão de Angle Classe III/cirurgia , Má Oclusão de Angle Classe III/terapia , Maxila/anormalidades , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Palato/cirurgia , Planejamento de Assistência ao Paciente , Estudos Prospectivos , Resultado do Tratamento
17.
Dent Med Probl ; 56(2): 191-196, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31274257

RESUMO

Class II malocclusion may be caused by the maxillary protrusion or the mandibular retrusion. One treatment method is to use a headgear, which might affect the dimensions of the patient's airway. The aim of this study was to assess the effect of a headgear on the airway dimensions in class II malocclusion patients. A digital search and a manual search were conducted for English-language articles published from January 2000 to December 2018 about human clinical trials, including the usage of a cervical headgear in class II malocclusion patients who had measurable changes in the airway and/or jaw size. The synthesis methods of the study consisted of data concerning the study design, the type of treatment device, the patient's age at the start, the sample size, the treatment duration, the type of radiography, and the results of treatment; this data was extracted and compared. The quality of the selected articles was assessed. All of the studies had a high risk of bias, providing low-quality evidence of the effectiveness of the headgear therapy on the airway dimensions. The conclusions of the articles differed from each other and there were different mechanisms of changes in the jaw or airway dimensions. Therefore, further studies are required to find the clearest results showing the effect of a cervical headgear in class II malocclusion.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe II , Traqueia , Cefalometria , Humanos , Má Oclusão de Angle Classe II/terapia , Maxila , Radiografia , Traqueia/anatomia & histologia , Traqueia/diagnóstico por imagem
18.
Am J Orthod Dentofacial Orthop ; 156(1): 113-124, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256824

RESUMO

Scissor bite often remains unnoticed by patients although it can adversely affect facial symmetry, jaw growth, and mastication. This case report illustrates the efficacy of temporary skeletal anchorage devices (TSADs) and a modified lingual arch in correcting severe scissor bite. A 28-year-old woman presented with severe scissor bite in the mandibular right posterior segment. To treat this condition, TSADs were used for maxillary posterior intrusion and a modified lingual arch for buccally uprighting mandibular posterior teeth. Long-term retention records demonstrate stable treatment results.


Assuntos
Oclusão Dentária , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe I/terapia , Ortodontia Corretiva/métodos , Adulto , Cefalometria/métodos , Modelos Dentários , Feminino , Humanos , Má Oclusão de Angle Classe I/diagnóstico por imagem , Má Oclusão de Angle Classe I/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Fios Ortodônticos , Ortodontia Corretiva/instrumentação , Técnica de Expansão Palatina , Planejamento de Assistência ao Paciente , Fatores de Tempo , Resultado do Tratamento
19.
Am J Orthod Dentofacial Orthop ; 156(1): 137-147, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256827

RESUMO

A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva/métodos , Sobremordida/terapia , Piezocirurgia/efeitos adversos , Adolescente , Dente Pré-Molar/cirurgia , Parafusos Ósseos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/patologia , Incisivo/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Sobremordida/diagnóstico por imagem , Sobremordida/cirurgia , Radiografia Panorâmica , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária/métodos , Resultado do Tratamento , Dimensão Vertical
20.
Am J Orthod Dentofacial Orthop ; 156(1): 148-156, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256828

RESUMO

This article reports on the technical aspects of using a computer-aided design-computer-aided manufacturing (CAD-CAM) insertion guide for the placement of orthodontic mini-implants used for the purpose of providing anchorage support for maxillary molar distalization. A 10-year-old girl presented with a bilateral full-step Angle Class II molar relationship in the permanent dentition, with anterior arch-length insufficiency and blocked out maxillary canine teeth. The primary treatment objective was to provide an esthetic and functional occlusal outcome, and secondarily to avoid the removal of multiple premolar teeth. The patient was initially treated with an implant-supported distalization device, and the occlusion was subsequently detailed with preadjusted fixed orthodontic appliances. The CAD-CAM procedure facilitates the safe and precise insertion of mini-implants in the anterior palate, potentially broadening the scope of use of palatal mini-implants for less experienced clinicians. The illustrated protocol allows for the insertion of mini-implants and fitting of a prefabricated appliance in a single office appointment.


Assuntos
Parafusos Ósseos , Desenho Assistido por Computador , Implantes Dentários , Má Oclusão de Angle Classe II/terapia , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico/métodos , Técnicas de Movimentação Dentária/métodos , Dente Pré-Molar , Cefalometria/métodos , Criança , Dente Canino , Modelos Dentários , Dentição Permanente , Estética Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico/instrumentação , Aparelhos Ortodônticos Fixos , Fios Ortodônticos , Palato/diagnóstico por imagem , Palato/cirurgia , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
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