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1.
J Clin Pediatr Dent ; 45(2): 140-145, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33951166

RESUMO

AIM: To compare maxillary development of individuals with unilateral cleft lip and palate (CLP) to individuals with skeletal Class I and Class III malocclusions. STUDY DESIGN: Cephalometric X-ray films from 90 patients (mean age: 13 ± 2.3 years) were used. The number of samples was determined by Power analysis and three groups consisting of 30 patients (Group 1: Skeletal Class I, Group 2: Skeletal Class III, Group 3: CLP) were formed. A total of 13 cephalometric measurements were performed using Dolphin imaging software 11.7. The Kruskal-Wallis and ANOVA tests were used to calculate the differences. The Dunn test and Bonferroni correction were used in paired group comparisons. RESULTS: SNA, Co-A, A-PTV Horizontal, Na-APog, A-Na-Pog, FH-NA, Sn'-Mx1, MxOP-TVL (p<0.001***), U6-PTV Vertical (p<0.01**), and NaBa PTV-Gn (p<0.05*) values were significantly different between the three groups. There was no significant difference in Na-ANS, FH-NPog, or Mx1 labial-ULA. SNA, Co-A, A-PTV Horizontal, Na-APog, and A-Na-Pog values between the 1st and 2nd groups and between the 1st and 3rd groups (p<0.001***) were significantly different. FH-Na-A, Sn'-Mx1, MxOP-TVL (p<0.001***), and U6-PTV vertical were different between groups 1 and 3 (p<0.01**), while FH-Na-A (p<0.001***), Sn'-Mx1, MxOP-TVL (p<0.01**), A-PTV Horizontal, and A-Na-Pog (p<0.05*) were significantly different between groups 2 and 3. CONCLUSION: Maxillary development in CLP differs from skeletal Class I but is similar to skeletal Class III. Considering the delay in maxillary development in the CLP patient, maxillary protraction and maxillary expansion are important treatment protocols in the early period.


Assuntos
Fenda Labial , Fissura Palatina , Má Oclusão de Angle Classe III , Cefalometria , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Maxila/diagnóstico por imagem
2.
Head Face Med ; 17(1): 13, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33853633

RESUMO

BACKGROUND: Orthognathic surgery can be carried out using isolated mandibular or maxillary movement and bimaxillary procedures. In cases of moderate skeletal malocclusion, camouflage treatment by premolar extraction is another treatment option. All these surgical procedures can have a different impact on the soft tissue profile. METHODS: The changes in the soft tissue profile of 187 patients (Class II: 53, Class III: 134) were investigated. The treatment approaches were differentiated as follows: Class II: mandible advancement (MnA), bimaxillary surgery (MxS/MnA), upper extraction (UpEX), or Class III: maxillary advancement (MxA), mandible setback (MnS), bimaxillary surgery (MxA/MnS), and lower extraction (LowEX) as well as the extent of skeletal deviation (moderate Wits appraisal: - 7 mm to 7 mm, pronounced: Wits <- 7 mm, > 7 mm, respectively). This resulted in five groups for Class II treatment and seven groups for Class III treatment. RESULTS: In the Class II patients, a statistically significant difference (p ≤ 0.05) between UpEX and moderate MnA was found for facial profile (N'-Prn-Pog'), soft tissue profile (N'-Sn-Pog'), and mentolabial angle (Pog'-B'-Li). In the Class III patients, a statistically significant differences (p ≤ 0.05) occurred between LowEX and moderate MxA for facial profile (N'-Prn-Pog'), soft tissue profile (N'-Sn-Pog'), upper and lower lip distacne to esthetic line (Ls/Li-E-line), and lower lip length (Sto-Gn'). Only isolated significant differences (p < 0.05) were recognized between the moderate surgical Class II and III treatments as well between the pronounced Class III surgeries. No statistical differences were noticed between moderate and pronounced orthognathic surgery. CONCLUSIONS: When surgery is required, the influence of orthognathic surgical techniques on the profile seems to be less significant. However, it must be carefully considered if orthognathic or camouflage treatment should be done in moderate malocclusions as a moderate mandibular advancement in Class II therapy will straighten the soft tissue profile much more by increasing the facial and soft tissue profile angle and reducing the mentolabial angle than camouflage treatment. In contrast, moderate maxillary advancement in Class III therapy led to a significantly more convex facial and soft tissue profile by decreasing distances of the lips to the E-Line as well as the lower lip length.


Assuntos
Má Oclusão de Angle Classe III , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Estética Dentária , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Mandíbula , Resultado do Tratamento
3.
BMC Oral Health ; 21(1): 130, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33736627

RESUMO

BACKGROUND: Posteroanterior and lateral cephalogram have been widely used for evaluating the necessity of orthognathic surgery. The purpose of this study was to develop a deep learning network to automatically predict the need for orthodontic surgery using cephalogram. METHODS: The cephalograms of 840 patients (Class ll: 244, Class lll: 447, Facial asymmetry: 149) complaining about dentofacial dysmorphosis and/or a malocclusion were included. Patients who did not require orthognathic surgery were classified as Group I (622 patients-Class ll: 221, Class lll: 312, Facial asymmetry: 89). Group II (218 patients-Class ll: 23, Class lll: 135, Facial asymmetry: 60) was set for cases requiring surgery. A dataset was extracted using random sampling and was composed of training, validation, and test sets. The ratio of the sets was 4:1:5. PyTorch was used as the framework for the experiment. RESULTS: Subsequently, 394 out of a total of 413 test data were properly classified. The accuracy, sensitivity, and specificity were 0.954, 0.844, and 0.993, respectively. CONCLUSION: It was found that a convolutional neural network can determine the need for orthognathic surgery with relative accuracy when using cephalogram.


Assuntos
Aprendizado Profundo , Má Oclusão de Angle Classe III , Má Oclusão , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , República da Coreia
4.
BMC Oral Health ; 21(1): 144, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752663

RESUMO

BACKGROUND: Maxillary skeletal expanders (MSE) is effective for the treatment of maxillary transverse deformity. The purpose of the study was to analyse the palatal bone thickness in the of MSE implantation in patients with skeletal class III malocclusion. METHODS: A total of 80 adult patients (40 males, 40 females) with an average angle before treatment were divided into two groups, the skeletal class III malocclusion group and the skeletal I malocclusion group, based on sagittal facial type. Each group consisted of 40 patients, with a male to female ratio of 1:1. A cone-beam computed tomography scanner was employed to obtain DICOM data for all patients. The palatal bone thickness was measured at 45 sites with MIMICS 21.0 software, and SPSS 22.0 software was employed for statistical analysis. The bone thickness at different regions of the palate in the same group was analysed with one-way repeated measures ANOVA. Fisher's least significant difference-t method was used for the comparison of pairs, and independent sample t test was employed to determine the significance of differences in the bone thickness at the same sites between the two groups. RESULTS: Palatal bone thickness was greater in the middle region of the midline area (P < 0.01), while the thickness in the middle and lateral areas in both groups was generally lower (P < 0.001). The bone in the anterior, middle, and posterior regions of the two groups became increasingly thin from the middle area toward the parapalatine region. The palatal bone was significantly thinner in the area 9.0 mm before the transverse palatine suture in the midline area, 9.0 mm before and after the transverse palatine suture in the middle area, and 9.0 mm after the transverse palatine suture in the lateral area. CONCLUSION: The palatal bone was thinner in patients with class III malocclusion than in patients with class I malocclusion, with significant differences in some areas. The differences in bone thickness should be considered when MSE miniscrews are implanted. The anterior and middle palatal areas are safer for the implantation of miniscrews, while the thinness of the posterior palatal bone increases the risk of the miniscrews falling off and perforating.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Maxila/diagnóstico por imagem , Palato/diagnóstico por imagem
5.
Am J Orthod Dentofacial Orthop ; 159(5): e423-e437, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33653638

RESUMO

INTRODUCTION: The objective of this research was to evaluate the correlation between 3-dimensional (3D) lip vermilion (LV) morphology and skeletal patterns as well as incisor measurements in young Chinese adults. METHODS: In all, 240 young adults were enrolled; these included 80 patients each with skeletal Class I, Class II, and Class III malocclusions, respectively. Each sagittal skeletal pattern included 40 male and 40 female subjects. Twenty-two 3D LV measurements were obtained from 3D facial scans. Skeletal and incisor measurements were evaluated on lateral cephalograms. Correlation and regression analysis were performed between soft and hard tissue measurements. RESULTS: Six of 22 LV measurements showed significant differences between male and female subjects. The 3D LV morphology showed significant differences with respect to different skeletal patterns and sex. Adults with skeletal Class III malocclusion tended to have thinner upper vermilion and fuller lower vermilion than subjects with skeletal Class II and III malocclusion. The mandibular plane angle negatively correlated with the upper-lower vermilion midsagittal curve length and surface area ratio in adults with skeletal Class I and II malocclusion, yet the vertical facial skeletal type showed no correlation in adults with skeletal Class III malocclusion. The vermilion angle, central bow angle, vermilion height, vermilion midsagittal curve length, vermilion height and width ratio, and vermilion surface area showed a significant correlation with incisor measurements. Regression analysis found that the ANB angle was an important factor affecting the upper and lower vermilion midsagittal curve length and surface area ratio. Further, the vermilion height and height and width ratio were closely correlated with the interincisal (U1/L1) angle, whereas the central bow angle was closely correlated with the maxillary incisor torque. CONCLUSIONS: Most LV morphology variables were correlated to skeletal patterns and incisor measurements. Skeletal Class III malocclusion showed significant differences in vermilion morphology. Both the sagittal and vertical skeletal pattern have effects on vermilion proportion. The incisor torque was closely correlated to vermilion shape and central bow angle and might influence the vermilion esthetics. However, the proportion of the upper and lower vermilion was mainly affected by the ANB angle.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Cefalometria , China , Estética Dentária , Feminino , Humanos , Lábio/diagnóstico por imagem , Masculino , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe III/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Adulto Jovem
6.
Am J Orthod Dentofacial Orthop ; 159(5): 564-573, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33674159

RESUMO

INTRODUCTION: The objective of this research was to compare maxillary width and hard palate thickness in men and women with different vertical and sagittal skeletal patterns. METHODS: A total of 241 adults (93 men and 148 women aged from 18 to 25 years) were divided into male and female groups. Subjects were then separately divided into 3 sagittal skeletal groups and 3 vertical skeletal groups. A lateral cephalogram and a cone-beam computed tomography were taken for each subject. We measured the parameters to make statistical analyses and compared them between the different groups. RESULTS: Women had smaller craniomaxillofacial bone width and palatal thickness than men. In sagittal groups, maxillary width, maxillary alveolar width, and external temporomandibular joint fossa width in Class II and Class III malocclusion groups were smaller than in the Class I group for both women and men. The internal temporomandibular joint fossa width was the same results in men and women. In vertical groups, palate thickness, maxillary width, and maxillary alveolar width of the high-angle group were smaller than those of the low-angle group, regardless of sex. CONCLUSIONS: To an extent, maxillary width is correlated with vertical and sagittal skeletal patterns, and insufficient maxillary width would lead to unfavorable skeletal patterns. Differences exist in the morphology of craniomaxillofacial bone between men and women. Therefore, these findings can provide clinicians with references for differential diagnosis and treatment plans.


Assuntos
Má Oclusão de Angle Classe III , Palato Duro , Adolescente , Adulto , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/diagnóstico por imagem , Maxila/diagnóstico por imagem , Palato Duro/diagnóstico por imagem , Articulação Temporomandibular , Adulto Jovem
7.
Am J Orthod Dentofacial Orthop ; 159(4): e377-e388, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33583695

RESUMO

INTRODUCTION: The purpose of this cross-sectional retrospective study was to evaluate the patterns of pharyngeal airway volume change determined by cervical vertebral maturation (CVM) stage and compare it with that which was characterized by chronological age. Correlations between hyoid bone positions and airway volumes were also examined. METHODS: CVM staging was determined from cone-beam computed tomography scans of 420 white patients aged 9-15 years. Patients were stratified on the basis of sex and skeletal pattern to establish pharyngeal airway volume clusters for each CVM stage. The horizontal and vertical positions of hyoid bones were measured using Hyoidius and Sella. RESULTS: Males had larger pharyngeal airway volumes compared with females. In males, the largest increases in pharyngeal airway volumes occurred at an earlier CVM stage than females. No statistically significant differences in pharyngeal airway volumes were noted in subjects with skeletal Class I, II, and III malocclusion. The hyoid bone in males was more anteriorly and inferiorly positioned compared with females. The Class III group had a further forward position of the hyoid bone than the Class I and II groups. CONCLUSIONS: The patterns of pharyngeal airway change obtained using CVM staging did not correlate well with traditional maturational models for skeletal growth. It implies that chronologic age could be a relatively reliable indicator for the assessment of pharyngeal airway volumes in adolescents, as outlined in part 1 of the present study. Subjects with anteriorly and superiorly positioned hyoid bones exhibited smaller pharyngeal airway volumes, which highlights the role of soft tissue and its influence on airway patency.


Assuntos
Osso Hioide , Má Oclusão de Angle Classe III , Adolescente , Cefalometria , Criança , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Feminino , Humanos , Osso Hioide/diagnóstico por imagem , Masculino , Mandíbula , Faringe/diagnóstico por imagem , Estudos Retrospectivos
8.
J Oral Maxillofac Surg ; 79(5): 1107-1121, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33549539

RESUMO

PURPOSE: The relationship between pharyngeal airway morphology and jawbone movements in skeletal Class III patients with mandibular asymmetry after orthognathic surgery remains unclear. This study was to measure the changes in pharyngeal airway morphology in skeletal Class III patients with mandibular asymmetry after bimaxillary surgery and evaluate associations between changes in pharyngeal airway morphology and skeletal movements. METHODS: In this retrospective cohort study, skeletal Class III patients who underwent bimaxillary surgery were enrolled. The predictor variable was facial symmetry status divided into 2 groups, asymmetric (Group A) and symmetric (Group B). The primary outcome variables were changes in airway parameters, including cross-sectional linear distances, cross-sectional area (CSA), minimum CSA (Min-CSA), and volume; and airway asymmetry index between the preoperative and 6-month postoperative imaging studies. Correlation analysis was performed between upper airway and skeletal changes. RESULTS: Twenty-five patients were included in this study, with 15 patients in Group A (mean age: 23.00 years; BMI: 22.83) and 10 patients in Group B (mean age: 22.30 years; BMI: 22.48). Group A showed a higher asymmetry index than Group B at T0; however, no significant differences compared to Group B at T1. The airway volume was significantly decreased in the oropharynx in Group A at T1, whereas it showed no significant differences in Group B (P < .05). Lateral movement of B point and Menton showed positive correlations with changes in Min-CSA in the oropharynx and negative correlations with changes in airway asymmetry index (P < .05). CONCLUSIONS: Pharyngeal airway exhibited an asymmetrical and constricted morphology in Group A before surgery. The airway morphology in Group A showed a tendency to adopt a symmetrical and less constricted shape after surgery. The airway space was reduced in the oropharynx in Group A after surgery. Surgical correction of mandibular asymmetry correlated with the improvement of pharyngeal airway morphology.


Assuntos
Má Oclusão de Angle Classe III , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Faringe/diagnóstico por imagem , Estudos Retrospectivos , Adulto Jovem
9.
Clin Oral Investig ; 25(4): 1587-1612, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33550467

RESUMO

OBJECTIVES: The present systematic review aims to report and critically assess the findings of the available scientific evidence from genetic association studies examining the genetic variants underlying skeletal class III malocclusion and its sub-phenotypes. MATERIAL AND METHODS: A pre-piloted protocol was registered and followed. The PubMed, Scopus, WOS, Cochrane Library, Gray Open literature, and CADTH databases were explored for genetic association studies following PICOS-based selection criteria. The research was reported in accordance with PRISMA statement and HuGE guidelines. The Q-genie tool was applied to assess the quality of genetic studies. Meta-analysis of genetic association studies was done by means of Meta-Genyo tool. RESULTS: A total of 8258 articles were retrieved, of which 22 were selected for in-depth analysis. Most of the studies did not differentiate between sub-phenotypes, and the cohorts were heterogeneous regarding ethnicity. Four to five principal components of class III malocclusion explained the phenotypic variation, and gene variants at MYO1H(rs10850110), BMP3(rs1390319), GHR (rs2973015,rs6184, rs2973015), FGF7(rs372127537), FGF10(rs593307), and SNAI3(rs4287555) (p < .05) explained most of the variation across the studies, associated to vertical, horizontal, or combined skeletal discrepancies. Meta-analysis results identified a statistically significant association between risk of class III malocclusion of A allele of the FBN3 rs7351083 [OR 2.13; 95% CI 1.1-4.1; p 0.02; recessive model]. CONCLUSION: Skeletal class III is a polygenic trait substantially modulated by ethnicity. A multicentric approach should be considered in future studies to increase sample sizes, applying multivariate analysis such as PCA and cluster analysis to characterize existing sub-phenotypes warranting a deeper analysis of genetic variants contributing to skeletal class III craniofacial disharmony. CLINICAL RELEVANCE: Grasping the underlying mechanisms of this pathology is critical for a fuller understanding of its etiology, allowing generation of preventive strategies, new individualized therapeutic approaches and more accurate treatment planification strategies.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Alelos , Cefalometria , Grupos Étnicos , Estudos de Associação Genética , Humanos , Má Oclusão de Angle Classe III/genética , Fenótipo
10.
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 de Angle Classe III , Má Oclusão , Prognatismo , Adulto , Feminino , Seguimentos , Humanos , Má Oclusão de Angle Classe III/cirurgia , Mandíbula , Prognatismo/cirurgia
11.
Am J Orthod Dentofacial Orthop ; 159(4): 522-535, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33485716

RESUMO

Class III malocclusion presents some complexity in terms of diagnosis and treatment and affects not only the jaws but the whole craniofacial complex. Besides, functional forward displacement of the mandible may be diagnosed in a patient presenting Class III malocclusion, as the 2 entities are not incompatible or mutually exclusive. This case report describes the multidisciplinary, nonsurgical, orthodontic treatment of an adult patient with a skeletal Class III malocclusion, anterior crossbite, and a palatally impacted canine, treated with fixed appliances and skeletal anchorage. To upright the mandibular molars, distalize the whole mandibular arch, and avoid excessive inclination of maxillary incisors to improve dentofacial esthetics, miniscrews were placed in the retromolar area. The treatment results were very satisfactory and remained stable after a reasonable retention period.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Procedimentos de Ancoragem Ortodôntica , Adulto , Cefalometria , Estética Dentária , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Técnicas de Movimentação Dentária
12.
Am J Orthod Dentofacial Orthop ; 159(2): 175-183.e3, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33390311

RESUMO

INTRODUCTION: The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS: The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS: The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS: The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.


Assuntos
Má Oclusão de Angle Classe III , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Incisivo/diagnóstico por imagem , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Reprodutibilidade dos Testes
13.
J Craniomaxillofac Surg ; 49(2): 146-153, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33423893

RESUMO

The aim of this study was to evaluate volumetric changes of the posterior airway space (PAS) following bimaxillary surgery using a high oblique sagittal split osteotomy (HSSO) of the mandibular ramus. The cone beam CTs of Class II and Class III patients taken before (T0) and 6-12 months after surgery (T1) were analyzed using 3D software (Mimics® Innovation Suite 18.0). The PAS was divided into three segments (superior, middle, inferior) by three planes parallel to the Frankfurt horizontal plane intersecting at the posterior nasal spine, the velum palatinum and the epiglottis. Total (TPAS) and partial volumes (SPAS = superior, MPAS = middle, IPAS = inferior) were calculated. For the 25 Class II patients, a highly significant increase (p<0.001) of the total, middle and inferior airway space (TPAS: +33.6%, MPAS: +43.1%, IPAS: +55.9%) was found, while the increase of the upper airway space was statistically not significant (+5.4%, p = 0.074). For the 28 Class III patients, the total, middle and inferior airway space increased statistically insignificantly (TPAS: +4.6%, p = 0.265, MPAS: +2.7%, p = 0.387, IPAS: +2.8%, p = 0.495), while the increase of the upper airway space was statistically significant (+9.7%, p = 0.010). Bimaxillary orthognathic surgery using the HSSO technique led to a significant increase of PAS for Class II patients and could conserve the PAS for Class III patients.


Assuntos
Má Oclusão de Angle Classe III , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão de Angle Classe III/cirurgia , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Faringe/diagnóstico por imagem
14.
Am J Orthod Dentofacial Orthop ; 159(3): 281-291, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33487496

RESUMO

INTRODUCTION: The purpose of this study was to determine the esthetic preferences of people at different levels of society and also to determine whether this preference is affected by sex, age, education level, social status, geographic region, and individual profile factors. METHODS: Facial profile photographs of 1 man and 1 woman, each having a profile designated as ideal (the ideal profile), were digitized. The sagittal and vertical dimensions of these photographs were modified, and 9 variations of each profile picture were obtained using different combinations of alterations. The photographs were scored by 373 participants. For the analysis, Mann-Whitney U and Kruskal Wallis-H tests were used in the comparison of the scores. RESULTS: The ideal profile was the most preferred in both sexes, whereas the least preferred was a severe Class III malocclusion with a reduced vertical dimension of 8 mm. In general, esthetics decreased as it moved away from the ideal profile in a sagittal or vertical direction. CONCLUSIONS: Some factors from among those sampled (sex, age, education, social status, geographic region, and personal profile) affected esthetic preference, whereas others did not.


Assuntos
Estética Dentária , Má Oclusão de Angle Classe III , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Dimensão Vertical
15.
Am J Orthod Dentofacial Orthop ; 159(3): e281-e290, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33487498

RESUMO

INTRODUCTION: This study aimed to assess the static posture in patients with Angle Class II and III malocclusions in the first 2 months after orthognathic surgery. METHODS: This was a longitudinal observational study. Eligible participants were adult patients who had an indication of orthognathic surgery (bilateral sagittal split osteotomy of the maxilla and/or mandible, can be associated or not with genioplasty). Thirty-five patients were evaluated from the orthognathic surgery group (OSG) and control group (CG). Measurements in OSG were performed at 3 time points: preoperative orthognathic surgery (P0), first postoperative month (P1), and second postoperative month (P2). Static posture was evaluated using the PostureScreen Mobile (PostureCo Inc, Trinity, Fla) application in 4 views. RESULTS: Patients with Angle Class II malocclusion in the OSG evidenced a tendency to a left hip translation at P1 with a significant difference at P2 in the anterior view (P = 0.052). In the right lateral view, patients with Angle Class II malocclusion in the OSG at P1 presented an accentuated anterior shoulder translation when compared with CG (P <0.001). At P1, patients with Angle Class II malocclusion in the OSG showed a significant anterior knee translation compared with the CG and OSG at P0 and P2 (P <0.001 for all). Patients in the OSG with Angle Class III malocclusion presented an average posterior head translation in the right lateral view at P1 when compared with those in the CG and OSG at P0, who presented an anterior translation (P = 0.0008). CONCLUSIONS: These findings suggest a realignment of static posture in the first 2 months after orthognathic surgery.


Assuntos
Má Oclusão de Angle Classe III , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria , Seguimentos , Humanos , Má Oclusão de Angle Classe III/cirurgia , Mandíbula , Maxila , Osteotomia de Le Fort , Postura
16.
Am J Orthod Dentofacial Orthop ; 159(3): 321-332, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33487499

RESUMO

INTRODUCTION: This study aimed to investigate the relative efficacy of maxillary protraction combined with a modified alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocol compared with conventional protocols in the early orthopedic treatment of skeletal Class III malocclusion. METHODS: A sample of 39 patients was divided into 3 groups on the basis of different interventions. Conventional facemask (FM) with splint-type intraoral devices was performed in the FM group (7 males and 5 females; mean age, 9.53 ± 1.37 years). Maxillary expansion with an activation rate of 0.5 mm/d (twice a day) followed by FM therapy was applied in the rapid maxillary expansion group (RME/FM) (6 males and 6 females; mean age, 9.31 ± 1.60 years). In the Alt-RAMEC/FM group (7 males and 8 females; mean age, 10.01 ± 1.31 years), Alt-RAMEC was started simultaneously and throughout the entire course of maxillary protraction, with repetitive alternations between activation and deactivation of expanders (0.5 mm/d for 7 days). The patients in all groups were instructed to wear FMs for a minimum of 12 h/d. Pretreatment and posttreatment lateral cephalograms were all traced and measured. RESULTS: The Alt-RAMEC group showed statistically more significant maxillary advancement than other groups (A-VRP, 3.87 mm vs 3.04 mm [RME/FM], vs 2.04 mm [FM]; P <0.05). Analysis of variance did not reveal significant intergroup differences in palatal plane angulation changes (P >0.05). No pronounced mandibular clockwise rotations were noted in the Alt-RAMEC/FM group with distinct intergroup differences (P <0.05). There were more skeletal effects (88.7%) during overjet correction in the Alt-RAMEC/FM protocol. CONCLUSIONS: A combination of the modified Alt-RAMEC protocol with FM revealed more favorable skeletal effects compared with FM and RME/FM protocols in treating prepubertal patients with maxillary deficiency.


Assuntos
Má Oclusão de Angle Classe III , Técnica de Expansão Palatina , Cefalometria , Criança , Constrição , Aparelhos de Tração Extrabucal , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/terapia , Máscaras , Maxila
17.
Angle Orthod ; 91(3): 399-415, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33373430

RESUMO

Treatment of skeletal Class II patients with dual bite and idiopathic condylar resorption (ICR) is challenging for orthodontists because of the unstable position of the mandible as well as skeletal relapse attributed to improper seating of the mandibular condyles. This case report describes the successful treatment of an 18-year-old Mongolian man diagnosed with centric relation-maximum intercuspation discrepancy and ICR. After making a definitive diagnosis from verified centric relation using bilateral manipulation, orthodontic treatment was initiated followed by three-dimensional computer-aided design/computer-aided manufacturing prebent titanium plate-guided sagittal split ramus osteotomy and genioplasty. Postoperative 3D superimposition demonstrated that this surgical guide approach provided accurate repositioning of the condyles, which were well positioned in the fossae. Complete orthodontic and surgical treatment time was 24 months. The patient's facial appearance and occlusion improved significantly, and a stable result was obtained with a 1-year follow-up.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Procedimentos Cirúrgicos Ortognáticos , Adolescente , Cefalometria , Humanos , Masculino , Má Oclusão de Angle Classe II/complicações , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Osteotomia Sagital do Ramo Mandibular
18.
J Prosthodont ; 30(S1): 67-71, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33331655

RESUMO

PURPOSE: This Best Evidence Consensus Statement evaluated the existing Angle's classification clinical literature to determine if the Angle's classification as historically determined in maximum intercuspal position (MIP) with hand held casts is coincident with the centric occlusion (CO) determined Angle's classification. In addition, it explored the value of using Angle's classification for edentulous patients MATERIALS AND METHODS: The search strategy was related to the focus questions and limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Trials (RCT) and Clinical Trials. Searches were completed using the term Angle's classification and Boolean Modifiers (AND) with the key terms: dental occlusion, dental occlusion centric, centric occlusion, centric relation, maximal intercuspation, MIP, intercuspal position, and edentulous patient, retrognathia, determination, and prognathia. Additional related articles were culled from the reference lists in the articles found in the PubMed searches. RESULTS: The search identified 494 articles related to the selected terminology. Titles were reviewed and selected if related to the focus questions for further review. Seven papers could be identified that addressed the specifics of the questions. CONCLUSIONS: There is evidence that the Angle's classification for many patients will change when recorded in CO compared to the historical MIP determination/definition. A different Angle's classification recorded in CO is potentially a significant diagnostic finding for patients needing complete mouth rehabilitation. The current definitions of Angle's Classification are not useful in the management of edentulous patients.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Relação Central , Consenso , Humanos , Prostodontia
19.
Braz. dent. sci ; 24(2): 1-11, 2021. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1178387

RESUMO

The present case report describes a conservative and uncommon treatment for class III malocclusion in a woman growing patient with aged eight years and four months. An unconventional treatment modality was used for the treatment of this malocclusion, reverse-pull headgear and distalisation of lower teeth using mandibular cervical headgear in the lower arch. At the end of the treatment (after 33 months), there was correction of the transversal and sagittal occlusal relationship between maxilla and mandible and correct dental intercuspation (AU)


O presente relato de caso descreve um tratamento conservador e incomum para má oclusão de classe III em uma paciente em crescimento com idade de oito anos e quatro meses. Uma modalidade de tratamento não convencional foi utilizada que consistiu no uso de tração reversa maxilar e aparelho extra-bucal inferior para distalização. Ao final do tratamento (após 33 meses), houve correção da relação oclusal sagital e transversal entre maxila e mandíbula e correta intercuspidação dentária (AU)


Assuntos
Humanos , Feminino , Criança , Ortodontia , Mordida Aberta , Má Oclusão de Angle Classe III
20.
Eur J Paediatr Dent ; 21(4): 262-270, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33337900

RESUMO

AIM: The use of maxillary protraction appliances (MPAs) and Facemask (FM), with or without a rapid maxillary expansion (RME), have become a routine orthopaedic treatment procedure for the treatment of Class III in growing individuals; several authors have suggested that maxillary protraction could have a positive impact on airway dimensions. The purpose of this systematic review and meta-analysis was to assess the efficacy of maxillary protraction appliances (MPAs), with or without a rapid maxillary expansion (RME), on airway dimensions in children in mixed or early permanent dentition. MATERIALS AND METHODS: An electronic search was performed on PubMed, Medline, Scopus, The Cochrane Library, EMBASE and the System for Information on Grey Literature in Europe until November 30th, 2019. The Newcastle-Ottawa (NOS) scale was used to assess the studies' quality. Review Manager 5.3 (provided by the Cochrane Collaboration) was used to synthesize the effects on airway dimensions. RESULTS: After full text assessment, 8 studies were included in the qualitative and quantitative synthesis. NOS scores ranged 6 to 9 indicating high quality. The effects of two therapeutic protocols were compared, treatment with MPAs only (113 subjects treated - 65 controls) and the treatment with MPAs + RME (137 subjects treated- 87 controls). The MPAs only treatment group displayed a significantly increase in nasopharyngeal airway dimension at PNS-AD1 (random: mean difference, 1.39 mm, 95% CI, 0.32 mm, 2.47 mm, p= 0.01) and at PNS-AD2 (random: mean difference, 1.70 mm, 95% CI, 1.14 mm, 2.26 mm, p= 0.00001). No statistically significant changes were found post treatment in MPAs + RME treatment groups at PNS-AD1 (P= 0.15), PNS-AD2 (P= 0.17), McNamara's upper pharynx (MPAs + RME P= 0.05, MPAs P= 0.99) and McNamara lower pharynx (MPAs + RME P= 0.25, MPAs P= 0.40). CONCLUSION: MPAs only treatment can increase the pharyngeal thickness after treatment both at PNS-A1 and PNS-AD2. MPA+ RME had no effect on sagittal widths compared with controls, but the effect on the transverse dimension could not be assessed.


Assuntos
Má Oclusão de Angle Classe III , Técnica de Expansão Palatina , Cefalometria , Criança , Europa (Continente) , Aparelhos de Tração Extrabucal , Humanos , Maxila
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