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1.
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
2.
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
3.
Angle Orthod ; 90(5): 715-722, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378484

RESUMO

OBJECTIVES: To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). RESULTS: All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). CONCLUSIONS: Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.


Assuntos
Má Oclusão de Angle Classe III , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Mandíbula , Seio Maxilar , Faringe/diagnóstico por imagem
4.
Angle Orthod ; 90(6): 851-856, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378513

RESUMO

OBJECTIVE: To compare second molar angulation to the occlusal plane with cephalometric measurements corresponding to AP skeletal discrepancy. MATERIALS AND METHODS: 72 patients' pre-orthodontic records were analyzed. A plane was constructed along the cusps of the upper second molar and measured to a proxy for the occlusal plane. The angle between the planes was measured. ANB, Wits appraisal, U1-SN, IMPA, A-B perpendicular to Frankfort, and overjet were measured on the patients' cephalograms. Generalized additive mixed model analysis was performed to analyze the relationship between the second molar angulation and the cephalometric measurements. RESULTS: All six cephalometric measurements showed a significant relationship with the second molar angulation, with Class III patients having a larger angle than Class II and I patients. CONCLUSIONS: Class III patients have upper second molars that are significantly tipped from the occlusal plane. The second molars require special attention for correction prior to orthognathic surgery for Class III patients in order to avoid deleterious effects from the malpositioned teeth.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Cefalometria , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe III/diagnóstico por imagem , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem
5.
Angle Orthod ; 90(4): 607-618, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378502

RESUMO

When considering camouflage orthodontic treatment for Class III malocclusion with skeletal facial asymmetry, it is crucial to preserve the favorable compensated posterior occlusion. Once the inclination of the compensated occlusion is changed during orthodontic treatment, unstable occlusion, such as crossbite or scissor bite may occur. A 23-year-old female patient had anterior spacing with Class III malocclusion and a mandibular asymmetry. A nonsurgical approach was adopted. The treatment objectives were to establish a Class I molar relationship with compensated inclination of the posterior dentition and to correct the midline deviation. To achieve these goals, the computer-aided design/computer-aided manufacturing (CAD/CAM) orthodontic system plus customized brackets was applied, and miniscrews were used to distalize the left mandibular dentition for midline correction. The results suggested that the CAD/CAM-based customized brackets can be efficiently used in camouflage treatment to achieve a correct final occlusion.


Assuntos
Assimetria Facial , Má Oclusão de Angle Classe III , Adulto , Cefalometria , Desenho Assistido por Computador , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/terapia , Feminino , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Mandíbula , Adulto Jovem
6.
Angle Orthod ; 90(4): 548-555, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378504

RESUMO

OBJECTIVES: To evaluate intersegmental displacement during long-term follow-up after bilateral sagittal split osteotomy (BSSO) by mandibular body area superimposition. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 23 patients ages 18-37 years with class III malocclusion before orthognathic surgery were obtained. A three-dimensional (3D) CBCT examination was performed at four stages: surgery (T0), 6 months after surgery (T1), 1 year after surgery (T2), and long-term follow-up (6.1 ± 2.1 years, T3). The CBCT datasets were superimposed on the symphyseal area and the lower part of the distal segment of the mandible between T0 and the other time points (T1, T2, and T3). The reference points (both condyle, coronoid, and sigmoid) were estimated by the CBCT analyzed program. RESULTS: The coronoid, condylion, and sigmoid showed changes within 6 months after surgery, but there was no significant change in the intersegmental displacement between 6 months and 6 years after surgery. The distances between the left and right coronoid, condylion, and sigmoid from T0 to T3 were noted. CONCLUSIONS: The change in intersegmental displacement between T0 and T3 affecting relapse after orthognathic surgery was not significantly different. This suggests that the mandible itself may have a stable morphology during the follow-up period.


Assuntos
Má Oclusão de Angle Classe III , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Seguimentos , Humanos , Imageamento Tridimensional , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Osteotomia Sagital do Ramo Mandibular , Estudos Retrospectivos , Adulto Jovem
7.
Orthod Fr ; 91(3): 239-248, 2020 10 01.
Artigo em Francês | MEDLINE | ID: mdl-33146618

RESUMO

The aim of our study was to evaluate the effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures and to describe the correlation between the skeletal changes and the sagittal airway dimension associated with tongue, soft palate, and hyoid bone position in skeletal Class III children. A total of 40 patients with Class III malocclusions were evaluated by the use of lateral cephalograms. Pretreatment and posttreatment cephalometric radiographs were analyzed; linear and angular measurements were performed by the same orthodontist. The effect of treatment with a maxillary protraction appliance on the development of the craniofacial structures were evaluated by Student's T test and the correlation between treatment changes in craniofacial morphology and those in upper airway, tongue, soft palate, and hyoid position was evaluated by Pearson's correlation test. A significant increase in maxillary forward growth, inhibition of mandibular forward growth, and clockwise rotation of the mandible were observed. The statistical analysis revealed that maxillary growth had a significant positive effect on the superior upper airway sagittal dimension. The nasopharyngeal airway dimensions can be improved in the short term with maxillary protraction in skeletal Class III children.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe III , Cefalometria , Criança , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Mandíbula , Maxila/diagnóstico por imagem , Faringe/diagnóstico por imagem
9.
Dental Press J Orthod ; 25(4): 24-32, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965384

RESUMO

OBJECTIVE: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. METHODS: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). RESULTS: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. CONCLUSIONS: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II , Sobremordida , Cefalometria , Humanos , Mandíbula/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento
10.
J Orofac Orthop ; 81(6): 407-418, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32676721

RESUMO

PURPOSE: The aim of this retrospective study was to evaluate the skeletal, dental, and soft tissue effects of the alternating rapid maxillary expansions and constrictions (Alt-RAMEC) protocol combined with a facemask in prepubertal patients. METHODS: The study group (mean age 9.74 ± 1.46 years) consisted of 20 patients with class III malocclusion characterized by maxillary retrognathism. They were treated with a facemask for 7 months following a 9­week Alt-RAMEC protocol. Cone-beam computed tomography (CBCT) records and three-dimensional (3D) photographs taken before (T0) and after the protraction and retention period (T1) were evaluated. The study group was compared with a well-matched control group of 16 untreated patients (mean age 9.44 ± 0.79 years) with the same malocclusion. The records for the control group included cephalometric radiographs and 3D photographs. RESULTS: In the study group, significant forward movements of A point (3.49 mm), nasal (2.91 mm) and zygomatic bones were achieved. Intermolar, internasal, and interzygomatic widths increased. Soft tissue points followed the hard tissue movements, apart from b and pog. In the control group, A (0.97 mm), B (1.69 mm), Pog, and b points presented forward movement. Significant differences were found regarding the forward movement of the maxilla between the groups. CONCLUSION: The Alt-RAMEC/facemask protocol was effective not only in the maxillary region but also in the midface.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe III , Cefalometria , Criança , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Maxila/diagnóstico por imagem , Técnica de Expansão Palatina , Estudos Retrospectivos
11.
J Oral Maxillofac Surg ; 78(10): 1834.e1-1834.e9, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32428461

RESUMO

PURPOSE: The straight locking miniplate (SLM) technique is a straightforward method to accurately reposition the maxilla during bimaxillary orthognathic surgery. The present study evaluated the accuracy of the SLM technique in maintaining the condylar position during surgery without the use of a cutting guide. PATIENTS AND METHODS: The present prospective, single-center study was conducted at Yokohama City University between 2016 and 2017 and included patients with skeletal Class III malocclusion. The patients were divided into 2 groups according to the fixation method used for the mandibular segments. The mandibular segments were fixed with miniplates either manually (manual group) or using the SLM technique (SLM group). Computed tomography was performed before and 3 days after surgery to compare the condylar position. The bodily and rotational movements of the condyle were analyzed. RESULTS: The subjects were 18 Japanese patients (36 condyles) who had undergone bilateral set back surgery with Le Fort I osteotomy. The amount of bodily movements in the manual and SLM groups were 1.44 and 0.62 mm, respectively. The degree of rotational movement in the sagittal plane in the manual and SLM groups was 3.33° and 0.23°, respectively. The bodily and rotational movements in the SLM group were significantly smaller than those in the manual group (P < .05 and P < .01, respectively). CONCLUSIONS: These results suggest that use of the SLM technique reduces the risk of condylar positional changes to less than 1 mm during orthognathic surgery without the use of any complex devices or a cutting guide.


Assuntos
Má Oclusão de Angle Classe III , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Mandíbula , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Estudos Prospectivos
12.
Orthod Craniofac Res ; 23(4): 445-454, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32406170

RESUMO

OBJECTIVE: The aim of this study was to compare treatment outcomes with different maxillary protraction methods in patients with skeletal Class III malocclusion resulting from maxillary retrognathia. SETTING AND SAMPLE POPULATION: A total of 55 individuals consisting of 29 females and 26 males with a mean age of 11.4 ± 1.06 years were included in this study. MATERIAL AND METHODS: Fifty-five treated maxillary retrognathic patients who underwent different protraction facemask methods were evaluated. Eighteen patients treated with RME were in the first group, and 19 patients treated with a modified Alt-RAMEC protocol were in the second group; eighteen patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Thirty measurements were made on lateral cephalometric radiographs before and after treatment. Differences between the groups were assessed with the ANOVA test. RESULTS: The mean age was higher in the SA group (11.96 ± 0.92 years) compared with the other groups. The mean ANB angle increased by 2.96°, 4.91° and 3.86° in the RME, Alt-RAMEC and SA groups, respectively. The forward movement of the maxilla was similar between the groups. However, while the rate of protraction was higher in the modified Alt-RAMEC group, a greater skeletal effect was found in the SA group. CONCLUSION: The most effective method in terms of skeletal effect is the application of the face mask with skeletal anchorage; the modified Alt-RAMEC protocol can be applied before face mask to obtain faster protraction.


Assuntos
Má Oclusão de Angle Classe III , Maxila , Cefalometria , Criança , Aparelhos de Tração Extrabucal , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Técnica de Expansão Palatina
13.
Dent Med Probl ; 57(1): 103-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32129951

RESUMO

Skeletal deformities constitute a relatively common structural and functional craniofacial abnormality. The chief complaints reported by patients include a lack of satisfaction with facial appearance, difficulty with breathing or eating, and altered speech. The management of skeletal malocclusion requires a complex orthodontic and surgical approach. The paper presents the case of a 28-year-old woman with maxillary constriction and skeletal class III malocclusion. Transpalatal distraction (TPD), based on the distraction osteogenesis phenomenon, was used for correcting transverse maxillary deficiency by increasing the maxillary bone base, and therefore the transverse maxillary dimension. The next stage was orthodontic treatment, involving dentoalveolar decompensation, as part of preparation for bimaxillary osteotomy (BIMAX). The last stage of the complex treatment was BIMAX, which ultimately eliminated skeletal defects in both the sagittal and frontal planes. This complex multidisciplinary management significantly improved facial harmony, increased nasal volume, caused a shift from mouth breathing to nasal breathing, and restored normal occlusal relationships.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Micrognatismo , Osteogênese por Distração , Adulto , Feminino , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia
14.
Sci Rep ; 10(1): 3858, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32123263

RESUMO

This study aimed to evaluate the factors contributing to postoperative anterior relapse or posterior drift of the distal segment after intraoral vertical ramus osteotomy. A retrospective cohort study was conducted which included 31 patients who underwent setback surgery for mandibular prognathism by the intraoral vertical ramus osteotomy technique. Uni- and multivariate analyses were performed to determine the association of potential explanatory variables (sex, age, magnitude of setback, differences in setback magnitude between sides (right/left), duration of splint use, Angle's classification of malocclusion, mandibular angle, and tightness of occlusion of the molars) with positional changes in the distal segment. The setback magnitude was only significant factor affecting (P = 0.015) for posterior drift, with significant posterior in setback magnitudes of less than 7.25 mm. Posterior drift after intraoral vertical ramus osteotomy is less likely if setback magnitude exceeds 7.25 mm. For setbacks less than 7.25 mm, posterior drift should either be carefully corrected postoperatively, or an alternative surgical technique should be used. The setback magnitude showed a significant association with the risk of posterior drift following intraoral vertical ramus osteotomy, and the determined cut-off value may serve as a predictor for postoperative outcomes.


Assuntos
Má Oclusão de Angle Classe III/cirurgia , Osteotomia Sagital do Ramo Mandibular , Prognatismo/cirurgia , Adolescente , Adulto , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/diagnóstico por imagem , Pessoa de Meia-Idade , Prognatismo/diagnóstico por imagem , Estudos Retrospectivos
15.
Biomed Res Int ; 2020: 7238263, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32149128

RESUMO

This study focus on the changes of the position and morphology of jaw and condyle after MEAW (the multiloop edgewise arch wire) treatment in adults with a nonlow angle (mean angle or high angle SN - MP > 27°) of skeletal class III (mild to moderate skeletal classs III means -5° < ANB < 0°) malocclusions measured by CBCT (cone beam computed tomography). Twenty adult patients (aged 17-26) with a nonlow angle of skeletal class III malocclusions were selected in this study taken orthodontic treatment by MEAW. CBCT was taken before and after the treatment to analyze the changes of the jaw and condyle. After treatment, the angle of L7-MP decreased 12.2°, L6-MP decreased 10.5°, L1-MP decreased 8.8° (P < 0.001 for each) and U1-SN increased (P < 0.05). There was no significant changes between anterior and posterior APDI index and between anterior and posterior spaces of the TMJ (temporomandibular joint) (P > 0.05). The linear ratio of the TMJ was the LR > 12 before treatment, while it was -12 < LR < 12 after treatment; however, there was no statistically significant difference between them (P > 0.05). There was also no significant change in anterior and posterior position and morphology of the condyle within the joint fossa after the treatment by MEAW in this study. MEAW technology in correcting the class III with nonlow angle patients mainly relies on the compensation of distally and posterior mandibular teeth, rather than the mandible and condyle moving backward to establish a neutral occlusal. This study was approved by the institutional ethics committee of the Second Hospital of Tianjin Medical University (No. KYJJ2013002).


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Oclusão Dentária , Má Oclusão de Angle Classe III/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Adolescente , Adulto , Cefalometria/métodos , Feminino , Humanos , Arcada Osseodentária/anatomia & histologia , Arcada Osseodentária/diagnóstico por imagem , Masculino , Má Oclusão de Angle Classe III/patologia , Má Oclusão de Angle Classe III/terapia , Mandíbula/diagnóstico por imagem , Côndilo Mandibular/anatomia & histologia , Côndilo Mandibular/diagnóstico por imagem , Braquetes Ortodônticos , Fios Ortodônticos , Articulação Temporomandibular/anatomia & histologia , Adulto Jovem
16.
Eur J Orthod ; 42(2): 200-205, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31067294

RESUMO

AIM: To develop and validate a prediction model to forecast long-term stability of early treatment with rapid maxillary expansion (RME) and facemask (FM) in a large sample of Class III growing patients. METHODS: The Brazilian Group (BG) consisted of 73 consecutively treated Caucasian Class III patients (41 females and 32 males). Mean age at T0 (before treatment) was 7.1 ± 1.6 years, while mean age at T1 (long-term follow-up) was 21.8 ± 3.2 years. The Italian Group (IG, validation cohort) comprised 28 consecutively treated Caucasian Class III patients (14 females and 14 males, mean age at T0 9.0 ± 1.3 years and mean age at T1 18.2 ± 1.4 years). Cephalometric analysis was performed on lateral cephalograms at T0. Gender and cephalometric variables, chronologic age, and dentition phase at T0 were used as predictors for long-term unsuccessful treatment at T1. All predictors for unsuccessful treatment in the BG were subjected to bivariate logistic regression. Only those statistically significant predictors in the bivariate logistic regression entered mixed stepwise logistic regression with P = 0.05 to enter and to leave. The validity of the prediction model derived from the BG was then tested on the IG. RESULTS: The prediction model consisted of only one cephalometric variable: the angle between the Condylar Axis and the Mandibular Plane (CondAx-MP) (odds ratio: 1.52, 95% confidence interval: 1.25-1.85, P < 0.0001). Unsuccessful treatment at T1 was predicted for values of CondAx-MP at T0 greater than the cut-off value of 147.8 degrees. BG patients predicted incorrectly were 3 out of 22 for the unsuccessful cases and 1 out of 51 for the successful cases. Therefore, accuracy was 0.95, sensitivity 0.86, specificity 0.98, and positive and negative predictive values were 0.95 and 0.94. When the predictive model was applied on IG, all five unsuccessful cases were predicted correctly, while only 1 out of 23 successful patients was predicted incorrectly. CONCLUSION: CondAx-ML was identified as a reliable predictor for long-term stability of early Class III treatment with RME and FM.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Maxila , Adolescente , Adulto , Idoso de 80 Anos ou mais , Brasil , Cefalometria , Criança , Pré-Escolar , Aparelhos de Tração Extrabucal , Feminino , Humanos , Masculino , Técnica de Expansão Palatina , Resultado do Tratamento , Adulto Jovem
17.
Eur J Orthod ; 42(2): 187-192, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31314883

RESUMO

OBJECTIVE: To evaluate dental and skeletal effects of a new orthopaedic appliance for the treatment of Class III malocclusion in growing patients. MATERIAL AND METHODS: This retrospective cephalometric study was performed on a sample of 18 patients with a skeletal Class III malocclusion (4 males; 14 females; mean age 8.8 ± 1.5 years) treated with the Pushing Splints 3 (PS3) protocol. The control group consisted of 18 subjects (5 males; 13 females; mean age 9.1 ± 1.8 years) selected from a database of subjects with untreated Class III malocclusion. The cephalometric analysis was performed at the beginning (T0) and the end of the orthopaedic therapy (T1). Significant differences between the treated and control groups were assessed with independent samples t-test (P < 0.05). RESULTS: In the PS3 group, the post-treatment cephalometric values showed a forward displacement of the maxilla, resulting in a statistically significant increase of the SNA angle. ANPg and Wits appraisal improved significantly compared with the control group. Lingual inclination of mandibular incisors and buccal inclination of the upper incisors were significantly increased in comparison with the control group. No significant differences were recorded for backward mandibular rotation. LIMITATIONS: This study presents a short-term evaluation of the treatment and the use of a historical control group. CONCLUSIONS: The PS3 was effective for the treatment of Class III malocclusion in growing patients, with favourable maxillary advancement and control of the vertical skeletal relationships.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/terapia , Ortopedia , Cefalometria , Criança , Feminino , Humanos , Masculino , Mandíbula , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Estudos Retrospectivos , Resultado do Tratamento , Dimensão Vertical
18.
Shanghai Kou Qiang Yi Xue ; 29(6): 632-637, 2020 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-33778832

RESUMO

PURPOSE: To investigate the relationships among tongue volume, hyoid position, airway volume and maxillofacial form in paediatric patients with Class Ⅰ, Class Ⅱ and Class Ⅲ malocclusion. METHODS: Data of 112 children with malocclusion in the Department of Stomatology, Wuxi Children's Hospital from December 2015 to December 2018 were collected. The children were divided into three groups according to Angle's classification: Class Ⅰ (n=42), Class Ⅱ (n=38) and Class Ⅲ (n=32). Tongue volume was evaluated by oral B-ultrasound, the hyoid position was obtained by lateral cephalogram, then the airway volume and maxillofacial form were evaluated by cone-beam CT (CBCT). Relationship among tongue volume, hyoid position, airway volume and maxillofacial form were analyzed. The data were processed by SPSS 20.0 software package. RESULTS: The tongue volume of Class III was significantly larger than that of Class I and Class II (P<0.05); H-FH and H-MP of Class II were significantly larger than those of Class I and Class III, and H-VL was significantly smaller than that of Class I and Class III (P<0.05). H-FH and H-MP of Class III were significantly smaller than those of Class I, and H-S was significantly larger than that of Class I (P<0.05); V throat of three types was the largest in Class Ⅲ, followed by Class I and Class Ⅱ, with significant difference (P<0.05). V nose of three types was the largest in Class Ⅱ, followed by Class I and Class Ⅲ, with significant difference (P<0.05). SNB angle of three types was the largest in Class Ⅲ, followed by Class Ⅰ and Class Ⅱ, with significant difference (P<0.05). ANB angle was the largest in Class I, followed by Class Ⅱ and Class Ⅲ, with significant difference (P<0.05). Tongue volume was positively correlated with V throat, V nose, and SNB, and negatively correlated with H-FH and ANB (P<0.05). H-FH and H-MP were negatively correlated with SNB angle and positively correlated with H-MP and ANB angle (P<0.05). CONCLUSIONS: Children with Class Ⅲ malocclusion have larger tongue volume, upward displacement of hyoid, and smaller nasopharyngeal volume. Children with Class II malocclusion have small tongue volume, downward displacement of hyoid, and small oropharyngeal volume. Tongue volume, hyoid position, airway volume and maxillofacial form are significantly correlated in paediatric patients with malocclusions, the influence of mandibular recession on the shape of upper airway should be considered during orthodontic treatment, in order to achieve the best aesthetic and therapeutic effects.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão de Angle Classe II , Má Oclusão , Cefalometria , Criança , Estética Dentária , Humanos , Osso Hioide/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe III/diagnóstico por imagem , Mandíbula , Língua/diagnóstico por imagem
19.
Sci Rep ; 9(1): 19309, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31848435

RESUMO

The aim of this study was to evaluate the differences in sella dimensions and shape between growing patients with Class I, Class II, and Class III skeletal malocclusions, evaluated through morphometric analysis. Seventy-eight subjects aged between 9 and 13 years were selected and assigned to either the Class I, Class II, or Class III groups according to the measured ANB angle (the angle between the Nasion, skeletal A-point and skeletal B-point). Six landmarks were digitised to outline the shape of the sella turcica. Linear measurements of the sella length and depth were also performed. Procrustes superimposition, principal component analysis, and canonical variate analysis were used to evaluate the differences in sella shape between the three groups. A one-way MANOVA and Tukey's or Games-Howell tests were used to evaluate the presence of differences in sella dimensions between the three groups, gender, and age. The canonical variate analysis revealed a statistically significant difference in sella shape between the Class I and the Class II groups, mostly explained by the CV1 axis and related to the posterior clinoidal process and the floor of the sella. No differences were found regarding linear measurements, except between subjects with different age. These differences in sella shape, that are present in the earlier developmental stages, could be used as a predictor of facial growth, but further studies are needed.


Assuntos
Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe I/diagnóstico por imagem , Sela Túrcica/diagnóstico por imagem , Adolescente , Fatores Etários , Pesos e Medidas Corporais/métodos , Cefalometria/métodos , Criança , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe I/fisiopatologia , Má Oclusão de Angle Classe II/fisiopatologia , Má Oclusão de Angle Classe III/fisiopatologia , Análise de Componente Principal , Sela Túrcica/fisiopatologia
20.
J Craniofac Surg ; 30(8): 2565-2569, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31689732

RESUMO

This clinical report presents the outcomes of segmental corticotomy-assisted orthodontic treatment in a class III patient. A 13.5-year-old female patient presented with class III anomaly and a thin alveolus in the mandibular anterior region. After the alignment of the mandibular incisors, segmental corticotomy with platelet-rich fibrin (PRF) was performed in the mandibular incisor area to facilitate incisor retraction to ensure periodontal support after the changes in the inclination of the teeth. Lateral cephalograms were taken at the beginning (T0), precorticotomy (T1), at the end of the treatment (T2), and 2 years after the treatment (T3). Cone-beam computed tomography (CBCT) records were collected at the T1, T2, and T3 periods to evaluate the bone structures. The measurements included the inclination and the position of the mandibular incisors, symphysis width, symphysis height, B-B' width, cervical alveolar width, the vertical alveolar bone level on the labial and the lingual sides, and the amount of labial and lingual bone at the apex in the mandibular central incisor and canine areas.The class I molar and canine relationship was achieved in this borderline case. The amount of labial bone at the root apex and the B-B' width increased. A vertical alveolar bone gain was observed. The facial profile was improved significantly. The treatment outcome was stable at the 2-year follow-up. The segmental anterior mandibular corticotomy provided an effective correcting inclination of the mandibular teeth with the use of class III elastics. This technique ensured the maintenance of a sufficient amount of labial bone with no periodontal side effects.


Assuntos
Má Oclusão de Angle Classe III/cirurgia , Fibrina Rica em Plaquetas , Adolescente , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Incisivo , Má Oclusão de Angle Classe III/diagnóstico por imagem , Mandíbula
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