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1.
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
2.
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
3.
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
4.
Dental Press J Orthod ; 25(5): 57-65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206830

RESUMO

INTRODUCTION: Supervising the development of occlusion, managing problems during the transition from mixed to permanent dentition, as well as controlling environmental factors that contribute to establishing malocclusion, are important actions to achieve a Class I occlusion with facial balance. Among these problems, the malocclusions associated with dysfunctions such as mouth breathing or obstructive sleep apnea syndrome (OSAS), atypical swallowing and abnormal tongue position, open bites, crossbites and maxillomandibular discrepancies, and especially the Class III malocclusion can be listed. OBJECTIVE: The purpose of this article is to present and discuss the main aspects relevant to the benefits of performing the treatment of Class III malocclusion in patients with growth.


Assuntos
Má Oclusão de Angle Classe III , Má Oclusão , Dentição Mista , Dentição Permanente , Humanos , Má Oclusão/terapia , Má Oclusão de Angle Classe III/terapia , Respiração Bucal
5.
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
6.
Am J Orthod Dentofacial Orthop ; 158(5): e63-e72, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33131569

RESUMO

INTRODUCTION: This study aimed to assess the stability of compensatory treatment of Class III malocclusion in permanent dentition. METHODS: Thirty-six patients (21 women and 15 men; mean age, 20 years) with Class III malocclusion were subjected to the compensatory treatment of permanent dentition and followed up for at least 3 years after orthodontic treatment (T3). Multivariate Poisson regression was performed to assess the influence of clinical, cephalometric, and dental cast variables at the beginning (T1) and the end of treatment on the stability of Class III malocclusion. RESULTS: Overjet changed from -0.25 mm (-3 to 0.5 mm) at T1 to 1.4 mm (1-2.5 mm) at the end of treatment and 0.8 mm (0-1.5 mm) at T3. Clinical relapse (overjet <1 mm and/or canine Class III relations) was observed in 11 patients (30.6%). Patients treated with extraction of mandibular premolars (risk ratio [RR] = 2.13 × 10-07, P <0.001), with better orthodontic end outcomes (RR = 1.16, P = 0.009) and which had lower maxillary incisor inclination at T1 (RR = 1.08, P = 0.035) showed a lower risk of relapse. Demographic (sex, age), clinical (length of treatment and posttreatment, number of treatment phases, time of Class III elastics), cephalometric (SNA, SNB, ANB, Wits appraisal, SNGoGn, IMPA), and dental cast (peer assessment rating index and arch dimensions) variables were not significantly associated with clinical relapse at T3. CONCLUSIONS: The stability of compensatory treatment of Class III malocclusion in permanent dentition is multifactorial, with few predictive variables. Patients treated with extraction and better orthodontic finishing had a lower risk of relapse, whereas larger maxillary incisor inclination at baseline increased the risk of relapse.


Assuntos
Má Oclusão de Angle Classe III , Sobremordida , Adulto , Cefalometria , Dentição Permanente , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe III/terapia , Mandíbula , Maxila , Resultado do Tratamento , Adulto Jovem
7.
Orthod Fr ; 91(1-2): 145-165, 2020 06 01.
Artigo em Francês | MEDLINE | ID: mdl-33146129

RESUMO

Class III dysmorphia, classically distributed in hereditary or functional etiology, have often multifactorial causes. Breaking the dysmorpho-dysfunctional cascade with early treatment may seem to be an essential alternative to give growth a new orientation. Whether the treatments are preventive, interceptive with or without an appliance, orthodontic or surgical (early, first-line or late), this takes more account of the clinical form than of age. The authors, through clinical cases, will develop their therapeutic approach, based on clinical common sense. Waiting to act at the right time is essential to set up treatments based on proven therapies.


Assuntos
Má Oclusão de Angle Classe III , Humanos , Má Oclusão de Angle Classe III/diagnóstico , Má Oclusão de Angle Classe III/terapia
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.
Int. j. morphol ; 38(4): 1053-1059, Aug. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1124896

RESUMO

The aim of this study was to evaluate the hard and soft tissue profile changes following treatment of functional and mild skeletal class III malocclusion in mixed dentition by means of the Frankel functional regulator (FR-3) appliance, and to reveal the mechanism and effectiveness of treatment with FR-3 appliance. Twenty-six patients (chronological mean age, 8.7±1.4 years; mean treatment duration, 10.3±1.3 months) with functional and mild skeletal class III malocclusion were selected and treated with FR-3 appliances. Lateral cephalogram was taken pre- and post-treatment, and the data was analyzed by paired-samples t test with SPSS22.0 software package. Differences were considered statistically significant at P < 0.05. The results demonstrated that the FR-3 appliance produced a statistically significant decrease in L1-NB, L1-MP, U1-L1 (P<0.01) and an increase greatly in ANB, MP-FH, Y axis, ANSMe, ANS-Me/N-Me and overjet (P<0.01). SNA, SNB were increased significantly (P<0.05). Meanwhile, N'-Sn-Pog', ULSn-SN, LLSiSN increased, S-N'-Si, LL-EP decreased with significant difference (P<0.01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes and Ns-Mes increased with significant difference (P<0.05). Therefore it was concluded that after FR-3 treatment, the position of mandible may rotate clockwise backwards and downwards, with the labioversion of upper incisors and linguoversion of lower incisors. Although point A moved mesially, the length and position of the maxilla did not change significantly. With the protrusion of upper lip and the retrusion of lower lip, the relationship among nose, upper lip, lower lip and chin become harmonious, the profile of soft tissue is more coordinated and attractive.


El objetivo de este estudio fue evaluar los cambios en el perfil de los tejidos duros y blandos después del tratamiento de la maloclusión funcional y leve de la clase III esquelética en la dentición mixta mediante el aparato regulador funcional Frankel (FR-3), y revelar el mecanismo y efectividad del tratamiento con el aparato FR-3. Veintiseis pacientes (edad media 8,7 ± 1,4 años; duración media del tratamiento, 10,3 ± 1,3 meses) con maloclusión funcional y leve de clase esquelética III fueron seleccionados y tratados con aparatos FR-3. El cefalograma lateral se tomó antes y después del tratamiento, y los datos se analizaron mediante la prueba t de muestras con el software SPSS22.0. Las diferencias se consideraron estadísticamente significativas a P <0,05. Los resultados demostraron que el dispositivo FR-3 produjo una disminución estadísticamente significativa en L1-NB, L1MP, U1-L1 (P <0,01) y un gran aumento en ANB, MP-FH, eje Y, ANS-Me, ANS -Me / N-Me y overjet (P <0,01). SNA, SNB se incrementaron significativamente (P <0,05). Mientras tanto, N'Sn-Pog', ULSn-SN, LLSi-SN aumentaron, S-N'-Si, LL-EP disminuyeron con una diferencia significativa (P <0,01). S-N'-Sn, Cm-Sn-UL, UL-EP, Sn-Mes y Ns-Mes aumentaron con una diferencia significativa (P <0,05). Por lo tanto, se concluyó que después del tratamiento con FR-3, la posición de la mandíbula puede girar en sentido reloj hacia atrás y hacia abajo, con labioversión de los incisivos superiores y linguoversión de los incisivos inferiores. Aunque el punto A se movió mesialmente, la longitud y la posición del maxilar no cambiaron significativamente. Con la protuberancia del labio superior y la retrusión del labio inferior, la relación entre la nariz, el labio superior, el labio inferior y el mentón se armoniza, el perfil del tejido blando es más coordinado y atractivo.


Assuntos
Humanos , Masculino , Feminino , Criança , Aparelhos Ortodônticos Funcionais , Dentição Mista , Má Oclusão de Angle Classe III/patologia , Má Oclusão de Angle Classe III/terapia , Cefalometria
11.
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
12.
Artigo em Inglês | MEDLINE | ID: mdl-32443794

RESUMO

The purpose of this investigation was to show how to manage an anterior crossbite in early mixed dentition with an eruption guidance appliance (EGA). The analyzed clinical case reported an anterior crossbite, a bimaxillary retrusion tendency, and a horizontal growth pattern. The anterior crossbite was an unfavorable occlusal condition that could lead to a class III malocclusion growth pattern. An early treatment approach was suggested to reach a correct sagittal jaw relationship. Hence, the selected approach acted on the dentoalveolar sector, aiming to have effects on the posterior vertical dimension and to improve the sagittal jaw's relation. An EGA was selected to treat the patient in early mixed dentition. After 7 months of therapy with night-time use, the dental malocclusion was completely resolved. The patient continued to be treated with the same device, used as active retention. With the EGA treatment, the erupting forces, rather than the active forces, were used to resolve the dental malocclusion. This approach allowed a low compliance requirement and had a minimum psychosocial and psychological impact on the patient. The early treatment was essential to give a functional occlusion and a good balance of the soft perioral tissues and muscles.


Assuntos
Má Oclusão de Angle Classe III , Técnicas de Movimentação Dentária , Dentição Mista , Humanos , Má Oclusão de Angle Classe III/terapia
13.
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
14.
Am J Orthod Dentofacial Orthop ; 157(3): 408-421, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115119

RESUMO

Anterior open bite malocclusion is generally associated with several causes. This case report describes the 2-phase treatment of a 13-year-old boy with a Class III malocclusion, severe anterior open bite, and bilateral posterior crossbite treated without surgical intervention. An orthopedic approach was performed in phase 1 with a hyrax-type palatal expander, followed by maxillary protraction with a facemask for a 10-month period to promote the correction of transverse and sagittal deviations. In phase 2, a comprehensive orthodontic approach using fixed preadjusted appliances associated with intermaxillary elastics was performed. These approaches, combined with good patient compliance, established a functional and esthetic occlusal relationship, normal overjet and overbite, and a well-balanced facial appearance. The 4.5-year follow-up indicated that treatment results were stable.


Assuntos
Má Oclusão de Angle Classe III , Mordida Aberta , Técnica de Expansão Palatina , Adolescente , Cefalometria , Estética Dentária , Humanos , Masculino , Má Oclusão de Angle Classe III/terapia
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.
Rev. ADM ; 77(1): 41-45, ene.-feb. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1088066

RESUMO

Introducción: La maloclusión clase III es considerada como severa y en la mayoría de los pacientes la etiología suele estar combinada entre componentes esqueléticos y dentoalveolares. Las posibilidades terapéuticas dependerán de la edad biológica del paciente y del tipo de maloclusión. Conforme va aumentando la edad del paciente va menguando la capacidad de crecimiento y se va asentando la relación de clase III esquelética. Las maloclusiones de clase III esqueléticas se pueden corregir mediante extracciones dentales y cirugía ortognática. Caso clínico: Paciente masculino de 13 años de edad con protrusión mandibular, discrepancia óseo dentaria negativa, convexidad facial disminuida y clase III dental y esqueletal. Resultados: Se resolvió la discrepancia óseo dentaria negativa del paciente, se logró la clase I Molar y canina con una sobremordida adecuada (AU)


Introduction: Class III malocclusion is considered severe and in most patients the etiology is usually combined between skeletal and dentoalveolar components. The therapeutic possibilities depend on the biological age of the patient and the type of malocclusion. As it increases the age of the patient wanes growth capacity and Will settled the relationship skeletal class III. The skeletal class III malocclusion can be corrected by tooth extractions and orthognathic surgery. Case report: Male patient 13 years old with mandibular protrusion, negative tooth bone discrepancy, decreased facial convexity and dental and skeletal class III. Results: Dental patient refusal bone discrepancy was resolved, I molar and canine class and adequate overbite was achieved (AU)


Assuntos
Humanos , Masculino , Adolescente , Técnica de Expansão Palatina , Aparelhos de Tração Extrabucal , Aparelhos Ortodônticos Fixos , Má Oclusão de Angle Classe III/terapia , Planejamento de Assistência ao Paciente , Extração Dentária , Fechamento de Espaço Ortodôntico
17.
Eur J Orthod ; 42(2): 193-199, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31750516

RESUMO

OBJECTIVES: The purpose of this study was to compare the results of skeletal anchorage (SAMP) and tooth- borne (TBMP) maxillary protraction followed by fixed appliance in growing skeletal Class III patients. MATERIALS AND METHODS: Patients treated with maxillary protraction were selected and classified into two groups (SAMP: n = 19, mean age = 11.19 years; TBMP: n = 27, mean age = 11.21 years). Lateral cephalograms taken before treatment (T0), after the maxillary protraction (T1), and after the fixed appliance treatment (T2) were analysed and all variables were statistically tested to find difference between the two groups. RESULTS: Compared to the TBMP, the SAMP showed significant forward growth of maxilla (Co-A point and SN-Orbitale) and improvement in intermaxillary relationship (ANB, AB to mandible plane, and APDI) after the overall treatment (T0-T2), with no significant sagittal changes in maxilla or mandible throughout the fixed appliance treatment (T1-T2). LIMITATIONS: In maxillary protraction, effects of skeletal anchorage were retrospectively compared with those of dental anchorage, not with Class I or III control. CONCLUSIONS AND IMPLICATIONS: After maxillary protraction, skeletal and tooth-borne anchorage did not cause significant differences in the residual growth of maxilla throughout the phase II treatment. Orthopaedic effects with skeletal anchorage showed appropriate stability in maxilla and intermaxillary relationship even after fixed appliance treatment.


Assuntos
Má Oclusão de Angle Classe III/terapia , Procedimentos de Ancoragem Ortodôntica , Cefalometria , Aparelhos de Tração Extrabucal , Humanos , Mandíbula , Maxila , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Técnica de Expansão Palatina , Estudos Retrospectivos
18.
Int J Pediatr Otorhinolaryngol ; 130: 109794, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31812840

RESUMO

OBJECTIVE: The aim of this investigation was to analyze the effects of RME and FM on the airway dimensions in Class III patients compared with untreated controls. METHODS: A sample of 47 Class III patients treated with RME and FM was analyzed. The treated group was compared with 18 untreated controls. Lateral cephalograms for each patient at T1, T2, and T3 were digitized. RESULTS: At long-term evaluation a significant increase in airway size and a significant decrease in adenoid size were found in the treated group as well as an improvement in the pharynx dimension. During active treatment the treated group showed a significant improvement in lower airway size and in lower pharynx dimension. A significant decrease in adenoid size was also found. CONCLUSION: The treatment with RME and FM produced favorable stable changes in the airway dimensions in Class III subjects when compared with untreated controls.


Assuntos
Aparelhos de Tração Extrabucal , Má Oclusão de Angle Classe III/patologia , Má Oclusão de Angle Classe III/terapia , Máscaras , Técnica de Expansão Palatina , Faringe/patologia , Fatores Etários , Cefalometria , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos
19.
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
20.
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
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