RESUMO
Scissor bite does not correct spontaneously. It gradually worsens by overeruption, negatively affecting masticatory function. It is intended with this manuscript to evaluate the different treatment strategies to correct this malocclusion in adult patients, exploring treatment with clear aligners, bite ramps, and MS (miniscrews), especially in this case of a patient with unilateral right scissor bite, with high dental compensation in the three planes of space, asymmetrical sagittal dental position, overeruption on the scissor bite condition, and a high mandibular arch constriction and maxillary expansion. A comprehensive literature research was performed from 2002 until March 2023. PubMed and BVS databases were used, with the following keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". Since correcting skeletal asymmetries after the growth completion is challenging, adult patient cases often involve a combined orthodontic-surgical approach. In the present clinical case, the severe limitations to decompensating tooth positions for a surgical treatment, with the necessity to perform lower asymmetric extraction and a must longer orthodontic treatment, were the major reasons to avoid the surgical approach, after the scissor bite correction. In spite of this, the efficiency of the clear aligners and auxiliaries like bite ramps, MS, and elastics in successfully correcting a complex scissor bite in an adult patient was demonstrated, with significant esthetic and functional commitment, demonstrated by the case reliability PAR (peer assessment rating) index.
RESUMO
Scissor bite (SB.) is a rare malocclusion that is challenging to diagnose and is often associated with a retrognathic mandible and a series of functional and structural abnormalities that negatively affect the patient. This article intends to analyze the treatment approaches applied to growing patients younger than 16 years old, comparing the conventional appliances described in the literature and a clinical case treated with clear aligners with mandibular advancement (MA.). SB is primarily related to skeletal Class I and II, according to Angle classification. In the various cases analyzed, it can also be mentioned as a significant number of cases with SB of dental origin (seven of dental and four of skeletal) in young patients. In children and adolescents who still have growth potential, the therapeutic possibilities are numerous. A comprehensive literature search was manually performed from 2002 until January 2023, in PubMed and BVS databases with the following conjugated keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". The present case report on a young patient demonstrated the efficiency of the clear aligners with MA to correct an SB, associated with several functional and structural anomalies such as Class II division 1 with an increased overjet and overbite as well as a severe curve of Spee in a hypodivergent biotype.