Treatment of mandibular deviation with the replacement of upper laterals with central incisors - a case report

Premature contact of teeth in posterior crossbite may be associated with facial asymmetry. To describe the surgical treatment of mandibular deviation associated with a marked facial asymmetry, and build up the two upper lateral incisors in place of the two upper central incisors. A 20 year-old boy with a unilateral posterior crossbite, noticeable facial asymmetry, and anterior crossbite is presented. He had a history of head injury in mixed dentition period. The upper central incisors were lost during trauma and the created space was replaced by the two upper lateral incisors. A removable appliance was used to correct the crossbite and it was followed by fixed appliances. Orthognathic surgery was done to complete the treatment. After that the two upper lateral incisors were built up and reshaped. Treatment resulted in a marked improvement in facial symmetry, elimination of the mandibular displacement and a stable occlusion. A patient with mandibular deviation and marked facial asymmetry was successfully treated surgically and two upper lateral incisors were built up and reshaped in place of the two upper central incisors

[ dentoskeletal effect of mandibular tongue guard in Cl II/I malocclusion]

The prevalence of Cl II malocclusion with tongue thrust and open bite is high. The pressure of the tongue during swallowing and its physiological activity could be transferred to the maxillary complex by the tongue crib and might advance the maxilla to an unfavorable position. This study aimed to evaluate the dentoskeletal change in the Cl II division 1 patients with anterior tongue thrust and mandibular deficiency treated by mandibular tongue guard, from a private office and orthodontic department of Azad University in Tehran. The sample consisted of 23 patients, [14 females aged 8 years and 9 months and 9 males aged 10 years and 6 months], with Cl II div 1 malocclusion in late mixed dentition with anterior tongue thrust. The patients were treated by mandibular tongue guard. Lateral Cephalograms were obtained and traced before and after treatment and certain angular and linear variables were measured. The pretreatment and post treatment measurements were compared using Paired t test to evaluate the significance of the results. The findings indicated that SNB, facial angle, the distance between B and Pogonion to the reference line and Interincisal angle were significantly increased [P<0.05]. The changes were mainly caused by mandibular growth, were observed after treatment by mandibular tongue guard. Decrease of IMPA, 1-SN, ANB, Wits were significant [P<0.05]. The changes of Jarabak index, SN-MP, SNA, Y-axis were not significant. In Cl II div 1 patients with mandibular deficiency combined with tongue thrust, mandibular tongue guard caused slight increase in mandibular growth

[ effect of inclined bite plane and modified FRII treatment on dentoskeletal changes in CL II/I malocclusion]

The prevalence of Cl II malocclusion is high in the population. The functional appliances are used in the patient who has mandibular deficiency. The present study was aimed to compare thc dentoskeletal changcs of CLII/I Malocclusion who used inclined anterior bite plan and modified FRII. The material consisted of 30 patients, with Cl II/I malocclusion, ANB > 4° in late mixed dentifion. Half of the patients [9 girls and 6 boys] were treated by inclined anterior bite plane and reminder [8 girls and 7 boys] by modified FRII appliance. Lateral cephalogroms were obtained and traced before and after treatment and certain angular and linear variables were measured. The pretreatment and post-treatment measurements were compared using Mann-whitney U test and Wilcoxon Test to evaluate the significancy of the results. Significant changes mainly caused by mandibular growth, were observed after treatment by modified FRII and inclined anterior bite plane. This study indicated no statistical significant differences between two groups except Ar-B and AR-Pog. Considering the less bulky anterior inclined bile plane and its easier construction we can use this appliance instead of modified FRIT