Tratamiento ortodóncico-quirúrgico de pacientes con asimetría facial / Orthodontic-surgical treatment of patients with facial asymmetry

Introducción: la asimetría facial es una condición notoria en el tercio inferior de la facie del sujeto y entre los tercios medio y superior, en este último será menos evidente esta condición, de tal manera que podría considerarse como una de las molestias de mayor incidencia en pacientes con necesidades o no de terapia or- todóncica. Objetivo: evaluar mediante una revisión de la literatura los tratamientos ortodóncico-quirúrgicos de pacientes con asimetría facial. Material y métodos: la literatura se seleccionó mediante una búsqueda en las bases de datos electrónicas: PubMed, Scopus, Web of Science. Las palabras clave utilizadas fueron: facial asymmetry, asymmetry, surgical treatment, surgical orthodontic treatment. La búsqueda se restringió a artículos en inglés publicados del año 2011 al 2021. Resultados: después de aplicar los criterios de inclusión y exclusión en total se obtuvieron y revisaron 27 artículos. Se realizó la revisión de literatura del tratamiento ortodóncico-quirúrgico en pacientes con asimetría facial. Conclusión: es preciso el abordaje ortodóntico quirúrgico para la corrección de la asimetría facial, del protocolo dependerá la situación clínica y la elección de tratamiento ortodóntico quirúrgico, lo que brindará mejoras significativas en la simetría facial (AU)

Introduction: facial asymmetry, is a notorious condition in the lower third of the subject's facie and between the middle and upper thirds, in the latter this condition will be less evident; in such a way, it could be considered as one of the discomforts of greater incidence in patients with needs or not of orthodontic therapy. Objective: to evaluate by means of a literature review the orthodontic-surgical treatment of patients with facial asymmetry. Material and methods: the literature was selected through a search in the following electronic databases: PubMed, Scopus, Web of Science. The keywords used were: facial asymmetry, asymmetry, surgical treatment, surgical orthodontic treatment. The search was restricted to articles in English published from 2011 to 2021. Results: after applying the inclusion and exclusion criteria, a total of 27 articles were obtained and reviewed. The literature review of orthodontic-surgical treatment in patients with facial asymmetry was performed. Conclusion: surgical orthodontic approach is necessary for the correction of facial asymmetry, the protocol will depend on the clinical situation, the choice of surgical orthodontic treatment, which will give significant improvements in facial symmetry (AU)

Treatment of adult patient with hyperdivergent retrognathic phenotype and anterior open bite: report of a case with non-surgical orthodontic approach

ABSTRACT Adult patients with anterior open bite and hyperdivergent retrognathic phenotype demand complex treatments, as premolar extractions, molar intrusion or orthognathic surgery. In the present clinical case, a young adult patient without significant growth, with Class I and anterior open bite, was treated with four premolar extractions. The therapeutic result shows good intercuspation, good facial esthetic, good function balance, and stability in a two-year post-fixed treatment follow-up.

RESUMO Pacientes adultos com mordida aberta anterior e fenótipo hiperdivergente retrognata demandam tratamentos complexos, com extrações de pré-molares, intrusão de molares ou cirurgia ortognática. No presente caso clínico, uma jovem adulta sem potencial significativo de crescimento, apresentando Classe I e mordida aberta anterior, foi tratada com extrações de quatro primeiros pré-molares. O resultado terapêutico alcançou boa intercuspidação, boa estética facial e bom equilíbrio funcional, e mostrou-se estável depois de dois anos da remoção do aparelho fixo.

Investigating the effect of pre-surgical orthodontic treatment on temporomandibular joint in patients with skeletal class Ⅲ malocclusion by cone-beam computed tomography / 华西口腔医学杂志

OBJECTIVE@#To investigate the effect of pre-surgical orthodontic treatment on temporomandibular joint (TMJ) in patients with skeletal class Ⅲ malocclusion treated with orthodontic-orthognathic surgical treatment.@*METHODS@#Twenty-four patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgical treatment were included in the study. Before and after the completion of orthodontic treatment, the symptoms of TMJ were examined and recorded, and the short- and the long-axis diameter of the condylar (d), condylar height (h), joint space (L) at different angles, bilateral condylar spacing (R), and the condylar angles were measured, with scanning performed by using cone-beam computed tomography (CBCT). Then, the changes of TMJ symptoms and bone structure at different periods were analyzed.@*RESULTS@#No significant changes were observed in the joint symptoms before and after the pre-surgical orthodontic treatment. No significant changes were found in the measurements of the bone structure of TMJ in the dimensional direction (P>0.05).@*CONCLUSIONS@#In the orthodontic-orthognathic surgical treatment procedure, the pre-surgical orthodontic process does not have a significant effect on TMJ.

Factors Affecting Length of Impacted Maxillary Central Incisors after Surgical-Orthodontic Treatment / 대한소아치과학회지

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth.The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.

Caninos permanentes retenidos en pacientes del Hospital Pediátrico Universitario Centro Habana. 2012-2015 / Retained permanent canines in patients of the University Pediatric Hospital of Centro Havana. 2012-2015

Introducción:Los caninos permanentes son dientes importantes para el aparato estomatognático. La retención de estos por limitación física en su erupción debe ser tratada en forma temprana con aparatología ortodóncica que permita una rehabilitación precoz y evitar tratamientos quirúrgicos más cruentos. Objetivo: Caracterizar los pacientes pediátricos con caninos permanentes retenidos atendidos en el Servicio de Cirugía Máxilofacial del Hospital Pediátrico Universitario Centro Habana, en el período de 2012 a 2015. Material y Métodos:Se realizó un estudio retrospectivo descriptivo en pacientes pediátricos con caninos permanentes retenidos atendidos en el Servicio de Cirugía Maxilofacial del Hospital Pediátrico Universitario Centro Habana, durante el período mencionado. Resultados: Se obtuvo un predominio del sexo femenino (69 por ciento).La edad de mayor detección de esta anomalía dentaria fue la de 13 años (26 por ciento). El canino permanente que más se retuvo fue el superior derecho (62 por ciento). El tipo de retención más frecuente la constituyó la unilateral (67 por ciento). La retención Clase I maxilar fue la de mayor presentación clínica (25 por ciento). El tratamiento más empleado fue la excéresis quirúrgica (50 por ciento). Conclusiones: En los pacientes pediátricos estudiados, los caninos retenidos se presentan fundamentalmente en el sexo femenino y los 13 años es la edad de mayor detección de esta anomalía dentaria. El canino permanente que más se retiene es el superior derecho (13) por palatino y la excéresis quirúrgica es el tratamiento más empleado(AU)

Hiperdoncia simple no sindrómica / Non-Syndromic Simple Hyperdontia

La hiperdoncia simple no sindrómica es el aumento del número de dientes en una única serie dentaria y que no está asociado a síndromes. La localización es única en los maxilares, sin acompañarse de otros dientes supernumerarios en otras zonas, ni formando parte de síndromes complejos. Se presentó el caso de un paciente que fue atendido en interconsulta de Cirugía Maxilofacial y Ortodoncia. Se describieron las características clínicas de la enfermedad y el tratamiento quirúrgico realizado, que consistió en un método quirúrgico-ortodóncico. Los dientes supernumerarios en al zona de incisivos es una enfermedad rara, existen pocos casos descritos en la literatura nacional y extranjera. Con la técnica quirúrgica utilizada para la exodoncia de los dientes supernumerarios y la reubicación ortodóncica del diente permanente retenido, se obtuvieron resultados estéticos satisfactorios.

Nonsyndromic simply hyperdontia is an increasing number of teeth in a single dental series and it is not associated with syndromes. The location is unique in the jaws, not accompanied by other supernumerary teeth in other areas, or as part of complex syndromes. A patient who was treated at Maxillofacial Surgery and Orthodontics consultation was presented. The clinical features of the disease and surgical treatment, which consisted of a surgical-orthodontic method, were described. Supernumerary teeth in the incisor area is a rare disease, there are few cases reported in the national and international literature. Satisfactory cosmetic results were obtained with the surgical technique used for extraction of supernumerary teeth and orthodontic retained permanent tooth.

Tracionamento ortodôntico-cirúrgico para caninos superiores impactados: revisão crítica e sugestão de protocolo / Surgical-orthodontic traction for impacted maxillary canines: a critical review and suggested protocolc

Maxillary canine impaction is a common occurrence, especially in the palate, despite sufficient space in the arch for tooth alignment. A proper approach requires knowledge of different specialties of dentistry, such as orthodontics, surgery, radiology, and periodontology, which are generally not centered on a single professional. The causes for canine impaction may be either generalized or localized, and the diagnosis should be made through specific clinical and radiographic examination. The prognosis of surgical–orthodontic treatment depends on the position of the canine in relation to the neighboring teeth and height of the alveolar process, in addition to careful surgical technique, considering that there are risks involved, such as ankylosis, loss of tooth vitality, root resorption of the involved tooth and adjacent teeth, and damage to supporting tissues. Given the important role played by impacted maxillary canines, their traction is the treatment of choice in orthodontically treated patients. The present study reviews the literature on important factors to be considered when approaching impacted canines, such as therapeutic possibilities, their advantages and disadvantages.

A impactação de caninos superiores é uma ocorrência freqüente, especialmente na região palatina, ainda que na presença de espaço suficiente para seu alinhamento na arcada. A abordagem exige conhecimentos de diferentes especialidades da odontologia, tais como a ortodontia, cirurgia, radiologia e periodontia e que, em geral, não se centram em um único profissional. Pode ser causada por fatores de ordem geral ou local, sendo que seu diagnóstico deve ser realizado por meio de exames clínico e radiográfico específicos. O prognóstico do tratamento ortodôntico–cirúrgico ira depender da posição do canino em relação aos dentes vizinhos e da sua altura no processo alveolar, além de técnica cirúrgica cuidadosa, haja vista que envolve riscos, como: anquilose, desvitalização, reabsorção radicular do dente envolvido e dos dentes adjacentes e dano aos tecidos de suporte. Em virtude das importantes funções desempenhadas pelos caninos inclusos superiores, o seu aproveitamento através do tracionamento é o tratamento de eleição nos pacientes assistidos ortodonticamente. O presente trabalho traz uma revisão bibliográfica acerca de importantes fatores a serem considerados na abordagem dos caninos impactados, tais como as possibilidades terapêuticas, suas vantagens e desvantagens.

Effect of maxillary premolar extraction on transverse arch dimension in Class III surgical-orthodontic treatment / 대한치과교정학회지

Collective changes caused by orthodontic tooth movement evaluated in a specific treatment modality could give suggestive information on the specific treatment strategy. The aim of this study was to investigate retrospectively the characteristics of the orthodontic tooth movement during surgical-orthodontic treatment in order to provide an effective presurgical orthodontic treatment planning for the maxillary premolar extraction modality in the skeletal Class III malocclusion patient. Pre- and posttreatment dental casts of skeletal Class III malocclusion patients with nonextraction (N=24) and the maxillary premolar extraction (N=31) were collected. The angulation and inclination measuring gauge (Invisitech Co. Seoul, Korea) was used to evaluate the orthodontic tooth movement. The changes in the maxillary and mandibular dental arch widths were also measured from the canines to the second molars. As a result, more palatal inclination change in the maxillary dentition was found with the premolar extraction modality than with the nonextraction modality. Linear regression analysis showed that the inter-arch width coordination was mainly due to the inclination changes of maxillary posterior teeth. We conclude that the indications and proper treatment planning for surgical-orthodontic treatment in skeletal Class III malocclusion with maxillary premolar extraction could depend partly on the magnitude of the transverse inter-arch coordination especially in the maxillary dentition.

Locus of control of surgical-orthodontic patient / 대한치과교정학회지

Surgical-orthodontic treatment is an increasingly more common dental procedure whose unique psycho-social or psychological feature has not been fairly quantified objectively. Since the treatment of a surgical-orthodontic (or orthodontic) patient is part science and part art, a subjective recognition of a patient about his or her own treatment may be more important than technical success during and after treatment. Therefore, the knowledge of the patient's underlying psychological status could be useful in the prediction of patient's response to surgical-orthodontic (or orthodontic) treatment. The purpose of this study was to investigate and evaluate the psychological difference between conventional orthodontic patient and surgical-orthodontic patient by using locus of control (LOC) examination. Locus of control scale has been proven to be extremely useful in the prediction of a variety of human behaviors. Two types of locus of control data (I-score, Internal locus of control score; E-score, External locus of control score) were obtained for 42 surgical-orthodontic patients and randomly selected 42 conventional orthodontic patients (as a control group) matched for age and gender. No statistically significant difference was observed in the scale of internal and external locus of control between the groups of surgical-orthodontic patients and conventional orthodontic patients. However, in the group of surgical-orthodontic patients, males showed lower E-score (external locus of control score, higher internal locus of control tendency) than females. The results of this study suggested that the psychological background of surgical-orthodontic patients, in contrast with that of cosmetic surgery patients, has a similar disposition with that of orthodontic patients.