ABSTRACT
Vertical facial growth triggers the rotation of mandible to move the chin point to the downward and backward direction, which showed remarkably effective result making the less prominent chin. Recently, the intraoral removable appliance utilizing class III elastic demonstrated the vertical growth trigger mechanism. The treatment change was very fast and wearing was quite easy, compared to extraoral appliances.The purpose of this study was to verify the duration of the treatment on class III malocclusion using intraoral removable appliances, which designed to accelerate vertical facial growth.56 patients were selected with the complaint of the protruded mandible and class III malocclusion (overjet : −3 – 0 mm, overbite : 0 – 4 mm). Information like; age at start, duration of the treatment events, type of the treatment, overjet, overbite etc. was collected and calculated.The average age of the patients delivering the initial brace was 8.75 ± 1.10 year. Most of the anterior crossbite was resolved within 6 months. The total treatment period was 21.79 ± 10.73 months with the additional procedures like the alignment of anterior teeth and torque control using additional removable and fixed orthodontic appliances. The correlation study showed that patient's cooperation (p = 0.000) and the use of fixed appliance (p = 0.032) were significantly influenced on treatment duration.
Subject(s)
Humans , Braces , Chin , Malocclusion , Mandible , Orthodontic Appliances , Overbite , Statistics as Topic , Tooth , TorqueABSTRACT
The classification of facial vertical patterns is a common practice among dentists of different specialties. It influences treatment planning and expected outcomes, but is usually carried out qualitatively. The aim of this study is to better understand vertical facial proportions, combining a critic review of the literature with the collection of data from 100 Brazilian adult sample in search of 3D quantitative parameters with the use of Cone-Beam Computed Tomography (CBCT) measurements. In Pubmed database, the following quoted phrases were used: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Longface syndrome" AND "Short-face syndrome" in a 25 years interval (1990-2015). Study selection was performed searching for crucial facial features, commonly used to determine the facial pattern of a patient. In CBCT exams, 100 patients had facial features measured and classified by the three most reliable methods. The literature on the field can be very confusing, as the methods, landmarks and averages differed considerably. Most of the facial features researched had different values when the literature was analyzed and compared to our data. This indicates that ethnic, age and gender variations play an important whole in facial pattern diagnostic and should be taken in account when using general cephalometric approaches on diagnosis. With a group sorting method, combining the ratios between the anterior Facial height and the width, the anterior vertical proportion and the gonial angle divergence, and with anatomical landmarks we successfully correlated the sample to the qualitative description, as shorter faced patients to larger bi-zygomatic distances and less divergent gonial angles and longer faced patients with narrower and more divergent faces.
A classificação de padrões faciais verticais é prática comum entre Cirurgiões Dentistas de diferentes especialidades. Esta influencia o planejamento de tratamento e resultados esperados, no entanto, essa tarefa é frequentemente realizada de forma qualitativa. O objetivo deste trabalho foi compreender melhor as proporções verticais da face, combinando uma análise crítica da literatura com a coleta de dados de 100 adultos brasileiros na procura por parâmetros quantitativos em 3D, usando tomografias computadorizada de feixe cônico (TCFC). Na base de dado pubmed, a seguinte frase foi utilizada: "Facial pattern" AND "Facial Index" AND "Facial height Index" AND "Facial height" AND "Dolichofacial" AND "Brachyfacial" AND "Long-face syndrome" AND "Short-face syndrome" em um intervalo de 25 anos (1990-2015). A seleção dos estudos foi realizada procurando características faciais cruciais e métodos comuns para a determinação do padrão facial do paciente. Em exames de TCFC de 100 pacientes adultos, foram medidas as dimensões faciais foram registradas e os três métodos mais confiáveis e encontrados na literatura foram testados. A literatura sobre o assunto pode ser muito confusa, ao ponto de que os métodos, pontos de referência e médias variaram consideravelmente. Muitas das características pesquisadas tinham valores diferentes quando analisada a literatura em comparação com os dados dessa pesquisa. Isso indica que variações de etnia, idade e gênero tem papel importante no diagnóstico do padrão facial e deve ser levada em consideração quando utilizados padrões cefalométricos para diagnóstico. Com a metodologia de agrupamento, utilizando o índice entre a altura facial anterior e a largura, a proporção anterior da face e a divergência do ângulo goníaco, assim como os pontos cefalométricos selecionados, nós correlacionamos com sucesso a amostra com as descrições qualitativas como: os pacientes de face curta e as distâncias bi-zigomáticas e ângulos faciais menos divergentes, assim como os pacientes de face longa com faces mais estreitas e menos divergentes.
Subject(s)
Tomography, X-Ray Computed , FaceABSTRACT
Introducción y Objetivo: El crecimiento craneofacial posnatal es un proceso complejo que continúa aún después de los 20 años de edad. Cuantifi car por primera vez en una población mestiza latinoamericana y colombiana el desarrollo vertical facial anterior (AFA) y posterior (AFP). Materialesy Métodos: seguimiento cefalométrico bianual de 44 sujetos con apariencia facial normal y sin ningúntipo de tratamiento ortodóncico.Resultados: Hubo una disminución continua del ángulo del planomandibular (SN/PM) en ambos sexos. Se encontraron aumentos continuos de la AFA y AFP con diferencias signifi cativas por sexo a partir de los 16 años. El pico puberal para las mujeres de la AFA y AFP fue alrededor de los 13 años, para los hombres alrededor de los 15. Esta tendencia general mostró variaciones individuales importantes. Antes de los 11 años de edad el 63% de la muestra tuvo incrementos bianuales de más de 3 mm, después de los 16 años el 29,5% de los sujetos tuvo incrementos bianuales de más de 2 mm. Las mujeres después de los 18 años no tuvieron un patrón de rotación mandibular a favor de las manecillas del reloj, ni los hombres en contra. Conclusiones: se muestran diferencias importantes respecto a otros estudios reportados en poblaciones caucásicasen cuanto a la variabilidad individual, presencia de varias etapas de aceleración del crecimientovertical pre y pospuberalmente y rotación mandibular después de los 18 años. Estas diferencias no son debidas a características genéticas o nutricionales sino probablemente a cambios normalesdel crecimiento vertical facial.
Introduction and Objetive: The postnatal craniofacial growth is a complex process that continues even after 20 years of age. To quantify for the fi rst time, the anterior (AFA) and posterior vertical facial (AFP) developmental growth, in a mestizo Colombian and a latin-american population. Materials and Methods: Biannual cephalometric follow-up of 44 subjects with normal facial appearance and without any type of orthodontic treatment. Results: There was a continuous decrease of the mandibular plane angle SN / PM in both sexes. There were continuous increases in the AFA and AFP with signifi cant differences by sex after the age of 16. The pubertal peak for women in the AFA and AFP was about 13 years of age, and for men around the age of 15. This general trend showed signifi cant individual variations. Before the age of 11, 63% of the sample had biannual increments over 3 mm, after the age of 16, 29,5% of the subjects had biannual increases more than 2 mm. Women after the age of 18 had no clockwise mandibular rotation, neither did men had counterclockwise mandibular rotation. Conclusions: It is shown that there is an important difference between this study and other studies reported from Caucasian populations in terms of individual variability, presence of various growth spurt stages in the vertical facial height pre-and postpuberty. There was a non specifi c gender tendency of mandibular rotation after 18 years of age. These differences are not due to genetic or nutritional changes, but probably normal vertical facial growth changes.