ABSTRACT
Antecedentes: La clase III esqueletal, es una deformidad dentofacial donde el tercio inferior de la cara es más prominente, el tratamiento se decide según la etiología y la edad del paciente; si se encuentra en crecimiento la malformación puede ser tratada con un protocolo interceptivo y si es posible evitar la cirugía ortognática a futuro. Objetivo: Mejorar la clase esqueletal, descruzar la mordida u obtener mordida borde a borde, mejorar la posición del labio superior y evaluar el comparativo inicial-final de SNA y ANB. Reporte de caso:Paciente masculino de 13 años, sin antecedentes personales patológicos o familiares reportados; presenta clase III esqueletal responsiva bimaxilar, crecimiento vertical, clase molar I y canina III; fue tratado con el protocolo de mini placas BAMP (bone anchored maxillary protraction) por sus siglas en inglés, elásticos intermaxilares y un paladar con pistas planas. Resultados:La fase ortopédica duro cinco meses y se logró mordida borde a borde y clase I esqueletal. Discusión: Se obtuvieron resultados con el uso de mini implantes sin anclaje extraoral en menos tiempo a comparación de otros métodos que tienen que ser usados por 9-12 meses.Conclusión:El protocolo BAMP puede ser usado en pacientes en crecimiento sin máscara facial para corregir la clase III esqueletal.
Background: Skeletal class III is a dentofacial deformity where the lower third ofthe face is more prominent. The treatment is decided according to the etiology and age of the patient; If the patient is in growing, the malformation can be treated with an interceptive protocol and if possible, avoid a orthognathic surgery in the future. Objective: Improve the skeletal class, uncross the bite or obtain an edge-to-edge bite, improve the position of the upper lip and compare the initial-final relationship of ANS and ANB.Case report:13-year-old male patient, with no reported pathological or family history; presents skeletal class III, vertical growth, molar class I and canine III; he was treated with the protocol of mini BAMP (bone anchored maxillary protraction) plates, intermaxillary elastics and a palate with flat tracks. Results:The orthopedic phase lasted five months and an edge-to-edge bite and skeletal class I were achieved.Discussion:Results were obtained with the use of mini plates without extraoralanchorage in less time compared to other methods that have to be used for 9-12 months. Conclusion: The BAMP protocol can be used in growing patients without a face mask to correct skeletal class III.
ABSTRACT
OBJECTIVE@#To assess the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents.@*METHODS@#Articles relating to the use of bone anchorage and maxillary facemask protraction devices for treating skeletal class Ⅲ malocclusion in adolescents were searched from the databases of Cochrane Library, PubMed, EmBase, CNKI, and Wanfang database. Several inclusion and exclusion criteria were developed for the article screening. The clinical data were extracted, and the quality of the selected articles was evaluated. A Meta-analysis of SNA, SNB, ANB, ANS-Me, Wits, and U1-PP change was performed by using RevMan 5.3.@*RESULTS@#Seven studies (264 patients) were included in the Meta-analysis. Among these studies, three were randomized controlled trials, and four were non-randomized controlled trials. Compared with the maxillary facemask protraction device group, the bone ancho-rage device group had higher SNA changes and lower ANS-Me, Wits, and U1-PP changes (P<0.05). No significant differences were observed in the SNB and ANB changes between these two groups.@*CONCLUSIONS@#Compared with the maxillary facemask protraction device, the bone anchorage device can increase the extent of protraction of the maxilla and has better controls for the labial inclination of the maxillary anterior teeth in treating skeletal class Ⅲ malocclusion among adolescents. However, additional high-quality randomized controlled trials must be performed to verify the results.
Subject(s)
Adolescent , Humans , Cephalometry , Extraoral Traction Appliances , Malocclusion, Angle Class III , Maxilla , Palatal Expansion TechniqueABSTRACT
Com o desenvolvimento da ancoragem esquelética, vários dos efeitos colaterais advindos de mecânicas ortodônticas foram minimizados. Entre os movimentos facilitados com o uso destes dispositivos, encontra-se a intrusão de molares. Este trabalho relata dois casos clínicos de intrusão de molares superiores com o auxílio de mini-implantes ortodônticos em pacientes adultos. O tratamento possibilitou a simplificação da mecânica, eliminando a necessidade de cooperação dos pacientes e/ou de um tratamento complexo ou cirúrgico. Os resultados clínicos mostraram intrusão satisfatória dos molares superiores sem evidências de efeitos colaterais indesejáveis.
The orthodontic skeletal anchorage improved some orthodontic movements and several side effects deriving from mechanical orthodontic were minimized. This paper reports two cases of intrusion of upper molars using orthodontic mini-implant as skeletal anchorage. The adult patients present for orthodontic treatment previous oral rehabilitation. The treatments were fast and simple because some biomechanical principles were used to became possible the simplification of mechanics and eliminating the need for patient cooperation. The clinical results showed satisfactory upper molar intrusion with no evidence of undesirable side effects.
Subject(s)
Humans , Female , Adult , Molar , Tooth Movement Techniques/adverse effects , Orthodontic Anchorage Procedures , Orthodontics, CorrectiveABSTRACT
Introducción y Objetivo: El manejo del anclaje es fundamental para el éxito del tratamiento en ortodoncia fi ja, sin embargo no hay consenso acerca de la efectividad del anclaje esquelético para la retracción de los dientes anteriores. El objetivo fue evaluar la efectividad del anclaje esquelético para el cierre de espacios en el arco maxilar.Materiales y Métodos: Se realizó una revisión sistemática de literatura a partir de las bases de datos PubMed, Lilacs, Cochrane, Scielo. Se incluyeron ensayos clínicos controlados, donde el anclaje esquelético fuera utilizado para el cierre de espacios; tresrevisores analizaron los resúmenes y textos completos para considerar el cumplimiento de los criterios de inclusión y exclusión de manera independiente, en un formato de extracción de datos.Resultados: Se identifi caron 324 artículos, de los cuales 316 fueron rechazados después de la evaluación, de los ocho estudios inicialmente seleccionados, cinco fueron excluidos. Sólo tres estudios cumplieron con los criterios de inclusión. Se realizó un metanálisis con el método de efectos aleatorios para el movimiento mesial del molar superior, en el cual los dispositivos de anclaje esquelético temporal mostraron ser más efectivos en el control del anclaje en -2,72 mm (-4,10,- 1,33 IC95%) al compararlos con los métodos de anclaje ortodóntico convencional, esta diferencia fue estadísticamente signifi cativa. Conclusiones: El anclaje esquelético temporal parece ser más efectivo para controlar el movimiento mesial del molar durante el cierre de espacios, comparado con el anclaje ortodóntico convencional, sin embargo la evidencia científi ca en la literatura es escasa.
Introduction and Objetive: Anchorage management is essential for successful fi xed orthodontic treatment; however there is no consensus about the effectiveness of skeletal anchorage for anterior teeth retraction. The aim of this review was to evaluate the effectiveness of skeletal anchorage forspace closure in the maxillary arch. Materials and Methods: A systematic review of the literature was performed in PubMed, Cochrane, Lilacs, Scielo databases. Controlled clinical trials were included, where skeletal anchorage was used for space closure. Three reviewers examined the abstracts and full texts to determine fulfi llment of the inclusion and exclusion criteria independently in a data extraction form. Results: 324 papers, out of which 316 were excluded after the evaluation of title and abstract of the eight initially selected trials. Only three trials met the inclusion criteria.A meta-analysis was performed with a random effects method for the mesial movement of upper molars in which the temporary skeletal anchorage devices showed to be more signifi cantly moreeffective in controlling anchorage -2,7 mm (-4,10,-1,33 CI 95%) when compared to the conventionalanchorage control methods.Conclusions: Temporary skeletal anchorage seems to be more effective in controlling the movement of molars during mesial space closure, when compared to the conventional orthodontic anchorage although evidence in the literature is limited.