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Objective @#To investigate the influence of abnormal occlusion factors on the incidence of temporomandibular disorders (TMDs) in junior college students and to provide an etiological basis for the prevention and treatment of TMDs.@*Methods @# We examined the temporomandibular joint (TMJ) and dental occlusion in 754 lower grade college students (male 354, female 400) at Zunyi Medical University (Zhuhai campus). A questionnaire was also administered. We analyzed the correlation between TMD and the other three factors (static abnormal occlusion, dynamical abnormal occlusion and oral parafunctional activity) from the perspective of multivariate unconditioned logistic regression and univariate unconditioned logistic regression with dummy variables.@*Results @#The prevalence of TMD was 31.7%. The incidence of TMD was significantly (P<0.05) associated with sleep bruxism (OR=2.070), clenching (OR=2.553), diurnal (OR=2.642) and anterior teeth overbite (OR=1.228). Univariate unconditioned logistics regression analysis by dummy variables was used to analyze the incidence of TMD at different deep overbites (mild, OR=1.558; moderate, OR=2.189; severe, OR=3.236; P<0.05). @*Conclusion@#The risk factors for TMD in lower grade college students included anterior teeth occlusion, sleep bruxism, clenching, and diurnal treatment. Worse deep overbite might increase the risk of TMD.
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Introducción: Los pacientes con el Síndrome de clase II división 2, además de presentar clínicamente una relación de molares y caninos en disto-oclusión, muestran una retroinclinación de los incisivos centrales superiores con proinclinación de los laterales y sobremordida profunda, lo cual puede llegar a convertirse en un factor de riesgo que provoca disfunción temporomandibular. Objetivo: Identificar la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Material y Métodos: Se realizó una revisión bibliográfica automatizada en las bases de datos de los sistemas MEDLINE, PubMed, Hinari y Google; se utilizó un total de 17 artículos. Desarrollo: Por las características clínicas de la oclusión en los pacientes con este síndrome, el rango de movimiento mandibular está limitado, y produce un efecto traumático que se relaciona con una posición de los cóndilos desplazados hacia atrás e intruidos en la fosa glenoidea. Este desplazamiento más distal produce la presión del espacio retrodiscal ricamente inervado y sería causa de inflamación de los tejidos circundantes y afectación de la función de la articulación por elongación de los ligamentos discales o adelgazamiento del disco que afecta el complejo cóndilo-disco. Conclusiones: Los estudios consultados muestran la relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular, dada las características clínicas presentes en este síndrome, que afectan el funcionamiento de la articulación temporomandibular y que al sobrepasar las capacidades adaptativas del paciente producen la disfunción en la misma(AU)
Introduction: Patients with Syndrome type II division 2 malocclusions, besides presenting a clinically established relationship between molars and canines in a distal occlusion, show a retro-inclination of the upper front teeth with pro-inclination of the lateral incisors and a deep overbite, which can result in a risk factor of temporomandibular dysfunction. Objective: To identify the relationship between Syndrome type II division 2 malocclusions and the temporomandibular dysfunction. Material and Methods: A bibliographic review was carried out through a search of databases such as MEDLINE, PubMed, Hinari, and Scholar Google. A total of 17 articles were used. Development: Because of the clinical characteristics of the occlusion in the patients with this syndrome, the range of jaw movement is limited, producing a traumatic effect that is related with a position of the condyles displaced backward and with glenoid fossa intrusion. This more distal displacement produces the pressure of the richly innervated retrodiscal tissue, which could be the cause of inflammation of the surrounding tissues and the affectation of the joint function due to an elongation of the discal ligaments or a thinning of the disc affecting the disc-condyle complex. Conclusions: The studies conducted demonstrate the relationship between the Syndrome type II division 2 and the temporomandibular joint dysfunction, given the clinical characteristics that are present in this syndrome, which affect the functioning of the temporomandibular joint, and produce its dysfunction when exceeding the adaptive capacities of the patient(AU)
Subject(s)
Humans , Male , Female , Temporomandibular Joint Dysfunction Syndrome/complications , Malocclusion, Angle Class II/complications , Bibliographies as Topic , Overbite/etiology , Malocclusion/classificationABSTRACT
A proper vertical dimension and a harmonious occlusal plane are essential to satisfy a patient esthetically and functionally. A maxillomandibular occlusal vertical dimension is determined by the elevators which repeatedly contracts to a certain length, and a tooth location is determined by a maxillomandibular vertical dimension. The patient of this case came in with the incongruity of the lips and the occlusal plane. The result of clinical test showed the lack of length of the lower anterior due to the reduction of vertical dimension, the deep overbite of anterior, the excessive attrition of anterior, and the incongruity of occlusal plane. After the diagnostic wax-up, the temporary restoration was installed, and final prosthesis was installed after 6 months. As a result, the patient obtained a functionally and esthetically satisfying result.
Subject(s)
Humans , Dental Occlusion , Elevators and Escalators , Lip , Overbite , Prostheses and Implants , Rehabilitation , Tooth , Vertical DimensionABSTRACT
ABSTRACT The orthodontic treatment of patients with chief complaint of temporomandibular disorders (TMD) presents doubtful prognosis, due to the poor correlation between malocclusions and TMDs. The present case report describes the treatment of an adult patient with Angle Class II Division 2 subdivision left malocclusion associated with anterior deep overbite and TMD. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), as part of the requirements to obtain the title of BBO Diplomate.
RESUMO O tratamento ortodôntico de pacientes com queixa principal de disfunção nas articulações temporomandibulares (DTM) apresenta prognóstico duvidoso, devido à baixa correlação entre as más oclusões e as DTMs. O presente relato de caso descreve o tratamento de um paciente adulto com má oclusão de Classe II, divisão 2, subdivisão esquerda, de Angle e sobremordida profunda, associadas à DTM. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.
Subject(s)
Humans , Male , Young Adult , Temporomandibular Joint Disorders/complications , Overbite/complications , Malocclusion, Angle Class II/complications , Orthodontics, Corrective , Overbite/therapy , Malocclusion, Angle Class II/therapyABSTRACT
Objective:To study the force system of teeth produced by utility arch and rocking-chair arch for the treatment of deep o-verbite.Methods:Finite element model of mandible,mandible teeth,edgewise brackets and arch was established,utility arch and rocking chair arch were applied respectively,the force direction and magnitude of molars and incisors was analyzed by ANSYS.Re-sults:When utility arch was used,incisors bear intrusive force and molars bear extrusive force.With the utility arch wire was giving intrusive force to canine,the intrusive force to incisors reduced,the extrusive force to the first molars increased.When adding the bracketed teeth,the intrusive force to incisors increased,but the extrusive force to the canines and the force direction of the molars changed.Conclusion:While the utility arch exerts intrusive pressing force to the canines,the intrusive force to the lateral incisors de-crease,therefore,pressing of canines shall be independently completed after completing pressing of incisors.Different application methods of rocking-chair arches will produce different force to teeth.With addition of teeth applied with rocking-chair arch,the force to lateral incisors and molars changes the most.
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Objective To investigate and evaluate the change and efficacy of Active-wing Appliance in patients with lingual tipping deep overbite of Angle classⅡdivision 2 malocclusion.Methods Twenty patients with lingual tipping deep overbite of Angle classⅡdivision 2 malocclusions were selected for our study. Among the twenty patients, fifteen are girls and five are boys, whose age are from 16.0 to 23.0 years old with average of 18.8 years old . The patients were treated with Active-wing technique and all of them were non-extracted.Cephalometric films were taken before and after treatment to assess the effect of treatment . Eleven angular and thirteen linear measurements were taken. Paired t test was performed to analyze and evaluate the effects before and after treatment. Results Active-wing Appliance have advantage of easy operat-ing with short treatment cycle for treatment of deep overbite of Angle class Ⅱ division 2 malocclusion. It only takes 11 months in average for the treatment. After treatment, mandibular plane angle were increased (23.00° ± 6.76° vs 21.59° ± 5.32°),overbite were decreased [ (1.02±0.81) mm vs (5.67±1.22) mm] to reach normal level;incisors were labial incline sig-nificantly with increased protrusion and inclination;Post treatment parameter improvement also include:U 1-NA distance in-creased (4.67±1.21 ) mm vs (1.24±1.37) mm;U1-NA angle increased (24.40°±6.36° vs 11.70°±6.87°);lower incisors were significantly intruded[ (37.16 ± 1.81) mm vs(38.90 ± 1.84)mm];L6-MP were extruded [(31.68 ± 2.87) mm vs (30.38 ± 3.45) mm]; The cuspid and molar relationships were changed from Class Ⅱ to ClassⅠ occlusion. Conclusion The Active-wing Appliance can quickly open overbite and correct incisor lingual tipping for Angle class II division 2 with lingual tipping deep overbite. It is easy to operate and has been improved as efficient and shortened treatment. Meanwhile, it also saves arch wire. The Active-wing Appliance is especially powerful for lingual tipping deep overbite. However, the deficiency in torque control of premolars might be noticed.
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Este relato de caso descreve o tratamento ortodôntico de uma paciente adulta, portadora de uma má oclusão Classe II, 2ª Divisão de Angle, com sobremordida e curva de Spee acentuadas e que apresentava vestibuloversão do dente 12 e algumas recessões gengivais. A paciente foi tratada com exodontia dos primeiros pré-molares superiores e máximo controle de ancoragem. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 6, ou seja, uma má oclusão com sobremordida acentuada, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.
This case report describes the orthodontic treatment of an adult patient, who presented a Angle Class II, Division 2, malocclusion, with overbite, severe curve of Spee, right maxillary lateral incisor proclined and gengival recessions. The patient was treated with extraction of the first premolars and maximum anchorage control. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) representing the category 6, deep overbite malocclusion, as part of the requirements for obtaining the title of Diplomate by BBO.
Subject(s)
Humans , Female , Adult , Diagnosis, Oral/methods , Malocclusion, Angle Class II , Orthodontics, Corrective , Surgery, OralABSTRACT
Objective To investigate the stress in the periodontal tissues using three-dimansional finite element method when Richtts Arch was used.Methods Three-dimensional finite element models of the lower left central incisor and first molar were set up by means of CT.Stress distribution in root,PDL and alveolar bone,and the tendency of the tooth movement were obtained by calculation under Richtts Arch.Results The value of the force at the left lower incisor was -0.34 Newton and the value of the force at the left lower molar was 0.65 Newton.The molar model revealed that the tensile stress concentration was at the mesial root cervix and the compressive stress was at the distal root cervix.The incisor model showed that the tensile stress was concentrated at the lingual cervix and the compressive stress was concentrated at the apical tip.The arch wire exerted intruding force,lingual force and the incisor tended to lingual movement and intruding movement.The molar had the tendency of lingual movement and distal tipping movement.Conclusion The anchorage molar will incline mesially when Richtts Arch is used in treatment of deep overbite,the additional torque must be used in the anchorage molar.
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This study was designed to investigate the position of anteroposterior center of resistance for genuine intrusion and the mode of change of the minimum distal force for simultanous intrusion and retraction of the upper and lower incisors according to the increase of labial inclination. For this purpose, we used the three-piece intrusion arch appliance and three-dimensional finite element models of upper and lower incisors. 1. Positions of the center of resistance in upper incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 6mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 9mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 12m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 16m behind the distal surface of the lateral incisor bracket. 2. Positions of the center of resistance in lower incisors according to the increase of the labial inclination were as follows; 1) In normal inclination situation, the center of resistance was located in 10mm behind the distal surface of the lateral incisor bracket. 2) In 10degrees increase of the labial inclination situation, the center of resistance was located in 13mm behind the distal surface of the lateral incisor bracket. 3) In 20degrees increase of the labial inclination situation, the center of resistance was located in 15m behind the distal surface of the lateral incisor bracket. 4) In 30degrees increase of the labial inclination situation, the center of resistance was located in 18m behind the distal surface of the lateral incisor bracket. 3. The patterns of stress distribution were as follows; 1) There were even compressive stresses in and periodontal ligament when intrusion force was applied through determined center of resistance. 2) There were gradual increase of complexity in compressive stress distribution pattern with increase of the labial inclination when intrusion and retraction force were applied simultaneously.
Subject(s)
Finite Element Analysis , Incisor , Periodontal LigamentABSTRACT
Este estudo cefalométrico prospectivo foi desenvolvido com o propósito de descrever, comparativamente, os resultados de duas estratégias de correção da sobremordida. Foram selecionados 27 pacientes, com faixa etária entre 11 e 15 anos, apresentando maloclusões de Classe II, Divisão 1, com sobremordida de no mínimo 4 milímetros. Desses, 9 indivíduos serviram como grupo controle, 9 foram tratados com aparelhos fixos e arco contínuo de liga níquel-titânio com curva reversa de Spee, de espessura de 0,016 e os outros 9 pacientes foram tratados com a mecânica de intrusão da técnica do arco segmentado. Foram colocados implantes metálicos de referência intra-mandibulares, para sobreposições de traçados, em todos os componentes da amostra. Telerradiografias cefalométricas, em norma lateral, para a avaliação do comportamento dos incisivos inferiores, e a 45 graus, para a avaliação dos primeiros premolares e primeiros molares inferiores, foram tomadas no início do tratamento e após o nivelamento da curva de Spee do arco inferior, e após aproximadamente 6 meses no grupo de controle. Os resultados na região de incisivos inferiores indicaram que: não houve diferença estatística entre os dois métodos de tratamento; houve intrusão real, avaliada pelos deslocamentos dos centros de resistência dos incisivos tratados com a mecânica de intrusão da técnica do arco segmentado; as bordas incisais, dos grupos experimentais, sofreram deslocamentos intrusivos; as raízes dos incisivos nos grupos tratados mostraram um deslocamento para lingual. As posições dos primeiros premolares não foram influenciadas pelos tratamentos realizados. Na região dos molares, as posições das coroas não foram influenciadas pelos tratamentos realizados. Na região dos molares, as posições das coroas não foram influenciadas pelos tratamentos; no entanto, os tratamentos promoveram significante restrição da irrupção quando considerados os pontos radiculares
A prospective study was carried out with the purpose of comparing the results of two treatment strategies for deep overbite correction. The sample comprised 27 Class II, Division 1, with deep overbite cases (age 11 to 15 years). One group was treated with a continuous arch wire technique (0.016 nickel-titanium wire with reverse curve of Spee); in other group, the semented arch technique (Burstone) was used for correction of vertical malocclusion; a control group of nine cases was used. Metallic implants were used for superimpositions. Lateral cephalometric radiographs were used for evaluation of lower first bicuspids and first molars. The radiographs were taken before and immediately after leveling of lower arch. Statistical analysis was performed on the collected data. The results showed that both techniques produced highly significant incisor intrusion (incisal edge). There was no difference between both treatment strategies on lower incisors. A real intrusion was observed on the center of resistance of the lower incisors treated by the segmented arch technique. A lingual movement of the root apex was observed on both techniques. There was no significant difference between the three groups on lower first bicuspids. Lower first molars crowns were not influenced by these two treatments. However, the molar root points were restricted in their normal eruption