ANCHORAGE PREPARATION FOR VARIOUS ORTHODONTIC TREATMENT

There are many kinds of orthodontic movements that make the clinical schedule a genuine test. With the appearance of the skeletal anchorage, it became more straightforward to take care of numerous issues, like anchorage, tipping, interruption among others. The reason for this article was to survey outright anchorage, including signs, implantation site, and any kind of orthodontic element

Anclaje esquelético para el tratamiento de las anomalías de clase II y mordida abierta anterior: informe de un caso / Skeletal anchorage for the treatment of class II anomalies and anterior open bite: report of a case

El reporte de este caso tiene como objetivo demostrar la utilidad de los anclajes esqueléticos temporarios como son las miniplacas cigomáticas y los microimplantes "buccal shelf" en el tratamiento ortodóncico, en una paciente de 17 años 10 meses de edad, clase II vertical, dólicofacial, con mordida abierta anterior y aumento de la altura facial inferior. Después de la primera fase de tratamiento, siguiendo la secuencia de arcos para completar la alineación, se utilizaron anclajes esqueléticos extrarradiculares con una mecánica de intrusión con fuerzas elásticas durante 10 meses. Se intruyeron sus piezas posteriores superiores e inferiores y se distalizó la arcada superior, corrigiéndose la oclusión. El mentón retrognático y su perfil convexo mejoraron con la autorrotación de la mandíbula (AU)

The objective of this report case is to demonstrate the usefulness of temporary skeletal anchors such as zygomatic miniplates and buccal shelf microimplants in orthodontic treatment, in a 17-year-old 10-month-old, vertical class II, dollicofacial patient with anterior open bite and increased lower facial height. After the first treatment phase, following the arch sequence to complete the alignment, extra-radicular skeletal anchors were used with intrusion mechanics with elastic forces for 10 months. Its upper and lower posterior pieces were intruded and the upper arch was distalized, correcting the occlusion. e retrognathic chin and its convex profile improved with autorotation of the jaw (AU)

Intrusion of posterior teeth using miniplates: intrusive mechanics is not the same as intrusion force

ABSTRACT Objective: Biologically explain some of the bone mechanisms involved in the intrusion, or intrusive effect, of teeth submitted to skeletal open bite correction using four miniplates. Methods: The results of dental intrusion were measured and compared in 3D reconstructions of cone beam computed tomography scans taken before and after treatment of 20 patients with skeletal open bite, aged between 18 and 59 years. Results: The results allow deducing that the compression and traction forces biologically promoted deformation or deflection of the osteocyte network that controls bone design, and these effects involved the external and internal surfaces of the bone, with the formation of new layers, including the cervical portion of the alveolar bone crest. This helps understanding how dental intrusion occurs in intrusive mechanics, whose forces are of inclination rather than intrusion. The root resorptions caused by the use of miniplates were insignificant, due to the more homogeneous distribution of forces in the several teeth simultaneously involved. Conclusion: Imaging studies in CT scans tend to capture in details the subperiosteal and endosteal phenomena of dental intrusion - before and after the application of intrusive mechanics -, in the form of a set of modifications called dental intrusion or intrusive effect .

RESUMO Objetivo: Explicar, biologicamente, alguns dos mecanismos ósseos envolvidos na intrusão, ou efeito intrusivo, de dentes submetidos à correção da mordida aberta esquelética por meio do uso de quatro miniplacas. Métodos: Foram mensurados, em reconstruções 3D de tomografias computadorizadas de feixe cônico, os resultados da intrusão dentária, comparando-se o antes e o depois em 20 pacientes com mordida aberta esquelética, com idades entre 18 e 59 anos. Resultados: Os resultados permitem deduzir que as forças de compressão e de tração promovem, biologicamente, deformação ou deflexão da rede osteocítica controladora do design ósseo, e esses efeitos envolvem as superfícies externas e internas do osso, com formação de novas camadas, incluindo a parte cervical da crista óssea alveolar. Isso ajuda a compreender como ocorre a intrusão dentária nas mecânicas intrusivas cujas forças são de inclinação, e não de intrusão. As reabsorções radiculares promovidas pelo uso de miniplacas são insignificantes, em função da distribuição mais homogênea das forças nos vários dentes simultaneamente envolvidos. Conclusão: Os estudos imagiológicos tendem a captar, nas tomografias, cada vez mais detalhadamente os fenômenos subperiosteais e endosteais da intrusão dentária nos pacientes - antes e depois da aplicação das mecânicas intrusivas -, na forma de um conjunto de modificações que se chama intrusão dentária ou efeito intrusivo.

Miniplates combined with reconstruction plate for the treatment of comminuted posterior wall acetabular fractures / 中华创伤杂志

Objective:To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods:A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019. There were 18 males and 9 females, at age of 23-61 years［（45.9±10.9）years］. All patients were treated by using miniplates combined with the reconstruction plate. The operation time, intraoperative blood loss, intraoperative blood transfusion, length of hospital stay and time of fracture healing were recorded. The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively. The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3, 6 months postoperatively and the final follow-up. Postoperative complications were observed, and heterotopic ossification was assessed by Brooker grading standard.Results:All patients were followed up for 12-48 months［36（24, 36）months］. The operation time was 123-242 minutes［（165.4±29.8）minutes］; the intraoperative blood loss was 170-550 ml［（358.3±111.3）ml］; nine patients required intraoperative blood transfusion of 300-500 ml［（377.8±66.7）ml］. The length of hospital stay was 12-29 days［（21.4±4.7）days］. The fracture healing time was 12-24 weeks［（16.3±3.0）weeks］. According to Matta radiographic standard, the reduction quality was excellent in 21 patients, good in 3 and poor in 3 at 2 days postoperatively, with the excellent rate of 89%. The modified Merle D'Aubigné-Postel score was 9-16 points［（13.1±1.9）points］at 3 months postoperatively, was 10-18 points［（15.4±2.0）points］at 6 months postoperatively, and was 12-18 points［（16.9±1.8）points］at last follow-up（ P<0.01）. The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different（ P<0.01）, and the difference between 6 months and the follow-up was statistically significant（ P<0.01）. The modified Merle D'Aubigné-Postel score was graded as excellent in 0 patient, good in 7, fair in 11 and poor in 9 at 3 months postoperatively, with the excellent rate of 26%; graded as excellent in 3 patients, good in 19, fair in 2 and poor in 3 at 6 months postoperatively, with the excellent rate of 81%; graded as excellent in 18 patients, good in 5, fair in 3 and poor in 1 at the last follow-up, with the excellent rate of 85%（ P<0.01）. No iatrogenic sciatic nerve injury, deep vein thrombosis or wound infection occurred after operation. No hardware loosening or loss of reduction occurred during the follow-up. The post-traumatic arthritis was identified in 2 patients. The avascular necrosis of femoral head was observed in 1 patient and thereafter underwent total hip replacement. The heterotopic ossification occurred in 3 patients, among which 2 patients were graded as Brooker class I and 1 as class II, but there was no adverse effect on hip function. Conclusions:Miniplates combined with reconstruction plate in the treatment of comminuted posterior wall acetabular fractures have reliable fixation effect and attain good reduction, high fracture healing rate, less complications and satisfactory functional recovery.

Evaluation of 3-Dimensional Titanium Miniplates in Mandibular Fractures

Introduction: Mandibular fractures are one of the mostcommon fractures of facial skeleton because of its prominentposition in maxillofacial region. Traditionally, surgeons haveattempted to achieve: anatomic reduction, immobilization andfixation, prevention of infection and rehabilitation of function.The aim of our study was to evaluate the following parameterslike surgical procedures, infection, hardware failure, wounddehiscence, neurosensoery deficit, and fate of implant.Material and methods: The present study was conducted inthe Department of Oral and Maxillofacial Unit, after obtainingethical clearance. A total of 20 patients were selected toevaluate the usefulness of 3-Dimensional titanium miniplatesin fixation of mandibular fractures. After surgical exposure,either straight 6 holed or 8 holed or curved 8 holed 3-Dtitanium miniplates are placed. The patients were in the agegroup of 21-40 years. Etiology of trauma in most of the patientwas Road traffic accident (70%).Result: The frequency of fracture site being mainlyparasymphysis fracture (50%). Two patients had infection(10%). None of the patients had malunion or nonunion. The3-Dimensional titanium miniplates are suitable for fixation ofsimple mandibular fractures and an easy to use alternative toconventional miniplates.Conclusion: This plate is associated with good stability offracture segments and low infection rate

Surgical management of chronic temporomandibular joint dislocations

Temporomandibular joint dislocation is described as the movement of mandibular condyle out of the fossa beyond its anatomical and functional boundaries causing pain and discomfort. It is often managed by conservative methods, but in long-standing, chronic conditions, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. Materials and Methods: This retrospective analysis involving a single center and a surgeon with 19 patients and 23 joint surgeries performed over a 10-year period. Patients who fulfilled inclusion and exclusion criteria and had earlier undergone surgical correction with hook-shaped miniplates and miniscrews fixed with or without bone grafts formed the study group. Results: In all, 12 were female (mean age, 41.9 ± 12.07 years) and the rest 9 were male (mean age, 39.8 ± 13.6 years), ranging from 32 years to 58 years. All patients had the dislocation for an average period of 19.26 ± 12.6 months before the surgery. The mean maximal mouth opening (without pain) preoperatively was 17.78 ± 2.13 mm (12–25 mm) while postoperatively it was 32.28 ± 3.17 mm (27–37 mm). There were no immediate or late surgical complications in the follow-up period that ranged from 8 to 37 months. Discussion: When proper case selection is employed and properly done, using hook-shaped miniplates with or without bone graft is more cost-effective, giving excellent short- and long-term effects. Conclusion: The results in this Indian population are very similar to that reported from other parts of the world.

Reduction and Fixation of Zygomatic Complex Fractures with Miniplates at the Fronto-zygomatic Suture and Zygomatic Buttress Area-A Clinical Study

Background Zygomatico-maxillary complex fractures are one of the most frequently occurring injuries of the facial skeleton due to its position and also the facial contour. The principal aetiologic factors that may result in zygomatic bone fracture include assaults, road traffic accidents and also falls. There are many methods of fixation that have been applied for treatment of zygomatic arch fractures. Aim To reduce and fix the zygomatic complex fracture using miniplates at the fronto-zygomatic suture and zygomatic buttress area. Material and method The present study includes five cases of zygomatic complex fractures who visited the Department of Oral and Maxillofacial Surgery in Government Dental College and Hospital, Hyderabad. The operative procedure adopted was the lateral bow incision for exposure of fronto-zygomatic suture, the Gillie temporal approach for reducing the zygoma and intra-oral incision for exposure of zygomatic buttress fracture. Fixation was done with miniplates at the fronto-zygomatic suture and the zygomatic maxillary buttress suture. Result All the cases were successfully treated without any post-operative complications and with uneventful restoration of aesthetics and function.

Mechanical comparison of two internal rigid fixation systems used for fixing facial fractures (an in vitro study) / Comparación mecánica de dos sistemas de fijación interna rígida utilizados en la fijación de fracturas faciales (estudio in vitro)

ABSTRACT Introduction: the use of titanium miniplates is the gold standard in the treatment of facial fractures. A Colombian company has developed a system of osteosynthesis miniplates for the treatment of facial fractures, which was chemically and mechanically compared with an imported system. Methods: comparative in-vitro tests were carried out to analyze the chemical composition and the biomechanical behavior of the national and imported systems. A sample of 36 items was selected, including 24 miniplates and 12 screws, in order to mechanically assess their materials by means of tensile and flexural tests for the plates and torque strength tests for the screws, and to perform a microscopic analysis of the chemical composition of the plates of both brands by means of scanning electron microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). Results: The findings showed that there are no major differences in terms of the chemical composition and the biomechanical behavior of the implants of both brands (national and imported) when assessing plates and screws separately. Conclusions: the results showed a higher content of titanium in the material of national plates; however, the mechanical properties of both brands are very similar. Taking into account the material′s biomechanical characteristics, either system is a good choice when selecting a device for rigid internal fixation of facial fractures.

RESUMEN Introducción: el uso de miniplacas de titanio representa el estándar de oro en el tratamiento de las fracturas faciales. Una empresa colombiana desarrolló un sistema de miniplacas de osteosíntesis para el tratamiento de fracturas faciales, el cual fue comparado química y mecánicamente con un sistema importado. Métodos: se realizaron pruebas in vitro comparativas para analizar la composición química y el comportamiento biomecánico del sistema nacional y del importado. Se seleccionó una muestra total de 36 elementos de prueba, de los cuales 24 eran miniplacas y 12 tornillos, con el fin de evaluar el material mecánicamente por medio de pruebas de tracción y flexión para las placas y pruebas de resistencia al torque para los tornillos, y realizar un análisis microscópico y de la composición química de las placas de ambas marcas por medio de Microscopía Electrónica de Barrido (SEM) y Energy Dispersive Spectroscopy (EDS). Resultados: los hallazgos mostraron que no existen grandes diferencias en cuanto a la composición química y el comportamiento biomecánico entre los implantes de ambas marcas (nacional e importado), al evaluar las placas y los tornillos por separado. Conclusiones: los resultados mostraron un mayor contenido de titanio en el material de las placas nacionales; sin embargo, se encontró que las propiedades mecánicas de ambas marcas son muy similares. Teniendo en cuenta las características biomecánicas del material, cualquiera de los dos sistemas es una buena alternativa en el momento de elegir un dispositivo para la fijación interna rígida de fracturas faciales.

Miniplates and mini-implants: bone remodeling as their biological foundation

Abstract The tridimensional network formed by osteocytes controls bone design by coordinating cell activity on trabecular and cortical bone surfaces, especially osteoblasts and clasts. Miniplates and mini-implants provide anchorage, allowing all other orthodontic and orthopedic components, albeit afar, to deform and stimulate the network of osteocytes to command bone design remodeling upon "functional demand" established by force and its vectors. By means of transmission of forces, whether near or distant, based on anchorage provided by miniplates, it is possible to change the position, shape and size as well as the relationship established between the bones of the jaws. Understanding bone biology and the continuous remodeling of the skeleton allows the clinician to perform safe and accurate rehabilitation treatment of patients, thus increasing the possibilities and types of intervention procedures to be applied in order to restore patient's esthetics and function.

Resumo A rede tridimensional formada pelos osteócitos controla o designósseo ao coordenar a atividade das células nas superfícies trabeculares e corticais, especialmente os osteoblastos e os clastos. Miniplacas e mini-implantes servem de ancoragem para que os demais componentes ortodônticos e ortopédicos possam - mesmo que à distância - deformar e estimular a rede de osteócitos a comandar uma remodelação no design de acordo com a "demanda funcional" criada pela forças aplicadas e seus vetores. Na transmissão próxima ou longínqua de forças, com base na ancoragem oferecida pela miniplacas, pode-se mudar a posição, o formato, tamanho e relação entre os ossos maxilares. Compreender a biologia óssea e a remodelação constante do esqueleto permite atuar com segurança e precisão nesse tipo de planejamento reabilitador dos pacientes, aumentando as possibilidades e tipos de intervenção para devolver a estética e função a eles.

Remodelação óssea e os planejamentos reabilitadores bucais com mini-implantes e miniplacas: algumas analogias para facilitar a compreensão / Bone remodeling and oral rehabilitation plans with mini-implants and mini-plates: a few analogies to facilitate understanding

Os ossos renovam-se constantemente e o turnover permite uma grande capacidade de adaptação a novas demandas físicas e metabólicas. A renovação óssea é completa em 4 a 5 anos no esqueleto do adulto jovem, comportando-se no dia a dia como o poeta disse "... prefiro ser uma metamorfose ambulante!". No simples movimento ortodôntico, na colocação de um implante osseointegrável, na aplicação do aparelho ortopédico, no movimento dentário com ganho de osso ou mudança de forma pela ancoragem em mini-implantes, e quer seja na transmissão longínqua de forças com base na ancoragem oferecida pela miniplacas, os osteócitos estão implicados, com sua rede tridimensional, no controle do design ósseo, por coordenarem a atividade de seus comandados nas superfícies trabeculares e corticais: os osteoblastos e os clastos. Compreender a biologia óssea e a remodelação constante do esqueleto permite atuar com segurança e precisão nos planejamentos reabilitadores dos pacientes e aumenta, também, as possibilidades de tipos de intervenção para devolver a estética e função a eles...

Bones are under continuous remodeling, and turover allows them to greatly adapt to new physical and metabolic demands. Bone remodeling ceases within 4 to 5 years in a young adult skeleton, and behaves as mentioned by the poet: “an ongoing metamorphosis.”Whether in orthodontic movement, osseointegrated implant placement, orthopedic appliance placement, tooth movement with bone gain or format changes caused by anchorage and mini-implants, or in the transmission of forces by means of miniplate-based anchorage, osteocytes are involved, by means of their tridimensional network, with bone design control, as they rule the activity of those which they command on trabecular and cortical bone surfaces: osteoblasts and clasts. Understanding bone biology and continuous remodeling of the skeleton allows us to perform safe and accurate rehabilitation treatment planning, thus increasing the number of intervention procedures to be applied in order to restore patient’s esthetics and function...

Mini-implants and miniplates generate sub-absolute and absolute anchorage

The functional demand imposed on bone promotes changes in the spatial properties of osteocytes as well as in their extensions uniformly distributed throughout the mineralized surface. Once spatial deformation is established, osteocytes create the need for structural adaptations that result in bone formation and resorption that happen to meet the functional demands. The endosteum and the periosteum are the effectors responsible for stimulating adaptive osteocytes in the inner and outer surfaces.Changes in shape, volume and position of the jaws as a result of skeletal correction of the maxilla and mandible require anchorage to allow bone remodeling to redefine morphology, esthetics and function as a result of spatial deformation conducted by orthodontic appliances. Examining the degree of changes in shape, volume and structural relationship of areas where mini-implants and miniplates are placed allows us to classify mini-implants as devices of subabsolute anchorage and miniplates as devices of absolute anchorage.

Uma demanda funcional sobre o osso promove alterações na forma espacial da rede de osteócitos e seus prolongamentos, distribuídos uniformemente na estrutura mineralizada. A partir da deformação espacial captada, os osteócitos comandam a necessidade de adaptações estruturais, formando osso em novas áreas e reabsorvendo em outras, para que sejam atendidas as demandas funcionais. O endósteo e o periósteo são os verdadeiros efetores desses estímulos osteocíticos adaptativos, nas superfícies internas e externas. As alterações de forma, volume e posição dos ossos maxilares, nas correções esqueléticas da maxila e mandíbula, requerem uma ancoragem para que a remodelação óssea redefina a morfologia, a estética e as funções, a partir de deformações espaciais dirigidas por aparelhos. Verificar o grau de alterações na forma, volume e relações estruturais das áreas onde se fixaram os mini-implantes e as miniplacas poderá levar à classificação dos mini-implantes como dispositivos de ancoragem subabsoluta e as miniplacas, como de ancoragem absoluta.

Miniplacas como ancoragem esquelética temporária em ortodontia / Miniplates for temporary skeletal anchorage in orthodontics

A ancoragem é um dos fatores determinantes para o sucesso do tratamento ortodôntico e seu controle é fundamental para a obtenção dos resultados desejados. Os recursos de ancoragem mais utilizados comumente são limitados e, muitas vezes, dependem da colaboração do paciente. Na busca pela solução deste problema, a ancoragem esquelética, por meio das miniplacas, surge como uma excelente opção, tendo a grande vantagem de serem estáveis, sendo utilizadas para a movimentação de dentes individualmente ou em grupo. O presente estudo teve como objetivo realizar uma revisão de literatura, discorrendo sobre as diversas aplicações clínicas das miniplacas, suas vantagens e desvantagens, sua forma, tamanho e design, o procedimento cirúrgico de colocação e remoção, bem como a mecânica ortodôntica possível de ser realizada sobre as mesmas. De acordo com a literatura consultada, pode-se concluir que as miniplacas são efetivas como dispositivo de ancoragem esquelética, permitem uma movimentação dentária tridimensionalmente previsível sem trazer danos ao osso e/ou tecido periodontal, muito menos perda de vitalidade pulpar ou reabsorções radiculares.

Anchorage is one of the determining factors for the success of orthodontic treatment and its control is fundamental to achieve the desired results. In this context, skeletal anchorage using miniplates can be an excellent choice, due to advantages as stability and the possibility of moving a group of teeth as well as a single tooth. This study aimed to conduct a literature review, discussing the various clinical applications of miniplates, their advantages and disadvantages, their shape, size and design, surgical placement and removal, as well as their possibilities regarding orthodontic mechanics. It was concluded that miniplates are effective as ann anchorage device, allowing predictable three- dimensional tooth movement without bringing damage to bone and/or periodontal tissue, and reducing the loss of pulp vitality or root resorption.

Tratamento da Classe II com miniplacas / Treatment of Class II with miniplates

O objetivo deste artigo é relatar o tratamento ortodôntico de uma paciente adulta, portadora de Classe II divisão 1ª com o auxílio de miniplacas. A paciente apresentava discrepância maxilomandibular (ANB = 8º), relação de Classe II de caninos e molares de ambos os lados, sobremordida profunda, sobressaliência aumentada e incisivos superiores protruídos. O perfil facial era convexo e o terço inferior levemente aumentado. O plano de tratamento consistiu em alinhamento e nivelamento dos arcos superior e inferior e, posteriormente, realizou-se a instalação das miniplacas que forneceram ancoragem para a distalização do arco superior. O resultado clínico pode ser considerado satisfatório para um tratamento esquelético compensatório.

The aim of this article is to report the orthodontic treatment of an adult patient, carrier of Class II division 1ª with the aid of miniplates. The patient had maxillomandibular discrepancy (ANB = 8), Class II relationship of canines and molars on both sides, deep overbite, increased overjet and, upper incisor protrusion. The facial profile was convex and the lower third slightly increased. The treatment plan consisted of alignment and leveling of the upper and lower arches and later held the installation of miniplates that provided anchorage for distalization of the maxillary arch. The clinical outcome can be considered satisfactory for treatment compensatory skeletal.

Application of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery / 中国综合临床

Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Sistema de Apoio Ósseo para Mecânica Ortodôntica (SAO®): miniplacas para ancoragem ortodôntica. Parte I: tratamento da mordida aberta / Skeletal Supported System for Orthodontic Anchorage (SAO®): mini-plates for orthodontic anchorage. Part I: openbite treatment

Este trabalho descreve uma nova forma de ancoragem por meio de miniplacas denominada SAO®, Sistema de Apoio Ósseo para Mecânica Ortodôntica. Após a descrição do sistema, protocolos de tratamento para mordidas abertas esqueléticas são apresentados. A aplicação de cantiléveres e alças apoiadas diretamente nos tubos do sistema de ancoragem permite que associações de problemas verticais e sagitais (Classe II e III) sejam tratadas de formas distintas. A aplicação de forças leves e constantes e o controle tridimensional das forças aplicadas são o grande diferencial desse novo sistema.

This paper describes the SAO®, Sistema de Apoio Ósseo para Mecânica Ortodôntica (Skeletal Supported System for Orthodontic Mechanics), a new approach for anchorage by means of mini-plates. After the description of the system, treatment protocols for skeletal openbite cases are presented. The use of cantilevers and different spring configurations attached directly in the tubes of the anchorage system allows various approaches for vertical and sagittal discrepancies.

Miniplacas de ancoragem no tratamento da mordida aberta anterior / Anchorage miniplates on anterior open-bite treatment

INTRODUÇÃO: o relato de caso apresentado descreve um tratamento ortodôntico auxiliado por miniplacas, de uma paciente adulta que apresentava mordida aberta anterior acentuada, rotação horária da mandíbula, biprotrusão e ausência de selamento labial. Após a extração dos primeiros molares e retração dentária superior e inferior, associada ao controle vertical propiciado pelas placas, ocorreu uma pequena rotação anti-horária da mandíbula e a correção da mordida aberta anterior, com significativa melhora facial. OBJETIVO: o presente relato corrobora as evidências atuais quanto à eficiência do uso de miniplacas de titânio como ancoragem temporária, especialmente em situações de correções de grande amplitude, envolvendo um problema vertical.

INTRODUCTION: The case report presented describes an orthodontic treatment supported by miniplates of an adult female patient who presented severe anterior openbite, clockwise rotation of the mandible, biprotrusion and the absence of labial sealing. After extraction of first molars and maxillary and mandibulary dental retraction, associated with vertical control provided by the miniplates, the anterior openbite was corrected with a little anti-clockwise rotation, resulting in a significant improve on facial appearance. AIM: This case report confirms the efficiency of titanium miniplates as temporary anchorage, especially in situations where great corrections are needed, involving a vertical problem.

Miniplacas permitem tratamento eficiente e eficaz da mordida aberta anterior / Miniplates allow efficient and effective treatment of anterior open bites

INTRODUÇÃO: o tratamento das deformidades e más oclusões que incluem mordidas abertas anteriores foi uma das primeiras aplicações de miniplacas como forma de ancoragem ortodôntica. A implementação desse sistema de tratamento reduz o número de pacientes indicados para a cirurgia ortognática e simplifica muitos problemas. Nessa abordagem, os dentes posteriores são intruídos e a mandíbula sofre um giro no sentido anti-horário, diminuindo a altura facial inferior e projetando os pogônios de tecidos duro e mole. OBJETIVO: o presente artigo apresenta os fundamentos da mecânica ortodôntica para correção da mordida aberta anterior e os ilustra com uma série de casos clínicos.

INTRODUCTION: The treatment of facial deformities and malocclusions, such as anterior open bite, was one of the first applications of miniplates for orthodontic anchorage. The use of this treatment system reduces the number of patients referred to orthognathic surgery and simplifies many problems. This approach applies intrusive forces to posterior teeth, and the mandible undergoes counterclockwise rotation, which decreases lower facial height and advances the projection of hard and soft tissue pogonions. OBJECTIVE: This study describes the principles of orthodontic mechanics in the correction of anterior open bite and illustrates these principles with a series of cases.

Maxillary protraction treatment of skeletal Class III children using miniplate anchorage / 대한치과교정학회지

The maxillary protraction headgear has been widely used in the treatment of skeletal Class III children with maxillary deficiency. A variety of treatment objectives which allow dentoalveolar movements may be established, but when only maxillary protraction without dentoalveolar movement is needed, one of the limitations in maxillary protraction with conventional tooth-borne anchorage is the loss of dental anchorage. This is because a bone remodeling occurs not only at circummaxillary sutures but also within the periodontal tissues. During protraction treatment in the mixed dentition phase, in older children or for the patient with multiple congenitally missing teeth, it is not uncommon to observe undesirable mesial movement of maxillary teeth. Such a side effect can be eliminated or minimized using absolute anchorage such as skeletal anchorage. The purpose of this case report is to introduce a new technique of the maxillary protraction headgear treatment using surgical miniplates.

Le Fort I Osteotomy and Posterior Maxillary Segmental Osteotomy for Correction of Malunioned Maxilla / 영남의대학술지

This is a case report of correction of malunioned maxilla after traffic accident by Le Fort I osteotomy and posterior segmental osteotomy. By this procedure, authors obtained the following results. 1. The malunioned maxilla after traffic accident which had anterior crossbite, posterior open bite and scissor's bite were corrected by Le Fort 1 osteotomy and posterior segmental osteotomy. 2. No postoperative infection and specific complication were seen in this case. 3. Postoperative intermaxillary fixation was maintained for 8 weeks. And then, the patient could open his mouth in normal range after a week of intermaxillary fixation removal. 4. For rigid fixation and reducing relapse, the osteotomized maxilla was fixed with miniplates.