Logistic regression analysis of the relationship between abnormal dental occlusion and temporomandibular disorders in lower grade college students / 口腔疾病防治

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.

Evaluation of temporomandibular joint space and condylar morphology in patients with anterior open-bite based on cone-beam CT / 口腔疾病防治

Objective@#To investigate the difference of the temporomandibular joint between patients with anterior open-bite and normal overbite with cone beam CT (CBCT).@*Methods @# Fifty-four patients with anterior open bites and 54 patients with normal overbites were selected from the Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University from June 2014 to August 2020. Sagittal and coronal images of the temporomandibular joint were reconstructed with multiplanar reconstruction techique. The Kamelchuk method was used to measure the superior, posterior and anterior space of the temporomandibular joint, and the condylar morphology was divided into two types: normal and abnormal. The joint space and condylar morphology of the anterior open-bite group and the normal overbite group were statistically analyzed. The anterior open-bite group was divided into 3 subgroups: ① Ⅰ° open-bite (open bite distance < 3 mm), ② Ⅱ° open-bite (open bite distance ≥ 3 mm and ≤ 5 mm) and ③ Ⅲ° open-bite (open bite distance > 5 mm). The difference of overbite spaces of the temporomandibular joint was compared among these three subgroups.@*Results@#Compared to the normal group, no significant differences were found for the anterior and superior space of the temporomandibular joint in the anterior open-bite group (P > 0.05), but the posterior space increased significantly (P < 0.01). A total of 52.8% of patients in the anterior open-bite group had abnormal condyles, whereas 21.3% of patients in the normal group, overbite significant differences was found between the two groups (P < 0.01). Compared with patients with Ⅰ° and Ⅱ° openbite, the condyle of patients with III° open bites was more forward in the fossa (P < 0.05).@*Conclusion @#The position of the condyle in the fossa of patients with anterior open bites is more forward, and abnormal condylar bone is more common found.

Dental malocclusions in the anterior sextant, in a group of mexican patients between 3 and 14 years old / Frecuencia de maloclusiones dentarias en el sextante anterior, en un grupo de pacientes mexicanos entre 3 y 14 años

Aim: To evaluate the association between the frequency of malocclusions in the anterior sextant with dentition type, age, and sex. Material and methods: A descriptive, transversal and prospective study was carried out, in a convenience sample of 200 patients between 3 and 14 years old, of both sexes who attended the pediatric dentistry clinic of Dentistry Faculty from Autonomous University of Tlaxcala, Mexico. A dentist was standardized by a direct method (k=0.998, p=0.0001). Results: Crossbite and edge to edge bite were the most frequent (18% and 17% respectively), in no case the alterations in the previous sextant were related to sex, except altered overjet with age and dentition type (likelihood ratio=18,169, p=0.0001) (X2=18.820, p=0.0001). Conclusion: These observations highlight the importance of the diagnosis of possible alterations in the occlusion of the anterior sextant in both dentitions, in order to preventatively avoid major sequelae.

Objetivo: Evaluar la asociación entre la frecuencia de maloclusiones en el sextante anterior con el tipo de dentición, la edad y el sexo. Material y Métodos: Se llevó a cabo un estudio descriptivo, transversal, prolectivo en una muestra por conveniencia conformada por 200 pacientes entre 3 y 14 años, de ambos sexos atendidos en la clínica de odontopediatría de la Facultad de Odontología, de la Universidad Autónoma de Tlaxcala. Se estandarizó a una cirujana dentista a través del método directo (k=0,998, p=0,0001). Resultados: La mordida cruzada y borde a borde fueron las que se presentaron con mayor frecuencia (18% y 17% respectivamente), en ningún caso las alteraciones en el sextante anterior se relacionaron con el sexo, no así, el resalte alterado que se asoció con la edad y con el tipo de dentición (Razón de verosimilitudes=18.169, p=0.0001, X2=18.820, p=0.0001). Conclusión: El comportamiento observado permite reconocer la importancia del diagnóstico de las alteraciones en la oclusión del sextante anterior en ambas denticiones, con el propósito de actuar anticipadamente para evitar secuelas mayores.

Maloclusiones en estudiantes de la carrera de Odontología de la Universidad UTE / Malocclusions in students of the school of Dentistry at the UTE University

La maloclusión se considera uno de los problemas más comunes relacionados con la salud bucal, su diagnóstico temprano y adecuado permite establecer un correcto plan de tratamiento más efectivo. El objetivo fue describir las maloclusiones en estudiantes de último año de la carrera de Odontología de la Universidad UTE en Quito, Ecuador, durante los años 2018 y 2019. Los datos fueron obtenidos a partir de las respectivas historias clínicas archivadas en la clínica universitaria SERODU. Las valoraciones para determinar la maloclusión se hicieron a partir de la caracterización de los planos vertical, horizontal y transversal, utilizando los criterios de Angle. La media de edad entre los pacientes fue de 24,5 años, con una desviación estándar de 1,91. El análisis de la presencia de overjet y overbite permitió establecer que la mayor medida media estuvo enmarcada en la clase molar II, para 4,19 mm (DE=3,07) y 3,59 mm (DE=2,47) respectivamente. La mordida cruzada unilateral en el eje transversal (26,67%). La categoría normal preponderó en el tipo de mordida en los planos horizontal y vertical en las tres clases molares.

Malocclusion is considered one of the most common problems related to oral health, its early and adequate diagnosis allows establishing a correct and more effective treatment plan. The objective was to describe the malocclusions of students of the school of dentistry in final academic term at the UTE University in Quito, Ecuador, during the years 2018 and 2019. The data were obtained from the respective medical records on file at the SERODU university clinic. The evaluations to determine the malocclusion were made from the characterization of the vertical, horizontal, and transverse planes, using the Angle criteria. The mean age among the patients was 24.5 years, with a standard deviation of 1.91. The analysis of the presence of overjet and overbite allowed establishing that the highest mean measurement was framed in molar class II, for 4.19 mm (SD = 3.07) and 3.59 mm (SD = 2.47), respectively. The unilateral crossbite on the transverse axis (26.67%). The normal category prevailed in the type of bite in the horizontal and vertical planes in the three molar classes.

Evaluation of Change in Dento-Skeletal Vertical Dimensions using Two Retraction Methods: A Comparative Study

Introduction: The goal of Orthodontic treatment is toimprove the patient’s life through enhancement of Dentofacialfunctions and esthetics. Paradigms have started to shift inOrthodontic world since the introduction of mini-implantsin the anchorage armamentarium. So the present study wasundertaken to analyse and compare the amount of Intrusionin maxillary anterior teeth segment using one and twominiscrews, while paying an utmost attention to patientscomfort and esthetics during the treatment.Material and Methods: The sample consisted of 20 subjectswith deep overbite and complete root formation with increasedincisor show. Lateral cephlogram and P.A Cephalogram wererecorded before placement of implant. Sample was furtherdivided in to two groups, Group I (Implant group one implantis placed between maxillary central incisors and two implantsplaced between second premolar and first molar) and GroupII (Implant Group with Power arms, one implant is placedbetween maxillary central incisor and power arms fabricatedon first molar bilaterally). Clinical evaluation of intrusion wasrecorded on every six weeks.Results: The mean intrusion achieved is 0.28mm per 6weeks interval of time in both groups suggesting there is nodifference in amount of intrusion achieved in both groups withp value of 0.697 which is statistically non-significant. Changein Frankfort mandibular plane angle was observed with GroupI and Group II.Conclusion: On the base of study it was concluded thatimplant and power arm is better choice for intrusion inmaxillary anterior segment for correction of deep overbite andcorrection of gummy smile with minimal effect on posteriorsegment

Relación entre el Síndrome de clase II división 2 y la disfunción temporomandibular. Artículo de revisión / Relation between the Syndrome type II division 2 malocclusions and the temporomandibular joint dysfunction. Review article

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)

Full-mouth rehabilitation in a patient with inclined occlusal plane and reduced vertical dimension by an attrition: A case report / 대한치과보철학회지

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.

Overjet y overbite, un desafío terapéutico / Overjet and overbite, a therapeutic challenge

El estudio de diversas situaciones clínicas revela síntomas y signos que deben ser estudiados desde el punto de vista diagnóstico; el análisis dentario debe considerarse solamente como un aspecto morfológico. Lo importante es que la forma pone de manifiesto la acción de grupos musculares que determinan dicha posición y deben ser reeducados para lograr el equilibrio morfofuncional (AU)

Relationship between masseter muscle thickness and overbite values in a Nigerian population

Objective: This study determined the relationship between masseter muscle thickness and overbite values among Nigerians. Methods: The subjects included 66 consecutive patients (21 males and 45 females) who presented for fixed orthodontic appliance treatment. Overbite values were measured from standard lateral cephalometric radiographs taken for all patients,who were thereafter divided into three groups of reduced overbite (n=22, mean -1.11+ 2.18mm), normal overbite (n=22, mean 2.59+0.50mm) and increased overbite (n=22, mean 5.21+1.39mm). The masseter muscle thickness of each patient was measured bilaterally using ultrasonography. Associations between masseter muscle thickness and different overbite values were analyzed using unpaired t-test, ANOVA and Tukey's multiple comparison analysis. Results: Mean masseter muscle thickness was 11.23 ± 2.40 mm during relaxation and 12.81 ± 2.64 mm during contraction for study participants. The masseter muscle on the habitual side of mastication of participants was generally thicker but the difference was not statistically significant (P>0.05). There was a progressive increase in masseter muscle thickness from reduced overbite through normal overbite to increased overbite groups and the differences were statistically significant (P<0.01). Tukey's multiple comparisons showed significant differences between all the three overbite groups (P<0.05). Conclusion: There was a direct relationship between the muscle thickness and overbite variations (AU)

Class II Division 2 subdivision left malocclusion associated with anterior deep overbite in an adult patient with temporomandibular disorder

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.

Early vertical correction of the deep curve of Spee

ABSTRACT Even though few technological advancements have occurred in Orthodontics recently, the search for more efficient treatments continues. This paper analyses how to accelerate and improve one of the most arduous phases of orthodontic treatment, i.e., correction of the curve of Spee. The leveling of a deep curve of Spee can happen simultaneously with the alignment phase through a method called Early Vertical Correction (EVC). This technique uses two cantilevers affixed to the initial flexible archwire. This paper describes the force system produced by EVC and how to control its side effects. The EVC can reduce treatment time in malocclusions with deep curves of Spee, by combining two phases of the therapy, which clinicians ordinarily pursue sequentially.

RESUMO Apesar de haver poucos desenvolvimentos tecnológicos nos últimos anos dentro da Ortodontia, a busca por tratamentos mais eficientes não cessou. Assim, o presente artigo visa analisar, de maneira lógica, como otimizar uma das fases do tratamento ortodôntico que mais demandam tempo: a correção da sobremordida exagerada. Pretende-se demonstrar como realizá-la concomitantemente ao alinhamento inicial, por meio de uma técnica denominada correção vertical precoce (CVP). Essa técnica utiliza dois cantilevers associados ao primeiro fio de alinhamento ortodôntico, mas não restritos a ele, a fim de iniciar a planificação da curva de Spee o mais cedo possível. Assim, o tempo de tratamento pode ser diminuído, já que duas fases do tratamento, normalmente realizadas de forma independente, podem ser realizadas ao mesmo tempo. Além disso, tanto o sistema de forças quanto os efeitos colaterais e os passos da execução da técnica serão devidamente apresentados e discutidos.

Evaluation for vertical stability after various orthognathic surgical treatment plans for skeletal class Ⅲ malocclusion with anterior open-bite / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate vertical stability after various orthognathic surgical treatment plans for skeletal class Ⅲ malocclusion with anterior openbite.</p><p><b>METHODS</b>A retrospective multicenter cohort study was conducted to investigate vertical stability after various orthognathic surgical treatment plans for skeletal class Ⅲ malocclusion with anterior openbite. From 2010-2016, 122 patients from two domestic stomatological hospitals were included in our study. Patients were divided into four groups according to their treatment plans, namely, bilateral sagittal split ramus osteotomy (BSSRO), intraoral vertical ramus osteotomy (IVRO), BSSRO+Le Fort Ⅰ, and IVRO+Le Fort Ⅰ. All patients followed a standardized examination procedure at 6 and 24 months post-treatment. The observation indexes include overbite, mandibular plane angle, and intermaxillary angle.</p><p><b>RESULTS</b>1) The significantly reduced ratio of the overbite in the BSSRO+Le Fort Ⅰ and IVRO+Le Fort Ⅰ groups were less than the BSSRO and IVRO groups at 6 and 24 months post-treatment. 2) The significantly increased ratio of the mandibular plane in BSSRO+Le Fort Ⅰ and IVRO+Le Fort Ⅰ groups were less than BSSRO and IVRO groups at 6 and 24 months post-treatment. 3) The significantly increased ratio of the intermaxillary angles in BSSRO+Le Fort Ⅰ and IVRO+Le Fort Ⅰ groups were less than the BSSRO and IVRO groups at 6 months post-treatment, while there was no statistical difference at 24 months post-treatment.</p><p><b>CONCLUSIONS</b>Bimaxillary surgery (BSSRO+Le Fort Ⅰ and IVRO+Le Fort Ⅰ) is more effective than mandibular surgery to control vertical relapse.</p>

Correlação da curva de spee com overbite, overjet e padrão facial / Spee curve correlation with overbite, overjet and facial pattern

Objetivou-se com o presente estudo verificar a relação entre a profundidade da curva de Spee superior e inferior com o overjet, overbite e o padrão facial. Quarenta e três modelos e radiografias cefalométricas laterais iniciais foram selecionados de pacientes do arquivo do Curso de Especialização de Ortodontia da Faculdade de Odontologia da UERJ, pós-surto de crescimento, com dentição permanente completa e apresentando overjet de 1 a 3 mm. Os modelos foram digitalizados e a profundidade máxima da curva de Spee superior e inferior, o overjet e o overbite foram calculados, utilizando-se o programa 3Shape Ortho Analyser. O padrão facial foi determinado a partir do ângulo SN.GoGn. As associações da curva de Spee superior e inferior com overbite, overjet e padrão facial foram avaliadas através do teste de correlação de Pearson. Encontrou-se associação da profundidade da curva de Spee inferior com o overjet e com a curva de Spee superior. Não houve significância estatística na correlação da curva de Spee inferior com o overbite e padrão facial, nem da curva de Spee superior com o overbite, com o overjet ou com o ângulo do plano mandibular, sugerindo que a curva de Spee inferior acentuada está mais frequentemente associada ao overjet aumentado.(AU)

The aim of this study was to verify the relationship between the depth of the lower and upper curves of Spee with overjet, overbite and facial pattern. Forty-three initial casts and lateral cephalometric radiographs were selected from the archives of the Graduate Program in Orthodontics of Rio de Janeiro State University. All patients were postpubertal, with permanent dentition and presenting an overjet varying from 1 to 3 mm. The cast models were scanned and the maximum depth of the upper and lower curve of Spee, the overjet and the overbite were calculated using the 3Shape Ortho Analyzer software. The facial pattern was determined from the SN.GoGn angle. The associations of the upper and lower curve of Spee with overbite, overjet and facial pattern were assessed using the Pearson correlation test. An association was found between the depth of the lower curve of Spee with the overjet and with the upper curve of Spee. There was no correlation of the lower curve of Spee with the overbite and facial pattern, neither between the upper curve of Spee with the overbite, overjet or the mandibular plane angle, suggesting that a marked lower curve of Spee is more frequently associated with increased overjet. (AU)

Reliability of overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) in the assessment of different vertical and sagittal dental malocclusions: a receiver operating characteristic (ROC) analysis

ABSTRACT Introduction: Differential diagnosis of skeletal and dental relationships is crucial for planning orthodontic treatment. Overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) had been introduced in the past for assessment of vertical and sagittal jaw relationships, respectively. Objective: The objectives of this study were to evaluate the reliability of ODI and APDI in overbite and Angle malocclusions, as well as assess their diagnostic reliability among males and females of different age groups. Material and Methods: This study was conducted using pretreatment dental casts and lateral cephalograms of 90 subjects. For ODI, subjects were divided into three groups based on overbite (normal overbite, open bite and deep bite). Likewise, the same subjects were divided for APDI into three groups, based on Angle's malocclusion classification (dental Class I, II and III malocclusions). Mann-Whitney U test was applied for comparison of study parameters regarding sex and different age groups. The mean values of ODI and APDI were compared among study groups by means of Kruskal-Wallis and post-hoc Dunnet T3 tests. The receiver operating characteristic (ROC) curve was applied to test diagnostic reliability. Results: Insignificant differences were found for ODI and APDI angles, particularly in regards to sex and age. Significant intergroup differences were found in different overbite groups and Angle's classification for ODI and APDI, respectively (p < 0.001). ROC showed 91% and 88% constancy with dental pattern in ODI and APDI, respectively. Conclusions: ODI can reliably differentiate deep bite versus normal overbite and deep bite versus open bite. APDI can reliably differentiate dental Class I, II and III malocclusions.

RESUMO Introdução: o diagnóstico diferencial das relações esqueléticas e dentárias é essencial para o plano de tratamento ortodôntico. O indicador de profundidade da sobremordida (ODI)) e o indicador de displasia anteroposterior (APDI) foram desenvolvidos, no passado, para avaliação das relações verticais e sagitais dos maxilares, respectivamente. Objetivo: o objetivo desse estudo foi avaliar a confiabilidade do ODI e do APDI em diferentes sobremordidas e más oclusões de Angle, bem como verificar sua confiabilidade diagnóstica em homens e mulheres de diferentes grupos etários. Métodos: esse estudo foi conduzido utilizando-se modelos de estudo e radiografias cefalométricas laterais pré-tratamento de 90 indivíduos. Para o ODI, os indivíduos foram divididos em três grupos, com base na sobremordida (sobremordida normal, mordida aberta, mordida profunda). Ainda, para avaliação do APDI, esses mesmos indivíduos foram divididos em três grupos baseados na classificação de Angle para as más oclusões (Classes I, II e III dentárias). O teste U de Mann-Whitney foi aplicado para comparar os parâmetros estudados, quanto ao sexo e diferentes grupos etários. Os valores médios do ODI e do APDI foram comparados entre os grupos estudados por meio dos testes de Kruskal-Wallis e post-hoc T3 de Dunnett. A curva ROC (receiver operating characteristic) foi aplicada para testar a confiabilidade do diagnóstico. Resultados: diferenças não significativas foram encontradas para os ângulos ODI e APDI, particularmente em relação ao sexo e à idade. Diferenças significativas foram encontradas entre os grupos com diferentes sobremordidas e diferentes más oclusões de Angle, para o ODI e para o APDI, respectivamente (p < 0,001). A ROC mostrou 91% e 88% de concordância com o padrão dentário, para o ODI e APDI, respectivamente. Conclusões: o ODI mostrou-se confiável para diferenciar entre a mordida profunda e a sobremordida normal, e entre a mordida profunda e a mordida aberta. O APDI é confiável para se diferenciar entre as más oclusões dentárias de Classes I, II e III.

Correção precoce da sobremordida profunda com aparelho guia de erupção / Early deep overbite correction with eruption guidance appliance

A sobremordida profunda caracteriza-se por um trespasse vertical anterior positivo acentuado, geralmente associado à má oclusão de Classe II. Há diferentes opções de tratamento para a correção da sobremordida profunda e a escolha depende de alguns fatores, como idade do paciente, condições periodontais, eficiência da conduta e facilidade de utilização do aparelho. O tratamento precoce desta má oclusão possibilita uma correção mais simples, fácil, rápida e, principalmente, mais estável, devido ao crescimento vertical dos processos alveolares. Sendo assim, os aparelhos guia-de-erupção (nite-guide e occlus-o-guide) apresentam-se como uma opção terapêutica para intervenção precoce da sobremordida profunda. A melhor época de atuação para a terapia com o aparelho occlus-o-guide na correção da sobremordida profunda ocorre na fase de dentadura mista. Portanto, este trabalho relata um caso de uma paciente de 7 anos e 7 meses, que apresentava esse tipo de má oclusão, tratada com o aparelho occlus-o-guide por 12 meses. Os resultados clínicos indicaram que o aparelho occlus-o-guide foi eficaz na correção precoce da sobremordida profunda, pois houve melhora, com um bom posicionamento e inclinação dos dentes permanentes que já irromperam no arco dentário.

A pronounced positive trespass of anterior teeth, usually associated with Class II malocclusions, characterizes an anterior deep overbite. There are different treatment options for deep overbite correction and the choice depends on many factors such as the age of the patient, periodontal conditions, efficiency of techniques and complexity of the appliance’s use. Early treatment of this malocclusion enables a simpler, easier, faster and more stable correction mainly due to the vertical growth of the alveolar processes. Thus, the eruption guidance appliance (nite-guide and occlus-o-guide) represents a therapeutic option for early intervention of overbites. The best time for therapy with occlus-o-guide in overbite corrections is mixed dentition stage. This article reports the case of a 7 years and 7 months old patient, with this type of malocclusion, treated with occlus-o-guide during 12 months. As result, there was improvement on correction of the overbite, with good positioning and inclination of the anterior permanent teeth in the dental arch. Clinical results indicated that occlus-o-guide appliance was very effective in early correction of anterior deep overbite.

Frequência, razão de prevalência e associação do transpasse vertical dentário anterior em diferentes padrões faciais / Frequency, prevalence ratio and association of anterior overbite in different facial patterns

Determinados padrões faciais são citados na literatura como responsáveis diretos pelo acometimento de más oclusões de transpasse vertical anterior. Apesar disso, ainda não está elucidado de que forma as diferenças dos padrões faciais estão associadas aos problemas dentários. Os objetivos deste estudo são: verificar a correlação do grau de transpasse vertical com os padrões faciais e com fatores esqueléticos e dentários; investigar a frequência dos hábitos deletérios de acordo com os tipos de overbite; e investigar a frequência e as razões de prevalência dos tipos de transpasse vertical dentário anterior de pacientes com diferentes padrões faciais. A amostra consistiu de telerradiografias de perfil de adultos, com registro de ausência ou presença de hábitos deletérios e a coleta foi realizada em diferentes centros de ensino de ortodontia do território brasileiro. Os filmes radiográficos foram digitalizados e analisados através do software Dolphin Imaging 11.0 e os resultados foram obtidos através de uma análise estatística descritiva, utilizando o software SPSS 17.0. Quanto às correlações, o overbite apresentou fraca correlação com fatores esqueléticos e dentários, inclusive com a variável AFPI/AFAI, determinante do padrão facial. A presença ou a ausência de hábitos deletérios não apresentou diferença estatística quando comparadas aos tipos de problemas verticais. Todos os padrões faciais apresentaram todos os tipos de transpasse vertical anterior, porém pacientes hiperdivergentes apresentaram uma frequência estatisticamente significativa de casos com mordida aberta anterior, assim como uma razão de prevalência indicativa de situação de risco, quando comparados aos pacientes normodivergentes e hipodivergentes. Presume-se que exista a predisposição de outros fatores associados aos problemas verticais, seja a presença de hábitos deletérios, sejam os desequilíbrios de forças musculares em pacientes hiperdivergentes para que a presença da mordida aberta anterior seja mais frequente neste padrão facial.

Certain facial patterns are described in the literature as directly responsible for the involvement in vertical anterior malocclusions. However, how differences in facial patterns are associated with dental problems it is not yet elucidated. The aims of this study were to verify the correlation between the degree of overbite with the facial pattern, and with skeletal and dental factors; to investigate the frequency of deleterious habits according to the overbite; and to investigate the frequency and odds ratio of the types of overbite of patients with different facial patterns. The sample consisted of cephalometric radiographs of adults, with records on the presence or absence of deleterious habits. The sample was collected in different centers of orthodontic education in Brazil. The radiographic films were scanned and analyzed using the Dolphin Imaging 11.0 software and the results were obtained through a descriptive statistical analysis using SPSS 17.0 software. The overbite showed a weak correlation with the skeletal and dental factors, including the variable LPFH/LAFH, which determines facial pattern. The presence or absence of habits showed no statistical difference when compared to the overbite types. All facial patterns presented all sorts of overbite, but hyperdivergent patients showed a statistically significant higher frequency of cases with anterior open bite, compared to normodivergents and hypodivergent patients, as well as the odds ratio indicated a risk situation. It is assumed that there is a predisposition of other factors associated to anterior vertical problems, such as the presence of deleterious habits or imbalanced muscle forces in hyperdivergent patients, for a greater frequency of anterior open bite to be found in this facial pattern.

Comparison of two types of biomecanics for deep overbite correction

To compare two types of treatment for Class II deep overbite malocclusion assessing maxillary and mandibular arches behavior in subjects submitted to full orthodontic treatment with standard edgewise appliance and those who used straight wire appliance. METHODS: The sample consisted of 50 patients treated with full fixed appliances either with edgewise appliance n=25, Group 1, or with straight wire appliance n=25, Group 2. In both groups lateral cephalometric radiographs were compared with those done at the beginning of treatment and at its end, in order to quantify the cephalometric measures 8 linear and 6 angular presenting the maxillary and mandibular arches behavior in the anteroposterior and vertical directions. All patients were treated without extraction or use of Class II intermaxillary elastics during the full orthodontic treatment. RESULTS: In both groups the treatment of malocclusion contributed for mandibular forward displacement, reduction of deep overbite and overjet, reduction of mandibular plane with anti-clockwise rotation and labial projection of maxillary incisors. CONCLUSIONS: In both groups the sample showed favorable mandibular displacement, reduction of facial convexity, and profile improvement with anti-clockwise rotation. The correction of deep overbite was due to labial projection and intrusion of maxillary incisors...

A intrusão isolada dos incisivos centrais superiores na má oclusão Classe II, divisão 2 – relato de caso / An individual intrusion of maxillary central incisors in Angle Class II, division 2 – case report

A má oclusão Classe II divisão 2 de Angle é caracterizada pela relação molar de Classe II associada a um posicionamento vertical ou retroinclinado dos incisivos superiores e, geralmente, associada a uma sobremordida exagerada. No presente caso clínico com tais características foi, inicialmente, intruído os incisivos centrais superiores com o arco de intrusão preconizado por Burstone. Após o tratamento corretivo, os objetivos de função, saúde e estética adequada foram plenamente alcançados...

Angle Class II division 2 malocclusion is characterized by a Class II molar relation associated with retroclined or vertical positioning of the upper incisors and usually associated with overbite. The present study reports a clinical case with the previous characteristics in which the initial step was the intrusion of maxillary central incisors using the Burstone intrusion archwire. After orthodontic treatment proper function, health and aesthetics were fully achieved...

A Cephalometric Evaluation of Anterior Deep Bite in Class II Malocclusions.

Background & objectives: Vertical malocclusions of the incisor teeth namely, anterior openbite and deep overbite present a challenge to the orthodontic clinicians. Determining the etiology of these is utmost important for further treatment planning and prognosis. Present study was carried out to understand the dentofacial skeletal pattern of the deep overbite in two types of deformities, Angle's Class II Div.l & Class II Div.2 (study group) and comparing them with normal occlusion (control group). Methods: Lateral cephalogram of total 60 pts, 20 in each of the above mentioned groups were analysed using 19 linear and 8 angular parameters and results of each group were compared with other two groups and conclusions were drawn. Result and conclusion: Larger posterior facial height, lower anterior facial height, lower gonial angle, larger Jaraback’s ratio & reduced lower molar height together contribute to horizontal growth pattern. It was concluded that there is more horizontal growth pattern in class II div. 2 cases hence the deepbite is more severe in class II div.2 cases compared to div.1 cases.

Malocclusion and socioeconomic indicators in primary dentition

The aim of the present study was to determine the prevalence of malocclusion and associations with socioeconomic indicators among preschoolers. A cross-sectional study was conducted with 732 children 3 to 5 years of age in the city of Campina Grande, Brazil. Three dentists underwent a calibration exercise (K = 0.85-0.90) and diagnosed malocclusion based on the criteria proposed by Foster & Hamilton and Grabowski et al. Parents/guardians answered a questionnaire addressing sociodemographic aspects. Data analysis involved descriptive statistics and bivariate Poisson regression (PR; α = 5%). The prevalence of malocclusion was 62.4%. The most frequent types were increased overjet (42.6%), anterior open bite (21%) and deep overbite (19.3%). An association was found between malocclusion and age: the prevalence of malocclusion was greater among younger children, with the highest prevalence among 3-year-olds (PR = 1.116; 95%CI = 1.049-1.187). The prevalence of malocclusion was high. Mother's schooling and household income were not associated with malocclusion. Socioeconomic factors were also not associated with the occurrence of malocclusion.