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SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.
El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.
Subject(s)
Humans , Child , Posture , Cervical Vertebrae/anatomy & histology , Head/anatomy & histology , Malocclusion, Angle Class III/therapy , Cephalometry , Anatomic LandmarksABSTRACT
Comparar la permeabilidad de las vías aéreas y el tamaño de los senos maxilares en relación con la clase esqueletal. se midieron 90 radiografías lateral de cráneo, divididas en 3 grupos, comparando las 3 clases esqueletales, las cuales se determinaron con la medida ANB de Steiner, y estas a su vez en dos subgrupos que fueron hombres y mujeres, en las cuales se utilizó el análisis de McNamara para el análisis de vías aéreas y para el área del seno maxilar se tomaron dos medidas una antero-posterior y cefálica-caudal. Al comparar los hombres con las mujeres se identificó significancia estadística en vía área superior de clase II (p=≤0.017), vía aérea inferior de clase III (p=≤0.006). Al comparar las clases esqueletales en hombres se identificó diferencias en la vía aérea superior en las clases I vs III (p=≤0.05), inferior en la clase I vs III (p=≤0,001) y II vs III (p=≤0.044). Con respecto a mujeres se identificó significancia en la vía aérea superior al comparar la clase I vs II (p=≤0,043), vía aérea inferior en la clase II vs III (p=≤0.05), longitud del seno maxilar al comparar clase I vs II (p=≤0.017). Entre la clase I esqueletal y la clase II, el tamaño de los senos maxilares resulto menor en longitud en las mujeres de clase II esqueletal. Entre la clase I y clase III esqueletal en hombres, se encontró una longitud menor en la vía aérea superior e inferior en la clase I. Las vías aéreas resultaron en menor tamaño en sujetos de clase II.
SUMMARY: To compare the airway permeability and the size of the maxillary sinuses in relation to the skeletal class. 90 lateral skull radiographs were divided into 3 groups, comparing the 3 skeletal classes, which were determined with Steiner's ANB measurement, and these were once in two subgroups that were men and women, in any McNamara analysis was used for the analysis of airways and for the maxillary sinus area measurements were made an antero-posterior and cephalic-caudal. When comparing males with females, statistical significance was identified in the upper class II route (p=≤0,017), lower class III airway (p=≤0.006). At least skeletal classes in men, differences were identified in the upper airway in classes I vs III (p=≤0.05), lower in class I vs III (p=≤0.001) and II vs III (p=≤0.044). With respect to women, significance was identified in the upper airway when comparing class I vs II (p=≤0.043), lower airway in class II vs. III (p=≤0.05), maxillary sinus length to class I vs II (p=≤0.017). Between skeletal class I and class II, maxillary sinus size was shorter in length in skeletal class II women. Between class I and skeletal class III in men, a lower length was found in the upper and lower airways in class I. The airways were found to be smaller in class II subjects.
Subject(s)
Humans , Male , Female , Permeability , Nasopharynx/diagnostic imaging , Maxillary Sinus/diagnostic imaging , Nasopharynx/anatomy & histology , Malocclusion, Angle Class I , Malocclusion, Angle Class II , Malocclusion, Angle Class III , Maxillary Sinus/anatomy & histology , MexicoABSTRACT
Objective@#To explore the ideal sagittal position of the lower third of the face in high-angle patients with different forehead forms and to provide a reference for clinical treatment. @*Methods@#Informed consent and portrait authorization were obtained from all patients, and the study passed the ethical review of the unit. We categorized forehead forms into four types: straight, rounded, type I angular (angled at the middle third of the forehead) and type II angular (angled at the upper third of the forehead). Profiles of high-angle patients with different forehead forms were collected. The initial position was when the facial axis point (FA point) was positioned at the goal anterior-limit line (GALL). After being silhouetted, the lower third of the face was moved forward and backward by 1 mm, 2 mm, 3 mm, and 4 mm each, plus the initial silhouetted picture, to obtain 9 images for each patient. A survey was created with these lateral profile silhouettes, and the silhouette images were ranked by 30 orthodontists and 30 laypersons. @*Results@# There were significant differences in profile scores at different movement distances of the lower third of the face among high-angle patients with different forehead shapes (P<0.05). Overall, high-angle patients with straight or type II angular foreheads had higher scores when the lower third of the face did not move. For high-angle patients with a rounded forehead, orthodontists and laypersons gave the highest scores when the lower third of the face was moved backward by 2 mm and 4 mm, respectively. For high-angle patients with a type I angular forehead, orthodontists thought the scores of backward movement of 4 mm were the highest, and laypersons thought the scores of backward movement of 3 mm were the highest. No significant difference was found in scores between orthodontists and laypersons (P>0.05). @*Conclusion @#The forehead forms and the sagittal position of the lower third of the face will affect the face’s profile aesthetics. Patients with straight and type Ⅱ angular foreheads has the best profile when the FA point is located on the GALL line. For patients with rounded and type Ⅰ angular foreheads, a posterior location of the lower third of the face is more desirable than the initial position.
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OBJECTIVE@#To evaluate the decompensation effectiveness and alveolar bone remodeling of mandibular anterior teeth after preoperative orthodontic treatment in high-angle patients with skeletal class Ⅱ malocclusion using lateral cephalogram and cone-beam computed tomography (CBCT).@*METHODS@#Thirty high-angle patients with skeletal class Ⅱ malocclusion who had received preoperative orthodontic treatment and orthognathic surgery in Peking University School and Hospital of Stomatology between Ja-nuary 2017 and August 2022 and had taken lateral cephalogram and CBCT before and after preoperative orthodontic treatment were selected. Items were measured with lateral cephalogram including: The lower central incisor (L1)-Frankfort plane angle (L1-FH), the L1-mandibular plane angle (L1-MP), the L1-nasion-supramental angle (L1-NB) and the vertical distance from the incisal edge of lower central incisor to NB line (L1-NB distance), etc. The incidence of dehiscence/fenestration and the length of dehiscence at labial side (d-La) and lingual side (d-Li) were measured using CBCT. Pearson correlation analysis was used to evaluate the correlation between the changes of d-Li of L1 and age, duration of preoperative orthodontic treatment and the cephalometric measurements before preoperative orthodontic treatment to screen out risk factors affecting the periodontal risk of preoperative orthodontic treatment in high-angle patients with skeletal class Ⅱ malocclusions.@*RESULTS@#After preoperative orthodontic treatment, L1-FH, L1-MP, L1-NB and L1-NB distances changed by 11.56°±5.62°, -11.13°±5.53°, -11.57°±5.43° and (-4.99±1.89) mm, respectively, and the differences were all statistically significant (P < 0.05). Among the 180 measured mandibular anterior teeth, 45 cases with labial dehiscence/fenestration before preoperative orthodontic treatment (T0) had no longer labial dehiscence/fenestration after preope-rative orthodontic treatment (T1); 142 cases without lingual dehiscence/fenestration at T0 had lingual dehiscence/fenestration at T1. After preoperative orthodontic treatment, the d-La of lower lateral incisors (L2), lower canines (L3) and lower anterior teeth (L1+L2+L3) decreased by (0.95±2.22) mm, (1.20±3.23) mm and (0.68±2.50) mm, respectively, and the differences were statistically significant (P < 0.05); the d-Li of L1, L2, L3 and L1+L2+L3 increased by (4.43±1.94) mm, (4.53±2.35) mm, (3.19±2.80) mm and (4.05±2.46) mm, respectively, and the differences were statistically significant (P < 0.05). The increase of d-Li of L1 was positively correlated with L1-FH (r=0.373, P=0.042).@*CONCLUSION@#This study showed that high-angle patients with skeletal class Ⅱ ma-locclusion could achieve ideal decompensation effect of mandibular anterior teeth after preoperative orthodontic treatment with bilateral mandibular first premolars extracted, but the lingual periodontal risk of mandibular anterior teeth was increased. This risk could be correlated to L1-FH before preoperative orthodontic treatment, which should be paid more attention in the design of orthodontic-orthognathic surgical treatment.
Subject(s)
Humans , Malocclusion, Angle Class III , Malocclusion, Angle Class II/surgery , Facial Bones , Incisor , Orthognathic Surgical Procedures , Cone-Beam Computed Tomography , MandibleABSTRACT
OBJECTIVES@#This study aimed to conduct a meta-analysis of the efficacy of mandibular advance clear alig-ners with traditional functional appliances as the control group.@*METHODS@#PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Abstracts Database, China Knowledge Network Database, Wanfang Database, and Weipu Database were used in this study. The two groups of researchers screened the literature and extracted data based on the inclusion and exclusion criteria established by PICOS entries, and used the ROBINS-I scale for quality evaluation. Revman 5.4 and Stata 17.0 software were used for meta-analysis.@*RESULTS@#Nine clinical controlled trials were included in this study with a total sample size of 283 cases. No significant difference was found in SNA, SNB, ANB, Go-Pog, U1-SN, Overjet, and other aspects between the invisible group and the traditional group in the treatment of skeletal class Ⅱ ma-locclusion patients; there was a 0.90° difference in mandibular plane angle between the two groups; the growth of the mandibular ramus (Co-Go) in the traditional group was 1.10 mm more than that in the invisible group; the lip inclination of the lower teeth in the invisible group was better controlled, 1.94° less than that in the control group.@*CONCLUSIONS@#The invisible group can better control the lip inclination of the mandibular anterior teeth when guiding the mandible. Furthermore, the mandibular plane angle (MP-SN) can remain unchanged, but the growth of the mandibular ramus is not as good as the traditional group, and auxiliary measures should be taken to improve it in clinical practice.
Subject(s)
Humans , Malocclusion, Angle Class II/therapy , Mandibular Advancement , Orthodontics, Corrective , Orthodontic Appliances, Functional , Mandible , Orthodontic Appliances, Removable , CephalometryABSTRACT
@#Class III malocclusion can be defined as a skeletal facial deformity that is characterized by a forward mandibular position with respect to the cranial base and or the maxilla. We present a case of a 15-year-old man with skeletal Class III malocclusion who was treated with non-extraction orthodontic camouflage treatment using an orthodontic conventional technique. A fixed appliance, straight wire appliance (SWA) technique was used with a non-extraction treatment plan. Treatment was accompanied by intermaxillary Class III elastics. The total duration of active treatment was 23 months. There was a significant improvement in his occlusion, smile esthetics, and soft tissue profile pattern. Orthodontic camouflage can be considered an effective therapy for correcting milder cases of skeletal Class III malocclusion.
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@#Skeletal Class III malocclusion treatment is complex, especially when jaw deviations are serious. Camouflage treatment of skeletal Class III malocclusion improves prognosis with a slight-to-moderate functional shift. This report presents the case of a 23-year-old male with poor facial esthetics associated with chin protrusion and an uncomfortable bite. He had a concave profile, unfavorable incisor displays, protrusive lower lip, and strained lip closure. Camouflage therapy with a passive self-ligating (PSL) system through the anterior teeth of the maxilla protraction and arch expansion was used. After 14 months of treatment, the overjet outcome was positive. The teeth were arched, asymmetry was addressed, the convex profile and no deviation occurred when the jaw was closed. Factors in using the PSL system were low friction between the bracket and archwire, torque selection, and the significant dental arch expansion ability. The PSL system is an appropriate option in treating adults with skeletal Class III malocclusion to achieve a normal occlusion and a pleasant facial profile.
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Objective@#To evaluate the effects of non-bracket invisible appliance mandibular advance(MA) on skeletal Class Ⅱ growing patients with mandibular retrusion.@*Methods@#Nineteen skeletal Class Ⅱ growing patients with mandibular retrusion who were treated in the department of stomatology of Changshu traditional Chinese medicine hospital from January 2018 to May 2021 were selected. They had an average age of (12.32±1.51) years old. The treatment group consisted of 10 children who were treated with MA. The control group consisted of 9 children who refused to treat their malocclusion. Cephalometrics of all patients were taken before and after the observation or treatment. The cephalometric data of two groups were analyzed. @*Results@#Compared with the control group, in the treatment gruop SNB angle, L1-NB angle, L1-NB distance, L6-MP distance, Z angle increased significantly (P<0.05);Co-Go distance, Co-Gn distance, SL increased more greatly than the control group; ANB angle, U1-SN angle, U1-NA angle, U1-NA distance, L1-MP distance, FCA angle decreased significantly (P<0.05); SE did not change significantly in the treatment group, but increased significantly in the control group (P<0.05).@*Conclusion @# MA can promote mandibular growth and improve lateral profile. The angle of the lower teeth and the angle of the mandible plane can be controlled by MA appliance.
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Objective@#To analyze the condylar and inclination of the occlusal plane features in skeletal Class Ⅲ malocclusion patients with mandibular asymmetry by using cone beam computed tomography(CBCT).@* Methods@#Forty eligible patients with Angle Class Ⅲ malocclusion were enrolled. All individuals were classified based on the distance from Me point to median sagittal plane. The left and right angles between OP and FH plane, the position and morphology of the condyle were measured in both groups.Then the data collected were statistically analyzed. @* Results@#Compared to the opposite side, there was a statistically significant difference(P<0.05) in angle between OP and FH plane, the anterior joint space, superior joint space, lateral joint space and condylar mediolateral diameter, with a higher proportion of joint posteriority in deviated side. Mandibular deviations were positively correlated with both the anterior joint space of the deviated side and the angle between OP and FH plane of the opposite side(P<0.01). There was no statistical difference between the left and right side of angles between OP and FH plane, the position and morphology of the condyle in skeletal Class Ⅲ patients without mandibular deviation(P>0.05); the joint was predominantly in anterior and middle position. @*Conclusion@#There is asymmetry on the left and right sides of the inclination ofocclusal plane, the position and morphology of the condyle of skeletal Class Ⅲ malocclusion patients with mandibular asymmetry. Compared with the opposite side, the deviated side has smaller angle between OP and FH plane and smaller condylar mediolateral diameter, and the condyle shows generally more posterior, inferior and inward movement in glenoid fossa. The inclination of the occlusal plane and the position of condyle are significantly and positively correlated with the distance from Me point to median sagittal plane.
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Rationale: Orthodontic camouflage serves its purpose in treating mild to moderate skeletal dysplasia and in conditions where the patient is reluctant to opt for orthognathic surgery or when it is contraindicated. Patient Concerns: A 22?year?old male was concerned about his irregular teeth. Diagnosis: Angle’s dentoalveolar class III malocclusion on class III skeletal on an average mandibular plane angle with anterior crossbite, deep bite, crowding in maxillary and mandibular anteriors, proclined maxillary anteriors and retroclined mandibular anteriors with reverse overjet and congenitally missing 12, 22, palatally impacted 13 and retained deciduous 63 and palatally placed 23. Treatment: Orthodontic camouflage with a multi?disciplinary approach. Outcome: Optimal functional and dentofacial aesthetics were achieved by 22 months. Take?Away Lesson: The limitations of camouflage must be kept in mind and explained to the patient. The biomechanics need to be customized and integrating different specialties helps maximize the treatment benefits.
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El objetivo de esta investigación es evaluar si existen diferencias en la inclinación de la Posición Natural de Cabeza (PNC) entre las clases esqueléticas, mediante fotogrametría. Para esto se realizó un estudio observacional analítico de corte transversal. La muestra fue de 45 voluntarios de entre 18 y 50 años. Se determinó la clase esquelética mediante análisis de Steiner y Wits, en radiografías laterales de cráneo, utilizando el software BlueSkyPlan®. A cada participante se le tomó una fotografía de perfil en PNC. Posteriormente, en Photoshop®, se trazó un plano entre los puntos tragion y exocanto (plano t-ex) y la horizontal verdadera, para finalmente medir el ángulo formado en el programa UTHSCSA ImageTool3.0®, determinando así la inclinación de la cabeza. Luego de tabular los datos, se realizaron análisis estadísticos. Este estudio evidenció una diferencia de 6,68° en promedio en la inclinación de la PNC entre los pacientes clase II y I esquelética, con significación estadística, por lo que se concluye que los pacientes clase II esquelética tienen una PNC más inclinada en sentido horario respecto a los pacientes clase I, en la muestra analizada. Los pacientes clase III no mostraron diferencias.
The objective of this research is to evaluate the differences in the inclination of the Natural Head Position (NHP) between skeletal classes, using photogrammetry. For this, a cross-sectional analytical observational study was carried out. The sample consisted of 45 volunteers between 18 and 50 years old. The skeletal class was determined by Steiner and Wits analysis, in lateral skull radiographs, using the BlueSkyPlan® software. Each participant had a profile photograph taken at NHP. A plane was drawn between the tragion and exocanthion points and the true horizontal using Photoshop®, and the angle was measured using UTHSCSA ImageTool3.0® software, assessing the inclination of the head. After data tabulation, statistical analyses were performed. This study showed an average difference of 6.68° in the inclination of the NHP between skeletal class II and I patients, with statistical significance. It was concluded that skeletal class II patients have a more inclined NHP in a clockwise direction compared to class I patients, in the analyzed sample. Class III patients did not show differences.
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ABSTRACT Introduction: The intra-oral skeletally anchored maxillary protraction (I-SAMP) has been found to be an effective treatment for skeletal Class III malocclusion. Objective: This in-silico study explored the influence of different force directions of intra-oral skeletally anchored Class III elastics on the changes in craniomaxillofacial complex, using finite element analysis. Methods: A 3-dimensional (3D) finite element model of the craniomaxillofacial bones including circummaxillary sutures was constructed with high biological resemblance. A 3D assembly of four miniplates was designed and fixed on the maxilla and mandible of the finite element model. The model was applied with 250g/force at the miniplates at three angulations (10°, 20°, and 30°) from the occlusal plane, to measure stress and displacement by using the ANSYS software. Results: The zygomaticotemporal, zygomaticomaxillary, and sphenozygomatic sutures played significant roles in the forward displacement and counterclockwise rotation of maxilla and zygoma, irrespective of the angulation of load application. The displacements and rotations of the zygomatico-maxillary complex decreased gradually with an increase in the angle of load application between miniplates from 10° to 30°. The mandible showed negligible displacement, with clockwise rotation. Conclusions: The treatment effects of I-SAMP were corroborated, with insight of displacement patterns and sutures involved, which were lacking in the previously conducted 2D and 3D imaging studies. The prescribed angulation of skeletally anchored Class III elastics should be as low as possible, since the displacement of zygomatico-maxillary complex increases with the decrease in angulation of the elastics.
RESUMO Introdução: A protração maxilar com ancoragem esquelética intrabucal (I-SAMP) tem sido considerada um tratamento efetivo para a má oclusão esquelética de Classe III. Objetivo: O presente estudo in silico avaliou, usando análise de elementos finitos, a influência de diferentes direções da força dos elásticos Classe III com ancoragem esquelética intrabucal nas mudanças no complexo craniomaxilofacial. Métodos: Um modelo de elementos finitos tridimensional (3D) dos ossos craniomaxilofaciais, incluindo as suturas circum-maxilares, foi construído, com alta semelhança biológica. Uma montagem 3D de quatro miniplacas foi projetada e fixada na maxila e na mandíbula do modelo de elementos finitos. O modelo foi aplicado com o uso de 250g/força nas miniplacas em três angulações (10°, 20° e 30°) em relação ao plano oclusal, para medir as tensões e os deslocamentos, usando o programa ANSYS. Resultados: As suturas zigomaticotemporal, zigomaticomaxilar e esfenozigomática desempenharam um papel significativo no deslocamento para anterior e na rotação anti-horária da maxila e do zigoma, independentemente da angulação na aplicação da força. Os deslocamentos e as rotações do complexo zigomático-maxilar diminuíram gradualmente com o aumento de 10° para 30° no ângulo de aplicação da força entre as miniplacas. A mandíbula apresentou deslocamento irrelevante, com rotação no sentido horário. Conclusões: Os efeitos do tratamento com I-SAMP foram corroborados, com um vislumbre dos padrões de deslocamento e das suturas envolvidas, que não existiam nos estudos com imagens 2D e 3D realizados anteriormente. A angulação dos elásticos Classe III ancorados esqueleticamente deve ser a menor possível, visto que o deslocamento do complexo zigomático-maxilar aumenta com a redução no ângulo dos elásticos.
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Objective @#To study the effect of anterior traction on the temporomandibular joint in adolescent patients with skeletal Class Ⅲ malocclusion.@*Methods@#Twenty-nine patients with early permanent dentition with skeletal class Ⅲ malocclusions were measured by cephalometry and a coordinate system before and after maxillary protraction. The correlation between dentofacial structures and the temporomandibular joint was analyzed. @*Results @# After maxillary protraction, cephalometric measurements showed that the dentofacial structure changed significantly; ANB increased by 3.97° ± 2.32° (P<0.001); U1-SN increased by 4.97° ± 5.51° (P<0.001); L1-MP decreased by 1.26° ± 1.41° (P = 0.008); and MP-SN increased by 1.02° ± 3.90° (P = 0.003). The coordinate system measurement showed that the S-Fpx was decreased by 0.16 ± 1.52 mm (P = 0.041), the S-Ciy distance was significantly decreased by 0.09 ± 2.03 mm (P = 0.028), and there was no significant change in the temporomandibular joint spaces (A, P, and C) (P>0.05). Correlation analysis showed a moderate negative correlation between the posterior margin of the temporomandibular joint fossa and U1-SN (r = -0.427, P = 0.042). There was a moderate positive correlation between the leading edge of the condyle and ANB (r = 0.425, P = 0.043); there was no correlation between the joint space and dentofacial changes. @* Conclusion@#After treatment with maxillary protraction for adolescent skeletal class Ⅲ malocclusion, maxillary protraction had some effect on changes in the temporomandibular joint fossa and condyle and had no effect on the joint space.
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Objective@# To compare the hyoid bone position among patients with different sagittal skeletal malocclusions to provide a reference for clinicians to formulate treatment plans.@*Methods@#Lateral cephalograms of 284 orthodontic patients were selected. According to ANB angles, the types of skeletal malocclusion of patients were determined as follows: Class Ⅰ (1° ≤ ANB ≤ 5°), Class Ⅱ (ANB>5°) and Class Ⅲ (ANB<1°). Ten parameters were used to determine hyoid positions. After comparing the hyoid positions of the three groups, stratified analyses based on sex and age were conducted. @*Results @# No significant differences in demographic and vertical facial type features among skeletal Classes Ⅰ, Ⅱ and Ⅲ patients were observed (P>0.05). The angle between the Gonion-hyoid point line and the hyoid point-Menton line (Go-Hy-Me) of Class Ⅱ patients was significantly smaller than that of Class Ⅰ patients, and the angle between the most anterior and inferior point of the third cervical vertebra-hyoid point line and the hyoid point-Sella line (C3-Hy-S) of Class Ⅲ patients was smaller than that of Class I patients (P<0.05). Age-stratified analysis showed that in the juvenile group, the C3-Hy-S of Class Ⅲ patients was significantly smaller than that of Class Ⅰ patients in males and females (P<0.05). In the adult female group, the Go-Hy-Me of Class Ⅱ patients was significantly smaller, and the distance from the hyoid point to the mandibular plane (Hy-MP) was larger than that noted in Class Ⅰ patients (P<0.05); no significant difference in hyoid position between male Class Ⅱ and I patients was observed (P>0.05).@*Conclusions@#Compared with Class Ⅰ patients, the hyoid bone of Class Ⅱ patients in adult females was farther away from the mandible and that of Class Ⅲ patients in juveniles was farther away from the cervical vertebra and posterior cranial base.
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Desde la antigüedad la belleza y la armonía facial han sido objetivos que tanto pintores como escultores, médicos y las personas tratan de lograr. Los rostros han sido estereotipados y es así como las caras proporcionadas tanto en alto como en ancho con perfiles que son rectos o levemente convexos son los que se asocian a bondad, generosidad, personas con luz interior, princesas y son las "buenas de las películas". Pero ¿qué sucede con aquellos rostros cóncavos, con tercios inferiores ya largos o cortos? a ellos les ha tocado la peor parte, son los malos, los oscuros, los "villanos de las películas". Objetivos La finalidad de este trabajo es acercar a los colegas ortodoncistas una opción de tratamiento en clase III esqueletal, cuando el camuflaje ortodóncico no alcanza para resolver el crecimiento alterado entre el maxilar superior y el maxilar inferior (AU)
Beauty and facial harmony have been, since the beginning of humanity, a target for artists, painters, sculptores, and even people and doctors to accomplish. There is a stereotype of beauty: faces with proportional dimensions both in height and length, with straight profiles or somehow convex are associated with kindness, generosity and inner beauty. We can see this in movies where the heroes, the princesses, the "good guys" are portrayed with these types of faces. And what happens with people with concave faces, long or short inferior thirds? They are doomed to be the evil, the dark and "the villains" (AU)
Subject(s)
Humans , Male , Adolescent , Esthetics, Dental , Face/anatomy & histology , Orthognathic Surgery , Malocclusion, Angle Class III/surgery , Patient Care Planning , Argentina , Cephalometry , Genioplasty , Maxillofacial DevelopmentABSTRACT
Our Objective was to treat a patient having proclined, protruded teeth along with a Class II Skeletal malocclusion. 0.022 × 0.028 inch MBT Brackets were placed, and leveling alignment was commenced. Individual canine retraction was carried out in both arches, followed by retraction of the incisors in the upper arch with a Burrstone's T Loop. E2Z Forsus fatigue resistance appliance was given for the correction of Class II malocclusion. Proclination, protrusion, and crowding were corrected along with Class II Skeletal base. Individual canine retraction along with frictionless mechanics and noncompliant functional correction has sufficient potential to prevent anchor loss and correct a Class II skeletal base.
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Antecedentes: La clase III esqueletal, es una deformidad dentofacial donde el tercio inferior de la cara es más prominente, el tratamiento se decide según la etiología y la edad del paciente; si se encuentra en crecimiento la malformación puede ser tratada con un protocolo interceptivo y si es posible evitar la cirugía ortognática a futuro. Objetivo: Mejorar la clase esqueletal, descruzar la mordida u obtener mordida borde a borde, mejorar la posición del labio superior y evaluar el comparativo inicial-final de SNA y ANB. Reporte de caso:Paciente masculino de 13 años, sin antecedentes personales patológicos o familiares reportados; presenta clase III esqueletal responsiva bimaxilar, crecimiento vertical, clase molar I y canina III; fue tratado con el protocolo de mini placas BAMP (bone anchored maxillary protraction) por sus siglas en inglés, elásticos intermaxilares y un paladar con pistas planas. Resultados:La fase ortopédica duro cinco meses y se logró mordida borde a borde y clase I esqueletal. Discusión: Se obtuvieron resultados con el uso de mini implantes sin anclaje extraoral en menos tiempo a comparación de otros métodos que tienen que ser usados por 9-12 meses.Conclusión:El protocolo BAMP puede ser usado en pacientes en crecimiento sin máscara facial para corregir la clase III esqueletal.
Background: Skeletal class III is a dentofacial deformity where the lower third ofthe face is more prominent. The treatment is decided according to the etiology and age of the patient; If the patient is in growing, the malformation can be treated with an interceptive protocol and if possible, avoid a orthognathic surgery in the future. Objective: Improve the skeletal class, uncross the bite or obtain an edge-to-edge bite, improve the position of the upper lip and compare the initial-final relationship of ANS and ANB.Case report:13-year-old male patient, with no reported pathological or family history; presents skeletal class III, vertical growth, molar class I and canine III; he was treated with the protocol of mini BAMP (bone anchored maxillary protraction) plates, intermaxillary elastics and a palate with flat tracks. Results:The orthopedic phase lasted five months and an edge-to-edge bite and skeletal class I were achieved.Discussion:Results were obtained with the use of mini plates without extraoralanchorage in less time compared to other methods that have to be used for 9-12 months. Conclusion: The BAMP protocol can be used in growing patients without a face mask to correct skeletal class III.
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ABSTRACT@#Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.
Subject(s)
Malocclusion, Angle Class IIABSTRACT
Objective@#To analyze the correlation between skeletal vertical patterns and mandibular dental arch width, basal arch width and the dental buccolingual inclination of patients with skeletal ClassⅠ@*Methods@#The CBCT data of 62 skeletal ClassⅠ malocclusion patients were collected and divided into a high-angle group with 19 cases, a mean-angle group with 22 cases, and a low-angle group with 21 cases according to the GoGn-SN angle. Mandible 3D reconstruction of the three groups was performed using Dolphin software, and dental arch widths, basal arch widths and buccolingual inclination of canines, first premolars and first molars, were measured and statistically analyzed respectively. @*Redults@#Mandibular dental arch width showed no significant difference among the three groups (P>0.05). The basal arch widths of mandibular canines and first premolars in low-angle group were larger than those in the other groups (P<0.05). The buccolingual inclinations of mandibular canines and first premolars in high-angle group were larger than those in the other groups (P<0.05). The buccolingual inclination and basal arch width of the first molars among the three groups showed no significant differences (P>0.05). Pearson correlation tests showed that the basal arch widths of mandibular canines and first premolars were negatively correlated with GoGn-SN angle. Excluding the influence of dental arch width and basal arch width, there was still a significant positive correlation between the buccolingual inclination of mandibular canines and first premolars and the GoGn-SN angle (P<0.05).@*Conclusion@#The width of the basal bone arch between different skeletal vertical patterns mainly differs in the canine segment and the premolar segment, and the difference in the buccolingual inclination of the teeth is mainly to compensate for the difference in the GoGn-SN angle. In clinical practice, individualized therapy should be adopted according to the differences to achieve the long-term efficacy of correction.
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Objective @# To investigate the changes in the sagittal diameter of the upper airway before and after the treatment of skeletal Class Ⅲ malocclusion in adults with microimplant anchorage and class Ⅲ intermaxillary elastics and to provide a reference for clinical treatment. @*Methods @#A total of 35 adult patients with skeletal Class Ⅲ malocclusion were selected to be treated with the straight-wire technique. Microimplant group, 15 cases (group A): patients with severe skeletal Class Ⅲ malocclusion (vertical high angle) were treated with the straight-wire technique combined with microimplant anchorage; class Ⅲ intermaxillary elastics group, 20 cases (group B): Patients with mild or moderate skeletal Class Ⅲ malocclusion (vertical low angle and average angle) were treated with the straight-wire technique combined with class Ⅲ intermaxillary elastics, and cephalometric radiographs obtained before and after treatment in the upper airway in the two groups were measured and analyzed.@*Results @#Changes in cranial and maxillofacial measurements after correction: in group A, (sella-nasion-supramental angle) the SNB angle decreased significantly (P < 0.05), and (subspinale-nasion-supramental angle) the ANB angle increased significantly (P < 0.05). In group B, the SNB angle decreased significantly (P < 0.05), while (subspinale-nasion-subspinale angle) the SNA angle、ANB angle and anterior skull base plane-mandibular plane angle (Sn-MP) angle increased significantly (P < 0.05). Changes in sagittal diameter of the upper airway measurements after corrections: In group A, the width of the glossopharyngeal segment of the upper airway (TB-TPPW) decreased significantly (P < 0.05). In group B, first segment width of the upper airway behind the hard palate (PNS-R) increased significantly (P < 0.05). After correction, the decreased SNB and increased ANB in group A was higher than that in group B, and the difference was statistically significant （P < 0.05）. The decreased of TB-TPPW in upper airway of group A was greater than that of group B, and the difference was statistically significant （P < 0.05）.@* Conclusions @#In the treatment of skeletal class Ⅲ malocclusion with microimplant anchorage, the sagittal diameter of the glossopharyngeal segment of the upper airway has a negative impact.