ABSTRACT
O sucesso do tratamento precoce da classe III depende de um bom diagnóstico e da cooperação do paciente na utilização do aparelho extrabucal. Neste trabalho, por meio de um chip (Theramon) instalado na Máscara Facial de Petit da paciente, foi possível monitorar a quantidade de horas que a paciente utilizou o aparelho por dia, durante um período de quatro meses. Paciente do sexo feminino, 7 anos e 11 meses de idade portadora da má oclusão de classe III, utilizou o aparelho de disjunção da maxila (Hyrax) modificado, seguido da Máscara Facial de Petit com chip (Theramon) instalado. A média de uso foi maior do que 11 horas de uso diário. O uso deste dispositivo auxilia no monitoramento do tempo de uso do aparelho, cujo sucesso do tratamento depende da utilização deste pelo paciente(AU)
The success of early treatment of class III depends on a good diagnosis and the cooperation of the patient in the use of the extra oral appliance. In this study, the patient was able to monitor the number of hours the patient used the device per day during a period of four months using a Theramon chip installed in the Patient's Facial Mask. A 7-year, 11-month-old male with Class III malocclusion used the modified maxillary disjunction (Hyrax), followed by the Petit Facial Mask with a Theramon chip installed. The average use was greater than 11 hours of daily use. The use of this device assists in the monitoring of the time of use of the device, whose success of the treatment depends on the use of this by the patient(AU)
Subject(s)
Humans , Female , Child , Prognathism/therapy , Retrognathia/therapy , Malocclusion, Angle Class III/diagnosis , Malocclusion, Angle Class III/therapy , Prognathism , Retrognathia , Palatal Expansion Technique , Patient Compliance , Early Diagnosis , Malocclusion , Malocclusion, Angle Class IIIABSTRACT
ABSTRACT Obtaining long term stability allied to functional and aesthetic balance is the main goal of any orthodontic-orthopedic therapy. This case report describes the orthodontic therapy applied to a 7-year-9-month old child, who presented a Class II, division 1 malocclusion associated to skeletal open bite. Functional and skeletal corrections (sagittally and vertically) were obtained by means of mandible advancement achieved with a closed Balter's bionator appliance followed by a fixed appliance. This approach showed to be efficient in accomplishing both functional and aesthetic goals, that were kept stable five years after the treatment was finished. This case report was presented to the Board of Directors of the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as partial requirement to becoming a Diplomate of the BBO.
RESUMO A obtenção do equilíbrio funcional e estético em um contexto de estabilidade em longo prazo é o objetivo de qualquer abordagem ortodôntico-ortopédica. O presente relato aborda o tratamento ortodôntico realizado em uma criança com 7 anos e 9 meses de idade, portadora de Classe II, divisão 1, associada a mordida aberta esquelética. A correção funcional e esquelética (sagital e vertical) foi obtida por meio de avanço mandibular, com aparelho Bionator de Balters do tipo fechado, seguido de aparelho ortodôntico fixo. Essa abordagem foi eficiente para atingir as metas funcionais e estéticas, que continuaram estáveis cinco anos após a conclusão do tratamento. Esse caso clínico foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.
Subject(s)
Humans , Male , Adolescent , Retrognathia/therapy , Open Bite/therapy , Malocclusion, Angle Class II/therapy , Orthodontics, Corrective , Follow-Up Studies , Orthodontic Appliances, Functional , Mandibular AdvancementABSTRACT
La maloclusión clase II tiene una prevalencia de 37.1 por ciento en México, de ahí su importancia de ser diagnosticada y tratada a tiempo. Sepresenta como resultado de la combinación de componentes dentales,esqueléticos y/o funcionales. Sus características son molares en relacióndistal, retrognatismo, protrusión maxilar o una combinación deellos. Los hábitos nocivos como la succión de labio inferior producenalteraciones dentales como retrusión de los incisivos inferiores y protrusiónde los incisivos superiores. La clase II dentoesqueletal es una desarmonía que se agrava con el tiempo, cuya prevalencia aumenta con la edad, debido a que no tiende a corregirse a edades tempranas. El reporte del caso clínico es de una paciente de 13 años, la cual tiene hábito de succión labial, clase II molar y canina bilateral, protrusión maxilar, retrognatismo, biproinclinación dental, biprotrusión labial y crecimiento horizontal. Los objetivos del tratamiento fueron eliminar el hábito de succión del labio inferior, retruir los incisivos superiores,obtener una clase I canina y molar, corregir la sobremordida vertical yhorizontal y lograr un sellado labial armónico. El tratamiento consistióen colocar ortopedia funcional removible SN6 en dos etapas debido aque la sobremordida era de 9 mm. La aparatología ortopédica funcionalremovible puede considerarse una terapia efectiva para los problemasde maloclusión clase II y sobremordida horizontal y vertical.
Class II malocclusions have a 37.1% prevalence in Mexico; their timelydiagnose and treatment is therefore relevant. They appear as a result ofa combination of dental, skeletal and/or functional components. Amongthe intraoral characteristics, there are the distal molar relationship,retrognathism, maxillary protrusion, or a combination of all of them.Harmful habits, such as the suction of the lower lip they cause dentalalterations like the retrusion of the incisor teeth and the protrusion ofthe upper incisor teeth. Skeletal class II malocclusion is a misalignmentwhich steadily worsens; its prevalence increases as the person gets olderbecause it is not likely to be corrected at an early age. The clinicalcase report is that of a 13-year-old female patient, who has the habitof lip suction, class II molar and canine, and class II occlusion in bothcanines, maxillary protrusion, mandibular retrognathism, bimaxilarydental proclination, biprotrusive lips and horizontal growth. Thetreatment aimed at eliminating the lower lip suction habit, retractingthe upper incisor teeth, getting a canine and molar occlusion class I,correcting both overjet and overbite, achieving an adequate, lip seal.The treatment comprised SN6 removable functional orthopedics in twostages due to the 9 mm overbite. The removable functional orthopedic apparatus may be deemed an eff ective therapy for class II malocclusion problems, and both overjet and overbite.
Subject(s)
Female , Humans , Adolescent , Malocclusion, Angle Class II/therapy , Orthodontic Appliances, Functional , Orthodontic Appliances, Removable , Cephalometry/methods , Fingersucking/adverse effects , Fingersucking/therapy , Mexico , Retrognathia/therapy , Treatment OutcomeABSTRACT
The objective of this article was to investigate the perception of esthetic changes in the facial profile of bilateral Class II patients treated with the Modified Thurow Appliance for extraoral treatment. Silhouettes were traced of profiles of patients who initially presented a bilateral Class II molar relationship and who, post-treatment, presented molars in a Class I relationship. Three groups were formed: the first composed of patients with maxillary protrusion (SNA >84°), the second with maxillary retrusion (SNA <80°), and the third with a well-positioned maxilla (SNA 80-84°). A panel of 200 lay evaluators judged the profile esthetics by a randomized drawing of the silhouettes. The multiple analysis results showed that the profile esthetic scores for the three positions of the maxilla were greatly influenced by significant interactions with the characteristics (like sex and age) of the evaluators: retrusive maxilla (Score *Age Group, p< 0.001), normal maxilla (Score *Sex, p= 0.024; Score *Age Group,p= 0.050) and protrusive maxilla (Score *Age Group,p< 0.001). It was observed that the profile of Class II patients with protrusion, normal relationship and retrusion of the maxilla, improved in their esthetic post-treatment result; however, the evaluators showed greater satisfaction with the groups of protrusion and normal position of the maxilla. The Modified Thurow Appliance provided significant improvements in the esthetics of the profile of patients who presented protrusion and normal position of the maxilla. However, its use was not the best treatment option for patients with maxillary retrusion.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Esthetics, Dental , Face/anatomy & histology , Malocclusion, Angle Class II/therapy , Orthodontic Appliances , Age Factors , Analysis of Variance , Cephalometry , Perception , Prognathism/therapy , Retrognathia/therapy , Sex Factors , Treatment OutcomeABSTRACT
The present study reports a case of Angle Class II malocclusion treatment of a male growing patient with 10-mm overjet, excessive overbite and transverse maxillary deficiency. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), with DI equal to or greater than 10, as a requirement for the title of certified by the BBO.
O presente relato de caso aborda o tratamento de uma má oclusão de Classe II de Angle, em paciente do sexo masculino, em fase de crescimento, com sobressaliência de 10mm, sobremordida exagerada e deficiência maxilar transversa. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria com índice de grau de complexidade (IGC) igual ou acima de dez pontos, como parte dos requisitos para obtenção do título de Diplomada pelo BBO.
Subject(s)
Child , Humans , Male , Malocclusion, Angle Class II/therapy , Cephalometry/methods , Extraoral Traction Appliances , Mandible/growth & development , Maxilla/abnormalities , Maxilla/growth & development , Occlusal Splints , Orthodontic Brackets , Overbite/therapy , Palatal Expansion Technique , Patient Care Planning , Retrognathia/therapy , Tooth Movement Techniques/instrumentationABSTRACT
OBJECTIVE: To assess the dentoskeletal changes observed in treatment of Class II, division 1 malocclusion patients with mandibular retrognathism. Treatment was performed with the Herbst orthopedic appliance during 13 months (phase I) and pre-adjusted orthodontic fixed appliance (phase II). METHODS: Lateral cephalograms of 17 adolescents were taken in phase I onset (T1) and completion (T2); in the first thirteen months of phase II (T3) and in phase II completion (T4). Differences among the cephalometric variables were statistically analyzed (Bonferroni variance and multiple comparisons). RESULTS: From T1 to T4, 42% of overall maxillary growth was observed between T1 and T2 (P < 0.01), 40.3% between T2 and T3 (P < 0.05) and 17.7% between T3 and T4 (n.s.). As for overall mandibular movement, 48.2% was observed between T1 and T2 (P < 0.001) and 51.8% between T2 and T4 (P < 0.01) of which 15.1% was observed between T2 and T3 (n.s.) and 36.7% between T3 and T4 (P < 0.01). Class II molar relationship and overjet were properly corrected. The occlusal plane which rotated clockwise between T1 and T2, returned to its initial position between T2 and T3 remaining stable until T4. The mandibular plane inclination did not change at any time during treatment. CONCLUSION: Mandibular growth was significantly greater in comparison to maxillary, allowing sagittal maxillomandibular adjustment. The dentoalveolar changes (upper molar) that overcorrected the malocclusion in phase I, partially recurred in phase II, but did not hinder correction of the malocclusion. Facial type was preserved. .
OBJETIVO: avaliar as alterações dentoesqueléticas observadas no tratamento da má oclusão de Classe II com retrognatismo mandibular, realizado com aparelho ortopédico de Herbst durante 13 meses (Fase I) e aparelho ortodôntico fixo pré-ajustado (Fase II). MÉTODOS: foram obtidas telerradiografias laterais de 17 adolescentes, ao início (T1), final da Fase I (T2), primeiros 13 meses da Fase II (T3) e término da Fase II (T4). As diferenças entre as variáveis cefalométricas foram analisadas estatisticamente (variância e comparações múltiplas de Bonferroni). RESULTADOS: de T1 a T4, do total da projeção da maxila, 42% foram observados de T1 a T2 (p < 0,01); 40,3% de T2 a T3 (p < 0,05); e 17,7% de T3 a T4 (n.s.). Do total da projeção da mandíbula, foi notado 48,2% de T1 a T2 (p < 0,001) e 51,8% de T2 a T4 (p < 0,01), sendo 15,1% (n.s.) de T2 a T3, e 36,7% de T3 a T4 (p < 0,01). A relação molar e a sobressaliência foram corrigidas idealmente. Em T4, todos apresentavam características de oclusão normal. O plano oclusal que de T1 a T2 rotacionou no sentido horário, de T2 a T3 retornou aos valores iniciais, mantendo-se estável até T4. A inclinação do plano mandibular, responsável pela caracterização do tipo facial, não alterou em nenhum tempo. CONCLUSÃO: a mandíbula cresceu significativamente mais que a maxila, favorecendo o ajuste sagital maxilomandibular. As mudanças dentárias (molares superiores), que sobrecorrigiram a má oclusão na Fase I, recidivaram parcialmente na Fase II, sem comprometer a correção da má oclusão. O tipo facial foi preservado. .
Subject(s)
Adolescent , Child , Female , Humans , Male , Malocclusion, Angle Class II/therapy , Orthodontic Appliances, Functional , Retrognathia/therapy , Cephalometry/methods , Follow-Up Studies , Mandible/growth & development , Mandible/pathology , Mandibular Advancement/instrumentation , Maxilla/growth & development , Maxilla/pathology , Molar/pathology , Orthodontic Appliance Design , Palatal Expansion Technique/instrumentation , Rotation , Treatment Outcome , Tooth Movement Techniques/instrumentationABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the facial profile changes induced by Balters' bionator appliance in Class II division 1 patients, at mixed dentition stage. METHODS: The sample consisted of 28 prepubertal individuals at stages 1 and 2 of skeletal maturation (CVM), which were divided in two groups. The experimental group consisted of 14 individuals (7 boys and 7 girls, initial mean age of 8y12m) which were treated with Balters' bionator appliance for 14.7 months. The effects of treatment were compared to a control group of 14 subjects (7 boys and 7 girls, initial mean age of 8y5m) with Class II malocclusion, division 1, not orthodontically treated, which were followed up for 15.4 months. The statistical analysis was performed using Student's t test, at a significance level of 5%. RESULTS: The results showed that the Balters' bionator appliance promoted a significant increase on the mentolabial angle, in addition to demonstrating a tendency to reduce the facial skeletal convexity, to restrict the maxillary growth and to increase the nasolabial angle and the lower anterior facial height. CONCLUSION: It can be concluded that the Balters' bionator appliance improved the facial profile of children treated at mixed dentition stage.
OBJETIVO: o objetivo desse estudo foi avaliar as alterações no perfil facial induzidas pelo uso do Bionator de Balters em indivíduos com má oclusão Classe II divisão 1, na fase da dentição mista. MÉTODOS: a amostra consistiu de 28 pacientes, pré-pubertários, que se encontravam nos estágios 1 e 2 de maturação esquelética (CVM), os quais foram divididos em dois grupos. O grupo experimental foi constituído por 14 indivíduos (7 meninos e 7 meninas, média de idade inicial de 8 anos e 12 meses) que foram tratados com o Bionator de Balters por um período médio de 14,7 meses. Os efeitos do tratamento foram comparados com um grupo controle de 14 indivíduos (7 meninos e 7 meninas, média de idade inicial de 8 anos 5 meses) Classe II divisão 1, não tratados ortodonticamente, que foram acompanhados por um período médio de 15,4 meses. A análise estatística foi realizada por meio do teste t de Student, com nível de significância de 5%. RESULTADOS: os resultados indicaram que o o bionator de Balters promoveu um aumento significativo do ângulo mentolabial, além de demonstrar tendência à diminuição da convexidade esquelética facial, à restrição do crescimento maxilar e ao aumento do ângulo nasolabial e da altura facial anteroinferior. CONCLUSÃO: pode-se concluir que o Bionator de Balters melhorou o perfil facial de crianças tratadas na fase da dentição mista.
Subject(s)
Child , Female , Humans , Male , Activator Appliances , Face/anatomy & histology , Malocclusion, Angle Class II/therapy , Maxillofacial Development/physiology , Retrognathia/therapy , Age Determination by Skeleton , Case-Control Studies , Cephalometry , Cervical Vertebrae , Dentition, Mixed , Time FactorsABSTRACT
Objetivo: o objetivo desse trabalho é apresentar o aparelho Twin Block modificado por Henriques, indicado no tratamento de retrognatismo mandibular. Métodos: a não ser no padrão de crescimento vertical excessivo da face, o avanço mandibular é único. Os componentes são: porção acrílica, arco vestibular superior, tornos expansores superior e inferior, grampos de Adams e circunferenciais, planos de mordida anteriores e posteriores encaixados em 70º. As principais modificações em relação ao aparelho Twin Block original de Clark são o parafuso expansor inferior, a cobertura dos incisivos inferiores para evitar a inclinação vestibular ou protrusão desses dentes, 20º de inclinação para dentro (junto aos 70º) no aparelho superior, ou escudo lingual no inferior para evitar deslocamentos laterais da mandíbula. Os parafusos expansores superior e inferior são ativados em » de volta por mês apenas para acompanhar o crescimento maxilomandibular e evitar mordida cruzada. Em casos de mordida profunda, os desgastes seletivos no plano posterior do aparelho superior para a correção da curva de Spee são iniciados quando os contatos oclusais ocorrerem em padrão de fechamento de relação cêntrica. No padrão de crescimento vertical ou casos com altura anteroinferior aumentada (AFAI), os desgastes seletivos não são realizados, para não piorar esses casos. Resultados: mudanças esqueléticas e dentoalveolares são associadas com mudanças significativas no perfil duro e mole. Conclusão: o aparelho Twin Block modificado por Henriques pode ser adequado ao padrão de crescimento facial e tipo de má oclusão inicial, porém, por ser removível, depende totalmente da cooperação do paciente.
Subject(s)
Mandibular Advancement , Maxillofacial Development , Malocclusion, Angle Class II/therapy , Orthodontic Appliances, Functional , Retrognathia/therapyABSTRACT
The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus™ fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus™ FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus™ FRD.
Subject(s)
Biomechanical Phenomena , Cephalometry/methods , Female , Humans , Malocclusion, Angle Class II/therapy , Orthodontic Appliance Design , Orthodontic Appliances, Functional , Orthodontic Brackets , Orthodontic Wires , Retrognathia/therapy , Stress, Mechanical , Tooth Movement Techniques/instrumentation , Young AdultABSTRACT
La Clase II, 1ra. División o subdivisión, si bien son las de mayor consulta en nuestra práctica y estamos habituados a tratarlas, requieren como los casos atípicos o de difícil solución, de un diagnóstico completo para adecuar correctamente nuestra mecánica de tratamiento para alcanzar los objetivos deseados. El caso que se presenta es de una paciente de 13 años, que llega a la consulta por motivo de su apiñamiento dentario. En la inspección bucal se observa una ligera gingivitis marginal crónica y recesión gingival en un incisivo inferior
Subject(s)
Humans , Female , Adolescent , Malocclusion, Angle Class II/therapy , Retrognathia/therapy , Orthodontic Appliances , Cephalometry , Dental Articulators , Gingivitis/diagnosis , Orthodontics, Corrective , Gingival Recession/diagnosis , Orthodontic BracketsABSTRACT
O presente relato de caso clínico refere-se ao MPA - Aparelho de Protraçäo Mandibular - um dispositivo que acoplado ao aparelho fixo corrige a discrepância maxilo-mandibular e a relaçäo molar. Uma abordagem resumida dos requisitos para instalaçäo do aparelho e alguns dados cefalométricos säo apresentados comparando os valores pré e pós-tratamento
Subject(s)
Humans , Male , Adolescent , Malocclusion, Angle Class II/therapy , Orthodontic Appliances, Functional , Retrognathia/therapy , CephalometrySubject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Malocclusion/diagnosis , Malocclusion/therapy , Craniofacial Abnormalities/therapy , Maxillofacial Abnormalities/therapy , Orthodontic Appliances, Functional , Bruxism/prevention & control , Bruxism/therapy , Dentition, Mixed , Dentition, Permanent , Tooth Extraction , Extraoral Traction Appliances , Tongue Habits/therapy , Habits , Malocclusion, Angle Class II/diagnosis , Malocclusion, Angle Class II/therapy , Malocclusion, Angle Class III/diagnosis , Malocclusion, Angle Class III/therapy , Orthodontics, Corrective , Orthodontics, Interceptive , Palatal Expansion Technique , Prognathism/therapy , Retrognathia/therapy , Tooth, DeciduousSubject(s)
Retrognathia/surgery , Retrognathia/diagnosis , Retrognathia/therapy , Orthodontics , Surgery, OralSubject(s)
Humans , Female , Adolescent , Adult , Cephalometry , Jaw Abnormalities/diagnosis , Jaw Abnormalities/surgery , Osteotomy , Centric Relation , Mandibular Condyle/physiopathology , Esthetics, Dental , Jaw , Malocclusion, Angle Class II/therapy , Malocclusion, Angle Class III/therapy , Malocclusion/surgery , Malocclusion/diagnosis , Malocclusion/therapy , Occlusal Splints/standards , Orthodontic Wires/standards , Orthodontics, Corrective , Prognathism/diagnosis , Prognathism/surgery , Prognathism/therapy , Orthodontic Retainers , Retrognathia/surgery , Retrognathia/diagnosis , Retrognathia/therapy , Speech Therapy , Tomography, Emission-Computed/methodsABSTRACT
Se analiza la etiología y las características de la clase II/2, ilustrando, sobre una breve casuística, el papel del funcionalismo en su tratamiento
Subject(s)
Humans , Male , Female , Malocclusion, Angle Class II/diagnosis , Orthodontics, Corrective , Retrognathia/therapy , Activator Appliances , Palatal Expansion TechniqueABSTRACT
Tras clasificar a los estímulos terapéuticos utilizados por todas las escuelas como fuerzas extrínsecas o intrínsecas al organismo en tratamiento, se hace la definición del funcionalismo en ortodoncia y un resumen de su desarrollo histórico. Se aplican después sus principios al análisis mecánico-funcional de las clases II/1 y al tratamiento de varios casos de esta anomalía