Tratamiento ortodóncico prequirúrgico para la corrección de anomalías esqueléticas graves del complejo cráneo-facial / Presurgical orthodontic treatment for the improvement of severe skeletal anomalies of the craneofacial complex

Con la presente revisión bibliográfica se aportan elementos sobre la aplicación del tratamiento ortodóncico prequirúrgico en pacientes mayores de 18 años con anomalías esqueléticas graves del complejo cráneo-facial, quienes deben ser atendidos por un equipo multidisciplinario de Cirugía Ortognática. Al respecto, el trabajo del ortodoncista resulta de suma importancia en la predicción y planificación del procedimiento quirúrgico en aquellos que no mejoran con tratamiento ortodóncico o con cualquier otra terapéutica similar. Se concluyó que la detección y el diagnóstico temprano por los ortodoncistas de las diferentes áreas de salud en el segundo nivel de atención, posibilita el empleo de técnicas correctivas que proporcionan mejores condiciones, antes de que el afectado con dichas deformidades esqueléticas reciba algún procedimiento quirúrgico ortognático.

With the present literature review elements are offered on the role of the presurgical orthodontic treatment in patients older than 19 years with marked skeletal anomalies of the craneofacial complex, who should be assisted by a multidisciplinary team for orthognatic surgery. In this respect, the work of the orthodontist is of extreme importance in the prognosis and planning of the surgical procedure in those who have no improvement with the orthodoncic treatment or with any other similar therapy. It is concluded that the detection and the early diagnosis by the orthodoncist of the different health areas in the second care, facilitate the use of correction techniques which provide better conditions, before the affected patient with these skeletal deformities receives a surgical orthognatic procedure.

Correlation between menton deviation and dental compensation in facial asymmetry using cone-beam CT / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate the correlation between menton deviation and dental compensation in facial asymmetry. METHODS: Tooth axis and distance of first molar and canine to the reference plane were investigated by cone-beam computerized tomography. The subjects consisted of 50 patients with asymmetric mandibles (male 21, female 29, mean age 24.3 years). Control groups were also assessed (male 11, female 9, mean age 25.6 years). Nine measurements (5 linear measurements and 4 angular measurements) were measured in order to evaluate the correlation between menton deviation and the linear and angular difference of first molar and canine in the deviated and none-deviated sides using the defined MPR images. The differences between deviated and non-deviated side, according to menton deviation, were statistically analyzed using stepwise multiple regression analysis. RESULTS: From the result, Menton deviation was negatively correlated with mandibular first molar's angular measurement (Delta Angle LM6-Mn plane (dev.-ndev.)) and positively with maxillary fist molar's angular measurement (Delta Angle UM6-FH plane (dev.-ndev.)) (p<0.01). Two angular measurements (Delta Angle LM6-Mn plane (dev.-ndev.), Delta Angle UM6-FH plane (dev.-ndev.)) explained the variability in menton deviation with a significant r2 value of 0.589. CONCLUSIONS: This study suggests that the tooth axis of upper and lower first molars leans towards the deviated side of Menton when there is mandibular asymmetry with Menton deviation.

The differences of STO between before and after presurgical orthodontics in skeletal Class III malocclusions / 대한치과교정학회지

OBJECTIVE: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. METHODS: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks as coordinates of the X and Y axes. RESULTS: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. CONCLUSIONS: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.