Surgery-first approach with 3D customized passive self-ligating brackets and 3D surgical planning: Case report

ABSTRACT It is possible to unify three-dimensional customized orthodontic techniques and three-dimensional surgical technology. In this case report, it is introduced a treatment scheme consisting of passive self-ligation customized brackets and virtual surgical planning combined with the orthognathic surgery-first approach in a Class III malocclusion patient. Excellent facial and occlusal outcomes were obtained in a reduced treatment time of five months.

RESUMO É possível unificar técnicas ortodônticas personalizadas e tecnologia de planejamento cirúrgico 3D. No presente relato de caso, apresenta-se um plano de tratamento envolvendo o uso de braquetes autoligáveis passivos personalizados e planejamento cirúrgico virtual, combinado com cirurgia ortognática de benefício antecipado, em um paciente com má oclusão de Classe III. Foram obtidos excelentes resultados faciais e oclusais em um tempo reduzido de tratamento, de 5 meses.

The long term stability of skeletal class III malocclusion after orthodontic-surgery:A meta-analysis / 实用口腔医学杂志

Objective:To analyze the long term stability of the hard and soft tissues of the skeletal class III malocclusion after ortho-dontic-surgery by Meta-analysis.Methods:The randomized controlled trials(RCT),quasi-randomized controlled trials and clinical case-control trials(CCT)about the long-term stability of skeletal class III malocclusion after orthodontic-surgery was collected from Co-chrane Library,PubMed,Medline,CNKI,VIP and Wanfang databases from inception to December 31,2013 by literature search.Two professionally trained reviewers evaluated the quality of the screened literatures,scored literatures with the NOS evaluation tool,and collectd data and information of the literatures with medium and higher quality.Revman5.2 was used for the Meta-analysis.Results:4 CCTs articles and 178 cases were included.The results of Meta-analysis showed that:1.The stability of the hard tissue:the differ-ence of SNA(WMD =-0.58,95%CI[-1.18,0.02]),SNB (WMD =0.25,95%CI[-0.42,0.91]),ANB(WMD =-0.70, 95%CI[-1.44,0.04])and MP-SN(WMD =0.39,95%CI[-0.25,1.04])at post-operation and 3 years after operation had no statistical significance.Point A remained relatively stable position and point B had some replace 3 years after surgery compared with that at post-operative.2.The stability analysis of soft tissue:the healing effect of the soft tissue was stable,except the LowerlipeNperp had some recurrence 3 years after surgery.Conclusion:In the long term,after orthodontic and surgical treatment for skeletal class III malocclusion the hard and soft tissues kept stabile except a little replapse of the mandibular and the LowerlipeNperp.

A systematic review of the long-term stability of the hard tissue of skeletal classⅢmalocclusion after ortho-dontic combined surgical treatment / 医学研究生学报

[Abstract ] Objective The orthodontic-surgery is the most effective way to treat the severe skeletal class Ⅲmalocclusion,but the long-term stability is still disputed .The aim of this systematic review is to analyze the long-term stability of hard tissue of seriously skeletal Class Ⅲ malocclusion patients treated with orthodontic combined surgical treatment . Methods Literature were searched through the Cochrane Central Register of Controlled Trials , Cochrane Library, Medline via pubmed (1950-2014), EMBASE (1980-2014) and other foreign databases , and Chinese Biomedical Literature Database , China National Knowledge Infrastructure Database , VIP Database for Chinese Technical Periodicals , digital journal of Wan fang Data and so on .Unpublished conference papers and gray litera-tures were collected manually .The literatures consist of randomized controlled trials ( RCT) , quasi-randomized controlled trials and clini-cal case-control trial (CCT) were selected.Then meta analysis was performed for annexable literatures and qualitative description was performed for diverged documents . Results Five foreign articles and 1 Chinese article suitable for analysis were ultimately studied . All the studies were CCT and a total of 260 patients were involved in the present systematic review .Meta analysis showed that the SNA , SNB, ANB, MP SN and Y-axis did not change significantly during 3 years after operation (P>0.05) and a good skeletal class I facial types were maintained .The comparison results of MP-SN and Y-axis showed that there was no significant statistical difference and the mandibular plane angle maintained the relative stability .Meta analysis was not performed because of the different measurement methods of A, B, Pg and Ramus inclination , so the qualitative description was used .Point A and Ramus inclination remained relatively stable posi-tion, but point B and Pg had some replace compared with post-operative. Conclusion The orthodontic and surgical treatment for skeletal classⅢmalocclusion could keep the hard tissue relative stabil-ity except a little replace of the mandibular .

Progressive Hemifacial Atrophy Treated by Orthodontic Surgery / Oral Science International

Progressive hemifacial atrophy (PHA) is a self-limited atrophy of subcutaneous tissues (and less frequently of hard tissues) on one side of the face. It is a sporadic, slowly progressing disease whose pathogenesis is still unknown. As a rule the asymmetry caused by PHA (usually of soft tissue) is treated by volume augmentation that involves free tissue grafting or a pedicled flap transfer.We describe a rare case of hard tissue PHA. The atrophic changes occurred in the left molar tooth, maxilla and mandible and were associated with moderate soft tissue atrophy. The left side of the patient's mouth was higher on the right side, and the occlusal plane was severely inclined in spite of normal occlusion. After no alteration and no progression of the atrophy were established, the patient was treated with orthodontic surgery. To correct the inclined occlusal plane and asymmetry profile, we performed a Le Fort I and intraoral vertical ramus osteotomy. In the 3-year follow-up, there were good occlusal balance and improved symmetrical profile without relapse or recurrence of the atrophy. Thus, orthodontic surgery was effective as a first procedure to treat hard tissue atrophy that appeared with moderate soft tissue atrophy.