Evaluación del aparato funcional postratamiento de Waveney como alternativa en la contención del avance mandibular

Fundamento: Para la contención del avance mandibular es necesario utilizar un aparato que mantenga la mandíbula en la posición lograda por los aparatos activos y que su diseño no provoque movimientos dentarios indeseados. Objetivo: Describir los cambios clínicos y cefalométricos del aparato funcional postratamiento de Waveney como alternativa en la contención del avance mandibular. Metodología: Se realizó una investigación descriptiva observacional de corte transversal en el servicio Ortodoncia de la Clínica Estomatológica Docente Provincial Dr. Justo Ortelio Pestana Lorenzo de la provincia Sancti Spíritus, desde septiembre 2019 a febrero 2022. Se seleccionaron 20 pacientes que iniciaron su etapa de contención en este período y cumplieron los criterios de inclusión. Se utilizaron métodos del nivel empírico y estadístico. Se analizaron las variables: edad, sexo, variables morfológicas clínicas y cefalométricas, así como resultado de la contención. Resultados: Se constató una edad promedio de 15.6; el 65 % de los escolares pertenecían al sexo femenino. Al año de iniciada la contención se mantuvo el sobrepase incisivo en 2.95 mm, la relación molar de neutroclusión en el 65 %, ángulo SNB en 79°, el ángulo ANB en 2.80°, la posición del incisivo superior 2.45 mm, la posición del incisivo inferior en 1.90 mm y el perfil estético en 0.55 mm. Solo existió incremento en el valor promedio del resalte incisivo de 2.70 mm a 2.75 mm. Conclusiones: Al año de iniciada la contención con el aparato funcional postratamiento de Waveney no se observó modificación de las variables estudiadas, excepto el resalte incisivo con incremento de su valor promedio.

Background: For mandibular advancement containment, it is necessary to use an appliance that holds the jaw in the achieved position by active appliances and that its design does not provoke undesired dental movements. Objective: To describe the clinical and cephalometric changes of the Orthodontic Appliances after the Waveney treatment as an alternative in the mandibular advancement containment. Methodology: A descriptive observational cross-sectional research was conducted at the Dr. Justo Ortelio Pestana Lorenzo Provincial Teaching Stomatology Clinic orthodontic service in Sancti Spíritus province, from September 2019 to February 2022. 20 patients who started their containment stage in this period and fulfilled the inclusion criteria were selected. Empirical and statistical methods were used. The following variables were analyzed: age, sex, clinical morphological and cephalometric variables, as well as the containment result. Results: An average age of 15.6 was found; 65% of the schoolchildren were female. One year after the containment was started, the incisive overpass was maintained at 2.95 mm, the neutroclusion molar rate at 65%, SNB angle at 79°, the ANB angle at 2.80°, the upper incisor position 2.45 mm, the lower incisor position by 1.90 mm and the esthetic profile by 0.55 mm. There was only an average increase in the incisor protrusion value from 2.70 mm to 2.75 mm. Conclusions: One year after containment with the Waveney post-treatment Orthodontic Appliances was initiated no changes were observed in the studied variables, except for incisor protrusion with an increase in its average value.

Incidence of inferior alveolar nerve sensory deficit and intra-operative nerve encounters after advancement of retrognathic mandible – A cross-sectional survey study

Aims and Objectives: The aim of the current cross?sectional study was to conduct a survey among the oral and maxillofacial surgeons of South India regarding their experiences of incidence of inferior alveolar nerve (IAN) neurosensory deficit after bilateral sagittal split osteotomy (BSSO) for correction of mandibular retrognathism and to assess the intra?operative nerve encounters and its effect on the inferior alveolar neurosensory deficit (NSD), 6 months post?operatively. Materials and Methods: A self?administered questionnaire (SAQ) was prepared using Google Forms (Google Inc.) and sent to the prospective participants through various social media outlets such as Facebook, WhatsApp groups etc., of the maxillofacial surgery specialty for a period of 3 months. SAQ from surgeons with more than 5 years of experience in orthognathic surgery were included. Results: The incidence of NSD post?BSSO advancement surgery from 859 cases after 6 months was 15.1% (130). After splitting the mandible, the IAN was seen in the proximal fragment in 472 sites and needed dissection. The nerve was transected and neurorrhaphy was carried out in 26 sites. A Chi?square test was used to analyse the qualitative variables. The IAN was not visible post?osteotomy in 140 sites and in the distal fragment in 1080 sites. These groups had decreased incidence of NSD. The NSD was significantly higher in cases where the nerve was transected and sutured, P value <0.001 as compared with the other nerve status, followed by the nerve in the proximal fragment needing dissection. Conclusion: The IAN status intra?operatively can be assumed to have a significant role in persisting NSD

A cirurgia ortognática no tratamento da DTM em pacientes classe II / The orthognatic surgery in treatment of TMJ in class II patients

Introdução: A má oclusão Classe II pode influenciar negativamente na qualidade de vida dos pacientes, tanto na aparência facial, quanto função oral ou até ambas. Atualmente, o tratamento ortodôntico-cirúrgico é comumente utilizado em pacientes com discrepâncias esqueléticas graves. Objetivo: Este estudo tem como objetivo analisar os resultados da cirurgia ortognática associada ao tratamento ortodôntico nos pacientes que possuem DTM e má oclusão de Classe II por retrognatismo mandibular. Metodologia: Foi realizada uma pesquisa bibliográfica nas plataformas de buscas científicas Google Acadêmico, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, e nas revistas AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) e The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), utilizando as seguintes palavras chave: retrognatismo, cirurgia ortognática e transtornos da ATM. Conclusão: A maioria dos pacientes que apresentam sinais e sintomas de DTM pré-operatórios melhoram a disfunção e diminuem os níveis de dor com o tratamento ortognático. Além disso, o tratamento ortodôntico é de suma importância para se obter o sucesso do procedimento cirúrgico, assim como na estabilidade pós-cirúrgica.(AU)

Introduction: Class II malocclusion can negatively influence patients in quality of life, in the facial and oral appearance or both. Currently, orthodontic-surgical treatment is commonly used in patients with severe skeletal discrepancies. Objective: The objective of this study was to analyze the results of orthognathic surgery associated with orthodontic treatment in patients who have TMD and Class II malocclusion due to mandibular retrognathism. Methodology: A bibliographic search was performed in the scientific search platforms Google Scholar, CAPES/MEC, PubMed/Medline, Scielo, Elsevier, AJO-DO (American Journal of Orthodontics and Dentofacial Orthopedics) and in The Angle Orthodontist (An International Journal of Orthodontics and Dentofacial Orthopedics), using the keywords: retrognathism, orthognathic surgery and TMJ disorders. Conclusion: With orthognathic treatment, most patients who had preoperative DTM signs and symptoms showed an improvement and a decrease in pain levels. In addition, orthodontic treatment is important for the success of the surgical procedure, as well as for post-surgical stability.(AU)

Mandibular orthopedic advancement in different facial patterns and distinct stages of skeletal maturation

ABSTRACT The Herbst appliance can be very effective in treatment of Class II patients with mandibular retrognathism. Because of the continuous action in a full-time basis, treatment time using it normally takes from six to ten months, and is usually followed by a second phase of full fixed appliances, in order to obtain both occlusal refinement and long term stability. Despite Herbst appliance's effectiveness in the occlusal and dentoalveolar perspectives, its facial results may differ among patients with different growth patterns, as well as in distinct stages of skeletal maturation. In the current paper, two patients with different facial patterns are presented, who were treated under the same protocol, using Herbst and full fixed appliances in different skeletal maturation stages, and both dentoalveolar and facial results are compared and discussed.

RESUMO Um número significativo de pacientes que procuram o tratamento ortodôntico apresenta má oclusão de Classe II acompanhada pelo retrognatismo mandibular. Abordagens ortopédicas para avanço mandibular são comumente utilizadas enquanto houver crescimento facial remanescente e, nesses casos, o estágio de maturação esquelética deve ser avaliado para definir a melhor época de intervenção terapêutica. Após concluída a fase ortopédica, normalmente é realizada uma segunda fase ortodôntica para refinamento oclusal, com o intuito de oferecer maior estabilidade das correções em longo prazo. No presente artigo, serão discutidos os resultados do avanço mandibular ortopédico considerando-se diferentes estágios de crescimento.

Anatomical characteristics of mandibular bone in skeletal class I, II and III patients by using cone beam computed tomography images in an iranian population / Características anatômicas do osso mandibular em pacientes Classe I, II e III esquelética usando imagens de Tomografia Computadorizada de Feixe Cônico: em uma População Iraniana

Objetive: This study aimed to compare the anatomical characteristics of the mandible in patients with skeletal class I, II and class III disorders using cone beam computed tomography (CBCT). Material and Methods: CBCT scans of patients between 17 to 40 years taken with NewTom 3G CBCT system with 12-inch field of view (FOV) were selected from the archive. Lateral cephalograms were obtained from CBCT scans of patients, and type of skeletal malocclusion was determined (Class I, II or III). All CBCT scans were evaluated in the sagittal, coronal and axial planes using the N.N.T viewer software. Results: The ramus height and distance from the mandibular foramen to the sigmoid notch in class II patients were significantly different from those in skeletal class I (P < 0.005). Distance from the mandibular canal to the anterior border of ramus in class III individuals was significantly different from that in skeletal class I individuals (P < .005). Conclusion: Length of the body of mandible in skeletal class I was significantly different from that in skeletal class II and III patients. Also, ramus height in skeletal class I was significantly different from that in skeletal class II patients. CBCT had high efficacy for accurate identification of anatomical landmarks. (AU)

Objetivo: Este estudo teve como objetivo comparar as características anatômicas da mandíbula em pacientes com desordem esquelética Classe I, II e III usando imagens de tomografia computadorizada de feixe cônico (TCFC). Material e Métodos: Foram selecionadas de arquivo, imagens de TCFC (Sistema NewTon 3G) com FOV (campo de visão) 12 polegadas e incluindo pacientes entre 17 a 40 anos. Cefalometrias laterais foram obtidas a partir das imagens de TCFC e o tipo de maloclusão esquelética foi determinada (Classe I, II ou III). Todas as imagens de TCFC foram avaliadas nos planos sagital, coronal e axial usando o software de visualização N.N.T. Resultados: A altura do ramo e distância do forame mandibular para a incisura da mandíbula em pacientes Classe II foi significativamente diferente daqueles Classe I esquelética (p< 0.005). A distância do canal mandibular até a borda anterior do ramo em indivíduos Classe III foi significativamente diferente daqueles indivíduos Classe I esquelética (p<0.005). Conclusão: O comprimento do corpo da mandíbula na Classe I esquelética foi diferente significativamente daqueles pacientes em Classe II e III esquelética. Além disso, a altura do ramo na Classe I esquelética foi significativamente diferente daqueles pacientes Classe II esquelética. A TCFC apresentou alta eficácia para a identificação precisa de marcos anatômicos. (AU)

Resultados posoperatorios y satisfacción en pacientes operados de cirugía ortognática durante los años 2011-2018 en Hospital San José, Chile

Resumen Introducción: Las dismorfosis dentofaciales (DDF) corresponden a un conjunto de alteraciones en la forma, posición o tamaño de los huesos maxilares. La cirugía ortognática es el tratamiento quirúrgico de elección para tratar este tipo de alteraciones, permitiendo la reposición de los maxilares y restitución de las funciones masticatorias, fonéticas y respiratorias, así como la estética facial. Objetivo: Describir resultados posoperatorios y el grado de satisfacción de los pacientes que optaron por la cirugía ortognática durante los años 2011-2018 por el equipo de Cirugía Maxilofacial del Hospital San José. Material y Método: Estudio retrospectivo, se evaluaron los protocolos operatorios de 44 pacientes operados de cirugía ortognática. Criterio de inclusión: pacientes mayores de 15 años con diagnóstico de DDF clases II y III no asociado a síndrome craneofacial. Se aplicó una encuesta a estos pacientes para conocer el grado de satisfacción con respecto a la cirugía ortognática efectuada, presencia de pérdida de sensibilidad neurológica y localización anatómica de ésta si la hubiese. Posteriormente, se relacionaron las variables género, edad del paciente al momento de la cirugía, pérdida de sensibilidad neurológica, tiempo de evolución posoperatorio y clase esqueletal con el nivel de satisfacción del paciente respecto a la cirugía ortognática. Resultados: Un 90,9% de los pacientes está satisfecho con los resultados de la cirugía. No existe una relación estadísticamente significativa entre el grado de satisfacción con la cirugía ortognática y las variables, sexo, edad de operación, pérdida de sensibilidad neurológica (del nervio mentoniano, que da inervación sensitiva al tejido blando del mentón, labio inferior, encía por vestibular de incisivos, canino y primer premolar inferior), tiempo de evolución posterior a la cirugía y clase esqueletal. Conclusión: Existe un alto nivel de satisfacción en los pacientes intervenidos mediante cirugía ortognática. Las cinco variables analizadas no influyen en el nivel de satisfacción de los pacientes posterior a la cirugía ortognática.

Abstract Introduction: Dentofacial deformities are a set of alterations in the shape, position or size of the maxillary bones. Orthognathic surgery is the surgical treatment of choice for this type of alterations, allowing the replacement of the maxillary and restitution of masticatory, phonetic and respiratory functions, as well as facial aesthetics. Aim: Describe post-operative results and level of satisfaction in patients who opted for orthognathic surgery during the years 2011-2018 by the Maxillofacial Surgery team of San José Hospital. Material and Method: Retrospective study, the surgical protocols of 44 patients who underwent orthognathic surgery were evaluated. Inclusion criteria: patients over 15 years old with diagnosis of DDF class II and III not associated with any craniofacial syndrome. A survey was applied to these patients to know the degree of satisfaction with respect to the orthognathic surgery carried out, the presence of loss of neurological sensitivity and its anatomical location, if any. Subsequently, the variables gender, patient age at the time of surgery, loss of neurological sensitivity, time of postoperative evolution and skeletal class were related to the level of satisfaction of patients with orthognathic surgery. Results: 90.9% of patients are satisfied with the results of the surgery. There is no statistically significant relationship between the level of satisfaction patients with orthognathic surgery and the variables, gender, age at the time of surgery, loss of neurological sensitivity (of the mentonian nerve, that gives sensitive innervation to the soft tissue of the chin, lower lip, gum by vestibular of incisors, canine and first lower premolar), time of postoperative evolution and skeletal class. Conclusion: There is a high level of satisfaction in patients undergoing orthognathic surgery. The five variables analyzed do not influence the level of patient satisfaction after orthognathic surgery.

Utilización del Neville Bass en el tratamiento del retrognatismo mandibular. Reporte de caso / Using of Neville Bass in the treatment of mandibular retrognathism. Case report

RESUMEN Fundamento: El uso de placas de acrílico superior retentiva y extensión de elementos linguales para el tratamiento del retrognatismo mandibular, constituye una opción novedosa en Cuba. Objetivo: Ilustrar el resultado en una paciente con retrognatismo mandibular tratado con el aparato Neville Bass. Presentación de caso: Paciente femenino de 9 años de edad, mestiza, con disfunción neuromuscular, mala relación intermaxilar, causado por retrognatismo mandibular, se le realizó tratamiento a la paciente con el aparato Neville Bass. Conclusiones: El tratamiento a la paciente con el aparato Neville Bass permitió la obtención de una correcta relación de sus bases óseas.

ABSTRACT Background: The use of retentive upper acrylic plates and extension of lingual elements for the treatment of mandibular retrognathism is a novel option in Cuba. Objective: To illustrate the result in a patient with mandibular retrognathism treated with the Neville Bass device. Case Report: A 9 year-old, half blood, female patient, with neuromuscular dysfunction, having poor intermaxillary relationship, caused by mandibular retrognathism, the patient was treated with the Neville Bass device. Conclusions: The treatment using the Neville Bass device allowed obtaining a correct relation of their bone bases.

Nuevo aparato ortopédico fijo para el tratamiento de maloclusiones clase II división 1. Reporte de caso / New orthopedic fixed appliance to treat class II, division 1 malocclusions. Case report

Antecedentes: La corrección temprana de las maloclusiones clase II asociadas a retrognatismo mandibular se logra mediante avance mandibular sostenido y continuo que no requiera colaboración del paciente. Objetivo: Describir un caso de maloclusión tratado con un nuevo arco de adelantamiento mandibular fijo (AAMF). Descripción del caso: El AAMF se usó en una paciente de 11 años y 6 meses, clase II esquelética división 1, con retrognatismo mandibular y mordida profunda. Resultados: Al año de tratamiento había cambios estéticos y funcionales. El ángulo ANB disminuyó (6,6° a 5,0°). La longitud efectiva mandibular (Co-Gn) aumentó (96,1 mm a 103,4 mm). La inclinación de incisivos superiores pasó de 28,0° a 28,4°. Los incisivos inferiores se proinclinaron levemente (26,2° a 30,9°). Las cefalometrías después de la fase de ortodoncia mostraron medidas esqueléticas estables: ANB pasó de 5,0° a 5,1° y Co-Gn se mantuvo en 103,4°. Hubo cambios en la posición de los incisivos: superiores retroinclinaron de 28,4° a 22,5° e incisivos inferiores pasaron de 30,9° a 28,2°. Conclusión: El AAMF representa una alternativa de tratamiento en denticiones mixta y permanente temprana: Por ser fijo, permite lograr avance mandibular sostenido y continuo, sin requerir colaboración del paciente, y durante el tiempo necesario para generar cambios. Por la sencillez de su estructura (maxilar cementado solo en los primeros molares maxilares), avanza la mandíbula sin fijarse a ella cada vez que el paciente cierra la boca. Además es sencillo de elaborar, cementar, activar, limpiar y mantener en boca.

Background: Early correction of class II malocclusions associated to mandibular retrognathism is possible through sustained and continuous mandibular advancement that does not require patient collaboration. Purpose: To describe a case of malocclusion treated with a new fixed mandibular advance arch (FMAA). Case description: FMAA was applied to a 11-year-6-month-old skeletal class-II, division-1 girl with mandibular retrognathism and overbite. Results: After one-year treatment, there were functional and esthetic outcomes. ANB angle was reduced from 6.6° to 5.0°. Effective mandibular length (Co-Gn) increased (96.1 mm to 103.4 mm). Upper incisors inclinations went from 28,0° to 28,4°. Lower incisors experienced slight proinclinations (26.2° to 30.9°). Cephalograms after orthodontic treatment showed stable measures: ANB went from 5.0° to 5,1° and Co-Gn remained stable in 103.4°. Upper incisors had retroinclinations from 28.4° to 22.5° and lower incisors went from 30.9° to 28.2°. Conclusion: FMAA is a treatment alternative for mixed and early permanent dentitions for being a fixed appliance, it allows advancing mandible without requiring patient collaboration and during the necessary time to obtain changes. Because of its simple structure (cemented in the maxilla only to first molars), it advances without being fixed to the mandible every time the patient closes the mouth. In addition, it is easy to make, cement, activate, clean, and keep in mouth.

Authors' Reply to Letter to the Editor “Effects of airway evaluation parameters on the laryngeal view grade in mandibular prognathism and retrognathism patients”

No abstract available.

Letter to the Editor: Effects of airway evaluation parameters on the laryngeal view grade in mandibular prognathism and retrognathism patients

No abstract available.

El dimorfismo sexual en distintas relaciones cráneo-mandibulares / Sexual dimorphism in different craneomandibular relationships

La estimación del sexo en base a restos esqueletales es uno de los principales objetivos de las ciencias forenses. Esta estimación se basa en las diferencias de forma y tamaño que existen entre mujeres y hombres (dimorfismo sexual). En este trabajo se analiza la asociación entre el dimorfismo sexual de la mandíbula y las distintas relaciones cráneo-mandibulares (ortognata, prognata y retrognata). Se analizaron 4 medidas faciales (altura facial, altura de la rama de la mandíbula, ancho mínimo de la rama mandibular, largo del cuerpo de la mandíbula) en tele-radiografías de 114 pacientes chilenos de sexo y relación cráneo-mandibular conocidos para evaluar si, al igual que en poblaciones de otras partes del mundo, estas son sexualmente dimórficas. Los resultados indican que con la excepción del largo del cuerpo de la mandíbula, las demás variables permiten una elevada clasificación correcta del sexo de los individuos (88,6 % de los casos). Se concluye que una relación cráneo-mandibular retrognata o prognata, no afecta la estimación confiable del sexo de los individuos de población chilena.

Sex assessment using bone remains is one of the main goals of forensic sciences. This assessment is possible because of the morphological and size differences between women and men (sexual dimorphism). In this work we study the association between sexual dimorphism and the different positions of the mandible and skull (prognathism, retrognathism and orgotnatism). We analyze 4 facial measurements in 114 teleradiographies of Chilean patients with known sex and positional relationship of the mandible and cranium, to evaluate if, as in populations of other parts of the world, these are sexually dimorphic. The results indicate that, with the exception of mandible width, the rest of the variables allows a high correct classification of individuals by sex (88.6 % of the cases). We conclude that the relation between different positions of the mandible and skull does not affect a reliable sex assessment in Chilean population.

Effects of airway evaluation parameters on the laryngeal view grade in mandibular prognathism and retrognathism patients

BACKGROUND: Failure to maintain a patent airway can result in brain damage or death. In patients with mandibular prognathism or retrognathism, intubation is generally thought to be difficult. We determined the degree of difficulty of airway management in patients with mandibular deformity using anatomic criteria to define and grade difficulty of endotracheal intubation with direct laryngoscopy. METHODS: Measurements were performed on 133 patients with prognathism and 33 with retrognathism scheduled for corrective esthetic surgery. A case study was performed on 89 patients with a normal mandible as the control group. In all patients, mouth opening distance (MOD), mandibular depth (MD), mandibular length (ML), mouth opening angle (MOA), neck extension angle (EXT), neck flexion angle (FLX), thyromental distance (TMD), inter-notch distance (IND), thyromental area (TMA), Mallampati grade, and Cormack and Lehane grade were measured. RESULTS: Cormack and Lehane grade I was observed in 84.2%, grade II in 15.0%, and grade III in 0.8% of mandibular prognathism cases; among retrognathism cases, 45.4% were grade I, 27.3% grade II, and 27.3% grade III; among controls, 65.2% were grade I, 26.9% were grade II, and 7.9% were grade III. MOD, MOA, ML, TMD, and TMA were greater in the prognathism group than in the control and retrognathism groups (P < 0.05). The measurements of ML were shorter in retrognathism than in the control and prognathism groups (P < 0.05). CONCLUSIONS: Laryngoscopic intubation was easier in patients with prognathism than in those with normal mandibles. However, in retrognathism, the laryngeal view grade was poor and the ML was an important factor.

A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures / 대한치과교정학회지

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

Tutankhamun's Dentition: The Pharaoh and his Teeth

Tutankhamun was a Pharaoh of the 18th Dynasty (New Kingdom) in ancient Egypt. Medical and radiological investigations of his skull revealed details about the jaw and teeth status of the mummy. Regarding the jaw relation, a maxillary prognathism, a mandibular retrognathism and micrognathism have been discussed previously. A cephalometric analysis was performed using a lateral skull X-ray and a review of the literature regarding King Tutankhamun´s mummy. The results imply diagnosis of mandibular retrognathism. Furthermore, third molar retention and an incomplete, single cleft palate are present.

Resumo Tutankhamun foi um faraó da 18ª dinastia (Novo Império) do antigo Egito. Estudos médicos e radiológicos de seu crânio revelaram detalhes sobre o estado dos dentes e mandíbula da múmia. Já houve relatos sobre a relação mandibular, o prognatismo maxilar, retroganatismo e micrognatismo mandibular. Neste estudo foi feita análise cefalométrica com radiografia lateral e uma revisão da literatura a respeito da múmia do faraó Tutankhamun. Os resultados levam à conclusão de retrogantismo mandibular. Também estão presentes retenção de terceiro molar e fissura palatina singular incompleta.

Orthodontic-surgical management of a case of severe mandibular deficiency due to condylar ankylosis.

Dentofacial deformities involve deviations from the normal facial proportions and dental relationships and can range from mild to being severe enough to be severely handicapping.The term handicapping malocclusions though not a term commonly used, involves a fortunately small section (2-4%) of patients who can suffer from esthetic,psychological and functional problems. Craniofacial Orthodontics is the area of orthodontics that treats patients with congenital and acquired deformities of the integument and it's underlying musculoskeletal system within the craniofacial area and associated structures.This case report of a young woman with severe mandibular deficiency and facial asymmetry due to condylar ankylosis highlights the importance of team work in rehabilitation of such severe craniofacial deformities

A study on the relationship between maxillary protraction treatment and changes of nasomaxillary complex facial soft tissue of children with skeletal Class m malocclusion / 国际儿科学杂志

Objective To investigate nasomaxlllary complex facial soft tissue changes after the treatment with maxillary protraction appliance with skeletal Class Ⅲ malocclusion with a retruded maxilla.Methods Thirty growing subjects with skeletal Class Ⅲ malocclusions with maxillary retrognathism were selected and treated by facial mask(male 15,female 15,with an average age of 10.5).They were given a maxillary protraction treatment with face mask for 6-8 months.Cephalometric measurements about nasomaxillary complex soft tissue changes were analyzed to draw the statistic conclusion.Results After maxillary protraction treatment,PraY,nasofrontal angle,As-Y,UL-Y,UL-E,S-Ns-Sn increased (P ＜ 0.01) ; M-Y increased (P ＜ 0.05) ; LL-E,PosY,nasolabial angle decreased (P ＜ 0.05).There were no significant differences in the Ns-Y and columella-tip angle.Conclusion After maxillary protraction treatment,nasomaxillary complex area becomes more marked.Both the nasomaxillary complex soft tissue and lower facial profile are dramatically improved.The combining effect of these two changes results in a more harmony profile.

Tratamento ortopédico funcional da deficiência mandibular: relato de caso / Functional orthopedic treatment of mandibular deficiency: case report

Apesar de ser amplamente utilizada, muitas vezes a terapia funcional não é totalmente compreendida. A questão principal que permanece é: existe crescimento extra, este tem relevância clínica? Como diferenciá-lo das alterações relacionadas com o crescimento? Qual a influência do potencial genético e fatores ambientais no sucesso do tratamento? Este trabalho tem como objetivo a apresentação de um caso clínico de Classe II dentária, 1º divisão e Classe II esquelética por deficiência mandibular tratado com aparelho ortopédico funcional removível dentossuportado tipo monobloco modificado. Neste caso clínico, verificou-se a manutenção da posição da maxila, aumento insignificante no posicionamento mandibular, aumento do comprimento total da mandíbula, uma redução da discrepância anteroposterior maxilomandibular, redução da projeção e inclinação dos incisivos superiores, aumento insignificante da inclinação dos incisivos inferiores e aumento vertical do padrão de crescimento facial. O resultado estético, dentário, esquelético e funcional do caso clínico foi favorável. Pôde-se concluir que as alterações que ocorreram são combinações de restrição do comprimento maxilar, compensações dentoalveolar, alteração de rotação do complexo nasomaxilar e mandibular e crescimento mandibular (menor grau).

Orthodontists rely on a large number of devices for the correction of dental malocclusion and improvement of facial aesthetics. Despite its widespread use, often functional therapy is not fully understood. This paper aims to present a case of dental Class II, division 1 and Class II malocclusions by mandibular deficiency treated with removable orthopedic functional device, a modified monobloc. It was observed maintenance of the maxilla position, insignificant increase in the mandible position, increasing in the total mandible length, reduction of the severe anteroposterior maxillomandibular discrepancy, reduction in the projection and tilt of the upper incisors, increase of the inclination of the lower incisors and increased vertical facial growth pattern. The changes are amendments or combinations of disorders and the restriction or redirection of growth, combined with dentoalveolar changes. The present case report concludes that the aesthetic result, dental, skeletal and functional case was favorable. The changes that have occurred are combinations of restriction the length maxillary dentoalveolar compensation, change the rotation of the nasomaxillary complex and mandibular growth mandibular (lesser extent).

Comparison of Postoperative Stability between Distraction Osteogenesis and Bilateral Sagittal Split Ramus Osteotomy in Mandibular Retrognathism

0.05). Mean follow up periods were 10.77 months for BSSRO group and 11.28 months for DO group, respectively. After mandibular advancement, mean positional changes in the condyle were 0.56+/-1.43 mm horizontally and 0.72+/-1.61 mm vertically for BSSRO group and 0.53+/-1.56 mm horizontally and 0.56+/-1.75 mm vertically for DO group, respectively. Mean change of distance from B point to Y-axis was -1.76+/-0.83 mm for BSSRO group and -2.14+/-1.82 mm for DO group, respectively. According to the condylar position and B point, there were no significant differences in postoperative stability between the two groups (P>0.05).CONCLUSION: There was no significant difference in postoperative stability between DO and BSSRO group according to condylar position and B point. Based on the results of the present study, it is hypothesized that DO would be a good treatment choice for severe mandibular retrognathism because DO could achieve more mandibular advancement and concurrent soft tissue elongation.

Caracterização das funções estomatognáticas e disfunções temporomandibulares pré e pós cirurgia ortognática e reabilitação fonoaudiológica da deformidade dentofacial classe II esquelética / Functional characterization and temporomandibular disorders before and after orthognathic surgery and myofunctional treatment of class II dentofacial deformity

OBJETIVO: investigar as características funcionais e de disfunções temporomandibulares em indivíduos com deformidade dentofacial do tipo Classe II esquelética com indicação de cirurgia ortognática, assim como sua evolução após correção cirúrgica das bases ósseas e reabilitação miofuncional orofacial, buscando subsídios para o aprimoramento de reabilitação desses pacientes. MÉTODO: estudo longitudinal com 22 indivíduos com deformidade dentofacial Classe II, definidos após análise de critérios de inclusão e exclusão. A investigação dos dados referentes às queixas gerais, disfunções temporomandibulares e funções estomatognáticas foi realizada em avaliação miofuncional orofacial prévia à cirurgia, e em reavaliação quatro meses após realização da cirurgia ortognática e reabilitação fonoaudiológica. Foi utilizado teste de igualdade de duas proporções para análise estatística. RESULTADOS: as principais queixas foram funcionais. Constatou-se presença de disfunção temporomandibular na maioria da amostra, com remissão dos sinais em 81 por cento dos casos comprometidos. A caracterização das funções estomatognáticas foi descrita, sendo obtida melhora funcional após os tratamentos com diferenças estatisticamente significantes. CONCLUSÃO: os tratamentos, cirúrgico e fonoaudiológico, produzem modificações dos padrões funcionais e dos sinais de disfunção temporomandibular com redução das queixas iniciais, redução dos sinais e correção dos padrões funcionais, sendo a deglutição a função mais beneficiada pelos tratamentos.

PURPOSE: to investigate and to describe the functional characterization and temporomandibular disorders (TMD) before and after orthognathic surgery and myofunctional treatment of Class II Dentofacial deformity patients. METHOD: a longitudinal study including 22 subjects with Class II dentofacial deformity, defined after analysis of inclusion and exclusion criteria, was conducted. The investigation was divided in 2 steps: myofunctional evaluation prior to the surgery and a re-evaluation 4 months after the orthognathic surgery and myofunctional treatment. Statistical tests were used to compare the data. RESULTS: initial complaints included functional difficulties. The functional disorders were described. TMD was observed in the majority of the sample. After treatment the complaints decreased; the majority of the patients showed remission of the TMD and functional improvement. CONCLUSION: there are specific myofunctional modifications related to the stomatognathic functions and to TMD in Class II Dentofacial deformity patients. Both the surgery and the speech therapy produced myofunctional modifications, with reduction of initial complaints, as well as a decrease of TMD and correction of functional patterns. The swallowing function was the most benefited by the treatments.

Cephalometric evaluation of surgical mandibular advancement

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).