ABSTRACT
A 24-year-old woman had a Class II Division 1 malocclusion with a severe unilateral crossbite. The crossbite was due partially to the maxilla being much wider than the mandible, allowing the mandibular left canine and first and second premolars to overerupt, impinging on the palatal tissue in habitual occlusion. The maxillary left segment from the lateral incisor to the first molar also overerupted producing 2 planes of occlusion. The malocclusion was treated successfully with comprehensive orthodontics, combined with a 2 piece Lefort I osteotomy procedure, a 3 tooth mandibular segmental osteotomy procedure, and a bilateral sagittal split osteotomy procedure.
Subject(s)
Malocclusion, Angle Class II/therapy , Malocclusion/therapy , Orthodontics, Corrective , Osteotomy/methods , Adult , Bicuspid/pathology , Cephalometry , Cuspid/pathology , Dental Occlusion , Esthetics, Dental , Female , Follow-Up Studies , Humans , Malocclusion/pathology , Malocclusion/surgery , Malocclusion, Angle Class II/pathology , Malocclusion, Angle Class II/surgery , Mandible/pathology , Mandible/surgery , Maxilla/pathology , Maxilla/surgery , Osteotomy, Le Fort , Treatment OutcomeABSTRACT
This is a case report of a 21-year-old female with a Class II Division 1 malocclusion. The maxillary arch was constricted with an associated anterior open bite. The lower facial height was excessive, and the mandibular plane angle was high. The treatment options were limited due to a previously extracted mandibular right lateral incisor. The patient was successfully treated by a surgical rapid palatal expansion procedure, extraction of the mandibular left lateral incisor, extraction of the maxillary first premolars at the time of a 3-piece Lefort 1 maxillary osteotomy procedure, and a bilateral sagittal split osteotomy advancement procedure.
Subject(s)
Bicuspid/surgery , Incisor/surgery , Malocclusion, Angle Class II/therapy , Mandible/surgery , Maxilla/surgery , Retrognathia/therapy , Serial Extraction , Adult , Cephalometry , Female , Follow-Up Studies , Humans , Malocclusion, Angle Class II/surgery , Mandibular Advancement , Maxilla/abnormalities , Osteotomy/methods , Osteotomy, Le Fort/methods , Palatal Expansion Technique , Retrognathia/surgery , Treatment Outcome , Vertical DimensionABSTRACT
Close root proximity between the maxillary central incisors presents a problem in the surgical management of a maxillary palatal expansion. During the surgical fracture of this interdental area, the possibility exists for a separation to occur between the root surface and the bone. If this does occur, it is paramount that the gingival attachment remain intact. Asymmetric separation places more stress on the mesial gingival attachment because of the anatomy of the gingival fiber apparatus. Gingival detachment results in epithelial downgrowth in an apical direction, which in turn prevents bone apposition in a coronal direction. The resulting osseous defect is difficult to treat with an osseous graft procedure, as there are few if any intrabony walls. Treatment planning should include analysis of a recent periapical radiograph of the incisor roots to determine the need for orthodontic root separation before surgery. A postsurgical periapical radiograph should be taken to determine where the interdental separation has occurred. The expansion schedule should be adjusted depending on the symmetry of the separation and the health of the gingival attachment.
Subject(s)
Maxilla/surgery , Palatal Expansion Technique , Adult , Epithelial Attachment/pathology , Follow-Up Studies , Gingiva/pathology , Gingival Recession/etiology , Humans , Incisor/diagnostic imaging , Incisor/pathology , Male , Malocclusion/pathology , Malocclusion/surgery , Maxilla/diagnostic imaging , Maxilla/pathology , Maxilla/physiopathology , Maxillary Diseases/etiology , Osteogenesis/physiology , Osteotomy/adverse effects , Osteotomy/methods , Palatal Expansion Technique/adverse effects , Palatal Expansion Technique/instrumentation , Patient Care Planning , Periapical Tissue/diagnostic imaging , Radiography , Root Resorption/etiology , Tooth Movement Techniques , Tooth Root/diagnostic imaging , Tooth Root/pathology , Treatment OutcomeABSTRACT
This is a case report of a 23-year-old black woman with a skeletal Class II Division 1 malocclusion and an anterior open bite. The maxillary central incisor root was severely dilacerated, a maxillary lateral incisor and canine were transposed, a maxillary canine was impacted near the orbital rim, and a mandibular second premolar was congenitally missing. Selective extractions and attention to detail provided outstanding occlusal function and improved facial esthetics.
Subject(s)
Malocclusion, Angle Class II/therapy , Orthodontics, Corrective , Patient Care Planning , Adult , Anodontia/therapy , Bicuspid/abnormalities , Cuspid/pathology , Dental Occlusion , Esthetics, Dental , Female , Humans , Incisor/abnormalities , Serial Extraction , Tooth Eruption, Ectopic/therapy , Tooth Root/abnormalities , Tooth, Impacted/therapyABSTRACT
A case report presented to the American Board of Orthodontics in partial fulfillment of the requirements for certification.
Subject(s)
Malocclusion/therapy , Orthodontics, Corrective/methods , Retrognathia/therapy , Adolescent , Humans , Maxilla/abnormalities , Orthodontic Appliances , Orthodontic Retainers , Orthodontics, Corrective/instrumentation , Palatal Expansion Technique , Patient SatisfactionSubject(s)
Incisor , Malocclusion, Angle Class I/therapy , Orthodontic Appliances, Removable , Adult , Female , Humans , Mandible , Orthodontic Appliance DesignSubject(s)
Orthodontic Appliance Design , Space Maintenance, Orthodontic/instrumentation , Adolescent , Adult , Female , Humans , Male , Molar , Orthodontic Appliance Design/statistics & numerical data , Pain/etiology , Pain Measurement , Space Maintenance, Orthodontic/adverse effects , Space Maintenance, Orthodontic/statistics & numerical data , Surveys and QuestionnairesSubject(s)
Orthodontic Wires , Humans , Molar , Osteotomy, Le Fort/instrumentation , Patient Satisfaction , Silicone ElastomersSubject(s)
Orthodontic Appliance Design , Orthodontic Retainers , Tooth Movement Techniques/instrumentation , Adolescent , Adult , Female , Humans , Incisor , Malocclusion/therapy , MandibleSubject(s)
Dental Records , Jaw Relation Record , Patient Identification Systems , Humans , Models, DentalABSTRACT
This study was undertaken to determine the role of the headgear calendar and its relationship to headgear compliance. Headgear timers were used covertly to monitor actual headgear wear of 28 patients for three consecutive orthodontic appointments. Fourteen patients were asked to monitor their daily headgear wear by using a headgear calendar. The other 14 did not use a calendar. The results show that patients who monitor their headgear wear with a headgear calendar are more compliant than those patients who do not (7.9 hours compared with 5.3 hours). All age groups in this study wore their headgear more when a headgear calendar was used with the exception of the > 16-year-old group. There is a high degree of correlation (r2 = 0.60) between the number of hours recorded on the calendar compared with the number of hours actually worn. There was a poor correlation (r2 = 0.02) between the number of hours the patient said he wore his headgear compared with the actual number of hours worn.
