ABSTRACT
DATE OF BIRTH: 14/04/2000; sex: female. A. PRETREATMENT RECORDS: 12 y and 2m; 7/6/2012. DIAGNOSIS: The patient presents a left subdivision Angle's class II malocclusion associated with an incisor deep bite of 5mm and a deviation of the mandibular incisor midline to the left (of the patient). On a frontal view, we also note a slight asymmetry of the lower part of the face, the tip of the chin is slightly deviated to the left (of the patient). However, the patient presents a good labial occlusion at rest, a normal divergence and a harmonious face. TREATMENT PLAN: Bimaxillary multibracket appliance using Roth technique .022×.028'' with placement of the appliance in the maxillary before the mandible to allow the unlocking of the mandibular occlusion, then implementation of a class II appliance with intermaxillary traction elastics. B. POSTTREATMENT RECORDS: 13 y and 8m; 10/12/2013. DURATION OF ACTIVE TREATMENT: 18 months, good stability of the occlusion, preservation of the incisor midlines and of the deep bite. RETENTION: Maxillary: palatal wire bonded from teeth 12 to 22 and thermoformed splint; mandibular: lingual wire bonded from teeth 33 to 43 and thermoformed splint. C. POSTRETENTION RECORDS: (Minimum of 1 year): 15 years old; 3/4/2015.
Subject(s)
Facial Asymmetry/therapy , Malocclusion, Angle Class II/therapy , Orthodontics/methods , Overbite/therapy , Adolescent , Cephalometry/methods , Child , Face/anatomy & histology , Face/diagnostic imaging , Facial Asymmetry/diagnostic imaging , Female , Humans , Incisor/diagnostic imaging , Malocclusion, Angle Class II/diagnostic imaging , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imaging , Models, Dental , Orthodontic Brackets , Orthodontic Wires , Orthodontics/instrumentation , Patient Care Planning , Radiography, Panoramic , Treatment OutcomeABSTRACT
Obstructive sleep apnea/hypopnea syndrome (OSAS) is still not widely diagnosed in children as its clinical signs are extremely variable. The diagnosis is based on recognition of the nocturnal and diurnal clinical symptoms of the syndrome, but above all on analysis of a sleep recording revealing abnormal respiratory phenomena. This recording makes it possible to determine an Apnea/Hypopnea Index (AHI) for each hour of sleep. The abnormality threshold is 1.5AHI/h for children and 5AHI/h for adults. The higher the index, the more severe the OSAS. The consequences of this syndrome are far from negligible, leading possibly to learning difficulties, mood problems, growth abnormalities and delayed neurocognitive development; it may even have an impact on metabolism. The orthodontist, as a health specialist frequently in contact with young patients, needs to be able to detect OSAS by launching a dialogue on the question of sleep so as to refer the patient to a specialist who can confirm the diagnosis. Through observation of the patient, it is possible to identify children at risk. Potential OSAS can then be prevented or cured by increasing the volume of the upper airways thanks to orthodontic treatment. Management of patients suffering from OSAS is multidisciplinary, under the direction of the sleep specialist.
