Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report.

INTRODUCTION: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. OBJECTIVE: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. CASE REPORT: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. RESULTS: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. CONCLUSION: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.

Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report

ABSTRACT Introduction: Skeletal Class III malocclusion is one of the most challenging malocclusions to treat. In around 40% of Class III patients, maxillary retrognathia is the main cause of the problem and in most patients, orthopedic/surgical treatments includes some type of maxillary protraction. Objective: The aim of this case report was to describe a treatment method for a patient with maxillary retrognathia and Class III skeletal discrepancy using mandibular and maxillary skeletal anchorage with intermaxillary elastics. Case report: A 13-year-old boy with maxillary retrognathia and mandibular prognathism was treated using bilateral miniplates. Two miniplates were inserted in the mandibular canine area and two other miniplates were placed in the infrazygomatic crests of the maxilla. Class III intermaxillary elastics were used between the miniplates. Results: After eight months of orthopedic therapy, ANB angle increased by 4.1 degrees and ideal overjet and overbite were achieved. Mandibular plane angle was increased by 2.1 degrees and the palatal plane was rotated counterclockwise by 4.8 degrees. Conclusion: This case showed that the skeletal anchorage treatment method may be a viable option for treating patients with Class III skeletal malocclusion.

RESUMO Introdução: a Classe III esquelética é considerada uma das más oclusões mais difíceis de se tratar. Em cerca de 40% dos pacientes afligidos por ela, a principal causa do problema é o retrognatismo maxilar e, na maioria desses pacientes, o tratamento ortopédico/cirúrgico inclui algum tipo de protração da maxila. Objetivo: o objetivo do presente relato de caso é descrever o método de tratamento de um paciente Classe III com discrepância esquelética e retrognatismo maxilar, usando elásticos intermaxilares e ancoragem esquelética superior e inferior. Relato de caso: paciente de 13 anos de idade, com retrognatismo maxilar e prognatismo mandibular, tratado com miniplacas inseridas bilateralmente. Duas miniplacas foram instaladas na região dos caninos inferiores, e outras duas miniplacas foram inseridas na região da crista infrazigomática maxilar. Elásticos intermaxilares de Classe III foram conectados às miniplacas. Resultados: após 8 meses de tratamento ortopédico, o ângulo ANB aumentou 4,1o e obteve-se sobressaliência e sobremordida ideais. O ângulo do plano mandibular aumentou 2,1o e o plano palatal girou 4,8o no sentido anti-horário. Conclusão: esse caso clínico demonstrou que o método de tratamento com ancoragem esquelética pode ser uma opção válida para pacientes com má oclusão de Classe III esquelética.

HSP70 expression in dentigerous cyst, odontogenic keratocyst, and ameloblastoma.

Heat shock proteins (HSPs) work as molecular chaperones that can assist cells to deal with stressful situations. Members of the HSP70 family can regulate cell growth and transformation and are involved in the maintenance of cellular homeostasis. In view of the distinct clinical behavior of odontogenic lesions, the objective of the present study was to investigate the immunohistochemical expression of HSP70 in these lesions. In this study, 70 formalin-fixed paraffin-embedded tissue blocks of odontogenic lesion-16 unicystic ameloblastomas (UAs), 17 solid ameloblastomas (SAs), 18 odontogenic keratocysts (OKCs), and 19 dentigerous cysts (DCs)-were reviewed by immunohistochemistry for HSP70 staining. In this study, HSP70 immunostaining was evident in all groups of the specimen. Mean percentage of HSP70 staining in SAs (84.2 ± 11.3) and OKCs (83.4 ± 6.8) were significantly higher than UAs (64.4 ± 9.8) and DCs (12.6 ± 10.2) (p = 0.00). But, there was no statistically significant difference between HSP70 expression in SAs and OKCs. The result of this study proposes that high expression rate of HSP70 has a role in the pathogenesis of ameloblastoma and OKC and is one of the reasons for the aggressive behavior of ameloblastoma and high recurrence role of OKC, reinforcing the classification of OKC as an odontogenic tumor.