Effect of low-level laser therapy on en masse retraction in females with bimaxillary dentoalveolar protrusion : A single-center randomized clinical trial.

BACKGROUND: Acceleration of tooth movement has gained remarkable attention during the last decade. The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on en masse retraction of upper anterior teeth in adult women with bimaxillary dentoalveolar protrusion. MATERIALS AND METHODS: In this two-arm parallel trial, 36 women with bimaxillary dentoalveolar protrusion were randomly divided into two equal groups. Eligibility criteria included class I Angle molar relationship, good general and oral health as well as no systemic disease or syndrome. Four temporary anchorage devices (TADs) were used in the upper and lower arches for anchorage purposes. A 0.019×0.025-inch stainless steel wire with crimped hooks just distal to the maxillary canines was inserted. Nickle titanium (NiTi) closed coil springs (200 g/side) were employed for en masse retraction following extraction of the first premolars. In the laser group (LG), retraction of the upper anterior teeth was done along with the application of LLLT on days 0, 3, 7, and 14 after extraction and then repeated biweekly until the end of retraction. Retraction was completed without LLLT application in the nonlaser group (NLG). Data concerning the rate of retraction as well as first molars and anterior positional changes were gained from digitized models and cone beam computed tomography (CBCT) scans taken just before extraction and at the end of retraction. Treatment-associated pain and root resorption were evaluated using visual analogue scale (VAS) and CBCT scans, respectively. RESULTS: Four patients dropped out prior to follow-up. The duration of retraction was 10.125 ± 2.876 and 13.643 ± 3.455 months in the LG and NLG, respectively. The LG showed a statistically significant faster rate of en masse retraction (0.833 ± 0.371 mm/month) compared to the NLG (0.526 ± 0.268 mm/month; P ≤ 0.035). The observed root resorption was significantly less in the LG (P ≤ 0.05) with comparable pain scores in both groups. CONCLUSIONS: Within the constraints of the parameters of the LLLT used in the current study and despite the statistically significant results on the rate of en masse retraction and the associated root resorption, LLLT did not demonstrate a clinically relevant effect that justifies its use to enhance en masse retraction. NAME OF THE REGISTRY: Clinicaltrials.gov TRIAL REGISTRATION NUMBER: NCT05183451 DATE OF REGISTRATION: January 10, 2022, "Retrospectively registered" URL OF TRIAL REGISTRY RECORD: https://www. CLINICALTRIALS: gov/study/NCT05183451.

Incisor and Soft Tissue Characteristics of Adult Bimaxillary Protrusion Patients among Different Skeletal Anteroposterior Classifications.

The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among skeletal Class I (BM1), II (BM2) and III (BM3). Understanding these characteristics would be useful for incisor and lip diagnostics in different skeletal classifications. Fourteen linear and twelve angular variables of the incisors and lips were evaluated in 214 lateral cephalograms (BM1 = 91, BM2 = 84, BM3 = 39). ANOVA and Bonferroni tests compared the measurements. BM1 and BM3 exhibited a greater U1 position and U1 inclination than the norms, while BM2 presented only a greater U1 position than the norms but normal U1 inclination. BM1 and BM3 had a significantly greater U1 position than BM2. BM1 and BM2 demonstrated a greater L1 position and L1 inclination than the norms, whereas BM3 displayed only a greater L1 position than the norms but normal L1 inclination. BM2 had the most anterior L1 position, whereas BM3 had the least anterior position. Only BM2 had a longer anterior dental height (ADH) than the norms, while BM1 and BM3 had a normal ADH and the significantly shortest ADH, respectively. Only BM1 had a normal upper incisor display at rest (U1R), while BM2 and BM3 displayed an increased and decreased U1R, respectively, with significant differences among the three groups. The most significantly protruded upper and lower lips were presented in BM2, but these were exhibited the least in BM3. The most significant acute nasolabial angle (NLA) was found in BM3, whereas BM2 presented the least acute NLA. A normal lip-chin-throat angle (LCTA) was observed in BM1 and BM3, while only BM2 had a greater LCTA than the norms. The most significant obtuse LCTA was found in BM2, while BM3 had the least obtuse LCTA. Therefore, both U1 and L1 in all groups presented protrusion and proclination, except for U1 in BM2, while L1 in BM3 exhibited normal inclination. The ADH and U1R were increased in BM2 but decreased in BM3. The most acute NLA was found in BM3, whereas the least acute was found in BM2. The most obtuse LCTA was in BM2, while the least was in BM3.

Mini-Screw-Assisted Orthodontic Retraction of Class I Malocclusion in a Bimaxillary Protrusion Patient Using Sliding Mechanics: A Case Report.

A condition known as bimaxillary protrusion occurs when the front teeth protrude due to the forward positioning of the lower and upper jaws. Temporary anchorage devices (TADs) are utilized to provide anchorage and facilitate the controlled retraction of maxillary and mandibular protruding teeth, helping to correct the patient's bite and facial aesthetics. A 27-year-old female with bimaxillary protrusion reported to the Department of Orthodontics. On examination, the facial profile of the patient was convex. The clinical FMA was high. With a deep mentolabial sulcus and an acute nasolabial angle, lips were potentially competent. An intraoral examination revealed proclined incisors with spacing in the maxillary arch and proclined anterior teeth in the mandibular arch. Space closure was done using sliding mechanics with direct anchorage from a mini-screw after the extraction of all four first premolars. There was a significant improvement in the patient's profile posttreatment.

Frictionless Mechanics for Correction of Bimaxillary Protrusion: A Case Report.

The condition of bimaxillary protrusion is commonly seen by orthodontic practitioners in the course of our daily clinical work. It is characterized by both jaws being forwardly placed and increased prominence of the teeth along with lips. When there is a severe bimaxillary protrusion, it can be challenging to correct it effectively with maximum anchorage. In patients with protrusions or crowding, extraction therapy is often necessary. There are two ways to retract anteriors during extraction space closure: friction or frictionless. The present case report explains the frictionless mechanic protocol for the correction of bimaxillary protrusion using a reverse closing loop.

Dental, skeletal and soft tissue changes after bimaxillary protrusion treatment with temporary anchorage devices using different retraction mechanics.

BACKGROUND: Temporary anchorage devices (TADs), which are absolute anchorage, are used for retraction of the anterior teeth in cases of severe bimaxillary protrusion. There have been a number of studies regarding anterior tooth movement using TADs performed by simulation systems and actual treated materials with sliding mechanics. However, there are few studies regarding anterior tooth movement using TADs treated by loop mechanics The purpose of this study was to investigate the effect of TADs in anterior tooth movement using loop mechanics performed in actual cases of bimaxillary protrusion. METHODS: This study was performed in 20 adult patients with severe bimaxillary protrusion treated with four bicuspid extraction with sliding or loop mechanics (n = 10 in each mechanics) using TADs. The skeletal and denture patterns, as well as the soft tissue profile from pre-treatment (T0) and post-treatment (T1) lateral cephalograms, were compared between sliding and closing loop mechanics. RESULTS: The use of TADs is useful for retraction of anterior teeth without molar anchorage loss. in sliding and loop mechanics. The upper anterior teeth were less lingual tipped and lower anterior teeth were more upright resulting in less clockwise rotation of the occlusal plane in loop mechanics compared to sliding mechanics. CONCLUSION: An oblique retraction force vector with a lower point of application causes less intrusion and more lingual tipping of upper anterior teeth as well as more clockwise rotation of the occlusal plane compared to a parallel retraction force vector.

Changes in Soft Tissue Variable of Lips Following Retraction of Anterioir Teeth- A Cephalometric Study.

Aim: The purpose of this study was to assess the short-term perioral soft tissue variations of the lips before and after treatment cases in 15 patients with bi-maxillary protrusion using treated lateral cephalograms who had already achieved active growth. Methodology: Fifteen pre-treatment and post-treatment lateral cephalometric radiographs of 18-25-year-old individuals with bimaxillary protrusion treated with all four 1st premolar extractions were accessed from the records. From the reference planes and landmarks, 13 horizontal, 10 vertical, and 2 angular measurements were noted. Statistical comparisons between pre-treatment and post-treatment measurements were measured by a paired t-test to assess the importance of the mean variations at the predetermined significance level. Pearson's correlation coefficient (R) was utilized to assess the strength and significance of the linear relationship between the mean differences for paired (dependent and independent) variables. Results: Pearson's correlation exhibited a noteworthy positive association between the horizontal changes in upper lip position and the horizontal changes of the upper incisor tip point (H-tU1) (R = 0.748), the upper incisor cervical point (H-cU1) (R = 0.707), the lower incisor tip point (H-tL1) (R = 0.839), and the lower incisor cervical point (H-cL1) (R = 0.767). This indicated that upper lip changes are the aftermath of the retraction of the upper and lower incisors in class I bi-maxillary protrusion malocclusion. Conclusion: Thick upper lips showed more retraction of the upper lip in correlation with retraction of the incisors as compared with thin lips. The lower incisor cervical point displayed the strongest association with lower lip retraction.

Skeletal Anchorage Augmentation in Extraction/Nonextraction Orthodontic Treatment: A Randomized Clinical Study.

AIM: To evaluate and compare skeletal, dental, and soft tissue parameters by therapeutic extraction of first premolar and nonextraction distalization of maxillary and mandibular arches in bimaxillary proclination using the skeletal anchorage system. MATERIALS AND METHODS: About 40 orthodontic patients undergoing extraction or nonextraction treatment are enrolled in a randomized clinical trial. Participants are randomly assigned to either the extraction or nonextraction group and receive treatment augmented with skeletal anchorage. Mini implants were placed in the extraction group for retraction and infra-zygomatic crest (IZC) and buccal shelf screws were placed in the nonextraction group for distalization. OBSERVATIONS AND RESULTS: Comparison between the ages of the patients among both Groups showed no significant difference. A significant difference is observed in dental and soft tissue parameters before and after the treatment in group A, whereas skeletal parameters also showed significant changes along with dental and soft tissue parameters in group B. CONCLUSION: There is a significant change in the position of incisors by retraction and facial profile improves gradually in group A while for group B, a marked change in lower facial height was even seen. On comparing both the groups, a highly significant difference can be seen with respect to the amount of incisor retraction and change in molar inclination. The time taken for retraction of incisors is less in comparison to distalization. CLINICAL SIGNIFICANCE: With this, we can easily avoid premolar extraction, and in cases of impacted third molars distalization as when indicated can be helpful as a part of the nonextraction treatment plan.

Condylar positional changes and remodeling following bimaxillary anterior segment osteotomy with and without Le Fort I osteotomy: a three-dimensional comparative analysis.

OBJECTIVE: To evaluate 3D condylar displacement and long-term remodeling following the correction of bimaxillary protrusion by anterior segment osteotomy (ASO) with and without Le Fort I surgery. MATERIALS AND METHOD: This retrospective study included 32 adults with bimaxillary protrusion who underwent ASO alone (group 1) or with concomitant Le Fort I osteotomy (group 2). Subject's computed tomography scans at basic (T0), immediate postoperatively (T1), and at 1 year or more follow-up (T2) were collected. The condyle displacement was measured at superior-inferior, lateromedially, and anteroposterior surfaces, while condyle remodeling was measured at the superior, lateral, anterior, medial, and posterior surfaces. All 3D analyses were performed using 3D Slicer software (4.11.2). RESULTS: At T1, 52.7%, 86.7%, and 94.4% of condyles in group 1 were displaced inferiorly, laterally, and posteriorly, respectively, as well as 75%, 89.2%, and 53.5% of condyles in group 2, which had not fully returned to the original preoperative positions at T2. Condylar remodeling was observed in both groups at T2, and no significant difference was found in the overall condylar volume between T1 and T2 in both groups. Patients in group 2 exhibited significant bone resorption at both lateral and anterior surfaces compared to group 1 (P = 0.000 and 0.01, respectively). CONCLUSION: This study's results demonstrated that ASO is associated with a degree of condylar changes even if the posterior mandible is not osteomized. The positional changes vary between bimaxillary ASO alone and those with simultaneous Le Fort I osteotomy. However, both groups' condyle volume remained stable at the long-term follow-up.

Comparative Evaluation of Effect of Micro-Osteoperforation and Mechanical Vibration on Rate of Orthodontic Tooth Movement in Young Adults With Bimaxillary Protrusion.

AIM: To evaluate and compare the rate of orthodontic tooth movement and root resorption by micro-osteoperforation (MOP) and mechanical vibration in young adults with bimaxillary protrusion. METHOD: Twenty patients having class I bimaxillary protrusion who required all first premolar extraction were allocated into two groups MOP (Group A) and mechanical vibration (Group B), with a 1:1 allocation ratio. After leveling alignment MOP was performed on either side of the arch, and vibration was applied on the contralateral side 20 mins per day. Canines were retracted with nickel-titanium coil springs, and Alginate impressions were taken every four weeks till 4 months. RESULT: The mean rate of retraction of canines of Group A was more than Group B. There was a statistically significant difference between Group A and Group B. (p=0.0120) Conclusion: The mean rate of retraction of canines treated by MOP was 1.15 mm per 4 weeks, and by mechanical vibration, 0.8mm per 4 weeks.

Effects of Flapless Laser Corticotomy in Upper and Lower Canine Retraction: A Split-mouth, Randomized Controlled Trial.

Aim One of the major difficulties in orthodontic treatment is the lengthy course of therapy, particularly in situations involving extractions. Hence, various methods for accelerating tooth movement rate had been devised. Flapless corticotomy is one of those methods. This study aimed to evaluate the effects of flapless laser corticotomy (FLC) compared to the conventional retraction (CR) method on the rate of canine retraction. Methods A split-mouth, randomized controlled trial included 56 canines from 14 patients (12 females and two males) with a mean age of 20.4 ± 2.5 years, who were complaining of bimaxillary protrusion requiring extraction of four premolars. All canines were randomly assigned to four groups (maxillary FLC, maxillary control CR, mandibular FLC, and mandibular control CR). Randomization was performed by creating two equal, random computer-generated lists with a 1:1 allocation ratio-one list for the right side and one for the left. The allocation concealment was achieved using opaque sealed envelopes until the time of intervention. FLC was applied on the experimental sides before canine retraction by drilling six holes penetrating 3 mm into the bone on the mesial and distal sides of the canines. Subsequently, all canines were retracted employing closed coil springs to deliver a force of 150 g using indirect anchorage from temporary anchorage devices (TADs). All canines were assessed at T0 (before retraction), T1 (one month after retraction), T2 (two months), and T3 (three months) using three-dimensional (3D) digital models. Additionally, canine rotation, molar anchorage loss assessed using 3D digital models, root resorption assessed using cone beam computed tomography (CBCT), probing depth, plaque, gingival indices, and pulp vitality were all evaluated as secondary outcomes. It was possible to blind only the outcome analysis expert (single-blinded). Results The measurements of canine retraction during the follow-up period from T0 to T3 were 2.46 ± 0.80 mm and 2.55 ± 0.79 mm in maxillary FLC and control groups, respectively, and 2.44 ± 0.96 mm and 2.31 ± 0.95 mm in mandibular FLC and control groups, respectively. The results demonstrated a statistically non-significant difference in the distance of canine retraction between the FLC and control groups at all time points. Moreover, no differences were observed between groups in canine rotation, molar anchorage loss, root resorption, probing depth, plaque, gingival indices, and pulp vitality (p > 0.05). Conclusion In the FLC procedure performed in this study, the rate of upper and lower canine retraction could not be accelerated and no significant differences were observed between FLC and control groups in canine rotation, molar anchorage loss, root resorption, periodontal condition, and pulp vitality.

Bimaxillary Dentoalveolar Protrusion Case Treated with Anchorage by Buccally Implemented Mini-Implants Using a 3D-Printed Surgical Guide.

The article presents a case of bimaxillary dentoalveolar protrusion treated by distalizing the upper and lower teeth, using anchorage from mini implants. A 16-year-old male patient presented with severe upper and lower incisor proclination with protruding lips and a convex profile, with a background of bimaxillary dentoalveolar protrusion. Instead of having four premolars extracted, retraction of the dentition was decided with absolute anchorage, provided by mini implants. In order to carry out the procedure in one stage, four mini-implants were inserted as close to the root of the 1st molars as possible. Implementation was facilitated by a surgical template which was created on a digital model and then 3D printed. Accurate placement was achieved and the case was successfully treated by significant uprighting of the incisors and retraction of the anterior dentition, closing the spaces in the upper and lower arch. Facial aesthetics were also improved. A digitally designed surgical guide was utilized in this case of bimaxillary dentoalveolar protrusion in order to facilitate the accurate placement of the mini implants which were used for a one-stage retraction of the dentition.

An Assessment and Comparison of Root Resorption With Two Different Corticotomy Techniques During Anterior Teeth Retraction: A Split Mouth Prospective Clinical Study.

Aim The aim of this prospective split-mouth clinical study is to determine the apical root resorption of anterior teeth in patients with two different methods of corticotomy namely indentation and vertical corticotomy techniques. Methods Sixteen adult patients with bimaxillary protrusion requiring the need for extraction of the first premolars were included in the study. For each patient, the particular method of corticotomy technique was assigned randomly along with the side and the procedure was performed following which retraction forces were applied with the help of a closed coil Niti spring. The root resorption was recorded during the stage of space closure for which two cone beam computed tomography (CBCT) were taken, one before the retraction forces could be applied (T1) and one CBCT (T2) after the space closure had occurred. The apical root resorption was assessed and analyzed both linearly and volumetrically using the CBCT taken at T1 and T2.  Results There was root resorption present after the space closure was complete in both the maxillary and mandibular arches. The amount of root resorption that occurred in the indentation technique was slightly lesser as compared to the vertical corticotomy technique. Conclusion Indentation corticotomy cuts for accelerated tooth movement are considered to be a much safer, more effective method, lesser invasive to the surrounding tissues, technique sensitive, and good regional acceleratory phenomenon (RAP), with a Rapid healing process compared to the vertical corticotomy technique.

Management of Bimaxillary Protrusion.

Bimaxillary protrusion is a unique dentofacial deformity trait that can exist in an individual as an isolated problem or in combination with other skeletal and dental-related issues. Orthodontist and oral and maxillofacial surgeons are often the main primary team involved in the management of bimaxillary protrusion. Clinical dilemma often exists as cases can either be treated orthodontically or may require a combination of orthodontic and skeletal segmental orthognathic surgery. This article aims to help clinicians improve their approach to management of bimaxillary protrusion by creating a classification based on the severity that can guide treatment selection.

Comparative Evaluation of Orthodontically-Induced Root Resorption Using Cone Beam Computed Tomography (CBCT) and Orthopantomogram (OPG) During En-Masse Retraction of Maxillary Anterior Teeth.

BACKGROUND/PURPOSE: Orthodontically induced apical root resorption is an inescapable consequence of fixed orthodontics. This root resorption causes post-orthodontic complications in some treated cases. To avoid these complications proper diagnosis of the site and amount of resorption is important. The aim of this study was to compare the diagnostic ability of Orthopantomogram (OPG) and Cone Beam Computed Tomography (CBCT) in detecting apical root resorption after en-masse retraction of maxillary anterior teeth in a sample of Saudi Arabian population. MATERIALS AND METHODS: The study sample comprised of 30 patients diagnosed with bimaxillary dentoalveolar protrusion. The treatment plan involved extraction of all first premolars followed by en-masse retraction of the anterior teeth. OPG images were obtained at the beginning of treatment and after the end of the retraction phase and a CBCT image were also obtained for the same patient at the same centre other than orthodontic reason like implant placement, temporomandibular joint (TMJ) problems, sleep apnea, etc. after orthodontic treatment completion. The scoring system of Levander and Malmgren was used to assess the degree and severity of root resorption in the maxillary incisors. Dalhbergs error and coefficient of reliability (ICC) were used to calculate the correlation between the two sets of readings. Pearson chi-square test was used to compare the difference in root resorption between OPG and CBCT images. A P-value of <0.05 was considered to be statistically significant. RESULTS: No resorption was observed in 39.2% and 16.6% of incisors with OPG and CBCT respectively. Mild resorption was observed in 50% and 66.7% of incisors with OPG and CBCT respectively. Moderate resorption was found in 10% and 15% of incisors with OPG and CBCT respectively. Severe root resorption was found in 0.8% and 1.7% of incisors with OPG and CBCT respectively. Statistically, significant differences were found in both methods of evaluation in all grades of root resorption for all the maxillary incisors (P<0.05). CONCLUSION: OPG had consistently underestimated the amount of orthodontically induced apical root resorption when compared to CBCT. OPG is only useful for the primary evaluation of root resorption. CBCT can be used as an adjunct diagnostic tool on a case-to-case basis in patients with moderate to severe root resorption to manage post-orthodontic treatment complications.

Pulp blood flow changes in maxillary and mandibular anterior teeth after orthodontic retraction: a prospective study.

BACKGROUND: Previous studies of pulpal blood flow (PBF) changes in anterior teeth have been limited in the early phase of orthodontic treatment; less is known about the blood supply of anterior teeth in bimaxillary protrusion patients after orthodontic retraction. METHODS: Fifty bimaxillary protrusion patients (25 orthodontic patients ready for debonding and 25 non-orthodontic patients) were selected as study participants. The PBF of maxillary and mandibular anterior teeth were measured using laser Doppler flowmetry. For orthodontic patients, the PBF was measured at 1 day (T1), 1 month (T2), and 3 months (T3) after fixed appliance removal. Non-orthodontic patient PBF was measured as a control. Cone-beam computed tomography (CBCT) examinations before and after orthodontic treatment were performed for orthodontic patients to measure the root resorption. The anterior teeth in orthodontic group were further divided into subgroups according to root resorption and patient age. RESULTS: At T1 and T3, PBF changes did not differ significantly between the orthodontic and non-orthodontic groups. Maxillary lateral incisor, maxillary central incisor, and mandibular lateral incisor PBFs at T2 were significantly higher in the orthodontic group (P = 0.048, P = 0.04, and P = 0.021). No significant difference in PBF was found between the root resorption and non-resorption subgroups at any time point. Adolescent patients showed a higher PBF in the maxillary lateral incisor at T2 (12.23 ± 3.48) relative to that at T1 (9.10 ± 3.76) and T3 (9.81 ± 2.80) with statistically significant difference (P = 0.020). CONCLUSION: For bimaxillary protrusion patients with four premolars extraction, PBF in the maxillary anterior teeth increased transiently after orthodontic appliance removal and then returned to non-orthodontic levels 3 months later. This effect was more pronounced in adolescents. The PBF of anterior teeth after orthodontic retraction may not be influenced by root resorption.

Evaluation of the rate of anterior segment retraction in orthodontic patients with bimaxillary protrusion using friction vs frictionless mechanics: a single-center, single-blind randomized clinical trial.

OBJECTIVES: To evaluate the effect of friction vs frictionless mechanics on the rate of anterior segment retraction (ASR) in patients with bimaxillary protrusion. MATERIALS AND METHODS: Thirty females (18.3 ± 3.7 years) with bimaxillary protrusion were randomly allocated into the friction group, using elastomeric power chains, and the frictionless group, using T-loop springs for ASR. Eligibility criteria included absence of skeletal discrepancies and any systemic diseases or medications, among others. Randomization in a 1:1 ratio was generated by Microsoft Excel. Opaque sealed envelopes were sequentially numbered for allocation concealment. Only blinding of the outcome assessor was applicable. Activations were done every 4 weeks until completion of ASR. The primary outcome was the rate of ASR measured on digital models. Anchorage loss, molar rotation, and pain experienced were also assessed. RESULTS: Two patients were lost to follow-up. The rate of ASR was 0.68 ± 0.18 mm/mo in the friction group vs 0.88 ± 0.27 mm/mo in the frictionless group, with no significant difference. A significant difference in anchorage loss of 1.63 mm and molar rotation of 7.06° was observed, being higher in the frictionless group. A comparable pain experience associated with both mechanics was reported. CONCLUSIONS: No difference in the rate of ASR or pain experience was observed between friction and frictionless mechanics. However, extra anchorage measures should be considered when using frictionless mechanics as greater anchorage loss and molar rotations are anticipated.

Changes in Facial Profile after Modified Anterior Maxillary Subapical Osteotomy.

(1) Background: This study explored the effects of modified anterior maxillary subapical osteotomy (AMSO) on facial profile changes in patients with bimaxillary protrusion. (2) Methods: Cephalograms of patients were collected preoperatively and over 2 months postoperatively. The following landmarks were recorded: pronasale (Prn), subnasale (Sn), labrale superius (Ls), anterior nasal spine (ANS), and incisor superius (Is). The following distances and angles were measured: ANS-Prn, ANS-Sn, ANS-Ls, Is-Sn, Is-Ls, SNA angle, and nasolabial (NLA) angle. (3) Results: Is and ANS were significantly retracted by 7.3 and 2.3 mm, respectively. Soft tissue landmarks (Prn, Sn, and Ls) were significantly retracted (1.2, 1.6, 4.4 mm, respectively). Postoperative changes in soft/hard tissue ratios were 0.54, 0.72, 0.31, and 0.60 for Prn/ANS, Sn/ANS, ANS/Is, and Ls/Is, respectively. The NLA angle was increased significantly by 7.1°. (4) Conclusions: The horizontal soft/hard tissue ratios of Sn/Is, ANS/Is, and Ls/Is were 0.22, 0.31, and 0.60, respectively. The NLA angle was increased significantly by 7.1°. The modified AMSO provides an increased blood supply, allows for direct vision, and results in fewer complications than other AMSO methods.

Correction of bimaxillary protrusion with four first premolar extractions and T-Loop mechanics: A case report

@#Bimaxillary protrusion is a condition characterized by proclined upper and lower incisors with an increased prominence of the lips. This is a case of a 18-year-old with bimaxillary protrusion, mild crowding on the maxilla and mandible, and mandibular dental midline shift to the left by 1 mm. The four first premolars were extracted using a pre-adjusted bracket. This bracket had in-built prescriptions of torque, tip, and in-out for orthodontic cases. There were three pre-adjusted orthodontic bracket systems: Andrews, Roth, and MBT. T-loop was also used to achieve controlled space closure. After 26 months of orthodontic treatment, the patient’s profile was straighter and a pleasant smile was achieved at the end of treatment.

[Orthodontic treatment of adult patients with mandibular retrognathia]. / Ortodonticheskoe lechenie vzroslykh patsientov s nizhnei retrognatiei.

This article describes a case report of the patient with mandibular retrognathia, class II malocclusion, constriction and deformation of dental arches and bimaxillary protrusion. Due to the patient's refuse to undergo the orthognathic surgery, after diagnostic, it was decided to carry out the orthodontic dentoalveolar compensation. The combined use of the functional fixed telescopic appliance (FFTA), bracket system and orthodontic miniscrews made it possible to effectively normalize the mandibular position, achieve orthognathic occlusion, eliminate bimaxillary protrusion and improve the face profile. This method significantly reduced invasiveness and time of orthodontic treatment.

Data on alveolar mandibular bone thickness in Class I skeletal patient with bimaxillary protrusion.

The alveolar bone thickness influences both diagnosis and limitation of tooth movement, therefore significance retraction was commonly applied in treating patients with bimaxillary protrusion. This is a retrospective data collection of pre and post treatment lateral cephalographs from 18 to 40 years old patient treated with four premolars extraction. The alveolar mandibular bone thickness was identified in sagittal planes with Image-J software based on cephalometry lateral radiographs. Statistical analysis namely Wilcoxon test and Pearson correlation analysis coefficient were used to understand the correlation of alveolar mandibular bone thickness variables and mandibular incisors position to skeletal profile treated with first premolars extraction are presented. This data is essential for advancing in a further understanding of Class I skeletal patients with bimaxillary protrusion.