DOCSLIB.ORG

Surgical-Orthodontic Treatment of a Patient with Severely Asymmetrical Skeletal Class III Dentofacial Deformity

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Surgical-Orthodontic Treatment of a Patient with Severely Asymmetrical Skeletal Class III Dentofacial Deformity @2021 JCO, Inc. May not be distributed without permission. www.jco-online.com CASE REPORT Surgical-Orthodontic Treatment of a Patient with Severely Asymmetrical Skeletal Class III Dentofacial Deformity JIYU SONG, MDS XINGFU BAO, DDS, PhD LI CHEN CHENMENG LU, MDS GUOMIN WU, DDS, PhD MIN HU, DDS, PhD YI ZHANG, DDS, PhD ompared with a typical skel­ mandibular height in the vertical etal Class III mandibular pro­ dimension, and inconsistency of Ctrusion, an asymmetrical the maxillary and mandibular skeletal Class III is a more complex widths in the transverse dimen­ three­dimensional craniomaxillary sion.1,2 Comprehensive treatment deformity, involving unilateral ex­ including presurgical orthodontics, cessive mandibular growth or de­ orthognathic surgery, and post­ ficient maxillary growth in the sag­ surgical orthodontics is required ittal dimension, bilateral for these defects to be completely inconsistency of maxillary and resolved.3 Drs. Song and Lu are residents, Drs. Bao and Zhang are Lecturers and staff orthodontists, and Dr. Hu is Dean and Professor, Department of Ortho- dontics; Mrs. Chen is a diagnostic technician, Department of Oral Radiology; and Dr. Wu is Dean and Professor, Plastic Aesthetic Center, School and Hospital of Stomatology, Jilin University, Changchun, Jilin, China. E-mail Dr. Zhang at [email protected]. JCO/JULY 2021 © 2021 JCO, Inc. 210701 TREATMENT OF A PATIENT WITH SEVERELY ASYMMETRICAL SKELETAL CLASS III The long-term stability of conventional sur- The panoramic radiograph indicated general- gical-orthodontic treatment for a severely asym- ized horizontal bone loss in both arches, with the metrical skeletal Class III dentofacial deformity root of the upper left premolar shorter than normal. has been considered problematic because of the Cephalometric analysis (Table 2) confirmed a skel- possible inadequacy of dental decompensation be- etal Class III relationship (ANB = −4.2°, Wits ap- fore surgery, along with complications due to con- praisal = −13.5mm, APDI = 96.4°), a hyperdiver- dylar changes, airway conditions, and muscle pull gent pattern (SN-MP = 44.9°, FMA = 29.1°, and function.4 Considering these factors, it is im- S-Go/N-Me = 58.3%, y-axis = 74.7°, ODI = 46.7°), portant to carefully evaluate such a skeletal defor- and a skeletal open-bite tendency (ALFH/PLFH = mity and the dental compensation mechanisms to 1.9). The Ricketts frontal cephalometric analysis plan presurgical orthodontics that can achieve the indicated skeletal asymmetry of the mandible and desired goals and ensure stability. The magnitude dental asymmetry of the mandibular arch (Table 3). and amount of surgical correction will largely de- Cone-beam computed tomography (CBCT) pend on the efficacy of the presurgical orthodontic showed inconsistency in the morphology of the decompensation, which should be planned in all TMJ and widening of the anterior space on the left three planes of space.5,6 In the sagittal dimension, (Fig. 2). Functional examination found no signs of the proclined upper incisors and retroclined lower TMD, although the mandible deflected to the right incisors must be decompensated to place them in when opening. ideal positions with respect to the jaw; in the trans- The diagnosis was a skeletal Class III dento- verse dimension, the arches must be coordinated facial deformity with facial asymmetry, attribut- while controlling the torque of the posterior seg- able to abnormal development of the maxilla and ments; in the vertical dimension, the overerupted mandible in three dimensions; a congenitally miss- teeth must be intruded to establish an appropriate ing upper right first premolar; an abnormality in vertical anterior tooth display after surgery.3,7 the upper left second molar; and chronic general- This case report demonstrates comprehensive ized periodontitis. surgical-orthodontic treatment of a patient with Treatment objectives were to correct the severe skeletal discrepancies in all three planes: asymmetrical skeletal Class III deformity, thus sagittal (Class III malocclusion), transverse (facial achieving a harmonious facial appearance; align asymmetry), and vertical (long face and open bite). the dental midlines with each other and with the facial midline; establish ideal overjet and overbite Diagnosis and Treatment Plan with proper interdigitation of the posterior teeth; improve the periodontal condition; and facilitate A 27-year-old male presented with an asym- good oral hygiene. metrical face, with the chin shifted to the left, a Combined surgical-orthodontic treatment concave profile, and excessive lower facial height was the only viable approach to achieve these ob- (Fig. 1). He reported that a mild mandibular trauma jectives. Presurgical orthodontics would decom- had occurred a month earlier. Intraoral examina- pensate the dentition to achieve a maximum skel- tion found a more-than-full-cusp Class III molar etal correction and stable postsurgical occlusion. A relationship, anterior and posterior crossbites, and Le Fort I osteotomy was planned to advance, slight- an open bite. The patient also exhibited gingival ly rotate, and center the maxilla, with the advance- swelling with bleeding and recession. ment more pronounced on the left and the impac- Analysis of the study casts showed an overjet tion on the right and in the posterior regions. In of −4.4mm to −8.07mm and generalized spacing addition, a bilateral sagittal split ramus osteotomy in the upper and lower anterior segments (Table would set back and rotate the entire mandible 1). The upper right first premolar was congenital- counter clockwise, with more movement on the right ly missing, and the upper left second molar was to level the mandible with the maxilla. Postsurgical abnormal. orthodontics would finish and detail the occlusion. JCO/JULY 2021 210702 TREATMENT OF A PATIENT WITH SEVERELY ASYMMETRICAL SKELETAL CLASS III The presurgical orthodontic decompensation rior teeth were corrected by buccal root-torquing was carefully planned to coordinate with the bends. Occlusal interferences were removed by planned surgical movements (Table 4). Maxillary grinding the lingual marginal ridges of the upper premolars are commonly extracted to help decom- canines. pensate proclined upper incisors and coordinate After 24 months of presurgical preparation, the midline between the upper dentition and the the teeth were properly positioned relative to the maxilla. In this patient, because of the missing jaws, and the upper arch was coordinated with the maxillary right first premolar, the upper dental lower arch (Fig. 3). midline was deviated to the right compared with A visual treatment objective and model sur- the maxillary midline. This was a challenging sit- gery were used to plan a Le Fort I osteotomy, bi- uation, since the upper dental midline and facial lateral sagittal split ramus osteotomy, and genio- midline typically deviate to the same side. We de- plasty (Fig. 4). The maxilla was advanced by 5mm cided to extract the upper left first premolar and to and drifted to the right by 2.5mm, with a .5mm retract the upper left incisors with strong anchor- impaction on the right side and 4mm extrusion on age from a miniscrew in the left maxilla. The pa- the left, as well as a slight clockwise rotation to tient agreed to this plan and to extraction of the correct the open bite. The mandible was set back lower left and right third molars, followed by two- by 2mm on the left and 9mm on the right, and jaw surgery to correct his skeletal deformity. pogonion was advanced by 4mm. Rigid fixation was used in both the maxilla and the mandible, Treatment Progress with no intermaxillary fixation. The patient was closely monitored for two Before orthodontic treatment, the patient un- months after surgery. Postsurgical orthodontic derwent periodontal therapy, including scaling and treatment was then initiated, using .019" × .025" root planing, to control plaque and eliminate in- stainless steel archwires to finish and detail the flammation. Periodic periodontal maintenance occlusion. visits were scheduled during orthodontic treat- After a total 31 months of treatment, all ap- ment. pliances were removed. Considering the typical Presurgical orthodontics began with direct bilateral discrepancy in masticatory muscle tension bonding of .022" × .028" Victory Series brackets* in a patient with asymmetrical skeletal Class III in both arches; the lower anterior brackets were dentofacial deformity, we designed special remov- rotated 180° to effectively procline the retroclined able acrylic retainers for nighttime wear to help lower incisors. A customized orthodontic band was prevent relapse (Fig. 5). used to control the abnormal upper left second molar. Treatment Results After leveling and alignment of both arches, the diastema was closed with sliding mechanics on Post-treatment records confirmed good es- .019" × .025" stainless steel archwires. Self-tapping thetic and occlusal results (Fig. 6). Cephalometric miniscrews** were placed buccally between the analysis (Tables 2,3) and superimpositions showed roots of the upper first and second molars to pro- significant improvement in the soft and hard tis- vide strong anchorage for retraction of the upper sues. The interdigitation in the left molar area was left incisors and midline alignment. To expand the still unsatisfactory because of the abnormal upper upper arch and coordinate it with the lower arch, left second molar (Fig. 7). irrespective of the occlusal plane inclination, the inclinations of the upper posterior
Load more

Recommended publications
  • Orthodontic Camouflage Treatment of Skeletal Class III Malocclusion with Mandibular Bite Turbo Application
    CASE REPORT East J Med 25(2): 321-326, 2020 DOI: 10.5505/ejm.2020.57060 Orthodontic Camouflage Treatment of Skeletal Class III Malocclusion with Mandibular Bite Turbo Application Saadet Cinarsoy Cigerim Department of Orthodontics, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey ABSTRACT Treatment of skeletal class III malocclusions is difficult malocclusions. The treatment of skeletal class III malocclusions varies according to the jaw and the growth period of the anomalies. Adult individuals whose growth is over are treated with fixed orthodontic mechanics or orthognathic surgical approaches. If skeletal class III malocclusion is not severe and does not constitute a problem aesthetically, camouflage treatment can be done with fixed orthodontic mechanics. This case report presents the results of orthodontic camouflage treatment and treatment applied to a skeletal class III malocclusion female patient with chronological age of 17 years and 9 months and skeletally in the Ru period. The molar relationship of the patient with a slightly concave profile is Angle class III. In cephalometric examination, skeletal class III malocclusion was detected (ANB angle= -6). At the end of treatment, a Angle class I relationship and a smooth soft tissue profile were obtained. Key Words: Skeletal class III treatment, adult treatment, camouflage treatment, bite turbo Introduction jaw with anomaly and the growth period of the individual. Main treatment methods for skeletal class Skeletal class III malocclusions are anomalies that III malocclusion include the following ones. The first require difficult and complicated treatment (1). one, chincup, is an orthopedic treatment option Skeletal class III malocclusion may be observed due which is performed by devices such as class III to maxillary retrognathia, mandibular prognathia or activator or face mask.
    [Show full text]
  • SPACE ANALYSIS Space Analysis Is a Process That Allows an Estimation of the Space Required in Each Arch to Fulfil the Treatment Aims
    أ. د. أكرم فيصل الحويزي 5th Year Lec. No. 12 SPACE ANALYSIS Space analysis is a process that allows an estimation of the space required in each arch to fulfil the treatment aims. It helps to determine whether the treatment aims are feasible, and assists with the planning of treatment mechanics and anchorage control. Space planning is carried out in 2 phases: 1- to determine the space required for relief of crowding, overjet correction and creating space for any planned prostheses. 2- calculates the amount of space that will be created during treatment by molar distalization, arch expansion, inter-proximal stripping …etc. Before undertaking a space analysis, the aims of the treatment should be determined as this will affect the amount of space required or created. Space analysis can act only as a guide, as many aspects of orthodontics cannot be accurately predicted, such as growth, the individual patient’s biological response and patient compliance. MIXED DENTITION ANALYSIS: In mixed dentition space analysis, mesiodistal width of unerupted canine and premolars is predicted so that discrepancy between space available and space required for these teeth in the dental arch can be determined. There are three main approaches to mixed dentition space analysis: a) Measurement from radiographs: The widths of unerupted canine and premolars is estimated using proportionate measurement from radiographs, which takes into account any magnification. The widths of permanent canine and premolars are measured directly from dental radiographs. The width of a deciduous molar is measured from the radiograph and from the dental cast and the following equation is used: 푼풏풆풓풖풑풕풆풅 풕풐풐풕풉 풕풓풖풆 풘풊풅풕풉 퐷푒푐푑푢표푢푠 푚표푙푎푟 푡푟푢푒 푤푑푡ℎ = 푈푛푒푟푢푝푡푒푑 푡표표푡ℎ 푟푎푑표푔푟푎푝ℎ푐 푤푑푡ℎ 퐷푒푐푑푢표푢푠 푚표푙푎푟 푟푎푑표푔푟푎푝ℎ푐 푤푑푡ℎ Then the combined widths of the permanent canine and premolars is compared to the combined widths of the deciduous canine and molars.
    [Show full text]
  • Invisalign Treatment Planning Guide 1 Align Technology, Inc
    Table of Contents INTRODUCTION . 2 Getting Quality Clinical Outcomes with Invisalign. 2 Invisalign Applicability . 3 DIAGNOSIS AND TREATMENT OPTIONS 1. Crowding . 4 2. Spacing. 10 3. Narrow Arches . 16 4. Crossbite. 20 5. Deep Bite . 24 6. Open Bite . 28 7. Class II . 32 Invisalign 8. Class III . 38 CLINICAL NOTES Treatment IPR . 5 Tooth Size Discrepancy . 11 Planning Staging . 12 Auxiliary Treatment. 12 Guide Expansion . 17 Attachments. 25 Anchorage . 42 APPENDIX Prescription Form Tips. 44 Glossary . 46 Index. 48 Credits . 54 Invisalign Treatment Planning Guide 1 Align Technology, Inc. Introduction HOW TO USE THIS GUIDE Getting Quality Clinical The guide is organized by patient diagnosis. ABOUT THIS GUIDE Match your patient’s diagnosis to the appropriate Outcomes with Invisalign The goal of this guide is to provide you with a diagnosis decision tree to see some possible treat- decision making tool you can use while selecting ment options. Read the accompanying treatment Successful clinical outcomes with Invisalign and treatment planning your Invisalign cases. notes and evaluate your options given your start with attention to detail during case By outlining typically used Invisalign approaches Invisalign experience level. See Figure A, below. selection and treatment planning. Here are and discussing their complexity and predict- five guidelines for setting up your cases that ABOUT THIS SERIES ability, we hope to make the treatment planning pay great dividends later: This guide is the first in a three-part series options and implications more clear for you of Invisalign patient care references, comple- to evaluate. 1. Submit high quality records. Accurate menting the ClinCheck® Evaluation Guide PVS impressions and clear patient photos and (D4458) and the Invisalign Clinical Monitoring Align Technology is not a provider of medical, radiographs are critical for the creation of your Guide (D4219).
    [Show full text]
  • Tooth Size Measurements and Bolton Analysis for Fast-Set Plaster Models Versus Computer-Based Models Rendered from Dual Pour Alginate Impressions
    TOOTH SIZE MEASUREMENTS AND BOLTON ANALYSIS FOR FAST-SET PLASTER MODELS VERSUS COMPUTER-BASED MODELS RENDERED FROM DUAL POUR ALGINATE IMPRESSIONS by Gregory J Berman, DDS B.S., University of Michigan, College of Literature, Science and Arts, Ann Arbor, 1999 D.D.S., University of Detroit-Mercy, School of Dentistry 2004 Submitted to the Graduate Faculty of the School of Dental Medicine in partial fulfillment of the requirements for the degree of Master of Dental Science University of Pittsburgh 2010 UNIVERSITY OF PITTSBURGH SCHOOL OF DENTAL MEDICINE This thesis was presented by Gregory J Berman, DDS It was defended on May 25, 2010 and approved by Dr. Robert Robison, DMD, Clinical Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics Mr. John Close, MA, Assistant Professor, Department of Dental Public Health and Information Management Thesis Advisor: Dr. Janet Robison, PhD, DMD, Clinical Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics ii Copyright © by Gregory J Berman 2010 iii TOOTH SIZE MEASUREMENTS AND BOLTON ANALYSIS FOR FAST-SET PLASTER MODELS VERSUS COMPUTER-BASED MODELS RENDERED FROM DUAL POUR ALGINATE IMPRESSIONS Gregory J Berman, DDS University of Pittsburgh, 2010 Objective: The objective of this in vitro study is to compare measured values of pre- treatment tooth sizes and the Bolton overall and anterior analyses for fast-set plaster dental casts versus computer-based dental models made from a dual pour alginate impression. Materials and Methods: Maxillary and mandibular alginate impressions were made for a sample of thirty-six patients with permanent dentitions from first molar to first molar. Impressions were poured in fast-set orthodontic plaster within one hour and allowed to set for 8- 10 minutes.
    [Show full text]
  • Evaluation of Surgically Assisted Rapid Maxillary Expansion and Orthodontic Treatment Effects on Dental, Skeletal and Nasal Structures and Rhinological Findings
    Linköping University Medical Dissertations No. 1359 Swedish Dental Journal Supplement 229 Evaluation of surgically assisted rapid maxillary expansion and orthodontic treatment Effects on dental, skeletal and nasal structures and rhinological findings Anders Magnusson Department of Clinical and Experimental Medicine, Division of Neuroscience, Faculty of Health Science, Linköping University, Sweden. Oral and Maxillofacial Unit Section of Dentofacial Orthopedics, University Hospital, Linköping, Sweden. Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden. Linköping 2013 Copyright © Anders Magnusson Cover/Illustrations: Anders Magnusson, Johan Werner Avby Printed in Sweden by Liu-tryck, Linköping, Sweden, 2013 ISBN: 978-91-7519-666-4 ISSN: 0345-0082, 0348-6672 II To Helen, Cajsa, Måns and Maja “To everything there is a season, and a time for every purpose under the heaven” III Contents Abstract 1 List of papers 3 Abbreviations 4 Introduction 5 General introduction 5 Definition and classification 6 MTD in growing individuals 8 MTD in non-growing individuals 11 Areas of skeletal resistance 12 Principles of treatment 13 Segmented LeFort I osteotomy 14 Surgically assisted rapid maxillary expansion 14 Treatment effects on hard tissue 17 Treatment effects on soft tissue 17 Treatment effects on nasal respiration 18 Methodological background: rhinology 20 Methodological background: radiology 22 Aims 25 General aim 25 Specific objectives 25 Materials 27 Methods 29 Orthodontic and surgical procedures 29 Measurements
    [Show full text]
  • The Application of Bolton's Ratios in Orthodontic Treatment Planning For
    65 The Open Anthropology Journal, 2010, 3, 65-70 Open Access The Application of Bolton’s Ratios in Orthodontic Treatment Planning for Chinese Patients Chun Han#, Juan Dai#, Hong Qian, lei Chen, Yinxiong Wang, Na Huo and Yinzhong Duan* Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi’an, Shaanxi 710032, People's Republic of China Abstract: Aim: To investigate the application of Bolton’s ratios in the proper diagnosis and treatment planning for Chi- nese orthodontic patients with congenitally missing mandibular incisor. Materials and Methods: Twenty-seven Chinese cases (males 10, females 17) with congenitally missing mandibular inci- sor and class I molar relationship were recruited in this study. Guided by the anterior Bolton’s ratios, three therapeutic strategies (each for 9 patients) were carried out according to different indications, which included enamel stripping, pros- thetic restoration and extraction therapy. Results: After treatment, all the patients achieved good occlusion with normal Bolton’s ratios and the clinical results were satisfied. Conclusion: It suggested that the application of Bolton’s ratios in orthodontic treatment planning for Chinese patients with mandibular congenital missing incisor might be clinically beneficial for optimum treatment outcomes. Keywords: Bolton’s ratios, Chinese orthodontic patients, congenitally missing teeth. INTRODUCTION the treatment options could be stripping upper teeth, flaring the lower incisors and moderately increasing the overjet or It is important to establish an optimum balance between overbite [6, 7]. However, to the best of our knowledge, there the mesiodistal tooth sizes of the maxillary and mandibular is no study concerning how the Bolton’s ratios direct to the arches in order to ensure ideal interdigitation, overbite, and orthodontic treatment of Chinese patients with congenitally overjet at the completion of orthodontic treatment [1].
    [Show full text]
  • A Guide to Orthodontics
    Camelia Szuhanek Eleonora Schiller Adelina Grigore Adelina Popa A GUIDE TO ORTHODONTICS 1 LABORATORY GUIDES COLLECTION 2 “VICTOR BABEŞ” UNIVERSITY OF MEDICINE AND PHARMACY TIMIŞOARA FACULTY OF DENTAL MEDICINE Camelia Szuhanek Eleonora Schiller Adelina Grigore Adelina Popa A GUIDE TO ORTHODONTICS Editura „Victor Babeş” Timişoara, 2019 3 Editura „Victor Babeş” Piaţa Eftimie Murgu 2, cam. 316, 300041 Timişoara Tel./ Fax 0256 495 210 e-mail: [email protected] www.umft.ro/editura Director general: Prof. univ. dr. Dan V. Poenaru Director: Prof. univ. dr. Andrei Motoc Colecţia: GHIDURI ŞI ÎNDRUMĂTOARE DE LABORATOR Coordonator colecţie: Conf. univ. dr. Adrian Vlad Referent ştiinţific: Prof. univ. dr. Elisabeta Bratu Indicativ CNCSIS: 324 © 2019 Toate drepturile asupra acestei ediţii sunt rezervate. Reproducerea parţială sau integrală a textului, pe orice suport, fără acordul scris al autorilor este interzisă şi se va sancţiona conform legilor în vigoare. ISBN 978-606-786-126-6 4 TABLE OF CONTENTS PREFACE ......................................................................................................................................................... 7 1. PATIENT HISTORY AND THE GENERAL CLINICAL ASSESSMENT............................................ 8 2. FACIAL AND POSTURAL ASSESSMENTS ........................................................................................11 3. ASSESSMENT OF THE MUSCLES AND OF THE FUNCTIONS OF THE DENTO-MAXILLARY APPARATUS (DMA) ..........................................................................................16
    [Show full text]
  • Relationship of Bolton's Ratios and Tooth-Size Discrepancy
    Available online at www.globalilluminators.org GlobalIlluminators FULL PAPER PROCEEDING Multidisciplinary Studies Full Paper Proceeding MTAR-2014, Vol. 1, 116-123 ISBN: 978-969-9948-22-0 MTAR-14 Relationship of Bolton’s Ratios and Tooth-size Discrepancy Tarek Dokhan1, Najeeb Shebani 2 and Abdurraouf Zaet3*. 1,2,3Dental technology department, Faculty of Medical technology, Zawia University, Zawia, Libya Abstract The aim of this study was to determine whether there are differences in the influence of tooth size discrepancies among malocclusion groups in the general population; to know if there are any effects of tooth size discrepancies from region to another, and to study Bolton’s ratio of tooth size discrepancy in relation to malocclusion treatments. A quantitative study was carried out using many studies published in the English language from various population groups from different countries. Well defined guidelines for conducting analyses of observational studies were followed by electronic database (Entre Pub Med, www.ncbi.nim.nih.gov ). Additionally, a search in the Science Direct database ( www.sciencedirect.com ) will be performed, and data will be collected on the following items for the retrieved studies: year of publication, study design, materials (study sample, control sample,) methods of measurement, authors’ conclusions, and reference lists of relevant articles would be screened. © 2014 The Authors. Published by Global Illuminators. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Peer-review under responsibility of the Scientific & Review committee of MTAR-2014. Keywords― Tooth size discrepancy, Bolton’s ratio, and Malocclusion Introduction The main purpose in comprehensive orthodontic treatment is to achieve optimal final occlusion, overjet and overbite.
    [Show full text]
  • Issue-Pdf-Vol 4 Issue:2 June 2012-15.Pdf
    Indian Journal of Dental E ISSN NO. 2231-2293 Sciences P ISSN NO. 0976-4003 Official Journal of HP University, Shimla Editorial Board Chief Patron Patron Prof. A. D. N. Bajpai Dr. V.K. Gupta Vice Chancellor-HP University, Shimla Chairman,Dr Puran Chand Medical Trust Editor in Chief: Assistant Editor Dr. Vikas Jindal Dr. Amrinder Tuli Director-Professor,Department of Periodontics Senior Lecturer,Dept of Periodontics Himachal Dental college,Sundernagar,HP,India HDC, Sundernagar, HP, India Co-Editors Dr. Vinod Sachdev Dr. Anil Singla Dr. R.P. Luthra Principal, Prof and Head, Deptt of Director, Prof and Head, Deptt of Principal, Prof.and Head,Deptt of Pedodontics, HDC, Sundernagar, HP, India Orthodontics, HDC, Sundernagar, HP, India Prosthodontics Govt. Dental College, Shimla, HP Dr. Rajan Gupta Dr. Bharat Bhushan Dr. Gaurav Gupta Principal, Prof.and Head,Deptt of Principal, Prof and Head, Deptt of Director,Prof and Head,Deptt of Prosthodontics Periodontics HIDS, Paonta Sahib, HP Pedodontics DAV Dental College, Solan HIDS,Paonta Sahib,HP Dr. Jagmohan Lal Principal, Prof and Head, Deptt of Prosthodontics Bhojia Dental College, Nalagarh, HP Editorial Board Prof. H.S. Banyal Dr. K.S.Nagesh Dr. Ravi Kapoor Dean of Studies, Principal, D.A.Pandu Memorial Prinicipal Himachal Pradesh University R.V.Dental College, MM Mullana Dental Dr (Ms) Jaishree Sharma Bangalore College, Ambala Director, Medical Education & Research, Dr. R L Jain Dr. S G Damle Himachal Pradesh Principal, Prof and Head, Vice Chancellor Dr. Mahesh Verma Deptt of Pedodontics Guru MM Mullana Dental Director-Principal, Maulana Azad Nanak DentalCollege, College, Ambala Institute of Dental Sciences, Sunam, PB, India Dr.
    [Show full text]
  • White Spot Lesions/Decalcification — an Orthodontic Dilemma
    September 30, 2012 Original Rel.: September 2012 Termination: September 2014 ™ presents Vol. 26 No. 8 in Orthodontics Literature review and critical analysis from the publisher of Practical Reviews Dialogue White Spot Lesions/Decalcification — An Orthodontic Dilemma E-quiz code: 32053N Although usually caused by poor oral hygiene, it should be the goal of all orthodontists to prevent white spot lesions to avoid remineralization Issue Highlights By Phillip M. Campbell, DDS, MSD hite spot lesions/decalcification controlled for. In the largest study of preva - are an orthodontic dilemma. What lence conducted to date, approximately 23% These articles have can be done? It is gratifying to me of orthodontic patients developed white spot been selected by the Wto see the recent interest in research relat - lesions during treatment. With one-fourth of Coordinating Editor as Key Reviews. ing to prevention and resolution of white our patients developing white spot lesions, spot lesions in patients undergoing fixed or - prevention should be foremost in the mind of Critical Discussion thodontic treatment. In fact, there were at every clinical orthodontist. It appears the and Commentary least six such presentations prevalence of white spot Cognitive Behavioral Therapy on this topic at our recent lesions has increased with Is Effective for Managing Attempting to determine the Orthodontic Pain American Association of Or - the advent of bonding on thodontists annual session anterior teeth, possibly due pa ge 3 in Hawaii. A white spot le - etiology of such a difference in to acid etching of these sion is a subsurface enamel teeth prior to bonding, • Ideal Method for Rebonding incidence of white spot lesions a Lingual Retainer porosity from carious dem - which increases the likeli - pa ge 4 ineralization that presents between banding and bonding hood of decalcification.
    [Show full text]
  • Skeletal Class III Malocclusion Treatment Using Mandibular and Maxillary Skeletal Anchorage and Intermaxillary Elastics: a Case Report
    original article Skeletal Class III malocclusion treatment using mandibular and maxillary skeletal anchorage and intermaxillary elastics: a case report Mehrnaz Fakharian1, Erfan Bardideh2, Mostafa Abtahi3 DOI: https://doi.org/10.1590/2177-6709.24.5.052-059.oar 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 mini- plates 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. Keywords: Jaw abnormalities. Retrognathia. Maxillary retroposition. Functional orthodontic appliance. Bone plates. 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/ci- rúrgico inclui algum tipo de protração da maxila.
    [Show full text]
  • Bolton Analysis for Different Sagital Problems & Its Corelation with Dental Parameters
    Bolton Analysis for Different Sagital Problems BOLTON ANALYSIS FOR DIFFERENT SAGITAL PROBLEMS & ITS CORELTION WITH DENTAL PARAMETERS *SAAD ASAD, F.C.P.S (Orthodontics), Invisalign Certified Orthodontist *SAQIB NAEEM, F.C.P.S (Orthodontics) **WAHEED-UL-HAMID, M.S (Orth), MOrth RCSed (Edin) (Orthodontics) ABSTRACT The clinician should be familiar with discrepancies in tooth size at the initial diagnosis and treatment planning stages if excellence in orthodontic finishing is to be achieved. Bolton’s method of diagnosing tooth size discrepancies by analyzing the mesiodistal tooth size ratio between the maxillary and mandibular teeth has been widely used in scientific studies since its publication. Aim of my study was to calculate Bolton Ratio & Anterior Bolton Ratio1,2 for Different Skeletal Malocclusions i.e. Skeletal Class I , II & III. The study was also aimed at establishing correlation between Bolton’s anterior and overall ratios and dental parameters i.e. upper & lower incisor inclinations & Arch length Discrepancy. The study was conducted on 60 subjects with mean age 18.43+4.21. Study models & lateral Cephalogram were taken for each subject. Patients were categorized into Skeletal Class I , II & III. Bolton Analyses, Anterior Bolton Analyses, Arch length discrepancy for maxilla & mandible, UI-SN & IMPA were calculated and analyzed using SPSS version 13.It was concluded from the results that 1.Bolton Ratio though slightly different but was statistically insignificantly different in Skeletal Class I, II & II patients 2. Anterior Bolton Ratio though slightly different but was statistically insignificantly different in Skeletal Class I, II & II patients 3. Incidence of Anterior Bolton Ratio was more in Skeletal Class III cases than in Skeletal Class I & II 4.Statistically significant correlations between Arch Length Discrepancy in Maxilla and intermaxillary tooth size discrepancies were determined.
    [Show full text]