DOCSLIB.ORG

Maxillary Molar Distalization Or Mandibular

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Maxillary Molar Distalization Or Mandibular ORIGINAL ARTICLE Maxillary molar distalization or mandibular enhancement: A cephalometric comparison of comprehensive orthodontic treatment including the pendulum and the Herbst appliances Donald R. Burkhardt, DDS, MS,a James A. McNamara, Jr, DDS, PhD,b and Tiziano Baccetti, DDS, PhDc Ann Arbor and Okemos, Mich, and Florence, Italy Several methods of Class II treatment that do not rely on significant patient compliance have become popular during the last decade, including several versions of the Herbst appliance and the pendulum or Pendex molar-distalization appliances. Yet, these 2 general approaches theoretically have opposite treatment effects, one presumably enhancing mandibular growth, and the other moving the maxillary teeth posteriorly. This study examined the treatment effects produced by 2 types of the Herbst appliance (acrylic splint and stainless-steel crown) followed by fixed appliances, and the pendulum appliance followed by fixed appliances. For each of the 3 treatment groups, lateral cephalograms were analyzed before the start of treatment (T1) and after the second phase of treatment (T2). Patients were matched according to age and sex. The comprehensive treatment time for the pendulum group was 31.6 months, and the acrylic and crowned Herbst groups were treated for 29.5 months and 28.0 months, respectively. Overall from T1 to T2, there were no statistically significant differences in mandibular growth among the 3 groups. Skeletal changes accounted for a larger portion of molar correction in the Herbst treatment groups than in the pendulum group. Patients in the pendulum group had an increase in the mandibular plane angle. Conversely, the mandibular plane angle in patients treated with either Herbst appliance closed slightly from T1 to T2. At T2, the chin points (pogonion) of patients in both Herbst groups, however, were located slightly more anteriorly than were the chin points of the pendulum patients. It is likely that the slight downward and backward rotation of the mandible occurring during treatment in the pendulum patients accounted for much of this difference. The treatment effects produced by the 2 types of Herbst appliance were similar at T2, in spite of their differences in design. It is important not to generalize the findings of this comparison beyond the appliance systems evaluated. The 2 general approaches we evaluated involved a substantial dentoalveolar component in the treatment of Class II malocclusion. A comparison of a molar-distalizing appliance such as the pendulum with other types of functional appliances might yield differing results. (Am J Orthod Dentofacial Orthop 2003;123:108-16) he correction of Class II malocclusion is one of orthodontic patients treated for this condition. It is well the most common problems facing the orth- known, however, that Class II malocclusion is not a Todontist, with an estimated one-third of all single diagnostic entity1,2 but, rather, can result from various skeletal and dentoalveolar components. aGraduate orthodontic program, University of Michigan, Ann Arbor, and Many strategies are available for Class II treatment, private practice, Okemos and Ann Arbor, Michigan. and most orthodontists tend to choose a treatment bThomas M. and Doris Graber Endowed Professor of Dentistry, Department of protocol based on what part of the craniofacial skeleton Orthodontics and Pediatric Dentistry, School of Dentistry; Professor of Cell and Developmental Biology, School of Medicine; Research Scientist, Center they believe the appliance will affect the most. For 3,4 for Human Growth and Development, University of Michigan, Ann Arbor. example, the Herbst appliance commonly has been Private practice, Ann Arbor, Michigan. used to treat patients with mandibular skeletal retru- cAssistant professor, Department of Orthodontics, University of Florence, Florence, Italy; Thomas M. Graber Visiting Scholar, Department of Orthodon- sion, whereas the molar-distalizing pendulum appli- 5 tics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann ance typically is used in patients with maxillary Arbor. dentoalveolar protrusion. Reprint requests to: Dr James A. McNamara, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Perhaps more than any other type of functional MI 48109-1078; e-mail, [email protected]. appliance, whether fixed or removable, the treatment Submitted, February 2002; revised and accepted, August 2002. effects produced by the banded Herbst appliance have Copyright © 2003 by the American Association of Orthodontists. 0889-5406/2003/$30.00 ϩ 0 been well documented, especially by Pancherz and 4,6-19 doi:10.1067/mod.2003.7 colleagues. Other investigators have evaluated al- 108 American Journal of Orthodontics and Dentofacial Orthopedics Burkhardt, McNamara, and Baccetti 109 Volume 123, Number 2 ternative designs, including the cast Herbst appliance Table I. Sample selection and exclusionary criteria: by Wieslander20,21 and the acrylic-splint Herbst appli- stainless-steel crown Herbst appliance ance by McNamara et al,22 Lai and McNamara,23 and Franchi et al.24 No published studies have appeared Sample selection n concerning the treatment effects of the stainless-steel Parent sample 53 25-27 28 crown or the cantilever Herbst designs. The Primary exclusionary criteria short-term treatment effects of the pendulum appliance, 1. Poor film quality/magnification problems 4 which primarily affects the maxilla, also have been 2. Incomplete records 4 described.29-31 Secondary exclusionary criteria 1. T1 age less than 10 years 3 Although the long-term effects of the Herbst appli- 2. T1 to T2 interval greater than 48 months 4 32-36 ance used alone have been investigated, there is 3. Not Class II malocclusion 8 only 1 published study evaluating the treatment effects Final sample 30 of the Herbst appliance followed by a fixed-appliance phase of treatment.23 Furthermore, the treatment effects after the removal of the pendulum appliance have not The stainless-steel crown Herbst appliance been evaluated. Two designs of stainless-steel crown Herbst appli- Thus, considerable research has focused on the ance were used in this study. The stainless-steel crown treatment of Class II malocclusions with the Herbst and Herbst appliance,38 consisting of crowned maxillary the pendulum appliances. Presumably, knowing the first molars and mandibular first premolars,27,39 was treatment effects produced by different strategies to used in 23 patients; the stainless-steel crown cantilever correct a Class II malocclusion is essential when Herbst design38 was used in 7 additional patients. Aside considering what strategy to use to treat a Class II from the details of the Herbst design, the clinical patient. Therefore, the idea of treating the “wrong jaw” protocol for the Herbst appliance did not vary substan- has been an argument used by clinicians who support tially among practitioners. The maxillary and mandib- treatments aimed primarily at the maxilla or the man- ular crowns always were cemented permanently, ensur- dible. Surprisingly, however, only very limited infor- ing full-time wear of the appliance. mation is available regarding a direct comparison of a The stainless-steel crown Herbst sample was se- so-called mandibular-enhancing appliance such as the lected from an original group of 53 subjects from 4 Herbst and a molar-distalizing appliance such as the private orthodontic practices. To be included in this pendulum. Thus, it is the purpose of this study to make treatment group, patients had to meet all of the follow- a detailed comparison of the effects on Class II maloc- ing criteria: (1) a pretreatment Class II Division 1 clusions of the Herbst appliance followed by fixed malocclusion defined by at least an end-to-end molar appliances, and the pendulum appliance followed by relationship, (2) 2-phase treatment with Herbst therapy fixed appliances, to determine what morphological followed by preadjusted edgewise appliance treatment, differences, if any, are apparent at the end of treatment. (3) no permanent teeth extracted before or during treatment, and (4) good-quality radiographs with ade- quate landmark visualization taken before treatment PATIENTS AND METHODS began (T1) and immediately after removal of the This is a retrospective study designed to evaluate preadjusted edgewise appliances (T2). Thirty of the 53 cephalometrically the skeletal and dentoalveolar effects subjects met the inclusionary criteria (Table I). The of Class II correction obtained by 3 two-phase treat- sample consisted of 20 girls and 10 boys, whose ment modalities. The first treatment group consisted of average age was about 12 years (Table II). 30 patients treated with the stainless-steel crown Herbst appliance.27 The outcome of these treatments was The acrylic-splint Herbst appliance compared with that in 30 patients treated with the Serial cephalometric records of Class II Division 1 acrylic-splint Herbst appliance37 and in 30 patients subjects who underwent 2-phase treatment with an treated with rapid molar distalization with the pendu- acrylic-splint Herbst appliance37,40 immediately fol- lum appliance.5 Comprehensive fixed-appliance ther- lowed by preadjusted edgewise appliances also were apy followed Phase I treatment in all 3 groups. The analyzed. This acrylic-splint appliance had occlusal specific treatment protocols for the acrylic-splint and coverage from the canines to the first molars in the crown Herbst appliances and for the pendulum appli- maxillary
Load more

Recommended publications
  • Distalization of the Mandibular Dentition with Mini-Implants to Correct a Class III Malocclusion with a Midline Deviation
    CASE REPORT Distalization of the mandibular dentition with mini-implants to correct a Class III malocclusion with a midline deviation Kyu-Rhim Chung,a Seong-Hun Kim,b HyeRan Choo,c Yoon-Ah Kook,d and Jason B. Copee Uijongbu and Seoul, Korea, Philadelphia, Pa, and Dallas, Tex This article describes the orthodontic treatment for a young woman, aged 23 years 5 months, with a Class III malocclusion and a deviated midline. Two orthodontic mini-implants (C-implants, CIMPLANT Company, Seoul, Korea) were placed in the interdental spaces between the mandibular second premolars and first mo- lars. The treatment plan consisted of distalizing the mandibular dentition asymmetrically and creating space for en-masse retraction of the mandibular anterior teeth. C-implants were placed to provide anchorage for Class I intra-arch elastics. The head design of the C-implant minimizes gingival irritation during orthodontic treatment. Sliding jigs were applied buccally for distalization of the mandibular posterior teeth. The active treatment period was 18 months. Normal overbite and overjet were obtained, and facial balance was improved. (Am J Orthod Dentofacial Orthop 2010;137:135-46) very orthodontic tooth movement is accompa- patients. Therefore, several authors have attempted to nied by a reaction. This can make it difficult to treat this type of malocclusion by distal tooth movement Ecorrect a malocclusion by using intraoral appli- alone. For example, animal studies and clinical investi- ances alone, especially when complete distal movement gations have used conventional implants as absolute of the mandibular dentition is planned in nonsurgical anchorage2-4 and miniplates for intrusion or distalization Class III malocclusion treatment.
    [Show full text]
  • Molar Distalization-A Review
    Molar Distalization - A Review Dr. Sumnima Sharma1 , Dr. Vijayta Yadav2, Dr. Neha Choudhary3 P G Student1,3, Reader2, Department of Orthodontics & Dentofacial Orthopedics, Career Post Graduate Institute of Dental Sciences & Hospital , Lucknow Abstract The most important step of gaining space in the dental arch in treatment planning can be achieved by different methods one of which is molar distalization. Various appliances have been introduced to distalize molars by using non extraction treatment. Headgear was the first appliance which was used for this purpose but this appliance need patient cooperation and was esthetically unpleasant. Thus there were various intra oral appliance which have been introduced. How to cite this Article: Sharma S, Yadav V, Choudhary N.Molar Distalization - A Review. HTAJOCD.2019 Introduction distally inclined. * “New Distalizer” appliance reatment options in orthodontics may * Posteriorly and superiorly displaced * Crozat treatment differ depending on the type of condyles. * Crickett appliance Tmalocclusion whenever there is Various Modalities to Distalize Molars * Distalization using Microimplant space deficiency, the methods of gaining space A. Extraoral Appliances: * Distalization with Lever arm and Mini that strikes to our mind first are, extraction, I) To Cause Bilateral Molar Distalization Implant system expansion and stripping .In the past, 1. High pull headgear, 2. Straight pull * Palatal Implant Supported Distalization. orthodontists had two main options to create the headgear, 3. Cervical or low pull headgear * ZAS (Zygomatic Anchorage System) space in the arch .One was to expand the arch II) To Cause Unilateral Molar Distalization * SAS (Skeletal Anchorage System) and the other was to extract. Angle, proposed 1. Power arm face-bow, 2.
    [Show full text]
  • Intraoral Approaches for Maxillary Molar Distalization: Case Series Dentistry Section
    DOI: 10.7860/JCDR/2017/25656.9922 Case Series Intraoral Approaches for Maxillary Molar Distalization: Case Series Dentistry Section DEVINDER PREET SINGH1, SHEFALI ARORA2, SUMIT KUMAR YADAV3, NEAL BHARAT KEDIA4 ABSTRACT Correction of Class II malocclusion by distalization of maxillary molars with intraoral appliances is a non-extraction treatment approach, which has been described as an alternative to Head Gear. From the past few years, the procedures have undergone rectification to achieve treatment objective more precisely. This has been made possible by a better understanding of bone physiology, tooth movement, biomechanics and newer biomaterials. Nowadays newer distalizing appliances, like the Jones Jig, Lokar distalizer and Carrière distalizer, have been developed which have compact designs and cause minimal discomfort to the patient. Refinement in these appliances is concentrated mainly on achieving bodily movement of the molar rather than simple tipping. These appliances are also operator friendly as these are easy to insert and remove. The present case series presents the efficacy of these appliances in Class II malocclusion patients with a mean age of 16 years (age range of 15-17 years) that reported with the chief complaint of irregular upper front teeth, since non-extraction approach in correcting Class II malocclusion is gaining a lot of attention. Keywords: Intraoral distalizers, Malocclusion, Non-extraction One of the traditional approaches for Class II molar correction and and lateral incisors. Bilateral distalization of the upper maxillary space gaining is distalization, which can be obtained with either molars was initiated after the placement of the Jones Jig appliance Intraoral Appliances (IOA) or Extraoral Appliances (EOA).
    [Show full text]
  • Impact of Molar Teeth Distalization with Clear Aligners on Occlusal Vertical
    Caruso et al. BMC Oral Health (2019) 19:182 https://doi.org/10.1186/s12903-019-0880-8 RESEARCHARTICLE Open Access Impact of molar teeth distalization with clear aligners on occlusal vertical dimension: a retrospective study Silvia Caruso1†, Alessandro Nota1,2*†, Shideh Ehsani2, Elena Maddalone2, Kenji Ojima3 and Simona Tecco2 Abstract Background: A common strategy in the non-extraction treatment of Class II molar relationship is maxillary molar distalization, which could increase lower face height and cause clockwise mandibular rotation. The aim of this retrospective study was to analyse the effects on vertical dentoskeletal dimension of young adults treated with sequential distalization with orthodontic aligners. Methods: Lateral cephalometric radiographs of 10 subjects (8 females 2 males; mean age 22.7 ± 5.3 years) treated with upper molars sequential distalization with orthodontic aligners (Invisalign, Align Technology, San Josè, California, USA) were analyzed. Results: No statistically significant difference was observed for the primary outcome SN-GoGn between T0 and T1 and it was recorded a mean variation of 0.1 ± 2.0 degrees. Statistically significant differences were found in the linear position of the upper molars (6-PP, 7-PP) the molar class relationship parameter (MR) and the upper incisive inclination (1^PP) with at least p < 0.01. Conclusions: Upper molar distalization with orthodontic aligners guarantee an excellent control of the vertical dimension representing an ideal solution for the treatment of hyperdivergent or openbite
    [Show full text]
  • The Effectiveness of Tipback Mechanics for Correction of Class II Malocclusion" (2014)
    University of Connecticut OpenCommons@UConn Master's Theses University of Connecticut Graduate School 7-3-2014 The ffecE tiveness of Tipback Mechanics for Correction of Class II Malocclusion Nandakumar Janakiraman University of Connecticut School of Medicine and Dentistry, [email protected] Recommended Citation Janakiraman, Nandakumar, "The Effectiveness of Tipback Mechanics for Correction of Class II Malocclusion" (2014). Master's Theses. 632. https://opencommons.uconn.edu/gs_theses/632 This work is brought to you for free and open access by the University of Connecticut Graduate School at OpenCommons@UConn. It has been accepted for inclusion in Master's Theses by an authorized administrator of OpenCommons@UConn. For more information, please contact [email protected]. The Effectiveness of Tipback Mechanics for Correction of Class II Malocclusion. Nandakumar Janakiraman B.D.S. Government Dental College, Bangalore University, 1997. M.D.S. Government Dental College, NTR University, 2002. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Masters of Dental Science at the University of Connecticut 2014 i APPROVAL PAGE Master of Dental Science Thesis The Effectiveness of Tipback Mechanics for Correction of Class II Malocclusion Presented by Nandakumar Janakiraman, BDS, MDS Major Advisor________________________________________________ Flavio A. Uribe DDS, MDentSc Associate Advisor_____________________________________________ Ravindra Nanda BDS, MDS, PhD Associate Advisor_____________________________________________ David Shafer DMD University of Connecticut 2014 ii Acknowledgments I want to thank my parents, my wife and kids for all the sacrifices they make to make my dream come true. I want to thank Dr. Nanda, Dr. Uribe and School of Dental Medicine, University of Connecticut, for their support, encouragement, constant guidance and making my dream of becoming an Orthodontist in US.
    [Show full text]
  • Maxillary Molar Distalization with No-Compliance Fixed Orthodontic Equipment
    dentistry journal Review Dentoskeletal Class II Malocclusion: Maxillary Molar Distalization with No-Compliance Fixed Orthodontic Equipment Vincenzo Quinzi 1 , Enrico Marchetti 1 , Luigi Guerriero 1, Floriana Bosco 2, Giuseppe Marzo 1 and Stefano Mummolo 1,* 1 Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, L’Aquila 67100 Coppito, Italy; [email protected] (V.Q.); [email protected] (E.M.); [email protected] (L.G.); [email protected] (G.M.) 2 Private practice in 20121 Milan, Italy; boscofl[email protected] * Correspondence: [email protected] Received: 10 January 2020; Accepted: 28 February 2020; Published: 18 March 2020 Abstract: Dentoskeletal class II malocclusion due to a protruded upper dental arch is a major reason for an orthodontic treatment. In these cases, the correction of class II can be hindered by molar distalization, obtained with ‘no-compliance therapy’ that involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. The aim of this review was to outline the effectiveness of no-compliance fixed orthodontic devices in the molar distalization. After selection according to the inclusion/exclusion criteria, 16 articles from 2000 to 2019 were qualified for the final analysis. The literature shows various no-compliance fixed devices whose effect is to distalize the maxillary molars. The present revision allows to conclude that there is a need to increase the number of studies, especially with regard to the most recently introduced devices in the literature. The analysed studies allow to hypothesize that these appliances act with a minimal variability of molar distalization and disto-inclination among them, although different effects among the appliances can be observed as regards to the anchorage.
    [Show full text]
  • Treatment of a Class II Division 2 Malocclusion in a Teenage Patient
    Case Report iMedPub Journals Journal of Orthodontics & Endodontics 2017 http://journals.imedpub.com ISSN 2469-2980 Vol. 3 No. 4: 13 DOI: 10.21767/2469-2980.100047 Treatment of a Class II Division 2 Malocclusion Ramírez Silvia1*, 2 in a Teenage Patient: Clinical Case Report Siguencia Valeria , García Andrés3, Bravo Manuel4 Abstract 1 Dentist, Resident student of the Orthodontic Specialization of the This article describes the orthodontic treatment of an adolescent patient presenting a class II skeletal, convex profile, mesofacial biotype, upper dental University of Cuenca. midline deviated 1 mm to the left, Class I bilateral molar, canine distoclusion of 2 Specialist in Orthodontics and ½ right unit and left canine relationship non-determinable because piece 23 is in Maxillofacial Orthopedics. Professor ectopic position, proinclination and inferior protrusion. The treatment plan was to of Orthodontics at the University of distalize the maxillary molars and create enough space to incorporate pieces 13, Cuenca. Member of the Ecuadorian 23 in the dental arch, a pendulum appliance supported with two orthodontic mini Society of Orthodontics. implants were used. The active treatment lasted 18 months and at the end of it, all 3 Specialist in Orthodontics and the objectives were fulfilled, resulting in facial balance. The pendulum appliance Maxillofacial Orthopedics. Professor is a good alternative for a Class II dental correction, it produces distalization of the of Orthodontics at the University of maxillary molars in an optimal treatment time. Cuenca. 4 Doctor of Dentistry, University of Keywords: Adolescent patient; Treatment; Maxillary molars; Space; Crowding Cuenca. Master in Orthodontics, C. University of Sao Paulo-Brazil 2010.
    [Show full text]
  • Mandibular Skeletal Posterior Anatomic Limit for Molar Distalization in Patients with Class III Malocclusion with Different Vertical Facial Patterns
    THE KOREAN JOURNAL of Original Article ORTHODONTICS pISSN 2234-7518 • eISSN 2005-372X https://doi.org/10.4041/kjod.2021.51.4.250 Mandibular skeletal posterior anatomic limit for molar distalization in patients with Class III malocclusion with different vertical facial patterns Sung-Ho Kim Objective: The aim of this study was to compare the differences in mandibular Kyung-Suk Cha posterior anatomic limit (MPAL) distances stratified by vertical patterns in Jin-Woo Lee patients with skeletal Class III malocclusion by using cone-beam computed Sang-Min Lee tomography (CBCT). Methods: CBCT images of 48 patients with skeletal Class III malocclusion (mean age, 22.8 ± 3.1 years) categorized according to the vertical patterns (hypodivergent, normodivergent, and hyperdivergent; n = 16 per group) were analyzed. While parallel to the posterior occlusal line, the shortest linear distances from the distal root of the mandibular second molar to the inner Department of Orthodontics, Dankook cortex of the mandibular body were measured at depths of 4, 6, and 8 mm University College of Dentistry, from the cementoenamel junction. MPAL distances were compared between the Cheonan, Korea three groups, and their correlations were analyzed. Results: The mean ages, sex distribution, asymmetry, and crowding in the three groups showed no significant differences. MPAL distance was significantly longer in male (3.8 ± 2.6 mm) than in female (1.8 ± 1.2 mm) at the 8-mm root level. At all root levels, MPAL distances were significantly different in the hypodivergent and hyperdivergent groups (p < 0.001) and between the normodivergent and hyperdivergent groups (p < 0.01).
    [Show full text]
  • Clinical Impression Vol 5 (1996)
    CLINICAL ® ImpressionsPUBLISHED BY ORMCO CORPORATION • VOL. 5, NO. 1, 1996 Dr. Smith on Treatment Efficiency Page 2 Dr. Mayes on STM, Part 2 Page 6 Dr. Hilgers Takes a Step Backward Page 12 Dr. Scott on the Lokar Appliance Page 16 Dr. Smith A Treatment Efficiency Philo by John R. “Bob” Smith, D.D.S., M.S.D. Winter Springs, Florida ave you ever looked at one of your facing the orthodontist: patients’ charts and noticed that the 1. Noncompliance with orthodontic treatment record was as thick as an appliances (i.e., headgear, functional unabridged version of War and Peace? appliances, elastics). Then you saw a thin chart – one of your 2. Emergencies – broken or loose favorite patients, where the treatment appliances. Emergencies related to went smoothly with few office visits. Why improper management of archwire was there such a big difference? Usually, ends, protruding ligature ties and we are quick to blame the patient for the improperly contoured or activated extra visits and hassles. In some cases this wires or appliances are preventable. attitude is justified; however, many times 3. Poor oral hygiene and associated the responsibility for problems during decalcification, decay and periodontal treatment is due to the orthodontist’s complications. decisions on timing of treatment and 4. Root resorption. selection of orthodontic appliances. To minimize these problems, we must There has been a general trend in ortho- create positive changes by focusing on dontics to begin treatment at an earlier efficiency, quality control and profitability. age. The objectives of early treatment The most significant changes I made to H have been expanded to include manage- improve the quality of life, efficiency and ment of arch-length deficiencies and profitability in my practice were the use of skeletal malalignments.
    [Show full text]
  • Mini-Implants in the Anterior Palate; How to Improve TAD Stability In
    Mini-Implants in the Anterior Palate: How to improve Stability in the Long-term Björn Ludwig / Traben-Trarbach / Germany Benedict Wilmes / University of Düsseldorf / Germany Stability of Mini-implants Phase of low stability Stability Primary Secondary stability stability 1 2 3 4 5 6 7 8 9 Weeks Stability of Mini-implants How to measure primary stability: - Insertion Torque (in vivo / in vitro) - Resonance Frequency Analysis (RFA) (in vivo / in vitro) - Periotest (in vivo / in vitro) - Lateral loading / Pull Out Test (in vitro) Stability of Mini-implants Insertion site? No difference between median ISQ and paramedian insertion 40 Resonance 35 median Frequency 30 Analysis 25 ns paramedian ** * 20 ns median * 15 10 5 0 paramedian 0 2 4 6 Weeks Nienkemper M, Pauls A, Wilmes B, Drescher D. Development of mini-implant stability over the initial healing period: A prospective clinical pilot study. Angle Orthod. 2013 Nienkemper M, Pauls A, Wilmes B, Drescher D. Effect of implant length on mini-implant stability during the initial healing period: A prospective clinical study, Head and Face Med 2013 Nienkemper M, Pauls A, Ludwig B, Drescher D. Stability of paramedian inserted palatal mini- implants at the initial healing period: a controlled clinical study. Clin Oral Implants Res. 2013 Stability of Mini-implants Success rate in the anterior palate: 97.9% Karagkiolidou A, Ludwig B, Pazera P, Gkantidis N, Pandis N, Katsaros C. Survival of palatal miniscrews used for orthodontic appliance anchorage: A retrospective cohort study. Am J Orthod Dentofacial Orthop. 2013 1. Low failure rate 2. No root damage 3. Tad´s not in the path Stability of Mini-implants Stability of Mini-implants Optimal -Thick Bone site -Thin Mucosa Restricted site Ludwig B, Glasl T, Bowman J, Wilmes B, Kinzinger G, Lisson G.
    [Show full text]
  • Maxillary Molar Distalization with Micro-Implants
    Predictable Maxillary Molar Distalization with micro-implant Anchorage in the correction of class II Malocclusion Dr. Ramesh Sabhlok BDS, MDS, FDS RCS (Edinburgh), FDS RCPS (Glasgow), M. Orth RCS (Edinburgh), FACD, FICD Consultant Orthodontist Dubai Smile Dental Centre Dubai, United Arab Emirates [email protected] Maxillary Molar Distalization with micro-implants: • Intra-radicular micro-implant supported - Buccal and Palatal • Palatal Micro-implants • Conventional appliances like Distal Jet and Pendulum appliances supported with micro-implants Limitations with Conventional Molar distalization Appliances: • Group distalization is almost impossible • Undesirable counteraction o Anchorage Loss Flare out of incisors Overjet increase Mesial movement of Pre-molars Tipping of molars o Mandibular clockwise rotation • Complicated devices are required • Poor oral hygiene • Discomfort for patients • Need patients cooperation if removable appliances, headgear and or inter- maxillary elastics are combined 1 Implant supported Distalizing appliances: • With Mini-screw fixation there is a way to prevent or eliminate anterior anchorage loss during molar distalization, as it provides absolute anchorage. The Mini-screw can be placed either buccaly or palatally to distalize the first molars. • The Mini-screw in combination with Distal jet appliance may provide a less invasive alternative to the anchorage loss. In this case the Mini-screw is placed in the Maxillary alveolar process, between the palatal roots of the first and second pre-molar. This mechanical system prevents mesial movement of the anterior teeth during molar distalization. • Alternatively the Mini-screw can be placed buccaly between the second pre-molar and first molar and the distalization is achieved by activation of the Nitinol springs , placed on a sectional arch wire between first pre- molar and first molar.
    [Show full text]
  • Conference Proceedings
    South Eur J Orthod Dentofac Res Conference proceedings 2nd International CONGRESS OF Corresponding Author: Croatian SOCIETY OF Orthodontics Cvetanka Bajraktarova Misevska “ExcelLENCE IN Orthodontics”, PHO University Dental Clinical Centre St. Pantelejmon, th th Zagreb, SEPTEMBER 24 -27 , 2014 Clinic Of Orthodontics, Skopje, FYR of Macedonia e-mail: [email protected] Abstract TEMPOROMANDIBULAR DISORDERS - TRUTHS AND MISCONCEPTIONS Turner syndrome is one of the most frequent genetic anomalies affects approximately 1 in 2500 live female births worldwide. Iva Alajbeg* With different clinical expression, this syndrome is a challenge for monitoring and research, both from medical and dental aspect. *Department of Prosthodontics, School of Dental Medicine, The developmental specifics in 40 Turner syndrome children were University of Zagreb, Zagreb, Croatia studied over analysis of craniofacial and dental morphology, Corresponding Author: assessing the prevalence of malocclusion, skeletal and dental matu- Iva Alajbeg rity, and compared with 40 healthy female controls. The results Department of Prosthodontics, School of Dental Medicine, showed that the craniofacial complex was reduced in size and University of Zagreb, Croatia was characterized by an altered morphology. The curvature of the e-mail: [email protected] frontal bone was significantly increased, the diameters of the head were reduced while the flexion of the cranial base was increased. Abstract Both the maxilla and mandible were retrognathic, posteriorly Recognition and treatment of temporomandibular disorders rotated and reduced in antero-posterior length in the study group. (TMD) is still a problem, mainly because the term encompasses The most frequent oral findings were small teeth, early eruption of many symptoms of different etiology. Classification on joint and the secondary teeth and short roots.
    [Show full text]