DOCSLIB.ORG

Are Class II Elastics Necessary?

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Are Class II Elastics Necessary? Are Class II elastics necessary? ROBERT S. FREEMAK, D.D.S., X.S.D. Denver, Colo. INTRODUCTION ALTHOUGH my orthodontic experience is comparatively limited, I have found that most orthodontic treatment can be carried to a successful conclusion wit,hout resorting to the use of Class II elastics. Therefore, in my opinion, the use of Class IT elastics is seldom necessary, and in many cases I would consider their use con- traindicatcd. My first thinking along these lines was initiated during my graduate training in 1949 by an unforgettable remark made by Dr. Waldo Urban, who commented that he did not often use intermaxillary elastics in his office because he could not find the kind that most men seem to use-the ones that pull in only one direction. There are occasional cases in which the reciprocal forces of Class II elastics are desirable, but generally in Class II correction the only force desired by the operator is the distal force on the maxillary teeth. If this is true, it seems more logical to use appliances that create only the desired distal force on the maxillar!- teeth without the concomitant undesirable mesial force on the mandibular teeth. The extraoral appliances, of course, would satisfy this requirement, and the two that I use are a cervical gear directed against the molars and a high-pull headgear attached to the anterior part of the arch wire. I realize that there is nothing unique or original in the ideas presented here, as many orthodontists are making extensive USR of extraoral appliances. However. there are also many orthodontists who are not using them or who are using them in only a limited way or mostly for Class II mixed-dentition treatment. This article will discuss the use of extraoral appliances as the principal foy.~ irr treatment of the permanent dentition. CLASSIIELASTICSVERSUSEXTRAORAL AXCHORAGE It is not within the scope of this presentation to give a complete history of the use of Class II elastics and extraoral a,ppliances, but some conclusions and This thesis, which was given as a partial fulfillment of the requirements for cerri fication by the American Board of Orthodontics, is being published with the consent and the recommendation of the Board, but it should be understood that it dne~ 1101 necessarily represent or express the opinion of the Board. 3 6 6 E’rtmnnn Am. J. Orthodontics May 1963 observations made by other orthodontists rclativc to these subjects are of interest. In 1938 Brodie, Goldstein, and Nyerl published the first cephalometric evaluation of Class II, Division 1 cases treated with intermaxillary elastics. They concluded that in all of the cases studied the mandibular teeth were moved forward by the intermaxillary force. They further reportoil that the maxillary dental arch remained relatively stationary under the forces of Class II elastics, thereby indicating that most of the correction had been obtained by the undesirable forward positioning of the mandibular teeth. Since that report was published, many other orthodontists have arrived at the same conclusion that the mandibular arch does not provide adequate anchorage for intermaxillary elastics. The following quotations express some of these observations : . With few exceptions neither mandibular anchorage nor ‘ ‘ prepared ’ ’ man- dilmlar anchorage without extractions can sufficiently resist the pull of intermaxillary force to effect posterior movement of the maxillary dental arch without the forward movement of the mandibular teeth. In many cases where prolonged use of Class II elastics has been resorted to, the mandibular teeth move forward to an objeetion- able degree. This may result in an extreme labial inclinat,ion of the lower anterio teeth where they are unhealthy, unstable, and accentuate the chinless appearance of the patient. --Berctl. Fischer.~ I do not ordinarily use intermaxillary elastics in Class II cases because, in my judgment, since it is relatively easier to move teeth mesially than distally, the lower denture is in many cases moved forward off the supporting base boric by this therapy into an intolerable position, and this is followed either by an increase in the protrusion or (in the presence of good muscle tone in the lips) by recoil re- sulting in crowding in the anterior section. --Wazao Urban..? Stationary anchorage is a noble theoretical concept; pract,ically, the mandibular teeth either tip forward or slide forward on the base under prolonged rtastic: at- tack. -T. ill. Gmh,‘r. IV:C are on precarious ground when we use mandibular teeth for anchorage and subject them to prolonged forward horizontal stress. These teeth, like the teeth to 1~ moved, are embedded in living bone and if it is easier to move teeth mesially than distally, the teeth of the mandibular arch are especially unsuit,able for clffective I’?- sjstance to a forward elastic pull. --Stcphen C, IIopkins.:~ In an analysis of the components of force resulting from Class II elastics, Bien” concluded that “the deleterious forces exerted arc grcatcr than the useful distal driving component of force in the distal movcmcnt of teeth.” He pointed out particularly the undesirable clcvating force on t,he lower posterior teeth, which would have a tendency to tip the occlusal plane. Also, in a study of cases treated with cervical anchorage, King; found the changes in the occlusal plant to be very smdl as compared to the undesirable tipping reported by Tovsteins in cases that had been treated with Class IT elastics. It is claimed in some quarters that the use of Class II elastics will stimulate mandibular growth. I have never seen scientific evidence to substantiate this theory, and I do not believe that it is possible to stimulate the mandible to grow beyond its inherent potential by the use of Class II elastics or by any other means. If convincing evidence to the contrary is forthcoming, you can be assured that I will modify the treatment plan advocated in this article and use Class 11 elastics vigorously on every Class II case that enters the office. In regard to whether or not olthodontic treatment can influence mandihhil~ growth, the following opinions arc cited : . There is not enough evidence at hand to support a definite conclusion OW! way or the other. -Wendell L. Wylit.9 As get, there is no map of determining whether or not the growth which OC- curs in a horizontal and vertical direction on the ramus of the mandihle is stimulated l)y orthodontic therapy. --rlTton W. Xoorf:.JO . Orthodontists apparently cannot make the maudiljle grow any more with tlwir manipulations than it would grow without them. --2’. At. Gyabrzr.! The resistance of the mandihle to enforced change does not permit intermaxil- lary force to change its growt,h pattern, size, or position in the manner desired. --IT{ rcu Fiwhf r.: Est,raoral anchorage was introduced in the ninrtcent,h century and I)c~~am~~ quite> popnIx in the early part of this century. Then, after a period oi quiescence, in 1936 Oppenheim’l publishecl a paper in which hc reco~n~nc~n~l~~~~ extraoral anchorage based on the same principles in vogue today. lie atlvocsated acccptanccl of the position of the mandibular teeth as being the most, cor1~1 for the individual patient and the USC of occipital anchorage for mo\-ing the* maxillary teeth distally into correct relationship with their inltagonists. thtlrbby avoiding any possible disturbance of the mandibnlar t,cdh. Oppenheim also pointetl out that the maxillary teeth should 1~ moved clistdly while> thfz face and mantliblc were growing downward and forward in their normal tlit~edorr. Jn 1947 Rloehnl’ cited Oppenheim’s ccmcc:])ts and outlinctl ~1 trttilttrlent procetlurc for early treatment of Class II eases by means of ccr+al ttxetion. whereby hc hoped to reclucc the severity of the malocclusion by guiding a- rcolar growth and the eruption of teeth. Since then there have appc~;~retl III~~J~ articles advocating the utilization of extraoral appliances and analyzing the+ t’ results. I’ischcr” has been one of the foremost proponents of cervical gt~ forcch against the maxillary arch. In his 1948 article he also stated that. i‘bccaus~~ 01’ t,he limitations to forward movement of the mandibular teeth in treatment. thca antcroposterior malrelationships of the dental arches in masillnry l)rot rnsions iL?lClstructnral mandibular retmsions must 1x1 cot~rectetl I)y a I)ostt~t’iot~ i~ioV(‘- tnent of the maxillary dental arch.” The effect of estraoral forces on the maxillary structures has bc(kt7 thg~ subject, (Jf innumerable investigations. In a cephn.lomctric study of ( ‘lass 11 trcatntc>nt. lIoorc’O concluded that there was ” no evidence to prove that. ortho- clontic treattnent influenced the normal forward growth of the trlasilla. *! ill- though htl clitl feel that posterior traction on t,hc maxillary d(~nt7~rc~cluring treatment definit,cly inhibited the normal forward movc~mcnt of the drnluw. More recacntly, Ricketts’” stated. “We can no longer accol)t the maxilla as att it~7mutable structure. Yigorous retraction force on the tcdh, particularly l)ar~itl- ICI to the ;ISCS of roots, appears to prrvent f(~~wi~r(l growth ant1 ev(111(‘aus~’ tl113 Inasilla to grow downward and backwartl.” Brodie ‘$I*L crphalomctric growth stutlies co11~1~clctl that clu?+ing notvtl:il growth the face grows in an orderly manner, with the jaws and the teeth being carried clownward and forward from t,hc base of the craniu~n. La,nd+ ;rlso reportc(l ;I remarkable constancy of the 55X-1 angle, ancl Ric*k(atts” : st,77(]! 3 6 8 Freernun Am. J. Orthodontics May 1963 showed a slight increase of 0.4 degree in the SLYA angle in the two untreated control groups.
Load more

Recommended publications
  • Treatment Options for Jaw Growth Variations
    TREATMENT OPTIONS FOR JAW GROWTH VARIATIONS An Editorial by Robert M. Mason, DMD, PhD PROBLEMS OF OVERGROWTH OF A JAW: It is well known among orthodontists that where there is a growth process involving overgrowth of a jaw, the rule is that growth should be allowed to proceed and then treat the situation after growth has ceased. The reason for this is that growth cannot be effectively stopped or otherwise modified to the extent that jaw growth can be overpowered; that is, “Mother Nature” is smarter than any of us in dentistry. What can be accomplished with an overgrowth of a jaw, however, is orthodontic “remodeling” of some of the parts which are expressing overgrowth. An example is a Class III “growing” mandible. Functional appliances, such as the Frankel or Bionator, can influence the shape of the growing mandible by remodeling, which may give the appearance of manipulating growth, while instead, long-term studies show that such jaw shape changes are only temporary. Over time, the overgrowth pattern returns. Hence, the orthodontic caveat: it is best to let a mandible grow to its full extent and then treat it either by a combination of jaw surgery and orthodontics, or orthodontics alone which may amount to “camouflaging” the problem. What happens dentally in the example of overgrowth of the mandible is that in an attempt for the body to try to maintain dental contacts, the lower incisors tip lingually and the upper incisors tip labially (facially) in an attempt to maintain anterior dental contact relationships as lower jaw growth continues. If the treatment decision is to try to correct the problem with orthodontics alone, Class III elastics would be used along with orthodontic fixed appliances to maintain the lingual tipping and maxillary flaring of incisors.
    [Show full text]
  • A New Dimension of Success in Your Practice
    3D Imaging Family A new dimension of success in your practice dentsplysirona.com CEREC® Diagnosis Treatment Plan Guided Endodontics Airway Functional Orthodontics Integration Implantology Analysis Occlusal & TMD 2/3 Good reasons for 3D With 3D imaging, you have the ideal basis for a new dimension of success in your practice. Best image quality at a low dose and shorter visits—that is what Dentsply Sirona 3D X-ray units provide for your practice. These BETTER benefits provide greater certainty to help make difcult diagnoses Communicate with easier, while providing the opportunity to explore new options for stunning images implantology, endodontics, orthodontics, and more. to your patients Thanks to the 3D Family, Galileos® Comfort Plus, Orthophos® SL 3D and Orthophos XG 3D patients have a better understanding of the diagnosis and accept treatment more readily. It all adds up to efcient clinical workflow that leads to greater practice success. Enjoy every day. With Dentsply Sirona. SAFER Predictable diagnosis and treatment options FASTER Efcient clinical workflow 4/5 More insight More possibilities Your patients are candidates for 3D more often than you think. How severe is the bone atrophy or the periapical lesion? Is the tooth impacted? In all dental disciplines, there are numerous questions that can be answered far more easily using 3D imaging with CBCT. 3D CBCT from Dentsply Sirona ofers clinicians and specialists numerous When does 3D provide more certainty? options for diagnosis, treatment plans, patient consultation—all with a seamless, efcient workflow. This is one way you can expand your range Areas Cases of services and treat more patients at your practice.
    [Show full text]
  • Elastics and Elastomeric in Orthodontics Practice REVIEW ARTICLE
    IJPCDR Elastics and Elastomeric in Orthodontics Practice REVIEW ARTICLE Elastics and Elastomeric in Orthodontics Practice 1Sagar Mapare, 2Kanish Bansal, 3Ranjit Pawar, 4Richa Mishra, 5Ashutosh Sthapak, 6Sayed F Khadri ABSTRACT provides the clinician with the ability to correct both Elastics and elastomeric are an important part of orthodontic anteroposterior and vertical discrepancies. treatment with patients’ cooperation; they are used for Both natural rubber and synthetic elastomers are correction of anteroposterior and vertical discrepancies; there widely used in orthodontic therapy. Naturally produced are many types of elastics placement in relation with treatment latex elastics are used in the Begg technique to provide requirements. Elastics can be classified in many ways: intermaxillary traction and intramaxillary forces. Syn- according to the material, their availability, their uses, and force. Elastomer is a general term that encompasses materials that, thetic elastomeric materials in the form of chains find their after substantial deformation, rapidly return to their original greatest application with edgewise mechanics where they dimensions. Natural rubber is the first known elastomeric, are used to move the teeth along the arch wire. used by the ancient Incan and Mayan civilizations. Rubber-like The links of chain fit firmly under the wings of an materials that are made from chemicals were called synthetic edgewise bracket so that chain elastomers also serve to rubber because they were intended as substitutes for natural rubber. replace metal as the ligating force that holds the arch The types of elastic based on their use are class I, II, III, wire to the teeth. Since they are so positively located on palatal, lingual, cross, etc.
    [Show full text]
  • Class II Article
    Journal of the World Federation of Orthodontists 4 (2015) 40e49 Contents lists available at ScienceDirect Journal of the World Federation of Orthodontists journal homepage: www.jwfo.org Case Report A new, no-compliance class II correction strategy using nickel-titanium coil-springs Luca Lombardo a,*, Antonella Carlucci b, Francesca Cervinara c, Giuseppe Siciliani d a Adjunct Professor, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy b Postgraduate Student, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy c Private Practice in Bari, Italy d Chairman of Postgraduate School of Orthodontics, Department of Orthodontics, University of Ferrara, Ferrara, Italy article info abstract Article history: Background: Correcting Class II malocclusion with Class II elastics or functional appliances requires great Received 15 October 2014 patient collaboration. Here we describe two Class II cases successfully treated with an alternative Received in revised form approach using a fixed device designed to obviate compliance. 27 November 2014 Methods: We fitted specific Class II springs to the bilateral hooks on the stainless steel maxillary and Accepted 3 December 2014 mandibular archwires of a full fixed appliance to correct the Class II malocclusion and to promote Available online 14 February 2015 mandibular growth. Results: The new device brought about full Class I canine and molar relationships in both treated cases Keywords: Class II and improved the maxillomandibular relationship without relying on patient collaboration. Compliance-free Conclusion: Class II springs appear to be a simple, fast, and effective alternative approach to Class II Spring correction, facilitating mandibular growth even in noncompliant patients. Ó 2015 World Federation of Orthodontists.
    [Show full text]
  • Cephalometric and Malocclusion Analysis of Kadazan Dusun Ethnic Orthodontic Patients (Analisis Sefalometrik Dan Maloklusi Pesakit Ortodontik Etnik Kadazan Dusun)
    Sains Malaysiana 42(1)(2013): 25–32 Cephalometric and Malocclusion Analysis of Kadazan Dusun Ethnic Orthodontic Patients (Analisis Sefalometrik dan Maloklusi Pesakit Ortodontik Etnik Kadazan Dusun) ROHAYA MEGAT ABDUL WAHAB* HARTINI IDRIS, HABIBAH YACOB & SHAHRUL HISHAM ZAINAL ARIFFIN ABSTRACT The aims of this study were to assess the skeletal pattern and the malocclusion of Kadazan Dusun ethnic patients who seek for orthodontic treatment. Cephalometric radiographs (248) and 345 study models were collected from four orthodontic clinics in Sabah. The cephalometric mean values (SNA, SNB, ANB, MMA, SNMxP, UIMxP, LIMnP and ALFH) were measured and the study models were analysed for overjet, overbite, incisor and molar relationships. Some morphological or occlusal features such as shovel shape, Talon cusp, peg shape teeth, midline diastema, canine displacement and supernumerary tooth were also noted. The frequency and correlation of cephalometric mean values and prevalence of malocclusion were analysed using SPSS 18. Class I Skeletal pattern was the most common (48%) followed by Class II (33%) and Class III (18%). There was a strong correlation between SNA and SNB values (>0.70). Class II/1 incisor relationship has the highest frequency (41%) followed by Class III (32%), Class I (21%) and Class II/2 (6%). Class II Molar relationship of both right and left showed highest frequency (38%) followed by Class I (33%) and Class III (30%). Increased of overjet (44%) and reduced overbite (41%) and shovel-shaped incisor were the most common occlusal and dental features. The Kadazan Dusun patients who seek for orthodontic treatment in Sabah were mostly presented with Class I Skeletal pattern with high prevalence in Class II/1 incisor relationship, Class II molar relationship, increased overjet and reduced overbite.
    [Show full text]
  • Non-Surgical Treatment of an Adult Class III Malocclusion Patient with Facial Asymmetry by Unilateral Mandibular Arch Distalization
    Volume 29 Issue 2 Article 4 2017 Non-surgical Treatment of an Adult Class III Malocclusion Patient with Facial Asymmetry by Unilateral Mandibular Arch Distalization Chi-Yu Tsai Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Shiu-Shiung Lin Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Yi-Hao Lee Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Li-Tyng Sun Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Yu-Jen Chang Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College Fofollow Medicine, this and Kaohsiung, additional T aiwanworks at: https://www.tjo.org.tw/tjo Part of the Orthodontics and Orthodontology Commons See next page for additional authors Recommended Citation Tsai, Chi-Yu; Lin, Shiu-Shiung; Lee, Yi-Hao; Sun, Li-Tyng; Chang, Yu-Jen; and Wu, Te-Ju (2017) "Non-surgical Treatment of an Adult Class III Malocclusion Patient with Facial Asymmetry by Unilateral Mandibular Arch Distalization," Taiwanese Journal of Orthodontics: Vol. 29 : Iss. 2 , Article 4. DOI: 10.30036/TJO.201706_29(2).0004 Available at: https://www.tjo.org.tw/tjo/vol29/iss2/4 This Case Report is brought to you for free and open access by Taiwanese Journal of Orthodontics. It has been accepted for inclusion
    [Show full text]
  • Orthodontic Treatment of a Patient with Duchenne Muscular Dystrophy and Macroglossia: How Informed Consent Was Critical to Success
    CASE REPORT Orthodontic treatment of a patient with Duchenne muscular dystrophy and macroglossia: How informed consent was critical to success James R. Miller Golden Valley and Minneapolis, Minn This article describes the complex orthodontic treatment of a 22-year-old patient with Duchenne muscular dys- trophy and macroglossia. His orthodontic treatment hinged on providing proper informed consent and manage- ment of the malocclusion with glossectomy, extractions, fixed appliances, and elastics. Challenges to traditional treatment are outlined, and compromises to both process and outcome are discussed from an informed consent point of view because of the serious risks involved. The treatment objectives were met, and the outcome was considered a success. (Am J Orthod Dentofacial Orthop 2013;144:890-8) he purpose of this article is to describe the ortho- past medical history was remarkable for Duchenne Tdontic treatment of a 22-year-old man with muscular dystrophy and an allergy to Augmentin. He Duchenne muscular dystrophy and macroglossia. did not have a tracheostomy tube. He was unable to He used a power wheelchair that he controlled with a voluntarily lift his arms and relied on caregivers for joystick, and some aspects of diagnosis and treatment oral hygiene. The clinical examination and initial photo- were adapted to address his needs and abilities. I report graphic montage (Fig 1) in full occlusion showed gener- here the treatment we provided, including the compro- alized excessive buccal crown torque with an anterior mises that were made and the problems that arose. I open bite of 8 to 10 mm and a posterior open bite of discuss the patient's treatment based on his wishes 0 to 12 mm.
    [Show full text]
  • The Frontal Cephalometric Analysis – the Forgotten Perspective
    CONTINUING EDUCATION The frontal cephalometric analysis – the forgotten perspective Dr. Bradford Edgren delves into the benefits of the frontal analysis hen greeting a person for the first Wtime, we are supposed to make Educational aims and objectives This article aims to discuss the frontal cephalometric analysis and its direct eye contact and smile. But how often advantages in diagnosis. when you meet a person for the first time do you greet them towards the side of the Expected outcomes Correctly answering the questions on page xx, worth 2 hours of CE, will face? Nonetheless, this is generally the only demonstrate the reader can: perspective by which orthodontists routinely • Understand the value of the frontal analysis in orthodontic diagnosis. evaluate their patients radiographically • Recognize how the certain skeletal facial relationships can be detrimental to skeletal patterns that can affect orthodontic and cephalometrically. Rarely is a frontal treatment. radiograph and cephalometric analysis • Realize how frontal analysis is helpful for evaluation of skeletal facial made, even though our first impression of asymmetries. • Identify the importance of properly diagnosing transverse that new patient is from the front, when we discrepancies in all patients; especially the growing patient. greet him/her for the first time. • Realize the necessity to take appropriate, updated records on all A patient’s own smile assessment transfer patients. is made in the mirror, from the facial perspective. It is also the same perspective by which he/she will ultimately decide cephalometric analysis. outcomes. Furthermore, skeletal lingual if orthodontic treatment is a success Since all orthodontic patients are three- crossbite patterns are not just limited to or a failure.
    [Show full text]
  • 2016-Chapter-143-Oropharyngeal-Growth-And-Malformations-PPSM-6E-1.Pdf
    To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confidential until formal publication. Chapter c00143 Oropharyngeal Growth and Skeletal Malformations 143 Stacey Dagmar Quo; Benjamin T. Pliska; Nelly Huynh Chapter Highlights p0010 • Sleep-disordered breathing (SDB) is marked by manifestations has not been determined. The varying degrees of collapsibility of the length and volume of the airway increase until pharyngeal airway. The hard tissue boundaries the age of 20 years, at which time there is a of the airway dictate the size and therefore the variable period of stability, followed by a slow responsiveness of the muscles that form this decrease in airway size after the fifth decade of part of the upper airway. Thus, the airway is life. The possibility of addressing the early forms shaped not only by the performance of the of this disease with the notions of intervention pharyngeal muscles to stimulation but also by and prevention can change the landscape the surrounding skeletal framework. of care. u0015 • The upper and lower jaws are key components • Correction of specific skeletal anatomic u0025 of the craniofacial skeleton and the deficiencies can improve or eliminate SDB determinants of the anterior wall of the upper symptoms in both children and adults. It is airway. The morphology of the jaws can be possible that the clinician may adapt or modify negatively altered by dysfunction of the upper the growth expression, although the extent of airway during growth and development.
    [Show full text]
  • Ngan, Peter Treatment of Anterior Crossbite.Pdf
    AAO/AAPD Conference Scottsdale, Arizona, 2018 Speaker: Dr. Peter Ngan Lecture Date: Sunday, February 11, 2018 Lecture Time: 8:15 – 9:00 am. Lecture Title: “Treatment of Anterior Crossbite” Lecture Description Anterior crossbite can be caused by a simple forward functional shift of the mandible or excessive growth of the mandible. Chin cups and facemasks have been advocated for early treatment of skeletal Class III malocclusions. Long-term data showed greater benefits if treatment was started in the primary or early mixed dentitions. Is the benefit worth the burden? Will the final result of two stage treatment be better than that of a single course of treatment at a later stage? If so, how do we diagnose Class III problems early? Can we predict the outcome of early Class III treatment? The presenter will discuss these questions with the help of long-term treatment records. Lecture Objectives • Participants will learn how to diagnose Class III problems early • Participants will learn how to manage patients with anterior crossbite • Participants will learn the long-term treatment outcome of patients having anterior crossbite corrected in the primary and early mixed dentitions. CENTENNIAL SPECIAL ARTICLE Evolution of Class III treatment in orthodontics Peter Ngana and Won Moonb Morgantown, WVa, and Los Angeles, Calif Angle, Tweed, and Moyers classified Class III malocclusions into 3 types: pseudo, dentoalveolar, and skeletal. Clinicians have been trying to identify the best timing to intercept a Class III malocclusion that develops as early as the deciduous dentition. With microimplants as skeletal anchorage, orthopedic growth modification became more effective, and it also increased the scope of camouflage orthodontic treatment for patients who were not eligible for orthognathic surgery.
    [Show full text]
  • Scissors-Bite) in an Adult IJOI 37
    IJOI 37 iAOI CASE REPORT Full-Cusp Class II Malocclusion with Bilateral Buccal Crossbite (Scissors-Bite) in an Adult IJOI 37 Full-Cusp Class II Malocclusion with Bilateral Buccal Crossbite (Scissors-Bite) in an Adult Abstract Full-cusp Class II malocclusion with posterior buccal crossbite and an overjet exceeding 10mm, usually requires orthognathic surgery for an optimal correction. However, the use of extra-alveolar bone screws for anchorage has expanded the therapeutic envelope for conservative, nonextraction treatment. The dentoalveolar correction was facilitated by a 5-7mm retraction of the entire maxillary arch to achieve a Angle Class I molar relationship. Near ideal dental alignment was accomplished with passive self-ligating brackets, early light short elastics, posterior cross elastics, and bite turbos on lower molars. This challenging malocclusion with a discrepancy index (DI) of 22 was treated in 26 months to a Cast-Radiograph Evaluation (CRE) score of 22 and a Pink & White Esthetic Score of 3. (Int J Ortho Implantol 2015;37:60-79). Key words: excessive overjet, Angle Class II molar relationship, OrthoBoneScrew, extra-alveolar miniscrews, posterior buccal crossbite, Damon self-ligating brackets, early light short elastic, posterior criss-cross elastics, posterior bite turbos. History and Etiology A 25-year-old male patient presented for orthodontic consultation with two chief concerns: facial esthetics and crooked teeth (Figs. 1-3). There was no contributory medical or dental history. The etiology of the malocclusion was consistent with ectopic eruption of the permanent 1st molars into a buccal crossbite relationship, and a long-term lip trap, i. e. habitual posturing of the lower lip between the mandibular and maxillary incisors.
    [Show full text]
  • Craniofacial Growth Nasal Septum Deviation
    International Journal of Pediatric Otorhinolaryngology 74 (2010) 1180–1183 Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl Craniofacial growth in children with nasal septum deviation: A cephalometric comparative study Luca D’Ascanio a,b,*, Carla Lancione a, Giorgio Pompa b, Elena Rebuffini c, Nicola Mansi d, Marco Manzini a a Department of Otolaryngology – Head & Neck Surgery, Citta` di Castello Civil Hospital, Citta` di Castello (Perugia), Italy b Department of Dentistry and Maxillo-Facial Surgery, ‘‘La Sapienza’’ University of Rome, Rome, Italy c Department of Maxillo-Facial Surgery, University of Ferrara, Ferrara, Italy d Department of Otolaryngology, ‘‘Santobono–Pausilipon’’ Children’s Hospital, Naples, Italy ARTICLE INFO ABSTRACT Article history: Objective: Nasal-breathing impairment has been described as a possible determinant of maxillofacial Received 2 April 2010 development in children with adenoids/tonsils hypertrophy. However little is known about the possible Received in revised form 13 July 2010 influence of nasal septum deviation on craniofacial growth in childhood. We conducted a multicenter Accepted 15 July 2010 cephalometric study to compare skeletal and dental features in children with chronic nasal-breathing Available online 9 August 2010 obstruction secondary to nasal septum deviation and nose-breathing controls. Methods: Ninety-eight children (59M, 39F; mean age 8.8 years; age range 7–12 years) with obligate Keywords: mouth-breathing secondary to nasal septum deviation (group 1) and 98 age- and sex-matched nasal- Craniofacial growth breathing controls (group 2) were evaluated. Nasal-breathing function was assessed in all patients with Nasal septum Childhood clinical history, ENT instrumental examination and anterior active rhinomanometry.
    [Show full text]