1/77. Orthodontic correction of a class III malocclusion in an adolescent patient with a bonded RPE and protraction face mask.A case report of a 14-year-old Hispanic male with a Class-III skeletal profile and dental malocclusion with a long mandibular body and ramus and retrusive maxilla. The patient was initially referred for a surgical evaluation for a LeFort I maxillary advancement, but he wanted to avoid surgery. The Class-III malocclusion was corrected with a bonded rapid palatal expander and a maxillary protraction mask followed by nonextraction orthodontic treatment. A Class-I molar and canine relationship was achieved, and the facial profile improved. This case report demonstrates the orthodontic correction of a Class-III malocclusion in an adolescent patient with a bonded rapid palatal expander and protraction face mask. This case was presented to American Board of orthodontics as partial fulfillment of the requirements for the certification process conducted by the Board.- - - - - - - - - - ranking = 1keywords = dental (Clic here for more details about this article) |
2/77. Molarization of the lower second premolars.This paper presents a case of extreme tooth variation. The patient was first observed during the mixed dentition period, when she presented a mild Class II malocclusion with increased overjet and acceptable overbite. In a panoramic radiograph, the presence of lower second premolars of disproportionate dimensions was discovered. When these oversized premolars erupted, the Class I malocclusion tended toward Class III, with an edge-to-edge bite. This created an unstable occlusion and the possible need for extractions.- - - - - - - - - - ranking = 2.0367105464414keywords = tooth (Clic here for more details about this article) |
3/77. Nonsurgical and nonextraction treatment of skeletal Class III open bite: its long-term stability.Two female patients, aged 14 years 5 months and 17 years 3 months with skeletal Class III open bite and temporomandibular dysfunction are presented. They had previously been classified as orthognathic surgical cases, involving first premolar removal. The primary treatment objective was to eliminate those skeletal and neuromuscular factors that were dominant in establishing their malocclusions. These included abnormal behavior of the tongue with short labial and lingual frenula, bilateral imbalance of chewing muscles, a partially blocked nasopharyngeal airway causing extrusion of the molars, with rotation of the mandible and narrowing of the maxillary arch. Resultant occlusal interference caused the mandible to shift to one side, which in turn produced the abnormal occlusal plane and curve of Spee. As a result, the form and function of the joints were adversely affected by the structural and functional asymmetry. These cases were treated by expanding the maxillary arch, which brought the maxilla downward and forward. The mandible moved downward and backward, with a slight increase in anterior facial height. Intruding and uprighting the posterior teeth, combined with a maxillary protraction, reconstructed the occlusal plane. A favorable perioral environment was created with widened tongue space in order to produce an adequate airway. myofunctional therapy after lingual and labial frenectomy was assisted by vigorous gum chewing during and after treatment, together with a tooth positioner. Normal nasal breathing was achieved.- - - - - - - - - - ranking = 2.0367105464414keywords = tooth (Clic here for more details about this article) |
4/77. A comparison of autotransplantation and orthodontics in a case exhibiting two ectopic upper cuspids.Bilateral severely ectopic maxillary cuspids were treated differently on each side. On one side the ectopic cuspid was moved into position orthodontically, and on the other, the ectopic cuspid was positioned by autotransplantation. The orthodontic positioning took a long time and the tooth exhibited root resorption. Treatment time for the autotransplantation positioning was far quicker, and there was no resorption nor were there any other side effects.- - - - - - - - - - ranking = 2.0367105464414keywords = tooth (Clic here for more details about this article) |
5/77. Osseointegrated implants as an adjunct to facemask therapy: a case report.Branemark Implants were placed in the zygomatic buttresses of the maxilla in a 12-year and 1-month-old female patient with a Class III malocclusion caused by maxillary growth retardation secondary to repair of a unilateral cleft lip and palate defect. The implants were left to integrate for 6 months followed by placement of customized abutments that projected into the buccal sulcus. Elastic traction (400 g per side) was applied from a facemask to the implants at 30 degrees to the occlusal plane for 14 hours per day for 8 months (ages 12 years and 10 months to 13 years and 6 months). The maxilla moved downward and forward 4 mm rotating anteriorly as it was displaced. The change in the maxillary occlusal plane resulted in a secondary opening of the mandible. There was a 2 degrees increase in the SN-mandibular plane angle and an increase in nasion to menton distance of 9 mm. Clinically, this resulted in an increase in fullness of the infraorbital region and correction of the pretreatment mandibular prognathism. There was an increase in nasal prominence as the maxilla advanced. This contributed to the increase in facial convexity. The secondary dental change frequently seen in standard facemask therapy was avoided. The displacement of the maxilla was stable 1 year beyond cessation of facemask therapy. The patient's midface profile was improved by age of 13 years and 6 months. Details of the clinical procedure and treatment changes are presented.- - - - - - - - - - ranking = 1keywords = dental (Clic here for more details about this article) |
6/77. Dental changes and space gained as a result of early treatment of pseudo-Class III malocclusion.This study was designed to investigate the dental changes and the space gained following early treatment of pseudo-Class III malocclusion, using a simple fixed appliance. Twenty-one consecutively treated patients who had a pseudo-Class III malocclusion comprised the treated group. Fifteen untreated control subjects were used as matched controls for the three-year follow-up after completion of treatment. Lateral cephalograms and study models were analysed for the treated, the control and the follow-up group. The arithmetic mean and standard deviation were calculated for each variable, and paired t-tests were performed to assess the effects of treatment on the treated group. The Mann-Whitney test was performed to evaluate the difference between the follow-up group and the control group. Anterior crossbites and mandibular displacements were eliminated after the treatment. On average, the space gained as a result of the treatment was 4.7 mm in the upper arch (p < 0.001 degree). Comparison of the space available as a result of early treatment with the space required for alignment of posterior segments in the upper arch of the untreated control group indicated that there was enough space for the eruption of the canines and premolars as a result of early treatment; whereas, lack of space was evident in the untreated controls. In conclusion, a pseudo-Class III malocclusion, proclination of the upper incisors and/or retroclination of the lower incisors contributed to the correction of anterior crossbite and the elimination of mandibular displacement. Proclination of the upper incisors, utilisation of leeway space, and arch-width increase provided the space required for eruption of the premolars and canines.- - - - - - - - - - ranking = 1keywords = dental (Clic here for more details about this article) |
7/77. Treatment of a severe Class III skeletal discrepancy at an appropriate age.The 13-year-old female patient presented for correction of a severe Class III malocclusion with a Class III skeletal pattern. This was considered an appropriate age for treatment as earlier treatment may have been subject to relapse because significant facial growth may have occurred after treatment, and because treatment at a later age may have required orthognathic surgery. Initially, maxillary expansion was provided to widen the maxilla and to free the circum-maxillary sutures. Maxillary protraction headgear was worn to perform sagittal skeletal improvement. Fixed orthodontic appliances were placed to align the dentition and Class III elastics were used to improve intercuspation and stability. Patient cooperation was crucial for success. The skeletal changes provided rewards that included significantly improved facial and dental appearance, while avoiding orthognathic surgery.- - - - - - - - - - ranking = 1keywords = dental (Clic here for more details about this article) |
8/77. Severe dental open bite malocclusion with tongue reduction after orthodontic treatment.We treated a 21-year-old woman with a severe open bite and macroglossia with a standard edgewise appliance and without partial glossectomy. This was followed by retention using a Begg-type plate retainer for the upper dental arch and a fixed canine-to-canine for the lower arch. A crib was added to the upper plate retainer for suppression of a tongue thrust. The lower arch relapsed during the retention period, with a widening of the intermolar distance, flaring of the anterior teeth, and increased mobility of the teeth. We chose tongue reduction to resolve these problems and one-third of the middle dorsal part of the tongue was excised. After the tongue reduction, the patient experienced no functional problem in mastication, swallowing, and gustation, but she complained of mild speech difficulty and slight pain on the dorsal portion of her tongue. These symptoms disappeared 6 months after surgery. At this time, the mandibular dental arch was markedly improved. The flared lower dental arch had returned to an upright position and the tooth mobility reduced to normal. No appliance was used after surgery. Most of the recovery changes occurred within 4 months. This case highlights the importance of the teeth tending to move toward a balance between the tongue pressure from the inside and labio-buccal pressure from the outside.- - - - - - - - - - ranking = 9.0367105464414keywords = tooth, dental (Clic here for more details about this article) |
9/77. Pseudo-Class III treatment with reverse traction: case report.The pseudo-Class III can be defined as a functional reflex of an anterior positioning of the mandible, an acquired muscular position that simulates a mesiocclusion. The diagnosis and treatment plan of this condition must be based on a cephalometric evaluation that provides information about the relative contributions of the skeletal and dental components to the malocclusion. There is still great controversies about when is the best moment to start the Class III treatment. The purpose of this article is to describe a case report in which a Class III patient was successfully treated with reverse traction.- - - - - - - - - - ranking = 1keywords = dental (Clic here for more details about this article) |
10/77. Reduction of the hypocone of the maxillary first molar and Class III malocclusion.This study was conducted to examine the incidence of evolutionary changes of the maxillary molars in orthodontic patients and to investigate the association of this event with craniofacial growth. Among 4,892 Japanese patients treated at the orthodontic clinic of Hiroshima University Dental Hospital, 59 patients presented with a defect of the distolingual cusp of the maxillary first molar. They consisted of 52 female patients and seven male patients with a mean age of 14.7 years. Eruption of the maxillary first and second molars was delayed and the third molar was congenitally missing in all of these patients. Thirty-seven patients exhibited Class III malocclusion (Class III evolution group). The Z scores of cephalometric measurements were compared between the Class III evolution group and the Class III control group. The latter group consisted of 37 Class III subjects with no evolutionary dental anomalies and no orthodontic history. The tooth developmental score (TDS) for each age at the initial record was compared with Nolla's standard tooth developmental score (STDS) for equivalent ages using paired t-tests. The Z scores for Ptm'-A and Ar-A were significantly smaller in the Class III evolutionary group than in the Class III control group (P < .05). The TDS for the maxillary first and second molars were significantly smaller than the STDS for these molars (P < .01). The TDS for the maxillary second molar was significantly larger than the STDS for the maxillary third molar (P < .01). This study revealed that an evolution change of the maxillary molar is more common (P < .05) in female patients than in male patients, is more frequent (P < .05) in subjects with Class III malocclusion, and is related to the anteroposterior undergrowth of the maxilla.- - - - - - - - - - ranking = 5.0734210928827keywords = tooth, dental (Clic here for more details about this article) |
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