1/15. A less-invasive approach with orthodontic treatment in Beckwith-Wiedemann patients.The beckwith-wiedemann syndrome (BWS) is a rare genetic disorder, linked to an alteration on the short arm of chromosome 11 that comprises multiple congenital anomalies. macroglossia is the predominant finding, with subsequent protrusion of dentoalveolar structures, which results in a protruding mandible, anterior open bite, abnormally obtuse gonial angle and increased mandibular length. A less-invasive treatment with orthopaedic appliances in a patient with early tongue reduction is presented. This work summarizes the oral signs linked to macroglossia, and highlights the influence of macroglossia on mandibular growth structures. In our opinion, glossotomy could be carried out in the paediatric patient as a preventive measure in that it curbs the tongue's influence on skeletal growth and dramatically reduces the duration and extensiveness of subsequent treatment.- - - - - - - - - - ranking = 1keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
2/15. Moulding of the generate to control open bite during mandibular distraction osteogenesis.Distraction osteogenesis of the craniofacial skeleton has become a widely accepted, safe, and effective means of craniofacial reconstructive surgery. Despite excellent results in general, there are still some uncertainties related to the procedure, such as development of an anterior open bite (AOB) during mandibular distraction. The aim of this study was to examine whether 'moulding of the generate', i.e. use of intermaxillary elastics during the active distraction phase is possible to close the mandibular plane angle and open bite. Three subjects, 13- and 15-year-old males and a 7-year-old female, underwent mandibular linear and angular bilateral distraction osteogenesis with moulding of the generate. Lateral cephalograms were obtained before the introduction of elastics and following distraction, once the activation was stopped and the patients were ready for the consolidation phase. Conventional cephalometric measurements were used to assess possible changes in the mandibular plane angle and incisor position. Three different anchorage systems (dental, orthopaedic, and skeletal) were used for placement of the intermaxillary elastics. Cephalometric examination showed that the mandibular plane angle was decreased during active distraction osteogenesis with the introduction of elastics and angulation of the distraction device. Depending on the type of elastic anchorage system, smaller or greater amounts of extrusion of the incisors were noted. Moulding of the generate during active distraction can be performed to reduce the mandibular plane angle and open bite. To prevent unwanted dentoalveolar changes from occurring during elastic traction, skeletal rather than dental fixation of the elastics is recommended. Intrusive mechanics may be incorporated into the orthodontic appliances to balance extrusive force by the moulding elastics.- - - - - - - - - - ranking = 1keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
3/15. Indications and procedures for segmental dentoalveolar osteotomy: a review of 13 patients.The authors evaluated the surgical area, indications, and procedures for segmental dentoalveolar osteotomy carried out on 16 jaws in 13 patients treated at the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of medicine, between 1990 and 2001. osteotomy was indicated mainly in cases where tooth repositioning by orthodontic treatment was limited, where social conditions (e.g., age, time, finances) precluded orthodontic treatment, or where revision of orthodontic or surgical treatment was required. In cases of maxillary anterior segmental dentoalveolar osteotomy, the modified Wunderer method was used, where after an incision was made in the palatal mucosa, a mucoperiosteal flap was abraded as much as possible until the area of the osteotomy on the palatal side could be visualized. In maxillary posterior segmental dentoalveolar osteotomy, the operation was carried out in 2 stages because of the risk of necrosis of the bone fragments. In the first stage, an osteotomy was carried out on the vestibular side, since the vestibular gingival pedicle was intact. In the second stage, 3 weeks later, another osteotomy was performed after the palatal mucoperiosteal flap was abraded to visualize the area of the osteotomy as well as that of the maxillary anterior segmental dentoalveolar osteotomy.- - - - - - - - - - ranking = 8keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
4/15. Orthodontic fine adjustment after vertical callus distraction of an ankylosed incisor using the floating bone concept.The outcome of vertical callus distraction of a segment of tooth-supporting alveolar process might be functionally and esthetically unsatisfactory because of the unidirectional impact of intraoral distraction devices. In this case report, we describe how, with a shortened consolidation phase and application of the floating bone effect, the tooth-supporting osteotomy segment can be successfully aligned 3 dimensionally. We applied orthodontic force systems that went beyond the unidirectional vector preset by the mechanical properties of the distraction device.- - - - - - - - - - ranking = 0.00069766159701615keywords = alveolar (Clic here for more details about this article) |
5/15. Interdisciplinary treatment including forced extrusion and reintrusion of a traumatized mandibular incisor for a patient with Class II Division 1 skeletal open bite.A woman with Class II Division 1 long-face syndrome characteristics had a history of facial trauma, dentoalveolar fracture of her mandibular anterior teeth, and temporomandibular joint pain. The pretreatment apical radiograph showed a large area of external root resorption of the mesial surface of the mandibular left central incisor. To arrest the external root resorption, the mandibular left central incisor was extruded. During extrusion, sequential apical radiographs were taken. As the tooth moved away from the site of osteoclastic activity, resorption ceased, and repair took place on the root surface. At this time, the mandibular left central incisor was intruded, the mesial defect self-repaired, the tooth remained vital, and the periodontial ligament was intact. The biologic bases for this cessation of resorption and the repair of the tooth's surface are presented.- - - - - - - - - - ranking = 1keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
6/15. Differential diagnosis of skeletal open bite based on sagittal components of the face.AIMS: This study examined the morphology of skeletal open bite with respect to the sagittal components of the face. methods: The material consisted of cephalometric and hand-wrist films of 49 girls and 22 boys with skeletal open bite. The samples were grouped into Class I, II, and III facial types on the basis of ANB angle. In addition to conventional dentofacial variables, nasopharyngeal airway area was also measured on lateral headfilms. All measurements were examined by analysis of variance and Duncan test. Subsequently the factors leading to open bite were evaluated using multiple-regression analysis. RESULTS: Dentofacial morphology differed in the sagittal components of skeletal open bite, and the differences were most obvious between the Class II and Class III open bite groups. Posterior maxillary dentoalveolar height and mandibular incisor inclination were important factors in the development of open bite in the skeletal Class I and Class II open bite groups, while in the skeletal Class III open bite group, the nasopharyngeal airway and the gonial angle were involved. CONCLUSION: Sagittal components of skeletal open bite should be considered in the differential diagnosis and treatment planning of such cases.- - - - - - - - - - ranking = 1keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
7/15. rehabilitation of a hemophiliac with implants: a medical perspective and case report.A patient suffering from classical hemophilia had previous surgery for ankylosis of the right temporomandibular joint. This was replaced by a costochondral graft and an overlay of temporalis muscle. A bilateral sagittal split was performed for a micrognathic mandible and a sleep apnea problem. That procedure solved the sleep apnea; however, it resulted in a prognathic mandible and an anterior open bite. The lower anterior teeth were periodontally involved with impaired alveolar support. The restricted opening of the oral cavity of 18 mm between maxillary and mandibular centrals and the potential danger of bleeding complicated the surgical and restorative procedures. The patient was prepared medically on each of 4 occasions with factor viii replacement concentrate, and oral antifibrinolytic therapy (tranexamic acid). The treatment of choice was the extraction of the remaining lower incisors and their replacement with an implant-supported temporarily cemented retrievable fixed prosthesis. Serial extractions and chairside temporization provided the surgeon with precise guides for implant placement, and enabled the patient to enjoy unimpaired function through periods of healing and osseointegration.- - - - - - - - - - ranking = 0.00069766159701615keywords = alveolar (Clic here for more details about this article) |
8/15. An adult case of skeletal open bite with a large lower anterior facial height.Control of the height of posterior dentoalveolar regions is of great importance for the correction of skeletal open bite. Traditionally, second premolar extraction facilitates the closure of open bite by inducing a counterclockwise mandibular rotation without molar intrusion. This article reports treatment for a 24-year six-month-old female patient with an open bite and large anterior facial height. She complained of occlusal disturbances and difficulty of lip closure because of the open bite. Overjet and overbite were 3.0 mm and -3.0 mm, respectively. To correct open bite and crowding, the bilateral extraction of the maxillary and mandibular second premolars plus multibracket appliances for mesial movement of the molars was selected as the treatment plan. After a two-year treatment, an acceptable occlusion was achieved, the lower anterior facial height was decreased, and the lips showed less tension in a lip closure. An acceptable occlusion was maintained without recurrence of the open bite during a three-year retention period, indicating a long-term stability of the occlusion. The results of this treatment indicated that the correction of open bite with no or less molar intrusion or incisor extrusion is of great importance for achieving stable occlusion and avoiding the relapse of open bite.- - - - - - - - - - ranking = 1keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
9/15. Modified Thurow appliance: a clinical alternative for correcting skeletal open bite.open bite malocclusion is frequently discussed in orthodontics; diagnosis, treatment, and retention can be difficult because this malocclusion has numerous correlated etiological factors. The earlier this malocclusion is corrected, the better the prognosis will be, especially when the problem is skeletal. This article presents a patient with skeletal open bite who was treated in the mixed dentition with an orthodontic appliance that included an acrylic occlusal splint and an expansion screw, based on the original Thurow appliance, to guide the vertical force against the posterior teeth and the alveolar process.- - - - - - - - - - ranking = 0.00069766159701615keywords = alveolar (Clic here for more details about this article) |
10/15. Nonsurgical and nonextraction treatment of a skeletal class III adult patient with severe prognathic mandible.AIM: A patient with a skeletal Class III malocclusion, prognathic mandible, anterior open bite, large tongue, and temporomandibular disorders is presented. Treatment objectives included establishing a stable occlusion with normal respiration, eliminating temporomandibular disorder symptoms, and improving facial esthetics through nonextraction and nonsurgical treatment by creating a favorable perioral environment, restoring the harmony to the tongue and perioral environment, improving masticatory muscle function, and creating adequate tongue space for establishment of normal respiration. SUBJECT AND methods: The patient was a Japanese adult male, who had previously been advised to have orthognathic surgery, with tongue-size reduction. An expansion plate was used to expand the maxillary dentoalveolar arch. Distalization of the mandibular arch was achieved by reduced excessive posterior vertical dimension, through uprighting and intruding the mandibular posterior teeth and rotating the mandible slightly counter-clockwise. The height of the maxillary alveolar process and the vertical height of symphysis were increased slightly. The functional occlusal plane was reconstructed by uprighting and intruding the posterior teeth with a full-bracket appliance, combined with a maxillary expansion plate, with short Class III and vertical elastics in the anterior area. myofunctional therapy involved sugarless chewing gum exercises. RESULTS: The excessive posterior vertical occlusal dimension was reduced slightly, creating a small clearance between the posterior maxilla and mandible. At the same time, the interferences in the posterior area were eliminated by the expansion of the maxillary dentoalveolar arch. As a result, the laterally displaced mandible moved to a more favorable jaw relationship, with distalization of the mandibular arch. The functional occlusal plane was reconstructed and an almost-normal overjet and overbite were created. Adequate tongue space for normal respiration was established during the early stage of treatment, by 7 months. A stable occlusion, with adequate posterior support and anterior guidance, was established and maintained at more than 4 years posttreatment.- - - - - - - - - - ranking = 2.000697661597keywords = dentoalveolar, alveolar (Clic here for more details about this article) |
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