Cases reported "Prognathism"

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1/20. An unusual treatment with sagittal split osteotomy: report of a case involving an odontoma.

    Sagittal split osteotomy is one of the most commonly performed surgical techniques in the world and has been modified by many authors. The efficacy of this operation has been studied by many groups. When performing this surgery, there should be adequate contact of wide, cancellous bone surfaces, which guarantees excellent and rapid bony union in the desired position. In the present article, treatment of mandibular prognathism with open bite by sagittal split osteotomy with an odontoma in the third molar area is presented.
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ranking = 1
keywords = open bite, bite, open
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2/20. Efficacy of high condylectomy for management of condylar hyperplasia.

    The purpose of this study was to compare the treatment outcome and long-term stability of 2 groups of young adult patients diagnosed with active condylar hyperplasia and treated with 2 different surgical methods. Thirty-seven patients (19 females and 18 males) met the criteria for inclusion in the study. Group 1 (n = 12; average age at surgery, 17.5 years) was treated with orthognathic surgery only, while group 2 (n = 25; average age at surgery, 16.7 years) had high condylectomy, articular disc repositioning, and orthognathic surgery. All patients underwent standardized clinical and radiographic examination at initial consultation, immediately before surgery, immediately after surgery, and at longest follow-up. Objective evaluation of temporomandibular joint (TMJ) function included maximum incisal opening and lateral excursions. Subjective evaluations were performed in group 2 for TMJ pain, jaw function, and diet. Lateral cephalometric radiographs were evaluated for presurgical and postsurgical mandibular growth. There were no statistically significant differences (P >.05) between the 2 groups for maximal incisal opening, lateral excursions, or subjective jaw function before surgery. Presurgical growth differed significantly (P <.05), with group 2 showing more active growth. At the long-term follow-up, no differences were found in lateral excursions or subjective jaw function. There was a statistically significant difference in maximum incisal opening (P <.01), with a greater increase in group 2, as well as a statistically significant difference (P <.05) in cephalometric stability, with group 2 being much more stable at long-term follow-up. All patients in group 1 grew back into skeletal and occlusal Class III relationships and required secondary intervention. Only 1 patient in group 2 required secondary surgery, involving maxillary surgery to correct postsurgical transverse maxillary relapse; the mandible was stable at long-term follow-up. The results of this study showed that patients with active condylar hyperplasia treated with high condylectomy, articular disc repositioning, and orthognathic surgery have stable, predictable outcomes compared with those treated with orthognathic surgery alone.
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ranking = 0.001199398019694
keywords = open
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3/20. Maxillary expansion and protraction in correction of midface retrusion in a complete unilateral cleft lip and palate patient.

    A 7-year-old girl with a cleft lip and palate had a midface retrusion due to growth inhibition of the maxillary complex. She presented for correction of a severe total crossbite with a Class III skeletal pattern. Initially, maxillary expansion was provided to widen the maxilla and then maxillary protraction headgear was worn to improve the sagittal skeletal relation. Fixed orthodontic appliances were placed to align the dentition and Class III elastics were used to establish intercuspation and stability. The maxillary expansion and protraction usually provide effective improvement in skeletal Class III patients with repaired cleft lip and palate patients. The success of the orthopedic procedure essentially depends on the individual growth of the maxilla and the mandible. This case report shows the significant growth of the mandible after maxillary expansion and protraction in late adolescence.
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ranking = 0.0052662030089903
keywords = bite
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4/20. Treatment of severe mandibular prognathism in combination with maxillary hypoplasia: case report.

    We performed a Le Fort I osteotomy and sagittal split ramus osteotomy (Obwegeser-Dal Pont) combined with mandibular anterior segmental osteotomy without tooth extraction for a patient with severe mandibular prognathism accompanied by a hypoplastic maxilla, anterior open bite and normal anterior mandibular vertical dimension. The results of facial appearance and occlusion were excellent. This combined surgical method appears to be satisfactory for treating severe mandibular prognathism with hypoplastic maxilla.
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ranking = 1
keywords = open bite, bite, open
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5/20. Clinical treatment of oral manifestations of Beckwith-Wiedeman syndrome in a child.

    Orthodontic treatment in a young patient with Beckwith-Wiedeman syndrome (BWS) is reported and a multidisciplinary approach to the management of this syndrome is reviewed. The patient presented with a tendency to Class III malocclusion, an open-bite and a slight macroglossia, which was treated at an early age by glossotomy. It was decided to monitor growth without treatment and to wait for the best time to begin therapy. It was based only on functional rehabilitation, without any fixed appliances, in which optimum intercuspation of the teeth and the skeletal Class I relationship was achieved and maintained after the retention period of three years. In conclusion the treatment of BWS patients requires a multidisciplinary approach that includes orthodontics, orthopaedics and surgical intervention. It is also necessary to underline the significance of diagnosis at an early age and timely treatment to reduce the development of dento-skeletal alterations.
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ranking = 0.0056660023488883
keywords = bite, open
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6/20. An unexpected growth pattern: considerations in management.

    A case study spanning 16 years is presented. Routine treatment with serial extraction and an edgewise appliance for a Class I crowded occlusion began when the patient was 8 years old. By the time the patient was 17, his dentition had evolved, because of unanticipated growth, into a Class III malocclusion with complete-arch crossbite. The question of whether it is most appropriate to treat this patient in one or two surgical procedures is discussed, and some controversial aspects and concerns are presented.
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ranking = 0.0052662030089903
keywords = bite
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7/20. Lip sucking and lip biting in the primary dentition: two cases treated with a morphological approach combined with lip exercises and habituation.

    Lip sucking and lip biting in the primary-dentition period can cause the upper incisors to tip labially and the lower incisors to collapse lingually with the lower lip wedged between the upper and lower anterior teeth. The resulting lip incompetence further aggravates maxillary protrusion. Thus, there is a causal relationship between lip sucking/lip biting and maxillary protrusion. Orofacial myologists provide lip training to activate the flaccid upper lip and raise the child's awareness to help stop the sucking or biting of the lower lip, sometimes using an oral screen. Two primary-dentition cases with lip sucking and lip biting were treated with a functional appliance (F.A.), resulting in the elimination of the habits in 5 to 6 months along with the improvement of the overjet, overbite and facial profile. The authors prioritize myofunctional therapy (MFT) when treating open bite cases with tongue thrust in the primary dentition. However, the treatment of maxillary protrusion due to lip sucking and lip biting is approached differently with priority given to morphological improvement to create an oral environment that makes lip sucking and lip biting difficult, which is complimented with lip exercises and habituation. This combined approach was found to be effective in breaking the lip-sucking and lip-biting habits.
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ranking = 1.005266203009
keywords = open bite, bite, open
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8/20. Post-operative optimization of gum-chewing kinematics in a prognathic patient.

    Smooth jaw movements during gum chewing, which are defined as those driven by optimally smooth patterns of temporal change in acceleration/deceleration, have been quantified in subjects with acceptable occlusions. This paper reports a case in which significant improvement of the smoothness of masticatory jaw movement was observed following surgical-orthodontic treatment. A patient, who demonstrated a mandibular prognathism, underwent the treatment. The irregularity in acceleration/deceleration of jaw closing movement during gum chewing was quantified by the movement jerk-cost, where the jerk is rate of change in movement acceleration/deceleration. The normalized jerk-costs and results of maximum-smoothness model simulation were compared between jaw movements at pre- and post-treatment stages. The correction of mandibular prognathism and crossbite allowed the patient to close the jaw with wider lateral excursion. Furthermore, smoothness of the jaw closing movements increased significantly and the velocity profile was characterized as similar to that predicted by the kinematic model after treatment. These findings for achievement of 'functional occlusion' that allows the patient to perform smooth and economical jaw closing movements during chewing demonstrate necessity of orthodontic treatment of mandibular prognathism to improve jaw motor function.
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ranking = 0.0052662030089903
keywords = bite
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9/20. Surgical orthodontic treatment of a severe open bite malocclusion with cleft palate and neuropathy.

    AIM: This case demonstrates an orthodontic and surgical approach to a severe open bite malocclusion with cleft palate and neuropathy. methods: Pre- and postsurgical orthodontic treatment involved a multi-bracket appliance, Le Fort I osteotomy, and sagittal split mandibular ramus osteotomy. The diagnostic background and the treatment procedures are sequentially presented. CONCLUSION: The combined orthognathic surgery and orthodontic treatment resulted in a significant correction of the occlusion.
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ranking = 5
keywords = open bite, bite, open
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10/20. 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.
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ranking = 1.0003997993399
keywords = open bite, bite, open
(Clic here for more details about this article)
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