1/2. 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.- - - - - - - - - - ranking = 1keywords = overbite (Clic here for more details about this article) |
2/2. 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 = 1keywords = overbite (Clic here for more details about this article) |