Cases reported "Malocclusion"

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1/223. Treatment of a Brodie bite by lower lateral expansion: a case report and fourth year follow-up.

    The patient was a 4 year 4 month old boy at the first visit. The chief complaint was chewing dysfunction. The intra-oral and facial films, study casts, cephalometrics, muscle-balance monitor, temporomandibular joint radiographs were analyzed. The patient presented with a Brodie bite or unilateral posterior cross bite. The upper dental arch was wider than other children of his age. The lower dental arch was significantly smaller than the upper dental arch. The lower dental arch was expanded using a Schwarz appliance. The period of treatment was one year and two months. The period of observation was four years and ten months. First the patient underwent chewing training and secondarily then was treated by lateral expansion. After this treatment the patient achieved good occlusion and muscle function, while the morphology and function of the temporomandibular joints were improved, as well.
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keywords = dental
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2/223. Aspects of the use of endosseous palatal implants in orthodontic therapy.

    Control of anchorage is one of the fundamental aspects in orthodontics and dentofacial orthopedics. Osseointegrated implants provide such an anchorage in a reliable fashion, as has been demonstrated in orthodontic use of dental implants inserted for prosthetic reasons. More recently, special implants have been introduced that serve as temporary anchorage in orthodontics. One example is the Straumann Orthosystem (Institut Straumann AG, Waldenburg, switzerland), which is inserted in the midsagittal area of the palate. Owing to the reduced bone height available in the palate, only short implants should be considered; surface enlargement by texturing and the achievement of good primary stability are prerequisite for success. The use of a palatal implant provides a continuous stable anchorage for patients with compromised periodontal anchorage potential, as well as in cases in which compliance is not dependable or cases with esthetic considerations in which the use of extraoral anchorage aids or Class II elastics may be problematic. Minimal stress on the patient, combined with maximal anchorage, distinguishes this promising new treatment modality for the orthodontist cooperating with an oral surgeon. The treatment concept is well aligned with the emphasized need for integral treatment in dentistry, especially of the adult patient.
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ranking = 0.25
keywords = dental
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3/223. Accuracy of integration of dental casts in three-dimensional models.

    PURPOSE: This study investigated errors occurring in three-dimensional (3D) models when plaster dental casts are integrated into them. MATERIALS AND methods: Three-dimensional milling models of three patients with a jaw deformity were fabricated using the Endoplan system (SPARC International Inc, Santa Clara, CA). After this, plaster dental casts were integrated into the 3D models using a face-bow transfer system. Two cephalograms were then compared, one obtained from the patient and the other obtained from the 3D model painted with contrast medium. RESULTS: In two cases, the reproducibility of the dental position as determined by angle analysis was within 2 degrees, and that determined by distance analysis was within 2 mm. However, errors over 4 degrees and 4.2 mm, respectively, were observed in one case. CONCLUSION: It is clinically important to confirm the accuracy of the 3D model by cephalometric analysis, and it may be necessary to reposition the dental model based on the results.
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ranking = 2
keywords = dental
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4/223. Treatment planning and biomechanics of distraction osteogenesis from an orthodontic perspective.

    As in traditional combined surgical and orthodontic procedures, the orthodontist has a role in the planning and orthodontic support of patients undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function in addition to planning both the predistraction and postdistraction orthodontic care. Based on careful clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and evaluation of three-dimensional computed tomographic scans, the orthodontist, in collaboration with the surgeon, plans distraction device placement and the predicted vectors of distraction. Both surgeon and orthodontist closely monitor the patient during the active distraction phase, using intermaxillary elastic traction, sometimes combined with guide planes, bite plates, and stabilization arches, to mold the newly formed bone (regenerate) while optimizing the developing occlusion. Postdistraction change caused by relapse is minimal. growth after mandibular distraction is variable and appears to be dependent on the genetic program of the native bone and the surrounding soft tissue matrix. A significant advantage of distraction osteogenesis is the gradual lengthening of the soft tissues and surrounding functional spaces. Distraction osteogenesis can be applied at an earlier age than traditional orthognathic surgery because the technique is relatively simple and bone grafts are not required for augmentation of the hypoplastic craniofacial skeleton. In this new technique, the surgeon and the orthodontist have become collaborators in a process that gradually alters the magnitude and direction of craniofacial growth.
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keywords = dental
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5/223. Cephalometric soft tissue facial analysis.

    My objective is to present a cephalometric-based facial analysis to correlate with an article that was published previously in the American Journal of Orthodontic and Dentofacial orthopedics. Eighteen facial or soft tissue traits are discussed in this article. All of them are significant in successful orthodontic outcome, and none of them depend on skeletal landmarks for measurement. Orthodontic analysis most commonly relies on skeletal and dental measurement, placing far less emphasis on facial feature measurement, particularly their relationship to each other. Yet, a thorough examination of the face is critical for understanding the changes in facial appearance that result from orthodontic treatment. A cephalometric approach to facial examination can also benefit the diagnosis and treatment plan. Individual facial traits and their balance with one another should be identified before treatment. Relying solely on skeletal analysis, assuming that the face will balance if the skeletal/dental cephalometric values are normalized, may not yield the desired outcome. Good occlusion does not necessarily mean good facial balance. Orthodontic norms for facial traits can permit their measurement. Further, with a knowledge of standard facial traits and the patient's soft tissue features, an individualized norm can be established for each patient to optimize facial attractiveness. Four questions should be asked regarding each facial trait before treatment: (1) What is the quality and quantity of the trait? (2) How will future growth affect the trait? (3) How will orthodontic tooth movement affect the existing trait (positively or negatively)? (4) How will surgical bone movement to correct the bite affect the trait (positively or negatively)?
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ranking = 0.5
keywords = dental
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6/223. The surgical uncovering and orthodontic positioning of unerupted maxillary canines.

    1. The presence of the maxillary canine is vital to the function and esthetics of the dental complex. The availability of this tooth must be carefully considered during an orthodontic diagnosis. Lack of space is the most common cause of canine impaction. Other contributing factors are that this tooth has the longest period of developmenent and that it is bigger longer, and travels farther while erupting than any other tooth. 2. Proper management of unerupted canines is a challenge to the dental practitioner. Maxillary canines are found impacted to both the buccal and the lingual. Palatal impactions are much more common than labial impactions, but, of the two, labial impactions are more difficult to manage. 3. An appropriate surgical procedure which opens to the crowns of unerupted teeth is a key to uneventful orthodontic positioning of these teeth. Packing the follicular space with baseplate gutta-percha and keeping the crown open to the oral cavity with surgical WondrPak is an effective method of making the tooth erupt into the oral cavity. 4. Modern preformed bands and improved cements make the placement of attachment on malposed teeth relatively easy. Direct bonding techniques are also of value in the management of unerupted teeth. 5. It is practical to move teeth orthodontically from seemingly impossible positions into ideal alignment. Such teeth will function normally, and no evidence will be left of their original position or of their having been moved over long distances.
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ranking = 0.5
keywords = dental
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7/223. Interdental osteotomy for immediate repositioning of dental-osseous elements.

    The treatment of crowded, poorly aligned, and spaced teeth is most commonly accomplished by orthodontic means. Interdental osteotomy offers a method for the immediate repositioning of dental-osseous elements that may serve as an aid to orthodontic treatment or be used as an independent procedure. The history of the procedure, its indications, planning considerations, surgical methods, and case results are presented.
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ranking = 2.5
keywords = dental
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8/223. Model surgery prediction for mandibular midline distraction osteogenesis.

    Mandibular midline distraction osteogenesis is available as a treatment option for the correction of mandibular transverse arch deficiency. A model surgery technique is presented here through a case report that will allow the surgeon to predict the amount of transverse expansion that can be gained by this procedure. Utilizing measurements from a three-dimensional stereolithography model, the mandibular cast is mounted on a semi-adjustable articulator. The maxillary model is mounted onto the articulator using an interocclusal record. Acrylic straps are fabricated that relate the condylar elements of the articulator to the right and left mandibular dental segments. The mandibular model is sectioned at the midline, the hemi-mandibular segments are rotated laterally until the desired midline expansion is achieved and the mandibular model is luted into its new position. The post-expansion relationship of the maxillary and mandibular arches can be visualized on the articulator and provide useful information to the surgeon and orthodontist.
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ranking = 0.25
keywords = dental
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9/223. Clinical treatment with the Begg appliance.

    In a series of three articles, clinical treatment with the Begg appliance has been discussed. In the March, 1973 article, the standard procedures in the three stages commonly used in the Begg method were illustrated in a series of eight cases showing the wide range of orthodontic treatment possibilities of this method. The February, 1974 article contained a case report that illustrated some of the problems connected with orthodontic observation, diagnosis, Begg treatment, and retention. In this third article, due attention has been given to common problems of the chairside worker as encountered in daily practice. Certain comments have been offered, particularly with regard to child dental care and orthodontic guidance procedures of the growing child. A treatment approach, based on an individual optimum for each patient is discussed, following the course of treatment of three cases (Figs. 1, 2, and 4) with unfavorable jaw patterns and dental problems. These are compared with others having better anatomic proportions (Figs. 3 and 5). In the last case (Fig. 5) diagnosis and treatment planning are once again reviewed. The essential decision to be made for each orthodontic treatment, namely, whether and which teeth must be removed, is discussed and illustrated. In all cases, attention has been given to the portrayal of methods and technical details through the three stages of Begg treatment.
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ranking = 0.5
keywords = dental
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10/223. Second premolar serial extraction.

    serial extraction of mandibular second premolars should be considered if they are impacted or in cases with moderate arch length deficiency combined with an absence of dentofacial protrusion. The favorable dental changes associated with this approach greatly minimize future orthodontic treatment complexity and time.
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ranking = 0.25
keywords = dental
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