Cases reported "Malocclusion"

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1/14. The complex case--unforeseeable findings and interdisciplinary treatment.

    Orthodontic treatment is described in a case requiring an early treatment start due to disturbed eruption in the upper front, with displacement of an upper central incisor, tongue dysfunction and Class III tendency. The further course revealed additional problems which had been unforeseeable at treatment onset: ankylosis of the lower left first molar and dehiscences in the lower front. Treatment duration was very long due to treatment measures overlapping. The interdisciplinary treatment measures are outlined and the difficulties posed by contractual guidelines are pointed out.
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2/14. Aesthetic improvements in mid-lower face skeletal surgery.

    Current surgical techniques allow to correct congenital and acquired facial deformities as well as aesthetic deficiencies resulting from inadequate bone support with excellent functional and aesthetic results. Hard and overlying soft tissue being in a closer anatomic relationship, remarkable aesthetic improvements can be achieved through the three-dimensional shifting of skeletal sections. Hence, facial aesthetic plays such an increasingly critical role in the repair surgery of basal deformities and in the surgical correction of poor aesthetics associated with growth abnormalities as to possibly trespass plastic surgeons' scope of activity. After setting forth our diagnostic and therapeutic guidelines through some relevant clinical cases, the increasingly closer relation between aesthetics enhancement and purely functional surgery of facial muscular and bone structures will be emphasized. Finally, some of the possible treatments currently available will be outlined.
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3/14. Orthodontic finalization following therapy with an anterior repositioning splint.

    After phase I splint therapy for the management of posterior condylar displacement, it is not unusual to find that a posterior open bite has been created. Finalization of a new occlusal position may be effected via occlusal equilibration, prosthodontics, orthodontics, orthognathic surgery, or a combination of these procedures. Stabilizing the occlusion with orthodontics in the new orthopedic jaw position requires a systemic approach. This article outlines a strategy for orthodontic finalization in phase II therapy. The splint-guided position is maintained while intra-arch and interarch malocclusions are corrected. The objective in treatment of posterior condylar displacement via splint therapy and orthodontics lies in the provision of a sound condylar position and the movement of the teeth and mandible into a stable and esthetic position.
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4/14. Complications in the use of compression plates in the treatment of mandibular fractures.

    The use of internal rigid fixation with plates in the treatment of facial fractures continues to increase in popularity. The principal advantage is in avoiding the use of maxillary mandibular fixation (intermaxillary fixation), thus enabling early return of function. However, there are clear guidelines for their use and technique of placement. A case is reported that demonstrates several avoidable complications in the use of compression plates and outlines the principles for the correct use of bone plates in mandibular fractures.
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5/14. Mandibular displacement and dentitional changes during orthodontic treatment and growth.

    Mandibular displacement during orthodontic treatment and/or growth is usually analyzed through cephalometric superposition on the cranial base. Evaluation of mandibular movement in relation to the maxillary base has considerable value because the occlusion of the teeth is associated directly with the position of the maxillary and mandibular basal bones. The method of superimposition is outlined and applied to a number of treated malocclusions. Incorporation of this method in the study of treatment results is suggested.
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6/14. Differential diagnosis and treatment planning for the adult nonsurgical orthodontic patient.

    Increasing numbers of adult patients are seeking orthodontic care and some, despite significant skeletal malocclusions, elect not to have combined orthodontic-surgical treatment. The purpose of this article is to outline some of the diagnostic and therapeutic principles that can be used in the adult nonsurgical orthodontic patient. The importance of realistic goal setting in the face of compromised occlusions is emphasized. diagnosis should include evaluation of all three dimensions and recognize the limitations of therapy in each dimension for the nongrowing patient. Periodontal considerations, extraction decisions, and retention regimens are of vital importance to the achievement and maintenance of an optimum result. Clinical records will demonstrate four commonly seen problems and their resolution.
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7/14. A case of thalassaemia major with gross dental and jaw deformities.

    A patient is presented who developed a gross maxillary deformity resulting from thalassaemia major. An outline of the general condition is presented and the operative measures used to correct this particular case are described. It is interesting to note that although this was done in rather primitive conditions, the patient achieved a satisfactory aesthetic and functional result.
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8/14. The Herbst appliance--its biologic effects and clinical use.

    The purpose of this article is to survey the Herbst bite-jumping method. An outline of appliance design and appliance construction is given. The effects of the treatment method on the dentofacial complex and on the masticatory system have been analyzed with the aid of dental casts, cephalometric roentgenograms, and electromyographic registrations from the masticatory muscles. The use and effectiveness of the Herbst appliance in the treatment of Class II malocclusions are exemplified by clinical cases, some of which were followed for 5 years after treatment. The Herbst appliance is most effective in the treatment of Class II malocclusions, provided it is used as indicated. Thus, the appliance must be limited to growing persons only. The treatment method should not be looked upon as a last resort to be used only when other treatment approaches have failed. Treatment prognosis is best in subjects with a brachyfacial growth pattern. Unfavorable growth, unstable occlusal conditions, and persisting oral habits after treatment are potential risk factors for occlusal relapses. As treatment with the Herbst appliance is performed during a relatively short period, the hard and soft tissues (teeth, bone, and musculature) would need some time for adaptation to the new mandibular position after the appliance is removed. Posttreatment retention as a routine with a removable functional appliance is therefore recommended.
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9/14. Orthodontic tooth movement response in ehlers-danlos syndrome: report of case.

    The clinical manifestations of ehlers-danlos syndrome have been discussed. These include oral symptoms and problems with the integument, joints, and vasculature. An outline of the variations in the types of ehlers-danlos syndrome was given. The expected tissue response to tooth movement was discussed. Finally, a report of the orthodontic treatment of a patient with ehlers-danlos syndrome with its special clinical considerations was provided.
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10/14. thumb sucking habit and associated dental differences in one of monozygous twins.

    A case report is presented of a set of monozygotic twins aged 14 years, one of whom sucked her thumb and one who did not indulge in the habit. The thumb sucker had a wider lower arch and a narrower upper arch than the non-thumb sucker. The thumb sucker also appeared to have a more forward position of her premaxilla on cephalometric analysis together with an increased overjet. Superimposed outlines of the tongue showed that the thumb sucker was adopting a lower position of the dorsum of the tongue at the time of initial examination.
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