Cases reported "Mouth Breathing"

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1/13. Bimaxillary orthognathic surgery in a patient with long face: a case report.

    The primary characteristics of long face patients are gummy smile and/or anterior open bite. Consequently, correction of esthetic and functional problems are especially important for long face patients. Since orthodontic therapy alone is not sufficient to solve the problem, orthognathic surgical approach is indicated for these patients. In this report, orthognathic surgical therapy of a severe long face patient with similar findings was presented. Following clinical and cephalometric examination and preoperative orthodontic therapy, a Le Fort I osteotomy, a bilateral sagittal split osteotomy, and vertical and horizontal reduction genioplasties were performed. Alternative surgical therapies, complications, and the effects on the upper respiratory tract are also discussed.
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ranking = 1
keywords = bite
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2/13. Dental malocclusion and upper airway obstruction, an otolaryngologist's perspective.

    INTRODUCTION: This paper, through the presentation of eight case reports and a limited literature review, attempts to illustrate the negative effect that upper airway obstruction can have on developing dental occlusion and the positive effect that upper airway relief can have on the 'normalization' of various malocclusion patterns believed to be related to chronic obligate mouth breathing. OBJECTIVE: To study the effect of airway relief (usually through tonsillectomy and/or adenoidectomy) on various patterns of dental malocclusion. methods: Children coming to the office of the lead author (D.J.W.) found to be obligate mouth breathers and who also had dental malocclusion had Polaroid 'bite' pictures taken at the time of their initial visit. One year or more after their surgery for upper airway relief (tonsillectomy and adenoidectomy in these cases) a second 'bite' photograph was taken and compared to the first. RESULTS: In all cases selected in this study there was observed improvement in their dental occlusion within a year following surgery to improve their breathing. CONCLUSION: It is the opinion of the authors of this paper that upper airway obstruction may have a negative effect on the developing transitional dental occlusion and that eliminating the cause of upper airway obstruction can lead to 'normalization' of occlusion in such children. Further orthodontic corrective modalities may be required for optimal occlusal results.
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ranking = 2
keywords = bite
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3/13. Long-term outcome of skeletal Class II Division 1 malocclusion treated with rapid palatal expansion and Kloehn cervical headgear.

    The treatment of a patient with a skeletal Class II Division 1 malocclusion, with excessive overjet, complete overbite, airway obstruction, and severe arch length deficiency in the mandibular dental arch, is presented. The maxilla was narrow compared with the mandible, and the posterior teeth were compensated, with the maxillary teeth inclined buccally and the mandibular teeth inclined lingually. The palatal vault was extremely high. Treatment included rapid palatal expansion to correct the transverse maxillary deficiency and Kloehn cervical headgear to correct the anteroposterior skeletal discrepancy. Long-term stability (12-year follow-up) is reported.
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ranking = 1
keywords = bite
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4/13. Craniofacial morphology in an unusual case with nasal aplasia studied by roentgencephalometry and three-dimensional CT scanning.

    OBJECTIVE: To examine the three-dimensional morphology of internal structures of the craniofacial region and present the orthodontic problems in an unusual case with nasal aplasia. PATIENT: The patient was an 11.5-year-old boy with aplasia of the nose and nasal cavity with extremely constricted nasopharyngeal airway. He did not have mental or somatic retardation. The patient had dacryostenosis. The morphology of the craniofacial structures was characterized by absence of septal structures, including cribriform plate, perpendicular plate of ethmoid bone, vomer, and septal cartilage; bony hypotelorism; midface hypoplasia; short and retrognathic maxilla with Class III jaw relationship; average mandibular plane angle; high arched palate; severe anterior open bite with bilateral posterior crossbites; and dental anomalies (agenesis of four maxillary permanent teeth, microdontia, taurodontism, and short roots). Thus, the patient had characteristic dentofacial phenotype, which might be caused by a combination of the primary anomaly and the functional disturbances secondary to the nasal obstruction.
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ranking = 2
keywords = bite
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5/13. Class II correction in a severe hyperdivergent growth pattern, bilateral open bite and oral compromise.

    Severe vertical growth pattern and open bites are frequent problems the orthodontist must resolve but require a proper diagnosis, treatment plan, timing, and mechanotherapy to be properly treated. A case report with these problems is presented.
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ranking = 5
keywords = bite
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6/13. Redirecting the growth pattern with rapid maxillary expander and chin cup treatment: changing breathing pattern from oral to nasal.

    AIM: This study was undertaken to assess the possibility of redirecting the growth pattern by using rapid maxillary expansion and a light-force chin cup for a short period of time, with limited patient cooperation, during the pre-growth and growth-spurt stages. methods: The study included a series of 60 patients, 24 males and 36 females from 7 to 14 years of age, with crossbite or midfacial deficiencies. Treatment involved wearing a chin cup 24 hours a day to force mouth closure during rapid maxillary expansion activation, which was 2 turns per day to rapidly expand the midpalatal suture and enhance nasal breathing. Lateral cephalograms and intraoral and facial photographs were taken 2 years before treatment, at the time of rapid maxillary expansion, 3 weeks following rapid maxillary expansion activation, 3 months after the cessation of rapid maxillary expansion activation, and 1 to 3 years post-rapid maxillary expansion activation. RESULTS: Despite the severity, the crossbite would always improve within 21 days following rapid maxillary expansion activation. The cephalograms and photographs demonstrated forward movement of the nasal bridge and maxilla, with backward rotation of the mandible. The bite depth remained nearly the same as pretreatment. CONCLUSION: The results suggested that 24 hours of light-force chin cup wear, while expanding the midpalatal suture, is the major factor to force mouth closure and enhance nasal breathing. As a result, there is advancement of the maxilla, avoidance of tongue encroachment upon the mandible, and deceleration of horizontal mandibular growth.
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ranking = 3
keywords = bite
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7/13. Dynamic MRI evaluation of tongue posture and deglutitive movements in a surgically corrected open bite.

    tongue thrust usually develops in the presence of anterior open bite in order to achieve anterior valve function. In the literature, tongue thrust is described both as the result and the cause of open bite. If it is an adaptation to malocclusion, then tongue posture and deglutitive tongue movements should change after treatment. In this case report, an adult who had skeletal open bite and Class II malocclusion caused by mandibular retrusion was treated surgically. The mandible was advanced in a forward and upward direction with a sagittal split osteotomy. The open bite and Class II malocclusion were corrected and an increase in the posterior airway space (PAS) was observed. Pretreatment and posttreatment dynamic magnetic resonance imaging (MRI) revealed that tongue tip was retruded behind the incisors and contact of the tongue with the palate increased. It was also determined that the anterior and middle portions descended, whereas the posterior portion was elevated at all stages. Advancement of the mandible, correction of open bite, and an increase in PAS affected not only the tongue posture and deglutitive movements, but also the breathing pattern of the patient.
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ranking = 9
keywords = bite
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8/13. Class I malocclusion with severe open bite skeletal pattern treatment.

    A case report of a Class I malocclusion with a severe skeletal open bite, excessive overjet, a high mandibular plane angle, and a forward maxillary rotation is presented. Treatment has eliminated the causative factors (i.e., mouth breathing, enamel hypoplasia of the first molars, and abnormal tongue posture and function). A normal growth pattern has been restored, ensuring a good and stable orthodontic result.
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ranking = 5
keywords = bite
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9/13. A case of open bite with Turner's syndrome.

    The treatment of a skeletal Class III open bite malocclusion with Turner's syndrome is described. Although the patient had a negative overbite of 9 mm, a positive overbite of 2 mm was obtained through treatment, without any tooth extractions; however, an excessive vertical growth of the anterior regions was noted.
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ranking = 7
keywords = bite
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10/13. A dental Class III malocclusion treated to a full-cusp Class II molar relationship.

    A case report of a Class III dental malocclusion superimposed on a straight skeletal pattern is presented. The patient was a 14-year-old girl with limited growth potential. This case included congenitally missing maxillary permanent lateral incisors, impacted maxillary permanent canines, and bilateral posterior open bites. The patient's soft-tissue profile was normally convex. In addition to her malocclusion, the patient had a history of difficulty breathing through the nose. The general treatment included palatal expansion, protraction headgear, and comprehensive edgewise orthodontic therapy.
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ranking = 1
keywords = bite
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