Cases reported "Open Bite"

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1/28. Occlusal side effects caused by a mandibular advancement appliance in patients with obstructive sleep apnea.

    mandibular advancement appliances (MAA) have been established as an alternative treatment option for obstructive sleep apnea (OSA). Although the therapeutic effect of these devices has been proven both clinically and polysomnographically through various studies, there are very few follow-up examinations in existence concerning possible dental side effects caused by the MAA. However, if lifelong treatment of OSA is considered, these follow-up examinations are of utmost importance. This article presents 2 cases with unexpected dental side effects and occlusal alterations caused by MAA therapy.
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ranking = 1
keywords = dental
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2/28. Schinzel-Giedion syndrome: interesting facial and orodental features, and dental management.

    Schinzel-Giedion syndrome comprises multiple congenital anomalies. The orofacial features include coarse facies, frontal bossing, ocular hypertelorism, anterior open bite and macrodontia. Two cases are presented in which the presence of specific craniofacial anomalies with bilateral hydronephrosis confirmed the diagnosis. In one patient, bottle-feeding was associated with caries in maxillary central and lateral incisors, but the second patient was permanently tube fed and did not experience any dental caries. Clinical management of these patients requires a coordinated approach from a team of medical and dental specialists.
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ranking = 5
keywords = dental
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3/28. Seckel syndrome: report of a case.

    An interesting case of a seven years old boy with a combination of clinical, genetic, radiological, pathologic and dental findings is presented in view of Seckel syndrome literature. General appearance of the patient was characterized by small forehead, posteriorly slanted ears, slightly beaked nose, midfacial hypoplasia very stunted stature with microcephaly. He had borderline mental retardation with normal motor development. Class II dentoskeletal pattern with mild overjet and open bite, congenitally missing permanent teeth, microdontia, enamel hypoplasia, taurodontism and dentinal dysplasia was observed according to the clinical and radiographic examination. In conclusion, Seckel syndrome is not encountered routinely in dental clinics, this case illustrates the importance of dental care in such a rare condition.
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ranking = 1.5
keywords = dental
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4/28. amelogenesis imperfecta: diagnosis and resolution of a case with hypoplasia and hypocalcification of enamel, dental agenesis, and skeletal open bite.

    A case of amelogenesis imperfecta with hypoplasia, hypocalcification of the enamel, congenital absence of teeth 12 and 22, delayed eruption of tooth 23, edge-to-edge incisal relationship, open bite, and bilateral posterior cross bite at the level of the first and second premolars is presented. Lateral skull teleradiography indicated a Class III skeletal pattern of maxillary origin associated with a dolichofacial pattern with multiple indicators of facial hyperdivergence. The patient presented a major esthetic abnormality of the face and required orthodontic treatment prior to a prosthetic solution with full-coverage metal-ceramic crowns in both the maxilla and the mandible. The diagnosis of cases such as this one and the therapeutic implications from an orthodontic and prosthetic standpoint are reported.
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ranking = 2
keywords = dental
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5/28. Correction of severe vertical maxillary excess with anterior open bite and transverse maxillary deficiency.

    patients requiring correction of large anterior open bites have historically been among the most challenging treatments for orthodontists. Adding to that fundamental challenge for the adult patient in this case was vertical maxillary excess, a severe transverse maxillary deficiency as well as an arch length inadequacy, even though the patient had prior orthodontic treatment. The prior orthodontist had included arch expansion and extracted four first bicuspids, which limited current treatment options. Various treatment modalities that have traditionally been used to correct transverse maxillary deficiency and the accompanying arch length inadequacy include extractions, labial and buccal dental tipping, segmental maxillary osteotomies, and rapid maxillary expansion with or without surgical assistance. Transverse maxillary distraction osteogenesis is a modification (ie, using a latency period and specific rate and rhythm of distraction) of the surgically assisted rapid maxillary expansion technique developed 25 years ago. This case demonstrates the relationship of transverse maxillary deficiency as well as vertical maxillary excess to apertognathia. Considerations regarding the use of segmental maxillary osteotomy vs transverse distraction osteogenesis are discussed. This case report illustrates the benefit of a team approach using transverse maxillary distraction osteogenesis, effective orthodontic mechanics, and orthognathic surgery to correct a severe dentofacial deformity.
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ranking = 0.5
keywords = dental
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6/28. Menkes disease: report of two cases.

    Menkes disease is a rare, autosomal recessive disorder characterized by neuronal degeneration, abnormal hair, malformed connective tissue, mental retardation, and a life span of three years. Previously reported dental findings include a high arched palate, delayed eruption of secondary dentition, and open bite. The case of twin seven-year-old males with Menkes disease is presented, along with previously unreported dental findings of spindle-shaped root resorption patterns on the primary maxillary central and lateral incisors.
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ranking = 1
keywords = dental
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7/28. An adult case of skeletal open bite with a severely narrowed maxillary dental arch.

    Surgically assisted rapid maxillary expansion is proposed as an efficient approach for adult patients with transverse maxillary deficiency. This article reports the treatment of an 18-year, seven-month old male patient with an anterior open bite and a severely narrowed upper dental arch. A posterior crossbite was present on both sides. For the correction of the posterior crossbite, a lateral maxillary expansion of more than 8 mm was required. A surgically assisted rapid maxillary expansion with Le Fort I corticotomy and mandibular setback with a sagittal splitting ramus osteotomy were determined as the treatment plan. The total treatment time was 24 months including five months of post-surgical observation. After the treatment, an acceptable occlusion was achieved with a Class I molar relationship. The amount of actual maxillary expansion was 6.3 mm at the canines and 9.7 mm at the first molars. The relapse of the expansion was 0.9 mm and 0.1 mm at the corresponding regions two years after the surgically assisted maxillary expansion. It is emphasized that surgically assisted rapid maxillary expansion is a secure and efficient approach for achieving a desirable lateral maxillary expansion with stability in adult patients demonstrating transverse maxillary deficiency. Furthermore, it is suggested that longterm observation of the maxillary arch width after retention is of a great importance for the maintenance of the acceptable treatment outcome.
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ranking = 2.5
keywords = dental
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8/28. Bilateral open bite in dicygotic twins. A combined orthodontic-prosthetic approach.

    CASE REPORT: Dizygotic twins, male, 25 years of age, required treatment for an identical orthodontic diagnosis. diagnosis: Class III malocclusion with mesial molar relation and frontal edge-to-edge bite, lyrate upper dental arch, grouped cross-bite and bilateral open bite in the molar and bicuspid region, retention and lingual inclination respectively of the lower left second bicuspid, mesial inclination of both lower first molars. The severity of the malocclusion differed in the two brothers. THERAPY: Orthodontic treatment was successful concerning the transversal expansion and alignment of the maxillary dental arch, the functional relation of the anterior teeth, the transversally correct relation of the upper and lower dental arches and, following surgical removal of the lower second bicuspids, the reduction of crowding in the lower arch. An attempt was made to upright the molars in the mandibular arch and to close the lateral open bite by means of vertical elastics. However, the 10-month period of resistance to the therapy suggested, after a tongue protrusion habit had been ruled out, a diagnosis of ankylosis. Further orthodontic treatment was renounced and a prosthetic solution was pursued instead: the teeth in infraocclusion were treated with full ceramic overlays and, in the regions with residual gaps, with pontics (Empress II, Ivoclar, Schaan, liechtenstein), after minimally invasive preparation (confined to removal of existing fillings). CONCLUSION: This case is particularly interesting because the infrapositioned molars in both brothers were very likely due to ankylosis, suggesting a genetic cause.
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ranking = 1.5
keywords = dental
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9/28. nickel allergy associated with a transpalatal arch appliance.

    AIM: The purpose of this article was to present a case in which nickel sensitivity of the oral mucosa was demonstrated during the use of a transpalatal arch appliance (TPA). CASE REPORT: An 11-year 8-month old post-menarchal female presented for orthodontic treatment with Class III buccal segments and bilateral open bite. The treatment plan consisted of placing a rapid palatal expansion appliance (RPE) and a TPA with soldered lateral tongue cribs, in order to eliminate her tongue thrusting habit. 8 months into treatment, the gingiva of the right posterior segment began to hypertrophy, particularly around the bands of the right first molar and premolar. A patch test of 5% nickel sulfate indicated a positive reaction to nickel. The treatment was finished without the use of nickel titanium wires and the mucosa reaction resolved. The patient had had her ear pierced at age 2 days old, which was 11 years before orthodontic treatment was initiated. The literature shows that this exposure may have been the sensitizing event. CONCLUSIONS: While the nickel sensitive patient may not present an extreme medical risk, the orthodontist must be aware of the problem and the likelihood of treating patients with this condition. It appears that the reaction may vary from patient to patient. The practitioner should possess a basic understanding of the occurrence rate, sex predilection, and signs and symptoms of allergy to nickel, and should be familiar with the best possible alternative modes of treatment, to provide the safest, most effective care possible in these cases. Practitioners should be aware that symptoms of nickel allergy may closely mimic those of typical gingival changes during orthodontic treatment of circumpubertal children.
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ranking = 0.041814113113039
keywords = gingival
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10/28. Moulding of the generate to control open bite during mandibular distraction osteogenesis.

    Distraction osteogenesis of the craniofacial skeleton has become a widely accepted, safe, and effective means of craniofacial reconstructive surgery. Despite excellent results in general, there are still some uncertainties related to the procedure, such as development of an anterior open bite (AOB) during mandibular distraction. The aim of this study was to examine whether 'moulding of the generate', i.e. use of intermaxillary elastics during the active distraction phase is possible to close the mandibular plane angle and open bite. Three subjects, 13- and 15-year-old males and a 7-year-old female, underwent mandibular linear and angular bilateral distraction osteogenesis with moulding of the generate. Lateral cephalograms were obtained before the introduction of elastics and following distraction, once the activation was stopped and the patients were ready for the consolidation phase. Conventional cephalometric measurements were used to assess possible changes in the mandibular plane angle and incisor position. Three different anchorage systems (dental, orthopaedic, and skeletal) were used for placement of the intermaxillary elastics. Cephalometric examination showed that the mandibular plane angle was decreased during active distraction osteogenesis with the introduction of elastics and angulation of the distraction device. Depending on the type of elastic anchorage system, smaller or greater amounts of extrusion of the incisors were noted. Moulding of the generate during active distraction can be performed to reduce the mandibular plane angle and open bite. To prevent unwanted dentoalveolar changes from occurring during elastic traction, skeletal rather than dental fixation of the elastics is recommended. Intrusive mechanics may be incorporated into the orthodontic appliances to balance extrusive force by the moulding elastics.
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ranking = 1
keywords = dental
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