Evaluation and Comparison of Stress Patterns and Teeth Displacement with Intrusion of Maxillary Posterior Segment by Skeletal Anchorage System (Infrazygomatic Crestal Bone Screw) and High Pull Headgear: A 3D Finite Element Study

2021 ◽  
Vol 55 (4) ◽  
pp. 367-376
Author(s):  
Malvi N. Thakkar ◽  
Dolly P. Patel ◽  
Sheron T. Bhanat
Keyword(s):  
Finite Element ◽  
Class Ii ◽  
Posterior Segment ◽  
Open Bite ◽  
3D Fem ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Bone Screw ◽  
Computed Tomographic ◽  
Stress Patterns

Introduction: In the last decades the application of the Finite Element Methodology (FEM) has become popular. It can calculate stresses and displacement in complex structures and can anticipate the tissue responses to orthodontic mechanics applied for treating different malocclusions. This study evaluated and compared the stress patterns and teeth displacement with application of 450g of intrusive force bilaterally on maxillary posterior segment utilizing a conventional old method, High-Pull Headgear (HPHG) and a newer method, Infrazygomatic Crestal Bone Screw (IZC-BS) using 3D-FEM. Method: A 3D-FEM model of the craniomaxillary segment with maxillary teeth was reconstructed from the Cone Beam Computed Tomographic image of a patient with class II div I malocclusion on class II skeletal base with anterior open bite and 450g of intrusive force was applied bilaterally on maxillary posterior segment utilizing HPHG and IZC-BS and stress patterns and teeth displacement were studied and compared. Result: Von Mises stresses on Zygomaticomaxillary, Zygomaticotemporal and Pterygomaxillary sutures and surface landmarks on maxillary, zygomatic, temporal and sphenoid bones were more pronounced and generalized for HPHG group. Intrusion, expansion and sagittal displacement of maxillary posterior segment were also more pronounced with HPHG group. Stresses weren’t present at the apical root areas of the maxillary posterior teeth for both the groups. Conclusion: On applying equal amount of intrusive force bilaterally to the maxillary posterior segment, stress patterns and teeth displacement were more pronounced and effective for HPHG group however; apical root areas of the maxillary posterior teeth in both the groups didn’t show any stresses.

Orthodontic Treatment of Skeletal Class II Adolescent with Anterior Open Bite using Mini-Screws and Modified Palatal Anchorage Plate

2015 ◽  
Vol 39 (2) ◽  
pp. 187-192 ◽  
Author(s):  
YA Kook ◽  
JH Park ◽  
Y Kim ◽  
CS Ahn ◽  
M Bayome
Keyword(s):  
Orthodontic Treatment ◽  
Class Ii ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
And Control

This article presents a non-extraction orthodontic treatment case using mini-screws and a modified palatal anchorage plate (MPAP) to intrude the maxillary posterior teeth, and distalize the whole arch dentition and control the extrusion of the maxillary posterior dentition during distalization.

scholarly journals Comprehensive approach to simultaneous molar intrusion and canine retraction in the treatment of Class II anterior open bite using miniscrew anchorage

2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Kaori Shirasaki ◽  
Yoshihito Ishihara ◽  
Hiroki Komori ◽  
Takashi Yamashiro ◽  
Hiroshi Kamioka
Keyword(s):  
Treatment Duration ◽  
Class Ii ◽  
Open Bite ◽  
Prolonged Treatment ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Canine Retraction ◽  
Maxillary Molars ◽  
Anterior Teeth ◽  
Molar Intrusion

ABSTRACT Introduction: Anterior open bite is one of the most difficult malocclusions to correct in orthodontic treatment. Molar intrusion using miniscrew anchorage has been developed as a new strategy for open bite correction; however, this procedure still has an important concern about prolonged treatment duration in the patient with anteroposterior discrepancy due to the separate step-by-step movement of anterior and posterior teeth. Objective: This article illustrates a comprehensive orthodontic approach for dentoalveolar open bite correction of an adult patient, by using miniscrew. Case report: A woman 19 years and 5 months of age had chief complaints of difficulty chewing with the anterior teeth and maxillary incisor protrusion. An open bite of -2.0 mm caused by slight elongation of the maxillary molars was found. The patient was diagnosed with Angle Class II malocclusion with anterior open bite due to the vertical elongation of maxillary molars. After extraction of the maxillary first premolars, concurrent movements of molar intrusion and canine retraction were initiated with the combined use of sectional archwires, elastic chains and miniscrews. Results: At 4 months after the procedure, positive overbite was achieved subsequent to the intrusion of maxillary molars by 1.5 mm and without undesirable side effects. Class I canine relation was also achieved at the same time. The total active treatment period was 21 months. The resultant occlusion and satisfactory facial profile were maintained after 54 months of retention. Conclusion: The presented treatment shows the potential to shorten the treatment duration and to contribute to the long-term stability for open bite correction.

scholarly journals Force magnitude as a variable in maxillary buccal segment intrusion in adult patients with skeletal open bite:

2020 ◽  
Vol 90 (4) ◽  
pp. 507-515
Author(s):  
Heba E. Akl ◽  
Amr M. Abouelezz ◽  
Fouad A. El Sharaby ◽  
Amr R. El-Beialy ◽  
Mohamed Abd El-Ghafour
Keyword(s):  
Null Hypothesis ◽  
Intervention Group ◽  
Posterior Segment ◽  
Open Bite ◽  
Adult Patients ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Force Magnitude ◽  
Comparator Group ◽  
Skeletal Open Bite

ABSTRACT Objectives To compare the effects of two different force magnitudes on maxillary posterior segment intrusion using mini-screws. The null hypothesis was that there would be no difference between the two force magnitudes. Materials and Methods Adult patients with skeletal open bite and a dental open bite ranging from 3 to 8 mm were recruited for this trial. The comparator group had 200 g of intrusive force applied for posterior segment intrusion, whereas 400 g of force was applied in the intervention group. Primary outcomes were the amount of posterior teeth intrusion and anterior open bite closure. Results Twenty-two subjects were randomized to include 11 participants in each group. One participant dropped out in each group, leaving us with 10 subjects to be analyzed per group. There was statistically significant posterior teeth intrusion of 2.42 ± 2.06 and 2.26 ± 1.87 mm for the comparator and intervention groups, respectively, with no difference between them. Statistically significant open bite closure was achieved in both groups, measuring 2.24 ± 1.18 and 3.15 ± 1.06 mm in the comparator and intervention groups, respectively, with no difference between them. Conclusions Both the 200 g and 400 g intrusive forces yielded similar outcomes in terms of posterior teeth intrusion and anterior open bite closure.

Abordagem precoce da má oclusão de Classe II esquelética com atresia maxilar e mordida aberta anterior e o uso de alinhadores ClearCorrect – relato de caso

2021 ◽  
Vol 14 (53) ◽  
pp. 97-106
Author(s):  
Roberto Hideo Shimizu ◽  
Isabela Almeida Shimizu ◽  
Ana Cláudia M. Melo Toyoffuku ◽  
Rebecca Marquesini ◽  
Tatiane Travizan Lima ◽  
...  
Keyword(s):  
Treatment Time ◽  
Low Complexity ◽  
Class Ii ◽  
Open Bite ◽  
Class Ii Malocclusion ◽  
Anterior Open Bite ◽  
Skeletal Class ◽  
Posterior Crossbite ◽  
Skeletal Class Ii ◽  
High Predictability

Adequate planning and early treatment of Angle Class II malocclusion with maxillary atresia and anterior open bite provides harmonization of maxillomandibular bone bases in the three planes of space. Orthodontic aligners have emerged as an alternative treatment having the following advantages: being more aesthetic and more comfortable for the patient, less treatment time when they are correctly indicated, less chairside time, less complications, possibility of remote monitoring, easier feeding, and dental hygiene. On the other hand, they offer difficulties to treat adults with severe skeletal Class II malocclusions, posterior crossbite and anterior open bite. Therefore, the objective of this clinical case report is to early correct skeletal Class II malocclusion with maxillary atresia through the use of mechanical orthopedics and devices that help eliminate habits and close the anterior open bite, and later the use of orthodontic aligners to finish the treatment. It was concluded that the early interceptive treatment of malocclusion was efficient to harmonize the bone bases in the anteroposterior, vertical, and transversal directions, changing this malocclusion from high to low complexity and, consequently, highly predictable and with an excellent prognosis for treatment with orthodontic aligners. The treatment with ClearCorrect aligners corrected the occlusion in a shorter period of time when compared to corrective orthodontics and with a high predictability in relation to the virtual setup.

scholarly journals Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Daniel Gheur Tocolini ◽  
Priscila de Oliveira Silva ◽  
Iduilton Grabowski ◽  
Julia Carelli ◽  
Nathaly Dias Morais ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Class Ii ◽  
Open Bite ◽  
Functional Improvement ◽  
Maxillary Incisor ◽  
Class Ii Malocclusion ◽  
Anterior Open Bite ◽  
Bone Segment ◽  
The Right ◽  
Dental Crowding

Ankylosed teeth may have a significant esthetic and functional impact especially at the anterior segment of the upper arch. Treatment of ankylosed teeth is challenging. The objective of this case report is to describe a clinical case in which an ankylosed tooth was treated with the use of osteogenic distraction associated with simplified orthodontic biomechanics. A 17-year-old female Caucasian patient presented with a Class II malocclusion, severe maxillary dental crowding, moderate mandibular dental crowding, anterior open bite, upper midline deviation to the right, and upper right central incisor in infraocclusion due to ankylosis. Treatment involved the use of the ankylosed tooth as anchorage for the distalization of the right upper segment to correct the Class II malocclusion and to create space prior to surgery. After one week of surgical osteotomy, traction of the tooth and bone segment was initiated with the use of intermaxillary elastics. The ankylosed tooth was moved to the desired position. Bone formation and mucogingival tissue adaptation were observed. Thus, esthetic and functional improvement was achieved. Osteogenic distraction associated with simplified orthodontic biomechanics is an alternative to the treatment of ankylosed teeth which can replace the use of distractor screws, making treatment simpler and more accessible.

scholarly journals Noninvasive and Multidisciplinary Approach to the Functional and Esthetic Rehabilitation of Amelogenesis Imperfecta: A Pediatric Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Juliana Feltrin de Souza ◽  
Camila Maria Bullio Fragelli ◽  
Marco Aurélio Benini Paschoal ◽  
Edson Alves Campos ◽  
Leonardo Fernandes Cunha ◽  
...  
Keyword(s):  
Case Report ◽  
Composite Resin ◽  
Preventive Treatment ◽  
Open Bite ◽  
Amelogenesis Imperfecta ◽  
Mixed Dentition ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Anterior Teeth

Case Report. An 8-year-old girl with amelogenesis imperfecta (AI) reported unsatisfactory aesthetics, difficulty in mastication, and dental hypersensitivity. The intraoral examination observed mixed dentition, malocclusion in anteroposterior relationships, anterior open bite, and dental asymmetry. A hypoplastic form of AI was diagnosed in the permanent dentition. A multidisciplinary planning was performed and divided into preventive, orthopedic, and rehabilitation stages. Initially, preventive treatment was implemented, with fluoride varnish applications, in order to protect the fragile enamel and reduce the dental sensitivity. In the second stage, the patient received an interceptive orthopedic treatment to improve cross-relationship of the arches during six months. Finally, the rehabilitation treatment was executed to establish the vertical dimension. In the posterior teeth, indirect composite resin crowns were performed with minimally invasive dental preparation. Direct composite resin restorations were used to improve the appearance of anterior teeth.Follow-Up. The follow-up was carried out after 3, 6, 12, and 18 months. After 18 months of follow-up, The restoration of integrity, oral hygiene, and patient satisfaction were observed .Conclusion. Successful reduction of the dental hypersensitivity and improvement of the aesthetic and functional aspects as well as quality of life were observed.

scholarly journals Microscrew Anchorage in Skeletal Anterior Open-bite Treatment

2007 ◽  
Vol 77 (1) ◽  
pp. 47-56 ◽  
Author(s):  
Chunlei Xun ◽  
Xianglong Zeng ◽  
Xing Wang
Keyword(s):  
Alveolar Bone ◽  
Open Bite ◽  
Anterior Open Bite ◽  
Posterior Teeth ◽  
Miniscrew Implants ◽  
Mandibular Plane ◽  
Lateral Cephalograms ◽  
Patient Cooperation ◽  
Skeletal Pattern ◽  
Skeletal Open Bite

Abstract Objective: To evaluate the effectiveness of miniscrew anchorage for intrusion of the posterior dentoalveolar region to correct skeletal open bite. Materials and Methods: The study was comprised of 12 patients (aged 14.3 to 27.2 years; mean 18.7 years) with anterior open bites. All the patients presented a Class II skeletal pattern and excessive posterior growth. Self-drilling miniscrew implants were inserted into the posterior midpalatal area and the buccal alveolar bone between the lower molars. A transpalatal and a lingual arch were used to maintain the molars on each side in order to avoid overrotation during intrusion. A force of 150 g was applied to the microscrews on each side to intrude the posterior teeth. Lateral cephalograms of all 12 patients were taken preintrusion and immediately after completion of the intrusion. The cephalometric films were measured and compared. Results: The results showed that the anterior open bites in 12 patients were all corrected in a mean of 6.8 months. Overbite increased by a mean of 4.2 mm (P < .001), from −2.2 mm in preintrusion to 2.0 mm in postintrusion. The maxillary and mandibular first molars were intruded for an average of 1.8 mm (P < .001) and 1.2 mm (P < .001), respectively. The mandibular plane angle was reduced by 2.3° (P < .001), which led to a counterclockwise rotation of the mandible with a significant decrease in the anterior facial heights (mean of 1.8 mm; P < .001). Conclusion: Miniscrew anchorage has the advantages of being a simpler procedure, being minimally invasive, and requiring minimal patient cooperation.

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