Assessment of facial profile changes in Class I biprotrusion adolescent subjects submitted to orthodontic treatment with extractions of four premolars

This is the second article in a series on conundrums in orthodontics. A Class I molar relationship is a frequent aim of orthodontic treatment. There are, however, examples where intentionally finishing to a Class III molar relationship is the more pragmatic and preferable option. Pursuing this approach in the appropriate circumstances may, for example, prevent deleterious consequences to the facial profile or avoid the need for further dental extractions. This article explores the indications for finishing cases to a Class III molar relationship with illustrated clinical cases. CPD/Clinical Relevance: Dogmatic attempts to deliver Class I molar relationships, in all cases, without consideration of the consequences, have the potential to cause the patient harm. The orthodontist must then consider all possible options available, including those resulting in a Class III molar relationship.

Download Full-text

Esthetic perception of facial profile changes in Class II patients treated with Herbst or Forsus appliances

The Angle Orthodontist ◽

10.2319/052719-362.1 ◽

2020 ◽

Vol 90 (4) ◽

pp. 571-577 ◽

Cited By ~ 1

Author(s):

Alexa Helena Kohler Moresca ◽

Nathaly Dias de Moraes ◽

Francielle Topolski ◽

Carlos Flores-Mir ◽

Alexandre Moro ◽

...

Keyword(s):

Orthodontic Treatment ◽

Random Sequence ◽

Treatment Method ◽

Class Ii ◽

Class Ii Malocclusion ◽

Analog Scale ◽

Herbst Appliance ◽

Facial Profile ◽

Significant Difference ◽

Profile Changes

ABSTRACT Objective To evaluate the esthetic perceptions of orthodontists and laypersons for facial profile changes after orthodontic treatment using Herbst or Forsus appliances. Materials and Methods Pre- and posttreatment facial profile contour images of 20 Class II patients treated with Herbst (group H; n = 10) and Forsus (group F; n = 10) appliances were analyzed by 30 orthodontists and 30 laypersons, who graded them from 1 (unattractive) to 10 (very attractive) using a visual analog scale. Two assessments were carried out with a 15 day-interval. In the first evaluation, 40 images were presented in a random sequence. In the second evaluation, initial and final facial profile images of each patient were randomly presented side by side. To compare groups in relation to treatment method, Mann-Whitney tests were used. To evaluate differences between time points, Wilcoxon tests were used. Results In the first evaluation, there was a significant difference between initial and final images only for group H, for both laypersons (P = .017) and orthodontists (P = .037). There was also a significant difference between laypersons and orthodontists in their ratings of posttreatment Herbst appliance profiles (P = .028). There was no significant difference between initial and final facial profile images for group F and no significant differences between or within evaluator groups in their ratings of initial or final Forsus appliance profiles. In the second evaluation, there was a significant difference between appliance groups only for laypersons, who considered cases treated with the Herbst appliance more attractive than those treated with the Forsus (P = .031). Laypersons also considered Herbst profiles more attractive than did orthodontists (P = .047). Conclusions Class II malocclusion treatment using the Herbst appliance may produce a more esthetically improved facial profile silhouette compared with Forsus appliances. The magnitude of perceived changes may not be considered clinically relevant.

Download Full-text

Skeletal Anchorage for Orthodontic Correction of Severe Maxillary Protrusion after Previous Orthodontic Treatment

The Angle Orthodontist ◽

10.2319/010307-3.1 ◽

2008 ◽

Vol 78 (1) ◽

pp. 181-188 ◽

Cited By ~ 5

Author(s):

Eiji Tanaka ◽

Akiko Nishi-Sasaki ◽

Takuro Hasegawa ◽

Clarice Nishio ◽

Nobuhiko Kawai ◽

...

Keyword(s):

Orthodontic Treatment ◽

Class I ◽

Skeletal Anchorage ◽

Facial Profile ◽

Retention Period ◽

System A ◽

Maxillary Molars ◽

History Of ◽

Maxillary Incisors ◽

Anchor Plates

Abstract The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3 months, complained of the difficulty of lip closure due to severe maxillary protrusion with a gummy smile. Overjet and overbite were +7.6 mm and −0.9 mm, respectively. She had a history of orthodontic treatment in which her maxillary first premolars were extracted. In order to conduct distal movement of the maxillary molars, anchor plates were placed in the zygomatic process. After achieving a Class I molar relationship, retraction and intrusion of the maxillary incisors were performed. After a 2-year treatment, an acceptable occlusion was achieved with a Class I molar relationship. Her convex facial profile with upper lip protrusion was considerably improved, and the lips showed less tension in lip closure. After a 2-year retention period, an acceptable occlusion was maintained without recurrence of maxillary protrusion, indicating a stability of the occlusion. The result of this treatment indicated that skeletal anchorage is of great importance as a remedy for achieving intrusion and retraction of the maxillary incisors in cases of severe maxillary protrusion with a patient who had previous orthodontic treatment.

Download Full-text

Extraction versus non-extraction orthodontic treatment: Soft tissue profile changes in borderline class I patients

Dental and Medical Problems ◽

10.17219/dmp/119102 ◽

2020 ◽

Vol 57 (3) ◽

pp. 275-283

Author(s):

Anahita Bakhshaei ◽

Sepideh Soheilifar ◽

Sanaz Soheilifar ◽

Vahid Mollabashi ◽

Payam Amini ◽

...

Keyword(s):

Soft Tissue ◽

Orthodontic Treatment ◽

Class I ◽

Soft Tissue Profile ◽

Profile Changes

Download Full-text

Do orthodontic extractions have an impact on the cutaneous profile?

Journal of Dentofacial Anomalies and Orthodontics ◽

10.1051/odfen/2018136 ◽

2018 ◽

Vol 21 (4) ◽

pp. 506

Author(s):

I. Dallel ◽

A. Megdiche ◽

Y. Ghedira ◽

S. Tobji ◽

A. Ben Amor

Keyword(s):

Soft Tissue ◽

Orthodontic Treatment ◽

Soft Tissues ◽

Tooth Movement ◽

Facial Profile ◽

Pearson Test ◽

Profile Changes ◽

Student Test ◽

Cephalometric Measurements ◽

The Relationship

Orthodontic treatments can have an impact on the soft tissues and more particularly on the cutaneous profile. The aim of this work was to evaluate profile changes following orthodontic treatment. Material and methods: This study concerned 90 patients randomly selected in the orthodontic department of Monastir (Tunisia). Profile headfilms at the start and at the end of orthodontic treatment were compared using, as reference lines, the SN-7° plane and the orthogonal to SN-7° plane going through the S-point (POSN- 7°). The Student test was applied to evaluate the variations in the cephalometric measurements. The Pearson test was used to study the correlation between the horizontal tooth movements and facial profile changes. Results: We noted a significant decrease in the upper labral (Ls) (p=0.049) and lower labral (p=0.048) as well as a significant increase in the labio-mental angle (p=0.025) in patients treated with extractions of premolars. A positive correlation between the incisor movements and the reduction of the labial protrusion was observed. Conclusion: The results of this study have shown that the movements of the incisors consecutive to extractions can have tangible effects on the cutaneous profile. Further investigations should be carried out to highlight the relationship between tooth movement and soft tissue.

Download Full-text

Perawatan Kaninus Ektopik Menggunakan Teknik Begg dengan Pencabutan Premolar Kedua

Majalah Kedokteran Gigi Klinik ◽

10.22146/mkgk.11918 ◽

2016 ◽

Vol 1 (1) ◽

pp. 39

Author(s):

Puspita Ndaru Putri ◽

Prihandini Iman ◽

JCP Heryumani

Keyword(s):

Orthodontic Treatment ◽

Facial Profile ◽

Deep Bite ◽

Anterior Crowding ◽

Premolar Extraction ◽

Dental Crowns ◽

Skeletal Malocclusion ◽

Anterior Teeth ◽

Profile Changes ◽

Lower Arch

Ektopik kaninus seringkali dijumpai dalam praktek bidang ortodontik. Sebagian orang yang merasa terganggu dengan keadaan ini akan datang ke dokter gigi untuk mendapatkan perawatan. Perawatan ortodontik dilakukan untuk mengoreksi gigi yang ektopik dan memperbaiki fungsi estetik. Pada perawatan kasus ektopik kaninus ini, pencabutan gigi premolar kedua dilakukan karena tidak diperlukan perubahan profil. Teknik Begg merupakan teknik ortodontik yang menggunakan gaya ringan dengan kawat busur berpenampang bulat. Kawat busur akan bergerak bebas tanpa friksi dan menghasilkan gerak tipping mahkota gigi. Tujuan dari studi kasus ini adalah untuk memaparkan perawatan kaninus ektopik dalam tahapan teknik Begg. Pasien perempuan usia 19 tahun mengeluhkan gigi depan yang gingsul dan berjejal. Hasil pemeriksaan objektif menunjukkan ektopik pada gigi 13, 23 dan 33, overbite 5 mm, crowding anterior mandibula, dan crossbite anterior pada gigi 22 dan 33. Maloklusi kelas I skeletal dengan protrusif bimaksiler dan protrusif bidental, ektopik kaninus maksila bilateral, ektopik kaninus mandibula unilateral, deep bite, crowding anterior mandibula dan crossbite anterior. Dilakukan perawatan ortodontik cekat teknik Begg multiloop dengan pencabutan 15, 25, 36 dan 46. Sembilan bulan setelah perawatan, crossbite anterior, dan gigi 13, 23 dan 33 yang ektopik telah terkoreksi. Crowding anterior mandibula telah mengalami perbaikan dan perawatan masih berlanjut hingga saat ini. Perawatan teknik Begg multiloop dengan pencabutan gigi premolar kedua merupakan alternatif perawatan untuk koreksi ektopik kaninus, jika tidak diperlukan perubahan profil wajah pasien. ABSTRACT: Ectopic Canines Treatment Using Begg Technique with Second Premolar Extraction. Ectopic canines are often found in the field of orthodontic practice. People who are annoyed with this situation usually come to an orthodontist to seek for treatment. Orthodontic treatment has been performed to correct ectopic teeth and improve the function of aesthetics. In this case of ectopic canines, a second premolars tooth was extracted because profile changes are not required. Begg orthodontic technique is a technique that uses light forces by using round archwire. Archwire will move freely without friction and produce a tipping movement of dental crowns. A 19 year old female patient complained of ectopic and crowding anterior teeth. The objective examinations find ectopic of 13, 23 and 33, overbite: 5 mm, anterior mandibular crowding, and anterior crossbite of 22 and 33. Class I skeletal malocclusion, bimaxillar protrusive, bidental protrusive, bilateral ectopic canine maxilla and lateral ectopic canine mandibula, deep bite, anterior crowding and anterior crossbite. A fixed orthodontic treatment was performed by multiloop Begg technique with tooth extraction of 15, 25, 36, and 46. 9 months after treatment, anterior crossbite and ectopic 13, 23, 33 have been corrected by using multiloop Begg technique. Crowding in the lower arch has improved compared to initial condition and treatment still continues to this day. Multiloop Begg technique with second premolars extraction is an alternative treatment for ectopic canines correction if patient’s facial profile changes are not required.

Download Full-text

Treatment of Class III Malocclusion in an Adolescent with Banded RPE/Face Mask and Self-Ligating System

UI Proceedings on Health and Medicine ◽

10.7454/uiphm.v1i0.13 ◽

2017 ◽

Vol 1 ◽

Author(s):

Dwita Pratiwi Dwita Pratiwi ◽

Benny Mulyono Soegiharto

Keyword(s):

Orthodontic Treatment ◽

Face Mask ◽

Class I ◽

Adolescent Patient ◽

Class Iii ◽

Class Iii Malocclusion ◽

Facial Profile ◽

The Right ◽

Cervical Vertebral Maturation ◽

Dental Malocclusion

<p>This case report describes the treatment of a 12-years-old female with a Class III skeletal profile and dental malocclusion. The clinical examination showed concave profile, class III dental relationship, buccal crossbite on the right side, and mild crowding. The cervical vertebral maturation analysis showed the patient was on the CS3 stage. The class III malocclusion was treated with combination of banded rapid palatal expander and face mask followed by non-extraction orthodontic treatment with self-ligating system. Banded rapid palatal expander and face mask were used to improve the skeletal discrepancy. Class I maxilla-mandibular relationship was achieved along with class I molar, incisor, and canine relationship. The buccal crossbite and mild crowding were corrected, the overbite and overjet were normal, and the facial profile was improved. This case demonstrates a good result of a class III malocclusion treatment in an adolescent patient with banded rapid palatal expander/face mask and self-ligating system.</p>

Download Full-text

A Class III look with Buccally placed high Canine of an Angle's Class I Malocclusion treated in a Non Extraction approach

Bangladesh Journal of Orthodontics and Dentofacial Orthopedics ◽

10.3329/bjodfo.v4i1.35755 ◽

2018 ◽

pp. 20-22

Author(s):

Nabila Anwar ◽

Gazi Shamim Hassan

Keyword(s):

Case Report ◽

Orthodontic Treatment ◽

Class I ◽

Class Iii ◽

Facial Profile ◽

Posterior Crossbite ◽

End Of Treatment ◽

Fixed Appliances ◽

Quad Helix

Class I malocclusion also called neutro-occlusion, this describes a normal molar relationship but there is malposition of one or more individual teeth. Treatment of Class I malocclusion varies depending on the condition and severity. However, the purpose of this report is to review the orthodontic treatment of a Class I malocclusion with buccally placed canine without extraction. This case report describes a 13-year-old girl with a Class I malocclusion, anterior and posterior crossbite, a retrusive maxilla with high canine. The Class I malocclusion with posterior crossbite was corrected with quad helix followed by non extraction orthodontic treatment with fixed appliances to correct anterior crossbite. At the end of treatment we obtained an acceptable occlusion relationship and the facial profile and the patient's smile were improved substantially.Ban J Orthod & Dentofac Orthop, April 2014; Vol-4 (1-2), P.20-22

Download Full-text

Class I malocclusion with anterior crossbite and severe crowding

Dental Press Journal of Orthodontics ◽

10.1590/2176-9451.19.2.115-125.bbo ◽

2014 ◽

Vol 19 (2) ◽

pp. 115-125 ◽

Cited By ~ 2

Author(s):

Daltro Enéas Ritter

Keyword(s):

Treatment Planning ◽

Female Patient ◽

Orthodontic Treatment ◽

Class I ◽

Diagnosis And Treatment ◽

Facial Profile ◽

Angle Class ◽

Dentofacial Orthopedics ◽

Functional Complaints

This article reports the orthodontic diagnosis and treatment planning carried out with a 14-year and 5-month-old female patient with esthetic and functional complaints. She presented an Angle Class I malocclusion, anterior crossbite and severe crowding in both maxillary and mandibular arches, in addition to a lightly concave straight facial profile. Orthodontic treatment did not require extraction. Crossbite was corrected by protrusion of upper teeth, which contributed to alignment and leveling of teeth, in addition to improving the patient's facial profile. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the BBO certification.

Download Full-text