scholarly journals Treatment of a Class III growing patient with mandibular prognathism and severe anterior crossbite

2012 ◽  
Vol 17 (4) ◽  
pp. 148-159 ◽  
Author(s):  
Ricardo Machado Cruz
Keyword(s):  
Skeletal Maturation ◽  
Growth Spurt ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Treatment Protocols ◽  
Mandibular Prognathism ◽  
Mandibular Plane ◽  
Skeletal Pattern ◽  
Almost All ◽  
Dentofacial Orthopedics

The treatment of growing patients with Class III skeletal pattern represents one of the greatest clinical challenges for the orthodontist. Several treatment protocols have been proposed, almost all involving rapid maxillary expansion and maxillary protraction. However, there are cases where the maxilla is properly positioned in the anteroposterior direction and there is no transverse discrepancy, featuring only a mandibular prognathism. In such cases, when there is a set of favorable factors such as lack of laterognathism and lower mandibular plane angle, a viable option and which could prove quite interesting is the use of orthodontic chin cup during the night, aiming at trying to redirect the forward growth of the mandible. To have success, it is necessary that this procedure involves pubertal growth spurt and is extended to full skeletal maturation. This case was presented to the board of the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements to become a BBO Diplomate.

scholarly journals Expansion/Facemask Treatment of an Adult Class III Malocclusion

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Gregory W. Jackson ◽  
Neal D. Kravitz
Keyword(s):  
Face Mask ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Older Children ◽  
Maxillary Expansion ◽  
Viable Option ◽  
Maxillary Protraction ◽  
Skeletal Pattern ◽  
Maxillary Deficiency ◽  
The Ideal

The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.

scholarly journals RELATIONSHIP BETWEEN OCCLUSAL PLANE ORIENTATION AND SAGITTAL MALOCCLUSIONS: STUDY OF AN ORTHODONTIC POPULATION

2021 ◽  
pp. 1-6
Author(s):  
INES DALLEL ◽  
SANA KANOUN ◽  
MARIEM NAHDI ◽  
MONCEF OMMEZINE ◽  
SAMIR TOBJI ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Class Ii ◽  
Significant Rise ◽  
Class I ◽  
Occlusal Plane ◽  
Class Iii ◽  
Angle Class ◽  
Mandibular Plane ◽  
Significant Difference ◽  
Skeletal Pattern

Objective: The aim of this study was to evaluate the association of the skeletal pattern and angle class with the occlusal plane (OP). This study also examined the effect of orthodontic treatment on this plane. Methods: Lateral cephalometric radiographs of a sample of 135 patients were collected. The angles between the Frankfort horizontal, palatal plane (PP), mandibular plane (MP), and the OP were analyzed and compared between several groups and subsequently before and after treatment. Results: The statistical comparison between 3 skeletal frame groups demonstrates that the cant of the OP showed a major difference. This difference was greater in class III subjects. Examination revealed that the OP was not meaningfully affected within the Angle classification. Statistically, a significant correlation was found between OP steepness and the vertical skeletal pattern. A significant rise of OP/sella-nasion (SN) for class I (p=0.019) and II (p=0.015) after orthodontic treatment. In addition, patients treated with elastics showed a significant decrease of OP/MP (mandibular plane) in Angle class III and considerable increase of OP/SN and OP/PP in Angle class II. Observations of the group treated with bimaxillary extractions showed that OP/SN (sella nasion line) and OP/PP differ in a meaningful way. Conclusion: This study confirms the association between the skeletal pattern and the OP inclination in adults. Concerning the Angle classification, there was no significant difference between the groups. Orthodontic therapy had an influence on the inclination of this plane for the different malocclusions. Premolars extraction in class I cases significantly modified the OP. For class II and III malocclusions, the OP inclination was mainly altered by the use of intermaxillary traction elastics.

scholarly journals Orthodontic retreatment using anchorage with miniplate to camouflage a Class III skeletal pattern

2016 ◽  
Vol 21 (3) ◽  
pp. 104-115 ◽  
Author(s):  
Marcel Marchiori Farret
Keyword(s):  
Class Iii ◽  
Mandibular Incisor ◽  
Skeletal Class ◽  
Anterior Teeth ◽  
End Of Treatment ◽  
Skeletal Pattern ◽  
Incisor Retraction ◽  
Previously Treated ◽  
The Right ◽  
Dentofacial Orthopedics

ABSTRACT This manuscript describes the treatment of a 27-year-old patient who was previously treated with two maxillary first premolar extractions. The patient had skeletal Class III malocclusion, Class III canine relationship, anterior crossbite, and a concave profile. As the patient refused orthognathic surgery, a miniplate was used on the right side of the lower arch as an anchorage unit after the extraction of mandibular first premolars, aiding the retraction of anterior teeth. At the end of treatment, anterior crossbite was corrected, in which first molars and canines were in a Class I relationship, and an excellent intercuspation was reached. Furthermore, patient's profile remarkably improved as a result of mandibular incisor retraction. A 30-month follow-up showed good stability of the results obtained. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as one of the requirements to become diplomate by the BBO.

scholarly journals Immediate and late follow-up effects of class III early correction in cleft lip and palate patients treated with maxillary protraction

2020 ◽  
Vol 49 ◽  
Author(s):  
Carolina Mazon MIRANDA ◽  
Rodrigo Matos de SOUZA ◽  
Giovana Cherubini VENEZIAN ◽  
Cristina FRANZINI ◽  
William CUSTODIO
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Maxillary Protraction ◽  
Chi Squared ◽  
Skeletal Pattern ◽  
Pre Treatment ◽  
The Stability

Abstract Introduction There is no consensus about the immediate and latte follow-up effects of maxillary protraction in cleft lip and palate patients. Objective To evaluate the stability of Class III early treatment in cleft lip and palate patients through maxillary expansion and protraction. Material and method The sample consists in three lateral cephalometric radiographs of 28 patients (mean pre-treatment age of 6.7±1.8 years) who presented cleft lip and palate and were treated with maxillary expansion and Petit facial mask. The angular (SNA, SNB, ANB, SN.GoGn, FMA, Z Angle) and linear (overjet, Co-A, Co-Gn, Nperp-A, Nperp-Pg, AO-BO) cephalometric measures were evaluated through the Dolphin® software, in three moments: T0 (initial), T1 (after treatment), and T2 (follow-up). Data were submitted to the analysis of variance (ANOVA) and Tukey-Kramer test. The correlation between cephalometric measures and patient’s age was determined by Pearson’s chi-squared test. Result The SNA, ANB, and AO-BO measures increased considerably (p<0.05), and they did not present any differences compared to the initial ones after the follow-up time. The overjet measure increased (p<0.05) after treatment and, even with its decrease at the follow-up time, it was still higher than at the beginning (p<0.05). The Z angle showed improvement with treatment and remained stable at the follow-up time. Conclusion After treatment (maxillary expansion associated with protraction), there was a skeletal pattern improvement. During the follow-up period, those alterations decreased to a measure close to the beginning. There was an improvement in the dental pattern and facial profile that continued in the follow-up period.

A Correlation Study of Two Methods of Assessing Skeletal Pattern

1979 ◽  
Vol 6 (4) ◽  
pp. 187-193 ◽  
Author(s):  
S. N. Bhatia ◽  
T. A. Akpabio
Keyword(s):  
Total Sample ◽  
Correlation Study ◽  
Class I ◽  
Recent Criticism ◽  
Plane Angle ◽  
Class Iii ◽  
Lower Incisor ◽  
Appreciable Difference ◽  
Mandibular Plane ◽  
Skeletal Pattern

A study was carried out to compare the two current methods, Downs' method and the conversion (Ballard's) method, of assessing skeletal pattern. Correlations were moderate to high for the Class I and Class III groups (+0·6 and +0·76 respectively), but low for the Class II group(+0·35). The latter correlation, however, improved to +0·54 when the angle ANB was corrected for the value of the angle SNA. The point of rotation of the incisors, whether at the apex or apical third of the root, and the adjustment in the lower incisor angulation for the maxillary-mandibular plane angle value did not make any appreciable difference to the correlations obtained. The correlation for the total sample was about +0·7. When the cases were classified into the three skeletal categories the correspondence between the two methods was about 69 per cent. It is concluded that there are insufficient grounds for the recent criticism of the conversion method.

scholarly journals A CBCT Evaluation of Midpalatal Bone Density in Various Skeletal Patterns

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7812
Author(s):  
Jong-Moon Chae ◽  
Leah Rogowski ◽  
Suchita Mandair ◽  
R. Curtis Bay ◽  
Jae Hyun Park
Keyword(s):  
Bone Density ◽  
Age Groups ◽  
Class Ii ◽  
Horizontal Line ◽  
Class Iii ◽  
Midpalatal Suture ◽  
Mandibular Plane ◽  
Skeletal Pattern ◽  
Pattern Differentiation ◽  
Angle Class Iii

The purpose of this study was to evaluate midpalatal bone density (BD) by using cone-beam computed tomography (CBCT) according to gender, age, and vertical and horizontal skeletal patterns. CBCT images from 126 subjects (64 females and 62 males) were reoriented and analyzed in order to attain BD values at the midpalatal suture. Four age groups were used for classification (adolescence, 10 ≤ early < 14 years, 14 ≤ middle ≤ 17 years, and 17 < late ≤ 21 years; adult > 21 years). Vertical skeletal pattern categories were differentiated by the Frankfort horizontal line to mandibular plane angle (hypodivergent < 22°, 22° ≤ normovergent ≤ 28°, and 28° < hyperdivergent). Horizontal skeletal pattern differentiation was defined by ANB angle (Class III < 0°, 0° ≤ Class I ≤ 4°, and 4° < Class II). Females showed significantly higher BD than males (p < 0.001). As age increased, BD increased significantly (p < 0.001). There were no significant differences between vertical skeletal patterns. Class II showed significantly less BD than Class III (p < 0.05). With this information, clinicians can better understand BD trends of the midpalatal suture and, thus, better understand our patient’s anatomy and potential hurdles in successful treatment.

scholarly journals Orthodontic retreatment of a Class III patient with significant midline asymmetry and bilateral posterior crossbite

2015 ◽  
Vol 20 (1) ◽  
pp. 118-126
Author(s):  
Ademir R. Brunetto
Keyword(s):  
Class Iii ◽  
Class Iii Malocclusion ◽  
Midline Shift ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Skeletal Pattern ◽  
Angle Class Iii Malocclusion ◽  
Dentofacial Orthopedics ◽  
Angle Class Iii

Posterior crossbite might cause serious long-term functional problems if not early treated. Nevertheless, in older patients, treatment might include palatal expansion in order to correct such malocclusion. In view of the above, this article aims at reporting late correction of bilateral posterior crossbite associated with Angle Class III malocclusion, right subdivision, with consequent midline shift (good skeletal pattern). The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), with DI equal to or greater than 10, as a requirement for the title of certified by the BBO.

scholarly journals The Airway Volume Related to the Maxillo-Mandibular Position Using 3D Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Víctor Ravelo ◽  
Gabriela Olate ◽  
Gonzalo Muñoz ◽  
Márcio de Moraes ◽  
Sergio Olate
Keyword(s):  
Class Ii ◽  
3D Analysis ◽  
Class Iii ◽  
Cross Sectional ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Mandibular Plane ◽  
Mandibular Position ◽  
Skeletal Pattern ◽  
Maxilla And Mandible

Objective. The aim of this research was to compare three cephalometric analyses and their correlation with the airway volume in subjects with different skeletal classes using 2D and 3D images. Study Design. Cross-sectional descriptive study. Material and Method. Steiner, McNamara, and Ricketts analyses and the airway volume were compared in 115 subjects who were candidates for orthognathic surgery under diagnosis using cone beam computed tomography (CBCT); 46 males (40%) and 69 females (60%) were included. The sagittal positions of the maxilla and mandible, the angulation of the mandibular plane, the sagittal positions of the upper and lower incisors, measurements of the largest or shortest airway area, and the volume were compared using Spearman’s test considering a p value < 0.05. Results. Differences were observed between the Steiner and McNamara techniques for the sagittal position of the maxilla ( p = 0.01 ). For mandibular angulation, there was a greater difference between values for Steiner and Ricketts techniques ( p = 0.001 ). In the upper incisor, the results for McNamara and Ricketts techniques were significantly different ( p = 0.004 ). Analysing the airway, subjects with a class II skeletal pattern had a smaller volume than those with a class III pattern ( p = 0.034 ). Conclusion. It may be concluded that skeletal class II patients have a significantly smaller airway volume than class III patients. The skeletal parameter does not always relate to the airway volume; however, the high mandibular angle could be related to the airway conditions.

scholarly journals Treatment of class III Malocclusion with maxillary expansion and face-mask therapy: A case report

2014 ◽  
Vol 2 (1) ◽  
pp. 59-63
Author(s):  
M Mansuri ◽  
VP Singh
Keyword(s):  
Treatment Option ◽  
Face Mask ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Maxillary Expansion ◽  
Mandibular Growth ◽  
Maxillary Protraction ◽  
Medical College ◽  
Skeletal Pattern ◽  
Functional Appliances

The developing class III malocclusion is one of the most challenging problems for the practicing orthodontist to manage clinically. True class III malocclusion is rare in our region as compared to Class II and Class I malocclusion. With adults, orthognathic surgery and dental camouflage is the viable treatment option. A variety of treatment alternatives exists for patients in the developing stages of a Class III malocclusion. In the past much of the therapy has focused on restriction of mandibular growth with chin cups and functional appliances. This is based on the traditional thought that developing Class III malocclusions were the result of  prognathic mandible. Recently, however, there has been a growing awareness that the majority of patients with a developing Class III skeletal pattern exhibit a maxillary deficiency with a normal or only slightly prognathic mandible. Therefore, considerable attention has been given to early treatment using maxillary protraction therapy. Using facemask therapy in conjunction with maxillary expansion has been shown in clinical reports to be a successful and predictable treatment option. Treatment should be carried out as early as possible with the aim to prevent it from becoming severe. A case treated with biphasic therapy – orthopaedic appliance followed by fixed orthodontic treatment is presented here. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11539 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1):59-63

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