scholarly journals Evaluation of Postsurgical Stability And Condylar Morphology In Skeletal Class II Patients With Condylar Resorption Following Orthognathic Surgery

2021 ◽  
Author(s):  
Minjiao Wang ◽  
Hanjiang Zhao ◽  
Xiangyu Wang ◽  
Yifeng Qian ◽  
Hongbo Yu ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Condylar Morphology ◽  
Ramus Height ◽  
Condylar Volume

Abstract Background: To retrospectively evaluate postsurgical stability and condylar morphology for skeletal class II malocclusion patients with condylar resorption (CR) treated with orthognathic surgery.Methods: Thirty-five patients treated with combined orthodontic and orthognathic surgery between 2014 and 2018 were enrolled in this retrospective study. CT scans were acquired preoperatively (T0), 2–7 days after surgery (T1), and 1 year postoperatively (T2). The amount of mandibular advancement, postsurgical relapse, condylar morphology and joint spaces were analysed respectively. Statistical analysis was performed using R, version 3.4.3 (R Development Core Team 2010).Results: The average mandibular advancement and counter-clockwise rotation were 5.51 mm and -2.82 degrees respectively. The average relapse was 1.08 mm (19.6% of the advancement) and 1.13 degrees. The condylar volume showed a postoperative reduction of 161.86 mm3(13.7% of initial condylar volume). AJS increased after surgery and gradually returned to its original state, while SJS and PJS decreased and remained stable. Surgical advancement of B point was significantly correlated with skeletal relapse. The optimal cut-off values were as follows: MP-FH (40.75°); ramus height (51.125 mm); SJS (1.63 mm); surgical displacement (4.72 mm); CCR (-4.3°); AJSC (1.07 mm).Conclusions: Skeletal class II patients with CR have a high risk of postsurgical condylar resorption, which was most related to nonsurgical risk factors such as gender(female) and condylar angle. Condylar had moved posteriorly to the concentric position after surgery and remained quite stable through the 1-year follow-up. Preoperative skeletal patterns such as lower ramus height and surgical procedures such as larger advancement of the mandible were closely associated with sagittal relapse of the mandible.

scholarly journals A combined Surgical-Orthodontic treatment in skeletal Class II malocclusion patients

2021 ◽  
Vol 3 (2) ◽  
pp. 82-87
Author(s):  
Prathyaksha Shetty ◽  
Dipjyothi Baruah ◽  
Amit Rekhawat ◽  
Karthik Cariappa ◽  
Sujala Ganapati Durgekar ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Sagittal Split Osteotomy ◽  
Skeletal Class Ii ◽  
Facial Esthetics ◽  
Bilateral Sagittal Split Osteotomy ◽  
Common Problems

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.

Evaluation of Upper Airway Dimensional Changes and Hyoid Position Following Mandibular Advancement in Patients With Skeletal Class II Malocclusion

2012 ◽  
Vol 23 (6) ◽  
pp. e623-e627 ◽  
Author(s):  
Nanda Kishore Sahoo ◽  
Balakrishnan Jayan ◽  
N. Ramakrishna ◽  
Sukbir Singh Chopra ◽  
Gagandeep Kochar
Keyword(s):  
Upper Airway ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Dimensional Changes ◽  
Skeletal Class Ii

scholarly journals Three-Dimensional Assessment of Mandibular Condylar Volume and Position Subsequent to Twin Block Functional Therapy of Skeletal Class II Malocclusion Accompanied by Low-Level Laser Therapy

2020 ◽  
Vol 8 (4) ◽  
pp. 115
Author(s):  
Mahmoud Abdel Hameed Mohamed ◽  
Khaled Farouk Abdallah ◽  
Farouk Ahmed Hussein
Keyword(s):  
Laser Therapy ◽  
Class Ii ◽  
Low Level Laser Therapy ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Low Level ◽  
Low Level Laser ◽  
Skeletal Class Ii ◽  
Level Laser ◽  
Condylar Volume

This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) on mandibular condylar volume and position following treatment of a Class II malocclusion with a twin block (TB) appliance employing cone beam computed tomography (CBCT). Twenty-four growing patients, aged 9–12 years, were randomly allocated into control and laser groups. All patients were treated with a TB appliance. The patients in the laser group were treated weekly with a gallium–aluminum–arsenide (GaAlAs) diode laser around the temporomandibular joint (TMJ) region for three months. CBCT images were obtained before and after TB therapy and the changes in TMJ and skeletal variables were evaluated and compared among and between the groups. In the laser group, the condylar volume of the right and left sides significantly increased by 213.3 mm3 and 231.2 mm3, respectively (p < 0.05), whereas in the control group it significantly increased by 225.2 mm3, and 244.2 mm3, respectively (p < 0.05), with forward and lateral positioning of both sides. Furthermore, effective mandibular, ramus, and corpus lengths were increased, which were not significant between the groups. Low-Level Laser therapy accomplished no considerable effect on mandibular condylar volume and position following the functional orthopedic treatment of skeletal Class II malocclusions using a TB appliance.

scholarly journals Management of severe Class II malocclusion with sequential modified twin block and fixed orthodontic appliances

2016 ◽  
Vol 6 ◽  
pp. 113-118
Author(s):  
Sonal Chowdhary
Keyword(s):  
Class Ii ◽  
Mandibular Advancement ◽  
Orthodontic Appliances ◽  
Class Ii Malocclusion ◽  
Functional Appliance ◽  
Deep Bite ◽  
Twin Block ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Fixed Orthodontic Appliances

Functional appliance is an effective way of treating skeletal Class II malocclusion in children and adolescents. A 12 months stepwise mandibular advancement protocol with Herbst appliance has been proved to enhance condylar growth and improve mandibular prognathism. The present case report documents a 12-year-old boy presenting with Angle’s Class II, division 1 malocclusion associated with excessive overjet (11 mm), 100% deep bite, and retrognathic mandible. He was treated by a phase I growth modification therapy using twin block appliance with lip pads in a stepwise mandibular advancement protocol followed by a phase II preadjusted Edgewise appliance therapy.

scholarly journals Differential Diagnosis of Skeletal Class II: Orthodontic-Surgical Approach with Surgery First

2021 ◽  
Vol 23 (4) ◽  
pp. 257-263
Author(s):  
Jessica Rico Bocato ◽  
Daiara Paula Pacheco ◽  
Mauro Toma ◽  
Ricardo Lima Navarro ◽  
Thais Maria Freire Fernandes ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Treatment Time ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Facial Profile ◽  
Skeletal Class ◽  
Angle Class Ii ◽  
Main Complaint ◽  
Skeletal Class Ii ◽  
Surgery First

AbstractOrthodontic-surgical treatment with the “Surgery First Approach” provides immediate facial aesthetic improvements and significantly reduces the patient's orthodontic treatment time, avoiding the transient worsening of the facial profile due to dental decompensation that occurs in surgical cases. Thus, this clinical case describes the retreatment of a 22-year-old female leukoderma patient, whose main complaint was related to the proclination of upper and lower incisors. The patient used a mio-relaxing plate for 30 days, which evidenced the skeletal mandibular deficiency and the ½ bilateral Class II malocclusion. Orthognathic surgery first approach associated with the extraction of the 4 premolars was chosen considering the patient’s aesthetic demand. The use of a mio-relaxing plate in the diagnostic stage was essential for the real diagnosis of mandibular deficiency and the technique employed made it possible to conclude the treatment avoiding aesthetic commitment, with excellent results. Keywords: Malocclusion, Angle Class II. Orthognathic Surgery. Orthodontics, Corrective. ResumoO tratamento ortodôntico-cirúrgico por meio do benefício antecipado proporciona melhorias estéticas faciais imediatas e reduz de maneira significativa o tempo de tratamento ortodôntico do paciente, evitando a piora transitória do perfil facial devido à descompensação dentária que ocorre em casos cirúrgicos. Assim, este caso clínico descreve o retratamento de uma paciente com 22 anos de idade, leucoderma, sexo feminino, que apresentava queixa principal relacionada à inclinação vestibular dos dentes anteriores. Após uso de placa miorrelaxante por 30 dias, verificou-se a presença de Classe II esquelética com deficiência mandibular e ½ Classe II dentária bilateral. Considerando a demanda estética da paciente, optou-se pela abordagem ortodôntico-cirúrgica com Benefício Antecipado associada à extração de 4 pré-molares para correção da inclinação dentária anterior. O uso da placa miorrelaxante foi fundamental para o diagnóstico real da deficiência mandibular e a técnica empregada possibilitou concluir o tratamento evitando o comprometimento estético pré-cirúrgico, com obtenção de excelentes resultados. Palavras-chave: Maloclusão Classe II de Angle. Cirurgia Ortognática. Ortodontia Corretiva.

scholarly journals Ortho-surgical Management of Severe Skeletal Class II Div 2 Malocclusion in Adult

2017 ◽  
Vol 7 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Suchita Tarvade Daokar ◽  
Gauri Agrawal ◽  
Charushila Chaudhari ◽  
Sheetal Yamyar
Keyword(s):  
Case Report ◽  
Surgical Approach ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
Growth Modulation ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Bilateral Sagittal Split Osteotomy ◽  
Mandibular Retrognathism

Skeletal Class II malocclusion is attributed to maxillary prognathism, mandibular retrognathism or combination of both. In adolescent cases, the treatment includes growth modulation with headgear or myofunctional appliances. However in adults, optimum esthetic and functional efficacy can be achieved by orthodontic-surgical combination. This case report describes a 21 years old post-pubertal male with severe skeletal Class II discrepancy with normal maxilla and retrognathic mandible. The case was treated with bilateral sagittal split osteotomy (BSSO) with mandibular advancement approach. Straight profile, pleasing esthetics, bilateral Class I molar and canine relationship, normal overjet and overbite were achieved because of a combined ortho-surgical approach.

Bimaxillary surgery to correct high-angle class II malocclusion: does a simultaneous genioplasty affect long-term stability?

2019 ◽  
Vol 42 (4) ◽  
pp. 426-433
Author(s):  
Nina Torgersbråten ◽  
Arild Stenvik ◽  
Lisen Espeland
Keyword(s):  
Class Ii ◽  
Open Bite ◽  
Mandibular Advancement ◽  
Class Ii Malocclusion ◽  
High Angle ◽  
Skeletal Class ◽  
Angle Class Ii ◽  
Post Surgery ◽  
Angle Class ◽  
Skeletal Class Ii

Summary Background and objectives High-angle skeletal Class II malocclusion is one of the most challenging dentofacial deviations to treat and, in adults, a combination of orthodontic treatment and bimaxillary orthognathic surgery is often indicated. This study examines the rate of clinically significant relapse and whether a genioplasty affects the treatment outcome of high-angle Class II malocclusions. Material and methods Cephalometric tracings of 36 consecutively treated high-angle Class II patients were evaluated from pre-surgery to 3 years post-surgery. All patients had undergone bimaxillary surgery (Le Fort I and BSSO), 13 of them had in addition a genioplasty. Results The maxilla remained stable, whereas relapse (greater than or equal to 2 mm) of the mandibular advancement was seen in 40 per cent of the patients. Advancement greater than 10 mm increased the risk for horizontal relapse. The overjet was normalized and remained stable despite mandibular relapse. Half of the patients had an anterior open bite 3 years post-surgery. A supplemental genioplasty did not affect the relapse rate. Conclusions and implications Overjet was normalized and remained stable long term; there was an open bite in half of the patients. Combined orthodontic and bimaxillary surgical treatment of high-angle Class II patients showed skeletal relapse (greater than or equal to 2 mm) of the mandible in 40 per cent of patients. Mandibular advancement greater than 10 mm increased the risk for relapse. There was no increased risk for dental or skeletal instability associated with a genioplasty in combination with maxillary and mandibular surgery in the treatment of high-angle skeletal Class II malocclusion.

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