scholarly journals Mechanism of Multi-loop Edgewise Archwire technique in correcting anterior open bites of Class II malocclusion patients with temporomandibular disorders - cephalometric assessment

2020 ◽  
Author(s):  
Huanye Liu ◽  
Heeyeon Suh ◽  
Young-Eun Jung ◽  
Kaiyuan Xu ◽  
Dan Zhang ◽  
...  

Abstract Background: An anterior open bite is considered challenging to treat because of its multifactorial etiology. Condylar resorption, which is one of the temporomandibular disorders (TMD) symptoms, has been identified as an etiologic factor of anterior open bites. It is essential to find an effective and efficient method to correct open bites while reducing the risk of exacerbating TMD during orthodontic treatment.Objectives: To evaluate the effect of the multi-loop edgewise archwire (MEAW) technique in correcting anterior open bite in patients with TMD. Materials and Methods: In this retrospective study, 20 patients with anterior open bites and TMD were included. 19 cephalometric measurements and 2 open bite indices were evaluated. A paired t-test was used to assess changes between pre- and post-treatments. Results: There were statistically significant changes after the treatment using the MEAW technique. The cephalometric measurements, including vertical positions of the incisors and molars, changed significantly. The maxillary and mandibular regional superimpositions for a subgroup of non-extraction patients showed slight intrusion of the upper molars (-0.6±1.0mm, p=0.04) and slight extrusion of the lower molars (1.0±1.1mm, p<0.01). Open bite correction was achieved predominantly through retraction and extrusion of the upper and lower incisors. Conclusions: The anterior open bite was successfully corrected by using the MEAW technique. However, the primary mechanism was the extrusion of the anterior teeth with a maintained vertical dimension. In the absence of apparent symptoms of joint discomfort, it is effective and relatively safe to use the MEAW technique to treat open bite patients with TMD.


2020 ◽  
Author(s):  
Huanye Liu ◽  
Heeyeon Suh ◽  
Young-Eun Jung ◽  
Kaiyuan Xu ◽  
Dan Zhang ◽  
...  

Abstract Background: An anterior open bite is considered challenging to treat because of its multifactorial etiology. Condylar resorption, which is one of the temporomandibular disorders (TMD) symptoms, has been identified as an etiologic factor of anterior open bites. It is essential to find an effective and efficient method to correct open bites while reducing the risk of exacerbating TMD during orthodontic treatment.Objectives: To evaluate the effect of the multi-loop edgewise archwire (MEAW) technique in correcting anterior open bite in patients with TMD. Materials and Methods: In this retrospective study, 20 patients with anterior open bites and TMD were included. 19 cephalometric measurements and 2 open bite indices were evaluated. A paired t-test was used to assess changes between pre- and post-treatments. Results: There were statistically significant changes after the treatment using the MEAW technique. The cephalometric measurements, including vertical positions of the incisors and molars, changed significantly. The maxillary and mandibular regional superimpositions for a subgroup of non-extraction patients showed slight intrusion of the upper molars (-0.6±1.0mm, p=0.04) and slight extrusion of the lower molars (1.0±1.1mm, p<0.01). Open bite correction was achieved predominantly through retraction and extrusion of the upper and lower incisors. Conclusions: The MEAW technique can be an effective method in correcting anterior open bites in Class II patients with TMD. Anterior open bites were corrected mainly by extrusion and retraction of the anterior teeth. The vertical dimension was maintained for the upper molars, but the mandibular molars were extruded. During treatment, the patients who had TMD did not show evident recurrence or worsening of their TMD conditions, indicating that orthodontic treatment can be performed when required.



2014 ◽  
Vol 21 (2) ◽  
pp. 178
Author(s):  
Vega Mandala ◽  
Wayan Ardhana ◽  
Christnawati Christnawati

Gigitan terbuka merupakan maloklusi yang bercirikan tidak terdapatnya tutup menutup gigi rahang atas dan bawah, dapat terjadi pada regio anterior maupun posterior dan dapat melibatkan dental maupun skeletal. Maloklusi ini memerlukan ketelitian dalam penentuan diagnosis dan perawatan untuk mendapatkan hasil perawatan yang baik dan kestabilan jangka panjang. Tujuan penulisan studi kasus ini adalah untuk menginformasikan manajemen pasien dengan gigitan terbuka tipe skeletal. Pasien pria berumur 19 tahun datang ke Klinik Ortodonsia FKG UGM dengan keluhan utama gigi depan yang tidak rata dan tidak dapat digunakan untuk menggigit. Pemeriksaan klinis menunjukkan pasien memiliki kebiasaan menelan dengan menjulurkan lidah. Pemeriksaan model studi menunjukkan maloklusi Angle kelas I dengan gigitan terbuka anterior dari regio premolar kedua kanan ke kiri sebesar 10,7 mm disertai malposisi gigi individual dan pergeseran garis tengah rahang bawah ke kiri. Pemeriksaan sefalometri menunjukkan relasi skeletal kelas II dengan retrusif bimaksila, rotasi mandibula searah jarum jam dan gigitan terbuka skeletal. Pasien menolak tindakan bedah ortognatik sehingga dilakukan perawatan ortodontik kamuflase. Perawatan diawali dengan latihan miofungsional untuk melatih cara penelanan yang benar dilanjutkan dengan perawatan ortodontik teknik straightwire dengan pencabutan empat gigi molar pertama. Penutupan gigitan terbuka menggunakan elastic box anterior. Hasil evaluasi menunjukkanpengurangan besar gigitan terbuka dari 10,7 mm menjadi 1,25 mm. Kesimpulannya elastic box anterior dapat digunakan untuk mengoreksi gigitan terbuka yang etiologinya melibatkan intrusi gigi anterior.  Skeletal Anteroposterior Open Bite Treatment with Straight Wire Technique. Open bite is a malocclusion with characteristic no overlapping between maxillar and mandibular teeth. This malocclusion may occur in anterior or posterior region and involved dental or skeletal. This malocclusion needed precise diagnosis and treatment to get a good treatment result and long term stability. The aim of this case report was to inform management of patient with skeletal open bite. A 19 years old male came to orthodontic clinic Faculty of Dentistry Gadjah Mada University with the chief complaint anterior crowding, and anterior teeth cannot be used to bite. Clinical finding showed patient had tongue thrusting habit. Study model analysis showed class I Angle malocclusion with 10.7 mm anterior open bite from right second premolar to left second premolar, with individual teeth malposition and mandibular midline shifting to the left. Cephalometric finding showed class II skeletal relationship with bimaxillar retrusive, clockwise mandibular rotation and skeletal open bite. This patient refused orthognatic surgery, so he received camouflage orthodontic treatment. This treatment was started with monofunctional exercise to correct the swallowing action then continued with straight wire orthodontic treatment with four first molar extractions. Anterior box elastic was used to close the bite. Evaluation result showed open bite was decreased from 10.7 mm to 1.25 mm. The conclusion was anterior box elastic could be used in open bite correction that involved anterior teeth intrusion as an etiology.



2020 ◽  
Vol 25 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Ei Ei Hsu Hlaing ◽  
Yoshihito Ishihara ◽  
Atsuro Fujisawa ◽  
Takashi Yamashiro ◽  
Hiroshi Kamioka

ABSTRACT Introduction: Tooth agenesis is one of the most common dental anomalies; however, the concomitant occurrence of opposite dental numerical variation of hypohyperdontia is extremely rare. Objective: To report the successful orthodontic management of a patient with non-syndromic concomitant bilateral agenesis of mandibular canines and two midline inverted supernumerary maxillary teeth. Case report: 21-year-old female patient with a chief complaint of protrusive right maxillary central incisor. The patient was diagnosed with a mild Class II skeletal base, Angle Class III molar relationship and increased overjet associated with hypohyperdontia. Anterior open bite accompanied with tongue-thrusting habit were also observed. Two temporary anchorage devices (TADs) were implanted at the buccal side of the maxillary molar region to control vertical height. Anterior teeth retraction was done after extraction of the maxillary first premolars, to improve the excessive overjet. The treatment mechanics involved lingual brackets system for the maxillary arch and transpalatal arch for anchorage control. Results: The total active treatment period was 35 months. Acceptable occlusion with increased bite force and contact area as well as functional excursion were established without interference, following complex orthodontic treatment with premolar substitution. The resultant occlusion and a satisfactory facial profile were maintained after 29 months of retention. Conclusion: The present case report provides implications regarding the orthodontic treatment of hypohyperdontia-associated substitution for missing teeth as an effective option for improving aesthetic and functional aspects.



2021 ◽  
Vol 32 (3) ◽  
pp. 120
Author(s):  
William Suryajaya ◽  
Haru Setyo Anggani

Pendahuluan: Perawatan ortodonti kamuflase adalah perawatan untuk menyamarkan diskrepansi skeletal dengan mengubah posisi dan angulasi gigi-gigi pada lengkung rahang. Perawatan tersebut merupakan perawatan yang dapat dipilih selain bedah ortognatik bagi kasus maloklusi skeletal kelas III pada pasien dewasa. Maloklusi skeletal kelas III sering pula disertai dengan keadaan lain seperti gigitan terbuka anterior yang menambah kompleksitas modalitas perawatan. Tujuan laporan kasus ini untuk menjelaskan pilihan modalitas perawatan pasien maloklusi skeletal kelas III secara kamuflase ortodonti. Laporan kasus: Pasien wanita usia 19 tahun 2 bulan datang ke klinik Ortodonti RSGM FKG UI dengan keluhan gigi atas depan tidak teratur dan gigi depan atas dan bawah tidak bertemu. Diagnosis menunjukkan pola skeletal kelas III dengan posisi maksila dan mandibula terhadap basis cranii retrognati (SNA 73°, SNB 74°, ANB -1°)  disertai dengan crowding sedang dan gigitan terbuka anterior. Tipe wajah pasien dolikofasial, simetris dan seimbang. Profil jaringan lunak dan skeletal cekung. Kasus ini dirawat dengan pendekatan ortodonti kamuflase tanpa pencabutan menggunakan piranti cekat standar Edgewise untuk mengoreksi crowding pada lengkung gigi atas dan bawah serta gigitan terbuka pada regio anterior. Perawatan ortodonti selesai dalam waktu 13 bulan dan crowding pada lengkung gigi atas dan bawah serta gigitan terbuka pada regio anterior telah terkoreksi. Simpulan: Perawatan ortodonti kamuflase pada maloklusi kelas III skeletal dengan gigitan terbuka anterior ringan merupakan pilihan perawatan yang cukup baik karena dapat mengoreksi maloklusi dengan kompensasi dentoalveolar sehingga diperoleh oklusi yang baik dan stabil. Hasil perawatan menunjukan hasil yang cukup baik dan dapat diterima oleh pasien.Kata kunci: Maloklusi skeletal kelas III, crowding, open-bite anterior, standar edgewise, ortodonti kamuflase. ABSTRACTIntroduction: Orthodontic camouflage is a treatment to disguise skeletal discrepancies by changing the teeth position and angulation in the jaw arch. This treatment is an option other than orthognathic surgery for skeletal class III malocclusion in adult patients. Skeletal class III malocclusion is often accompanied by other conditions such as an anterior open-bite which adds the complexity of the treatment modality. This case report was aimed to describe the choice of treatment modality for skeletal class III malocclusion patients by orthodontic camouflage. Case report: A female patient aged 19 years and two months came to the Orthodontic Clinics at the Faculty of Dentistry of University of Indonesia Dental Hospital (RSGM FKG UI) with complaints of irregular maxillary anterior teeth, and the maxillary and mandibular anterior teeth did not overlap. The diagnosis showed a skeletal class III pattern with the maxillary and mandibular position against the retrognathic cranii base (SNA 73°, SNB 74°, ANB -1°) accompanied by moderate crowding and anterior open-bite. The patient’s face type is dolichofacial, symmetrical and balanced, with the concave soft and skeletal tissue profiles. This case was treated with a non-extraction camouflage orthodontic approach using the standard edgewise fixed appliance to correct crowding in the maxillary and mandibular dental arches and open-bite in the anterior region. The orthodontic treatment was completed within 13 months, and crowding in the maxillary and mandibular dental arches and open-bite in the anterior region were corrected. Conclusion: Camouflage orthodontic treatment is a good treatment option for skeletal class III malocclusion with a mild anterior open-bite because it can correct malocclusion with dentoalveolar compensation to obtain a good and stable occlusion. The treatment results show good results and can be accepted well by the patient.Keywords: Skeletal class III malocclusion, crowding, anterior open-bite, standard edgewise, orthodontic camouflage.



2013 ◽  
Vol 18 (2) ◽  
pp. 133-140
Author(s):  
Matheus Melo Pithon

This clinical case reports the orthodontic treatment of a Class I malocclusion with anterior open bite and bimaxillary dentoalveolar protrusion in a 28-year-old female patient. The treatment of choice was to perform tooth extractions followed by retraction of the anterior teeth, with consequent closure of the anterior open bite and better accommodation of the teeth on their bony bases. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), representing the Category 2 - i.e., an Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth -, as part of the requisites to become a BBO diplomate.



PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 174-176
Author(s):  
PATRICK C. FRIMAN ◽  
VINCENT J. BARONE ◽  
EDWARD R. CHRISTOPHERSEN

Thumb sucking is common and adaptive in infancy and early childhood. But when sucking occurs beyond 4 years of age, a common result can be an anterior, open bite that requires expensive orthodontic correction.1 Prolonged sucking may also be a factor in class II malocclusion, narrowing of the dental arches, mucosal trauma, and digital malformation.1-4 In addition to the physical sequelae of sucking, the habit, because it is not socially approved, can generate persistent negative feedback which can adversely affect a child's self-esteem.5 Thumb sucking is a frequently reported child behavior problem that, in some children, can be associated with broader behavior disorders that require treatment.



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 ◽  
...  

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.



2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Daniel Gheur Tocolini ◽  
Priscila de Oliveira Silva ◽  
Iduilton Grabowski ◽  
Julia Carelli ◽  
Nathaly Dias Morais ◽  
...  

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.



2005 ◽  
Vol 84 (2) ◽  
pp. 133-137 ◽  
Author(s):  
S. Miyawaki ◽  
Y. Araki ◽  
Y. Tanimoto ◽  
A. Katayama ◽  
A. Fujii ◽  
...  

Patients with open bite often show a weak occlusal force and temporomandibular disorders (TMDs). If these are the main cause of open bite, it may be hypothesized that both pre-pubertal and adult open-bite patients would show a weak occlusal force and abnormal condylar motion. The purpose of this study was to test this hypothesis. Test group subjects consisted of 13 consecutive pre-pubertal and 13 adult patients with anterior open bite. They were compared with age-matched normal subjects. The adult open-bite group showed a weaker occlusal force and a shorter range of condylar motion compared with the control subjects. In the pre-pubertal subjects, however, there were no significant differences in the occlusal force and range of condylar motion between the open-bite and control groups. Therefore, these results suggest that a weak occlusal force or TMDs may not be the main cause of open bite.



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