scholarly journals Glossectomia como alternativa à recidiva de maloclusão: relato de caso

2020 ◽  
Vol 8 (12) ◽  
Author(s):  
Vítor Bruno Teslenco ◽  
Maylson Alves Nogueira Barros ◽  
Herbert de Abreu Cavalcanti ◽  
Guilherme Nucci dos Reis

Introdução: a macroglossia é uma condição incomum e pode ser caracterizada como uma desordem por hipertrofia muscular, podendo ter também origem tumoral, endócrina, causas congênitas e doenças adquiridas. Inúmeras são as técnicas cirúrgicas para correção desta anomalia, porém, o plano de tratamento deve ter como base a etiologia da macroglossia. A correção cirúrgica objetiva a retomada de forma e função da língua, reestabelecendo a capacidade mastigatória, respiratória, fonética e estabilidade oclusal. Objetivo: relatar a comunidade científica um caso de glossectomia parcial para correção de um quadro de macroglossia, facilitando assim, a estabilidade do tratamento ortodôntico do paciente. Relato de caso: Paciente de 50 anos, leucoderma, em tratamento por ortodontia corretiva há mais de 18 meses, sem sucesso observado. Devido ao quadro de instablidade ortodôntica, maloclusão sem resolução passiva, macroglossia diagnosticada e redução da capacidade respiratória foi optado por realizar a glossectomia parcial. O procedimento foi realizado sob anestesia geral, onde removemos o tecido muscular a partir da abordagem de buraco de fechadura (Técnica de Kole). Conclusão: constatamos no presente caso, que a técnica de buraco de fechadura empregada neste paciente se mostrou eficaz, uma vez que obtivemos uma melhora estética e funcional, diminuindo o comprimento e largura da língua. Da mesma maneira, o tratamento ortodôntico foi passível de ser finalizado.Descritores: Macroglossia; Cirurgia Bucal; Glossectomia.ReferênciasTopouzelis N, Iliopoulos C, Kolokitha OE. Macroglossia. Int Dent J. 2011;61(2):63-9.Neville BW, Allen CM, Damm DD, Chi AC. Patologia: oral e maxilofacial. 4.ed.  Rio de Janeiro: Guanabara Koogan; 2016.Gadiwalla Y, Burnham R, Warfield A, Praveen P. Surgical management ofmacroglossia secondary to amyloidosis. BMJ Case Rep. 2016:10.1136.Salmen FS, Dedivitis RA. Partial glossectomy as an auxiliary method to orthodontic treatment of dentofacial deformity. Int Arch Otorhinolaryngol. 2012;16(3):414-17.Costa SAP, Brinhole MCP, da Silva RA, Dos Santos DH, Tanabe MN. Surgical treatment of congenital true macroglossia. Case Rep Dent. 2013;2013:489194.Balaji SM. Reduction glossectomy for large tongues. Ann Maxillofac Surg. 2013;3(2):167-72.Cymrot M, Teixeira FAA, Sales FCD, Muniz NFJ. Glossectomia subtotal pela técnica de ressecção lingual em orifício de fechadura modificada como tratamento de macroglossia verdadeira. Rev Bras Cir Plást. 2012;27(1):165-69.Tanaka OM, Guariza-Filho O, Carlini JL, Oliveira DD, Pithon MM, Camargo ES.Glossectomy as an adjunct to correct an open-bite malocclusion with shortenedmaxillary central incisor roots. Am J Orthod Dentofacial Orthop. 2013;144(1):130-40.Salmen FS, Dedivitis RA. Glossectomia parcial como método auxiliar ao tratamento ortodôntico da deformidade dento-facial. Int Arch Otorhinolaryngol.  2012;16(3):414-17.Jung YW, On SW, Chung KR, Song SI. Simultaneous glossectomy with orthognathic surgery for mandibular prognathism. Maxillofac Plast Reconstr Surg. 2014;36(5):214-18.Vieira CA. Fonoterapia em glossectomia total: estudo de caso. Rev Soc Bras Fonoaudiol. 2011;16(4):479-82.

Processes ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1609
Author(s):  
Minh Truong Nguyen ◽  
Tien Thuy Vu ◽  
Quang Ngoc Nguyen

Orthognathic surgery and orthodontic treatment are required for patients with dentofacial deformities to obtain an ideal facial esthetic with good functioning. Recently, characterized by the surgery-first approach, an integrated orthodontic–surgical treatment has been introduced as an emerging solution to dentofacial deformity treatment. The surgery-first approach is regarded to have less treatment time and quicker enhancement of a facial profile than the conventional orthodontic–surgical treatment. Moreover, the recent advances in computing and imaging have allowed the adoption of 3-dimensional (3D) virtual planning protocols in orthognathic surgery as well as digital orthodontic treatment, which enables a paradigm shift when realizing virtual planning properly. These techniques then allow the surgeon and orthodontist to collaborate, plan, and simulate the dentofacial deformity treatment before performing the whole procedure. Along this line, in this research article, we present an integrated treatment method for the realization of an effective deformity treatment. Specifically, we implemented the integrated 3D technique by combining it with the surgery-first orthognathic approach (SFOA) as a novel treatment method for the patients. The outcomes from the combined treatments of the patients with dentofacial deformity, in practice, have demonstrated that our proposed 3D technique in orthognathics and orthodontics using clear aligner therapy (e.g., Invisalign) can enhance the satisfactory level of the patient since the start of treatment then improve their quality of life. As a result, the combined techniques realize the novel integrated treatment method using 3D technology with the use of 3D imaging and modeling as a promising development trend of dentistry, which fits into the context of Dentistry 4.0 as a key enabler to the concept of sustainable dentistry development.


2018 ◽  
Vol 11 (3) ◽  
pp. 211-218
Author(s):  
Felipe Ladeira Pereira ◽  
Luísa de Marilac de Alencar Pinheiro ◽  
Phelype Maia Araújo ◽  
LetíciaLiana Chihara ◽  
Renato Luiz Maia Nogueira ◽  
...  

Facial asymmetry, following early childhood condylar trauma, is a common complaint among patients who seek surgical treatment. G.D.M., a 27-year-old male patient, sought professional help to correct his cosmetic flaw, caused by a condylar fracture when he was 8-years-old. After the proper orthodontic treatment, he underwent a double jaw orthognathic surgery and, 9 months later, a second one to correct the remaining asymmetry. Two years after this second procedure, the patient is still under surveillance and has no complaints.


2017 ◽  
Vol 17 (1) ◽  
pp. 23-28
Author(s):  
Ieva Gavare ◽  
Ilga Urtane ◽  
Gundega Jakobsone ◽  
Laura Neimane

Summary Introduction. Although severe root resorption is rare, it is a side effect of orthodontic treatment which affects tooth prognosis. Patients with severe dentofacial deformity, for whom orthodontic treatment and orthognathic surgery was done at the age of 18 and later, had long duration orthodontic treatment and orthognathic surgery, and are at a high risk of root resorption. The impact of orthognathic surgery on root resorption has not been sufficiently studied, and therefore is an interesting topic to research. Aim of the Study. To identify the risk factors for apical root resorption of maxillary incisors and canines as a result of orthodontic and surgical treatment of Class III malocclusion involving LeFort I osteotomy. Material and methods. The root lengths of upper incisors and canines were measured on cone beam computer tomography (CBCT) scans obtained from a database of orthognathic surgery patients. As a criteria for root resorption was chosen the difference in root lengths between different time points. The measurements were performed using the scans taken before orthodontic treatment (T1), before surgery (T2), and after post surgery orthodontic treatment (T3), of 28 subjects, aged 20.5 ± 3.81 years, with the mean presurgery treatment time of 19.9 ± 8.8 months, and post-surgery time of 7.1 ± 3.1 months. Changes in root lengths during different time spans were correlated with treatment duration, the initial crown/root ratio, and the severity of dentofacial deformity (Wits appraisal, ANB angle, and overjet). Results. During T1 - T2 the roots of the lateral incisors shortened by a maximum of 0.78 ± 0.83 mm (p < 0.001), at a rate of 0.04 mm per month. During T2 - T3 the lengths of the central incisor roots decreased most by 0.49 ± 0.52 (p < 0.001) at a rate of 0.07 mm per month. The resorption speed for canines increased from 0.03 mm to 0.1 mm per month before and after surgery. There were statistically significant correlations between the crown-root ratio and the incisor root length (r = 0.319 for lateral and r = 303 for central, both p<0,05) and for canines (r = 482, p<0.01). The associations between the shortened root length, in different time spans for different teeth, and the severity of malocclusion were inconsistent. Conclusions. Overall, the shortened root length during combined orthodontic and surgical treatment might not be clinically significant. After surgery, the rate of root resorption (mm per month) increased, especially for canines. The teeth with initially shorter roots showed more resorption during treatment.


This chapter discusses the growth of the face, development of the dentition, and prevention and correction of occlusal anomalies, providing a concise overview of the fundamentals of orthodontics. Definitions relevant to orthodontics are outlined as well as a structured approach to orthodontic assessment. The Index of Orthodontic Treatment Need is explained, and its implications highlighted. The chapter also simplifies cephalometrics before detailing the management of increased overbite, anterior open bite, increased overjet, and various other dental and skeletal malocclusions. A further area included in this chapter is orthognathic surgery. The section includes diagnosis and treatment planning in these cases, surgery, and distraction osteogenesis.


2005 ◽  
Vol 42 (2) ◽  
pp. 212-217 ◽  
Author(s):  
Carine Laroche ◽  
Sylvie Testelin ◽  
Bernard Devauchelle

Objective Patients with Beckwith-Wiedemann syndrome suffer numerous anomalies, which vary somewhat from case to case. Cleft palate in combination with this syndrome has rarely been reported in the literature. Through two cases, this report examines the staging of the surgical repairs and the role of macroglossia in cleft palate and the consequences of the scarred palate on mandibular development. Results Of four patients with Beckwith-Wiedemann syndrome, only two had a cleft palate. The timing of the repair in these two children was different. Speech development was satisfactory in the first case but mediocre in the second. This result seemed to be related to a poor social environment. Mandibular prognathism persisted in both cases. Conclusion The treatment of patients with cleft palate and Beckwith-Wiedemann syndrome remains complex. It is preferable not to operate on a cleft palate before performing a tongue reduction plasty, but rather to combine these two surgical interventions. This would reduce the risks of anesthesia and enable the palate to heal more efficiently. Surgical treatment should be performed after the age of 6 months and before problems in speech development occur. An orthognathic surgery at adolescence could be performed if prognathism persists. While the origin of the cleft palate is still being discussed, we cannot claim that macroglossia is related to the development of cleft palate, nor that the scarred palate has an impact on the mandibular development.


2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Gregory W. Jackson

A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient’s severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient’s sleep continuity and architecture with the elimination of obstructive apneas.


2021 ◽  
Vol 14 (1) ◽  
pp. 21-25
Author(s):  
Tarun K Mittal ◽  
Kulraj Achal ◽  
James T Taylor ◽  
Jay D Kindelan

Orthodontic treatment of an anterior open bite is one of the most challenging malocclusions to treat, especially with respect to post-treatment stability. Complete diagnosis and targeted treatment is required for successful post treatment stability. In instances where macroglossia is the primary aetiology, partial glossectomy will greatly improve post treatment stability. The following case report describes a patient with severe anterior open bite and bimaxillary protrusion secondary to macroglossia. Treatment was successfully performed with partial glossectomy and straight wire orthodontics. Post-treatment relapse was minimal. CPD/Clinical Relevance: This article describes a review of the aetiology of anterior open bite and documents one possible treatment option, when the main aetiology of the malocclusion is of soft tissue origin


2016 ◽  
Vol 21 (6) ◽  
pp. 103-114 ◽  
Author(s):  
Marcelo Quiroga Souki

ABSTRACT The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate.


2014 ◽  
Vol 19 (6) ◽  
pp. 37-45 ◽  
Author(s):  
Juan Fernando Aristizabal ◽  
Rosana Martínez Smit

INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite.METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead.RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period.


2016 ◽  
Vol 73 (4) ◽  
pp. 318-325 ◽  
Author(s):  
Nikola Mikovic ◽  
Milos Lazarevic ◽  
Zoran Tatic ◽  
Sanja Krejovic-Trivic ◽  
Milan Petrovic ◽  
...  

Background/Aim. Postoperative condylar position is a substantial concern in surgical correction of mandibular prognathism. Orthognathic surgery may change condylar position and this is considered a contributing factor for early skeletal relapse and the induction of temporomandibular disorders. The purpose of this study was to evaluate changes in condylar position, and to correlate angular skeletal measurements following bimaxillary surgery. Methods. On profile teleradiographs of 21 patients with mandibular angular and linear parametres, the changes in condylar position, were measured during preoperative orthodontic treatment and 6 months after the surgical treatment. Results. A statistically significant difference in values between the groups was found. The most distal point on the head of condyle point (DI) moved backward for 1.38 mm (p = 0.02), and the point of center of collum mandibulae point (DC) moved backward for 1.52 mm (p = 0.007). The amount of upward movement of the point DI was 1.62 mm (p = 0.04). Conclusion. In the patients with mandibular prognathism, the condyles tend to migrate upward and forward six months after bimaxillary surgery.


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