Severe open bite with mandibular asymmetry treated using micro-implant anchorage

Abstract This case report shows the possibility of the application of a mandibular osteotomy to resolve mandibular asymmetry with independent and discordant movements of both bony segments. The authors report the case of a 25-year-old woman referred for mandibular asymmetry, with a transverse excess of the right hemi mandible and vertical defect of the left one. The patient underwent a bilateral sagittal split osteotomy, midline osteotomy, and genioplasty, which corrected the mandibular asymmetry with contraction of the entire right hemi mandible. A slight left vertical increase was also obtained through the surgically created lateral open bite. In the follow-up assessment, the patient's face appeared symmetrical with normalization of the bizygomatic-bigonial relationships, and the facial shape corresponded to ideal anthropometric features. This technique resulted in resolution of mandibular asymmetry. In addition, mandibular osteotomy permits the esthetic management of the shape of the entire mandibular body in relation to the other third of the face.

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Nonextraction treatment of an open bite with microscrew implant anchorage

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2005.07.014 ◽

2006 ◽

Vol 130 (3) ◽

pp. 391-402 ◽

Cited By ~ 55

Author(s):

Hyo-Sang Park ◽

Oh-Won Kwon ◽

Jae-Hyun Sung

Keyword(s):

Open Bite ◽

Implant Anchorage

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“Orthognathic Surgery to Improve the Facial Profile: Technique, 3D Planning and Assessment”

Aesthetic Surgery Journal Open Forum ◽

10.1093/asjof/ojaa051 ◽

2020 ◽

Author(s):

Kitae E Park ◽

Seija Maniskas ◽

Omar Allam ◽

Navid Pourtaheri ◽

Derek M Steinbacher

Keyword(s):

Orthognathic Surgery ◽

Skeletal Maturity ◽

Fat Grafting ◽

Open Bite ◽

Class Iii ◽

Maxillary Hypoplasia ◽

Delayed Treatment ◽

3 Dimensional ◽

Mandibular Asymmetry ◽

Facial Harmony

Abstract A concave profile with class III malocclusion is most often due to a combination of maxillary hypoplasia and mandibular hyperplasia. Surgical correction entails normalization of jaw positions and is more challenging in the setting of concurrent asymmetry and open bite. Treatment should optimize both facial harmony and occlusion. Orthognathic surgery for class III deformities occurs at skeletal maturity and should address all aspects of the condition while preventing unnecessary emotional stress from delayed treatment. In this article, the authors describe the 3-jaw orthognathic surgery technique to address maxillary hypoplasia, mandibular prognathism, open bite and mandibular asymmetry in a single procedure. The process of preoperative 3-dimensional virtual surgical planning, detailed surgical technique, fat grafting, and a comparison of pre and postoperative 3D aesthetic outcome is presented. Additionally, a retrospective review of postoperative outcomes of 54 patients who received 3-jaw orthognathic surgery is presented as well.

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Orthodontic-surgical treatment of class III malocclusion with mandibular asymmetry

Brazilian Dental Journal ◽

10.1590/s0103-64402011000200011 ◽

2011 ◽

Vol 22 (2) ◽

pp. 151-156 ◽

Cited By ~ 6

Author(s):

Ana Zilda Nazar Bergamo ◽

Marcela Cristina Damião Andrucioli ◽

Fábio Lourenço Romano ◽

José Tarcísio Lima Ferreira ◽

Mírian Aiko Nakane Matsumoto

Keyword(s):

Orthognathic Surgery ◽

Facial Asymmetry ◽

Open Bite ◽

Class Iii ◽

Posterior Crossbite ◽

Mandibular Asymmetry ◽

Skeletal Malocclusion ◽

Facial Esthetics ◽

The Face ◽

Maxillary Deficiency

Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone discrepancy may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 15 years and 1 month with Class III skeletal malocclusion, having narrow maxilla, posterior open bite on the left side, anterior crossbite and unilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the maxillary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patient's final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.

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Dentofacial Changes following Orthognathic Surgery in Seven Mandibular Prognathic Patients with Open Bite and Mandibular Asymmetry.

The Japanese Journal of Jaw Deformities ◽

10.5927/jjjd1991.8.203 ◽

1998 ◽

Vol 8 (3) ◽

pp. 203-212

Author(s):

TATSUO KAWAMOTO ◽

NOBUYOSHI MOTOHASHI ◽

KAZUYOSHI IGARASHI ◽

TAKASHI ONO ◽

KEIJI MORIYAMA ◽

...

Keyword(s):

Orthognathic Surgery ◽

Open Bite ◽

Mandibular Asymmetry

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Sur les Open-Bite avec infraclusion

Revue d Orthopédie Dento-Faciale ◽

10.1051/odf/2006008 ◽

2006 ◽

Vol 40 (3) ◽

pp. 283-287

Author(s):

Boris Terk

Keyword(s):

Open Bite

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Investigations on skeletal growth zones via bone scans as base of determination of optimal time for surgery in mandibular asymmetry

Nuklearmedizin ◽

10.1055/s-0038-1632257 ◽

2000 ◽

Vol 39 (05) ◽

pp. 121-126 ◽

Cited By ~ 1

Author(s):

R. Werz ◽

P. Reuland

Keyword(s):

Bone Growth ◽

Region Of Interest ◽

Tracer Uptake ◽

Optimal Time ◽

Mandibular Bone ◽

The Third ◽

Mandibular Asymmetry ◽

Bone Scans ◽

Epiphyseal Plates

Summary Aim of the study was to find out wether there is a common stop of growth of mandibular bone, so that no individual determination of the optimal time for surgery in patients with asymmetric mandibular bone growth is needed. As there are no epiphyseal plates in the mandibular bone, stop of growth cannot be determined on X-ray films. Methods: Bone scans of 731 patients [687 patients (324 male, 363 female) under 39 y for exact determination of end of growth and 44 (21 male, 23 female) patients over 40 y for evaluation of nongrowth dependant differences in tracer uptake] were reviewed for the study. All the patients were examined 3 hours after injection of 99mTc-DPD. Tracer uptake was measured by region of interest technique in different points of the mandibular bone and in several epiphyseal plates of extremities. Results: Tracer uptake in different epiphyseal plates of the extremities shows strong variation with age and good correlation with reported data of bone growth and closure of the epiphyseal plates. The relative maximum of bone activity is smaller in mandibular bone than in epiphyseal plates, which show well defined peaks, ending at 15-18 years in females and at 18-21 years in males. In contrast, mandibular bone shows no well defined end of growing but a gradually reduction of bone activity which remains higher than bone activity in epiphyseal plates over several years. Conclusion: No well defined end of growth of mandibular bone exists. The optimal age for surgery of asymmetric mandibular bone growth is not before the middle of the third decade of life, bone scans performed earlier for determination of bone growth can be omitted. Bone scans performed at the middle of the third decade of life help to optimize the time of surgical intervention.

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DISTRIBUSI MALOKLUSI BERDASARKAN KLASIFIKASI ANGLE PADA PASIEN DI DEPARTEMEN ORTODONSIA RSGMP FKG USU TAHUN 2009-2013

Dentika Dental Journal ◽

10.32734/dentika.v18i3.1963 ◽

2015 ◽

Vol 18 (3) ◽

pp. 257-261

Author(s):

Mimi Marina Lubis ◽

Andira Retno Utami

Keyword(s):

Open Bite ◽

Deep Bite ◽

Purposive Sampling

Maloklusi merupakan masalah kesehatan mulut dengan prevalensi tertinggi ketiga setelah karies dan penyakitperiodontal. Distribusi maloklusi menunjukkan hasil yang berbeda-beda dengan prevalensi cukup tinggi pada setiappopulasi di dunia. Tujuan penelitian ini adalah untuk mengetahui distribusi maloklusi berdasarkan klasifikasi Angle danmelihat apakah terdapat perbedaan antara laki-laki dan perempuan. Jenis penelitian ini adalah penelitian deskriptifmenggunakan 385 rekam medik dan model studi pasien di Departemen Ortodonsia RSGMP FKG USU tahun 2009-2013. Pemilihan sampel dilakukan menggunakan metode purposive sampling berdasarkan kriteria inklusi dan eksklusi.Hasil penelitian menunjukkan 41,55 % sampel memiliki hubungan molar Klas I Angle, 26,75 % Klas II subdivisi, 18,44% Klas II divisi 1, 5,71 % Klas III subdivisi, 4,67 % Klas II divisi 2 dan 2,85 % Klas III. Bentuk maloklusi yang palingumum adalah crowding rahang bawah 49,61 %, crossbite anterior 30,90 % dan spacing rahang atas 21,55 %. Sebanyak40,25 % sampel memiliki overjet normal, 19,48 % overjet berlebih, 69,61 % overbite normal, 14,02 % deep bite, 9,35 %edge to edge dan 7,79 % open bite. Deep bite menunjukkan adanya perbedaan distribusi berdasarkan jenis kelamin.

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