scholarly journals Do orthopedic corrections of growing retrognathic hyperdivergent patients produce stable results?

2019 ◽  
Vol 89 (4) ◽  
pp. 552-558 ◽  
Author(s):  
Alec J. Rice ◽  
Roberto Carrillo ◽  
Phillip M. Campbell ◽  
Reginald W. Taylor ◽  
Peter H. Buschang

ABSTRACT Objectives: To determine if posterior dental intrusion produces stable orthodontic and orthopedic corrections in growing retrognathic hyperdivergent patients. Materials and Methods: The sample included 14 subjects (five males and nine females), who were 13.4 ± 0.7 years pretreatment, treated for 3.5 years, and followed for 3.6 years posttreatment. During the initial orthopedic phase, 150 g NiTi coil springs were attached to two palatal miniscrew implants (MSIs) for maxillary intrusion; two buccal mandibular MSIs were used for posterior vertical control. Full orthodontic therapy was initiated to correct the malocclusions during the orthodontic phase. Patients were recalled a minimum of 1 year posttreatment (mean 3.6 ±1.6 years). Patients were compared to matched untreated controls. Results: Relative to the untreated controls, during treatment and retention, maxillary and mandibular molars underwent 2.8 mm and 3.7 mm of relative posterior intrusion, respectively. Maxillary incisors were extruded 1.3 mm and the mandibular incisors underwent 2.9 mm of relative intrusion. Overall orthopedic changes included a reduction in the mandibular plane angle (MPA; 3.3°), an increase in SN-Pg (2.4°), an increase in S-N-B (2.1°), and a 4.3 mm relative reduction in anterior facial height. The maxillary incisors, which showed 0.6 mm of intrusion (relative to controls), was the only dental or skeletal measure to show a statistically significant between-group posttreatment difference. Conclusions: Except for maxillary incisor position, the substantial dental intrusion and associated orthopedic corrections that were produced during treatment remained stable post-treatment.

2018 ◽  
Vol 23 (6) ◽  
pp. 48-55 ◽  
Author(s):  
Waqar Jeelani ◽  
Mubassar Fida ◽  
Attiya Shaikh

ABSTRACT Introduction: Maxillary incisal display is one of the most important attributes of smile esthetics. Objective: The aim of this study was to determine the relationship between maxillary incisal display at rest (MIDR) and various soft tissue, hard tissue and dental components. Methods: A cross-sectional study was conducted on 150 subjects (75 males, 75 females) aged 18-30 years. The MIDR was recorded from the pretreatment orthodontic records. The following parameters were assessed on lateral cephalograms: ANB angle, mandibular plane angle, palatal plane angle, lower anterior and total anterior facial heights, upper incisor inclination, upper anterior dentoalveolar height, and upper lip length, thickness and protrusion. The relationship between MIDR and various skeletal, dental and soft tissue components was assessed using linear regression analyses. Results: The mean MIDR was significantly greater in females than males (p = 0.011). A significant positive correlation was found between MIDR and ANB angle, mandibular plane angle and lower anterior facial height. A significant negative correlation was found between MIDR and upper lip length and thickness. Linear regression analysis showed that upper lip length was the strongest predictor of MIDR, explaining 29.7% of variance in MIDR. A multiple linear regression model based on mandibular plane angle, lower anterior facial height, upper lip length and upper lip thickness explained about 63.4% of variance in MIDR. Conclusions: Incisal display at rest was generally greater in females than males. Multiple factors play a role in determining MIDR, nevertheless upper lip length was found to be the strongest predictor of variations in MIDR.


2004 ◽  
Vol 15 (1) ◽  
pp. 68-74 ◽  
Author(s):  
Carla Enoki ◽  
Carlos de Souza Telles ◽  
Mírian Aiko Nakane Matsumoto

The dental and skeletal dimensions of individuals with Class I skeletal pattern in puberty were compared. Eighty patients with Class I malocclusion were selected, independent of the vertical relations (overbite) of the incisors. The sample was divided into 3 groups: normal, short and excessive lower anterior face height, based on facial proportions. The dental and skeletal measurements of the 3 groups were compared among themselves. In the angular measurements, the results showed no correlation in the mandibular plane angle. In the linear measurements, the mandibular length was significantly greater in the group of patients with short lower anterior face height, with a positive correlation among the three groups. The dentoalveolar heights of the incisors had a positive correlation among the three groups in relation to the lower anterior face height, showing that they are responsible for its variation.


2021 ◽  
Vol 45 (6) ◽  
pp. 433-440
Author(s):  
Sunock Yun ◽  
Jae Hyun Park ◽  
Na-Young Chang ◽  
Hye Young Seo ◽  
Jae-Hyun Sung ◽  
...  

Objective: The aim of this study was to compare the craniomaxillofacial changes when using high-pull J-hook headgear (HPJH) and mini-implants (MIs) as maxillary anchorage in adolescents. Study Design: 40 female adolescents with dentoalvolar protrusion were divided into 2 groups; the HPJH group (n=20) and the MI group (n=20). Lateral cephalograms taken before treatment (T0) and after anterior tooth retraction (T1) were superimposed on the stable structures and then craniomaxillofacial changes were evaluated. Results: The cranial base angle, SNB, and facial angle decreased in the HPJH group but increased in the MI group. ANB decreased more in the MI group than in the HPJH group. Mandibular plane angle increased in the HPJH group but decreased in the MI group. Facial height index increased in the MI group while it showed no change in the HPJH group. Mandibular true rotation occurred clockwise in the HPJH group and counterclockwise in the MI group. Maxillary central incisors were intruded and retracted more in the MI group than in the HPJH group. Maxillary first molars were extruded in the HPJH group and were intruded in the MI group. Maxillary first molars were protracted more in the HPJH group than in the MI group. Mandibular central incisors were retracted more in the HPJH group than the MI group. Mandibular first molars were extruded more in the MI group than in the HPJH group. Conclusion: More favorable craniomaxillofacial changes occurred in the MI group than in the HPJH group.


Author(s):  
Kensuke MATSUMOTO ◽  
Nipul TANNA

ABSTRACT Introduction: The efficacy and efficiency of early treatment of skeletal Class III patients with facemask therapy are well-documented; however, very few cases for adolescents or adults were reported. Objective: The aim of this case report was to demonstrate skeletal and dental correction of a post-pubertal-growth-spurt patient whose malocclusion consisted of a skeletal Class III with slight transverse deficiency, a high mandibular plane angle, and a retrusive maxillary complex. Case report: A 13-year-5-months old Hispanic female was diagnosed as a retrognathic maxilla and mandible, a high mandibular plane angle, open bite pattern, a bilateral Angle Class I molar relationship with an anterior crossbite on the maxillary lateral incisors. A TAD-supported Haas rapid palatal expander was utilized for maxillary protraction combined with a facemask, vertical control, and maxillary molar distalization with fixed appliance. Results: The total treatment time was 26 months. An improved facial profile with maxillary lip support and more prominent cheeks was established. Adequate vertical control prevented a change in the mandibular plane angle even though facemask treatment can increase the vertical dimension. After the 18-month retention, excellent stability of the treatment results was shown. Conclusion: With skeletal anchorage and facemask treatment, orthodontists have the ability of expanding and protracting the maxilla without tipping maxillary molars buccally and without the risk of unfavorable periodontal consequences. A TAD-supported Haas rapid palatal expander allowed to control the vertical dimension and distalize molars, while minimizing undesired consequences.


2019 ◽  
Vol 24 (6) ◽  
pp. 56-64 ◽  
Author(s):  
Rachelle Simões Reis ◽  
José F. C. Henriques ◽  
Guilherme Janson ◽  
Karina Maria Salvatore Freitas ◽  
Wilana Moura

ABSTRACT Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.


1993 ◽  
Vol 30 (4) ◽  
pp. 376-381 ◽  
Author(s):  
Leopoldino Capelozza ◽  
Sheyla Miki Taniguchi ◽  
Omar Gabriel Da Silva

The craniofacial morphology of 26 white unoperated complete unilateral cleft lip and palate patients (13 males, 13 females) was analyzed with cephalometry and compared with a control (normal) group. The results show that in the cleft group, the maxilla is smaller and more protruded, the lower anterior facial height is much larger, and the mandible shows well-defined differences (body, ramus, gonial angle, and mandibular plane angle).


2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093685
Author(s):  
Danqing He ◽  
Yan Gu ◽  
Yannan Sun

Objective To investigate the correlations between objective measurements and subjective evaluations of post-treatment facial attractiveness. Methods Ten orthodontists rated the subjective visual analog scale (VAS) scores of the facial profiles of 95 patients who had undergone orthodontic treatment. Post-treatment cephalograms and photographs were used. Eleven soft tissue measurements and eight maxillary incisor measurements were constructed and analyzed. Correlations between objective measurements and subjective VAS scores were evaluated using Pearson correlation and quadratic regression analysis. Results The VAS scores of different facial proportions were all correlated with the total VAS score. Among soft tissue measurements, the distances from the upper and lower lips to the E line, H angle, forehead inclination, distance from lower lip to the H line, and pogonion-menton angle were negatively correlated with the VAS scores. The Z angle, with a parabolic distribution, was also correlated with the VAS scores. Among maxillary incisor measurements, the distance from the maxillary incisors to the forehead’s anterior limit line and the angulation of the maxillary incisors to the APo line were negatively correlated with the VAS scores. Conclusions Several soft tissue and maxillary incisor position measurements were correlated with facial profile evaluation and therefore might be used to evaluate facial attractiveness.


2015 ◽  
Vol 28 (3) ◽  
pp. 316 ◽  
Author(s):  
Helena Afonso Agostinho ◽  
Ivo Álvares Furtado ◽  
Francisco Salvado e Silva ◽  
Josep Ustrell Torrent

<p><strong>Introduction:</strong> Orthodontists frequently treat children with mouth breathing. The purpose of the present study was to examine dental positions, skeletal effects and the pharyngeal airway space of children with chronic allergic rhinitis, when compared with a control group exhibiting a normal breathing pattern.<br /><strong>Material and Methods:</strong> Seventy Caucasian children from Santa Maria University Hospital - North Lisbon Hospital Center were evaluated, between September 2009 and February 2013. The study group comprised of 35 children with chronic allergic rhinitis, both genders, aged 5 - 14, with positive reaction to allergens, mouth breathing and malocclusion. The control group was composed of 35 children, both genders, displaying normal nasal breathing and malocclusion, who resorted to the orthodontic department. Measures of Ricketts, Steiner and McNamara’s analysis were used and the t- Student test was applied to the data obtained.<br /><strong>Results:</strong> Statistically significant differences were observed between the oral and nasal breathers, respectively: lower facial height (49.1/45.9 mm), Frankfurt – mandibular plane angle (30.1/26.9º) and Sela-Nasion - oclusal plane angle (17.3/15º), maxillary length (78.4/82.4 mm), mandibular length (102.4/107 mm), overbite (0.8/3.1mm) and overjet (4/4.7 mm).<br /><strong>Discussion:</strong> Comparison between the allergic rhinitis and control group showed that there is an increased lower facial height, larger Frankfurt – mandibular plane angle and Sela-Nasion oclusal plane angle in children with chronic allergic rhinitis. This group also had a shorter maxillary and mandibular length, less overbite and decreased upper airway space.<br /><strong>Conclusions:</strong> Children with allergic rhinitis and mouth breathing have longer faces, shorter maxillas and mandibles and a narrowed pharyngeal airway space. No statistical differences between the groups in sagital relationships or in dental inclinations were found.</p>


Author(s):  
Hailee RASK ◽  
Jeryl D. ENGLISH ◽  
Clark COLVILLE ◽  
Fred Kurtis KASPER ◽  
Ronald GALLERANO ◽  
...  

ABSTRACT Introduction: Orthodontists have been using clear aligners to treat malocclusions, and one potential effect of treatment with orthodontic aligners is the intrusion and/or resists extrusion of the posterior teeth. This “bite-block effect” is primarily anecdotal due to the frequent occurrence of posterior open bites in patients after clear aligner therapy. Objective: The purpose of this study was to compare changes promoted by clear aligners and traditional fixed appliances in cephalometric measurements of the vertical dimension and molar position in adult patients with Class I malocclusion treated with non-extraction. Methods: Pre- and post-treatment lateral cephalometric radiographs of adult patients treated with either clear aligners (n=44) or traditional fixed appliances (n=22) were selected for retrospective analysis. Eight interval measurements and one nominal measurement were evaluated: anterior overbite (OB), mandibular plane angle related to cranial base (SN_MP) and related to Frankfort (FMA), lower molar height (L6H) and upper molar height (U6H), palatal plane to mandibular plane angle (PP_MP), lower facial height (LFH), total facial height (TFH), and posterior open bite (Posterior_OB). A single evaluator traced all cephalographs, and changes in select measures of the vertical dimension were compared within and between groups. Results: OB decreased (1.15 mm) and L6H increased (0.63 mm) in the traditional fixed appliance group. Mandibular plane angles (related to cranial base and to Frankfort) increased (0.43° and 0.53°, respectively) in the clear aligner group, but just FMA showed significant difference between groups (difference of 0.53°). LFH and TFH increased (ranging from 0.52 mm to 0.80 mm) in both groups, with no differences between treatment modality. Presence of visible posterior open bite significantly increased over the course of treatment. OB, FMA and L6H exhibited an interaction between treatment stage (pre- and post-treatment) and modality (clear aligner therapy and traditional fixed appliances), but no interaction among these three variables was found. Conclusions: The evidence does not support the theory that clear aligner therapy produces better vertical dimension control than traditional fixed appliances. Traditional fixed appliance therapy slightly extruded the lower molar, and clear aligner therapy produced a slightly mandibular backward rotation.


Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 438
Author(s):  
Arvind Sivakumar ◽  
Prasad Nalabothu ◽  
Huyen Nguyen Thanh ◽  
Gregory S. Antonarakis

The dental, skeletal, and soft-tissue characteristics of a particular malocclusion can differ based on ethnicity, race, age, sex and geographical location with Class II malocclusion being one of the most prevalent malocclusions encountered in orthodontic clinical practice. The broad understanding of the characteristics of vertical skeletal and dental parameters in patients with Class II malocclusion can help clinicians to identify patterns and variations in the expression of this phenotype for better treatment outcomes. Hence, we compared the craniofacial characteristics of skeletal and dental Class II malocclusion traits from Indian and Vietnamese individuals to analyze the vertical skeletal and dental patterns in both population groups. The sample comprised of lateral cephalograms from 100 young adults with Class II malocclusion, of which fifty (25 males and 25 females) were from South India and the other 50 age- and sex-matched adults from Vietnam. The lateral cephalometric radiographs were digitized into anonymous image files and were traced and assessed for 16 vertical skeletal and dental parameters. The ANB angle was greater in males (+1.4 deg; p < 0.001) and females (+1.9 deg; p < 0.001) in the South Indian population. The Vietnamese males had a larger mandibular plane angle, articular angle, anterior facial height and lower anterior facial height compared to the Indian males. The Vietnamese females had larger mandibular plane and articular angles compared to the Indian females. The skeletal class II malocclusion was more severe in the South Indian compared to the Vietnamese adults. The Vietnamese sample showed a generalized tendency towards a more vertical skeletal growth pattern and in males this pattern seemed to be due to the dentoalveolar component. The Vietnamese females showed a tendency towards a vertical growth pattern, but without apparent contribution by the dentoalveolar component.


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