Lingual Orthodontic Camouflage Treatment of Skeletal Class II Adult Demanding Orthognathic Surgery

2021 ◽  
Vol 11 (4) ◽  
pp. 290-301
Author(s):  
Kyung-So Jeong ◽  
Su-Hyun Lee ◽  
Eon-Hwa Lee
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ozkan Semih Cankaya ◽  
Fatih Celebi ◽  
Ali Altug Bicakci

Abstract Background The aim of this study was to evaluate the effect of different nose types on the perception of facial aesthetics following camouflage treatment and orthognathic surgery for skeletal class II female patients. Methods A pre-treatment profile photograph of a skeletal class II adult patient was selected from the department archive. Two constructed photographs were created to represent orthognathic surgery and camouflage treatments with the aid of computer software. A total of 18 constructed images was composed using three profiles (pre-treatment, post-camouflage, and post-orthognathic surgery) and six nose types. These photographs were shown to the three groups (orthodontists, plastic surgeons, and lay people), and they were asked to assign an attractiveness score to each photo ranging from 0 to 100, with 0 indicating the least attractive and 100 indicating the most attractive. Results For the convex nose profiles, anterior movement of the mandible obtained by orthognathic surgery did not result in a significant change in the scores given by the lay people. When surgical or camouflage treatment was not implemented and, instead, just rhinoplasty was performed for these profiles, there was a significant increase in the aesthetic scores given by all groups. For the straight nose profiles, orthognathic surgery increased the attractiveness scores given by all groups. Furthermore, for all the profiles, extraction treatment did not affect the aesthetic scores given by any of the groups (P > 0.05). Conclusions The lay people perceived that having a convex-bridged nose was a bigger problem than having a retrognathic profile. Overall, in terms of skeletal and dental orthodontic treatments, nose shape should be considered during the treatment planning process.


Author(s):  
Alrezami K ◽  
Pu Y

Condylar resorption and its incidence at an early age or after orthognathic surgery are well-documented issues, but it is associated with high controversies regarding its etiology and management. Lack of clear understanding of its pathogenies and the limitation of the available evidence inherited for the development of a systematic treatment approach and most previous studies recommended further investigation of the problem. This review aims to cover the problem of condylar resorption and its association with orthodontic and orthognathic surgery as well as to discuss the prospective treatment measure available through the literature. According to the available literature, most previous studies covered the condylar resorption of this type of patient (skeletal class II with high mandibular plane angle) following the orthognathic surgery. However, no studies investigated the long-term condition of the condyles of the involved patient before the surgery. Furthermore, there is no evidence for the orthodontic management of this challenging condition, and most recommendations come from case reports. So, it is crucial to assess the changes that happened to the condyle during the preoperative orthodontic and correlate the finding with what happened after the surgery to provide clear evidence that may help further understand the problem of condylar resorption. This evidence could be beneficial for both patients and clinicians. CT or CBCT images have been regarded as the best choice of detailed diagnosis and investigation of condylar resorption. The incidence of condylar resorption after orthognathic surgery with or without disc repositioning of skeletal class II with high mandibular plane angle is extremely suspected. However, artificial joint replacement is considered a gold standard treatment measure in severe or relapsed cases.


2021 ◽  
Author(s):  
Minjiao Wang ◽  
Hanjiang Zhao ◽  
Xiangyu Wang ◽  
Yifeng Qian ◽  
Hongbo Yu ◽  
...  

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.


2021 ◽  
Vol 23 (4) ◽  
pp. 257-263
Author(s):  
Jessica Rico Bocato ◽  
Daiara Paula Pacheco ◽  
Mauro Toma ◽  
Ricardo Lima Navarro ◽  
Thais Maria Freire Fernandes ◽  
...  

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.


2019 ◽  
Vol 64 ◽  
pp. S299
Author(s):  
S. Pérez Ramos ◽  
J. Bordas Martínez ◽  
M. Gasa Galmes ◽  
A. Izquierdo Miranda ◽  
C. López-Padrós ◽  
...  

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