scholarly journals Interdisciplinary Management of an Orthodontic Patient with Temporomandibular Disorder

2017 ◽  
Vol 7 ◽  
pp. 230-241 ◽  
Author(s):  
Tsang Tsang Franklin She ◽  
Anita-Tak Ying Wong
Keyword(s):  
Temporomandibular Disorder ◽  
Anterior Segment ◽  
Computer Software ◽  
Signs And Symptoms ◽  
Class Ii ◽  
Interdisciplinary Management ◽  
Skeletal Class ◽  
Splint Therapy ◽  
Skeletal Class Ii ◽  
Anterior Disc Displacement

A 21-year-old female patient presented with temporomandibular disorder, skeletal Class II, Angle Class II division 2 malocclusion, gummy smile, and incomplete overbite was managed successfully by splint therapy and orthodontic camouflage with miniscrew anchorage and extraction. She was treated with occlusal splint to alleviate signs and symptoms of anterior disc displacement without reduction and the associated masticatory dysfunction and revealed the true malocclusion before orthodontic treatment. Computer software facilitated the formulation of visual treatment objective (VTO) and occlusogram which guided the whole arch intrusion, retraction of the upper anterior segment, mesialization of lower left dentition, and distalization of lower right dentition. In this case report, the rationale and importance of preorthodontic splint therapy and specific considerations in orthodontic mechanics for managing this patient were discussed.

scholarly journals Effects of different nose types on class II treatments for female patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ozkan Semih Cankaya ◽  
Fatih Celebi ◽  
Ali Altug Bicakci
Keyword(s):  
Orthognathic Surgery ◽  
Planning Process ◽  
Computer Software ◽  
Class Ii ◽  
Skeletal Class ◽  
Female Patients ◽  
Lay People ◽  
Skeletal Class Ii ◽  
Pre Treatment ◽  
The Aesthetic

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.

Evaluation of post-surgical stability in skeletal class II patients with idiopathic condylar resorption treated with functional splint therapy

2020 ◽  
Vol 48 (3) ◽  
pp. 203-210
Author(s):  
Nayoung Ha ◽  
Yueyang Hong ◽  
Luyao Qu ◽  
Miri Chung ◽  
Ranyi Qu ◽  
...  
Keyword(s):  
Class Ii ◽  
Skeletal Class ◽  
Splint Therapy ◽  
Skeletal Class Ii

scholarly journals Full Mouth Reconstruction of a Skeletal Class II Division 1 Patient with Adenoid Cystic Carcinoma Using an Interim Immediate Obturator and a Definitive Obturator

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Mehran Bahrami ◽  
Seyed Mehran Falahchai
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Anterior Segment ◽  
Class Ii ◽  
Skeletal Class ◽  
Anterior Teeth ◽  
Adenoid Cystic ◽  
Skeletal Class Ii ◽  
Division 1 ◽  
The Right ◽  
Class Ii Division 1

A 61-year-old female patient with adenoid cystic carcinoma (ACC) of the right maxilla and Angle class II division 1 malocclusion had received a subtotal maxillectomy in right side and used a conventional clasp-retained obturator. After implants placement, a maxillary interim immediate obturator (IIO) and then a definitive obturator using six endosseous implants were fabricated. During one-year follow-up, the patient was completely satisfied. Ideally, after implants placement in edentulous patients suffering from hemimaxillectomy, an implant-supported obturator (ISO) is designed in order to prevent nasal reflux and to improve speech and swallowing. However, in the following case, because of skeletal class II division 1 malocclusion and implants insertion in the premaxilla, using an ISO was impossible because it would cause excessive upper lip protrusion and lack of anterior teeth contact. Therefore, a five-unit implant-supported fixed partial denture (FPD) was fabricated in the maxillary anterior segment so that anterior teeth contacts were possible and the patient’s normal lip support was achieved. A bar and three ball attachments were used in the maxillary posterior segment. A closed-hollow-bulb ISO was preferred. Conventional ISO in these patients results in several problems. Using a maxillary anterior FPD along with ISO caused satisfactory results in the current patient.

scholarly journals Surgical Orthodontic Treatment of Severe Skeletal Class II

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Fahad F. Alsulaimani ◽  
Maisa O. Al-Sebaei ◽  
Ahmed R. Afify
Keyword(s):  
Orthodontic Treatment ◽  
Anterior Segment ◽  
Class Ii ◽  
Mandibular Advancement ◽  
Sagittal Split Ramus Osteotomy ◽  
Skeletal Class ◽  
Maxillary Osteotomy ◽  
Skeletal Class Ii ◽  
Segment 8 ◽  
Jaw Surgery

This paper describes an adult Saudi male patient who presented with a severe skeletal class II deformity. The case was managed with a combination of presurgical orthodontic treatment followed by a double jaw orthognathic surgery and then another phase of orthodontic treatment for final occlusal detailing. Extraction of the four first premolars was done during the presurgical orthodontic phase of treatment to decompensate upper and lower incisors and to give room for surgical setback of the maxillary anterior segment. Double jaw surgery was performed: bilateral sagittal split ramus osteotomy for 8 mm mandibular advancement combined with three-piece Le Fort I maxillary osteotomy, 6 mm setback of the anterior segment, 8 mm impaction of the maxilla, and 5 mm advancement genioplasty. Although the anteroposterior discrepancy and the facial convexity were so severe, highly acceptable results were obtained, both esthetically as well as occlusally.

scholarly journals Republication: Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine

2018 ◽  
Vol 8 ◽  
pp. 146-160
Author(s):  
Ariel Wong ◽  
Chris Chang ◽  
W. Eugene Roberts
Keyword(s):  
Conservative Management ◽  
Anterior Segment ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Maxillary Canine ◽  
Deep Bite ◽  
Fixed Appliance ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Gummy Smile

A 21-year-old female presented with chief complaints of crooked teeth, canine impaction, deep bite, and “gummy smile” (excessive maxillary gingival exposure when smiling). Increased facial convexity (15.5°), increased lower facial height (56%), and incompetent protrusive lips (E-line to upper left 2 mm, E-line to lower left 2 mm) were associated with a severe Class II malocclusion (nearly a full cusp bilaterally). There was 7.5 mm of overjet, 100% anterior deepbite, and a left posterior buccal crossbite. Cephalometrics revealed a skeletal discrepancy due to a protrusive maxilla and a retrusive mandible (SNA 85°, SNB 78°, and ANB 7°). Cone-beam computed tomography imaging revealed a palatally impacted right maxillary canine (UR3) near to the adjacent lateral incisor (UR2). The retained right primary canine (URc) was extracted. A simplified open-window technique was utilized to surgically expose its impacted successor. A maxillary anterior mini-screw provided anchorage to align the UR3 in its correct anatomical position. Nonextraction treatment with a passive self-ligating fixed appliance was indicated to align and level both arches. Anchorage provided by infrazygomatic crest bone screws, and maxillary anterior miniscrews were used for the correction of Class II malocclusion and gummy smile. To achieve more esthetic crown lengths in the maxillary anterior segment, gingivectomy was performed with a diode laser 2 months after fixed appliances were removed. This challenging skeletal Class II malocclusion with a Discrepancy Index of 38 was treated in 32 months to excellent outcomes: Cast-radiograph evaluation score of 25 and an pink and white dental esthetic score of 2. All facial and dental corrections were stable at the 6 months follow-up evaluation (Int J Orthod Implantol 2017;48:24-46). Republished with permission from: Ariel Wong, Chang CH, Roberts WE. Conservative Management of Skeletal Class II Malocclusion with Gummy Smile, Deep Bite, and a Palatally Impacted Maxillary Canine. Int J Orthod Implantol 2017;48:24-46.

Multidisciplinary Approach for an Adult Patient with Skeletal Class II, Multiple Teeth Missing and Constricted Maxilla

2020 ◽  
Vol 10 (3) ◽  
pp. 205-217
Author(s):  
Seung-Weon Lim ◽  
Ha-Yeon Park ◽  
Won-Young Park ◽  
Min-Hee Oh ◽  
Kyung-Min Lee ◽  
...  
Keyword(s):  
Adult Patient ◽  
Multidisciplinary Approach ◽  
Class Ii ◽  
Skeletal Class ◽  
Skeletal Class Ii

Uso de propulsor mandibular fixo Flex Developer como recurso no tratamento da Classe II em paciente não colaborador

2020 ◽  
Vol 13 (52) ◽  
pp. 40-51
Author(s):  
Renato Barcellos Rédua
Keyword(s):  
Upper Airway ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Skeletal Class ◽  
Advantages And Disadvantages ◽  
Skeletal Class Ii ◽  
High Incidence ◽  
Therapeutic Alternatives ◽  
Smile Aesthetics ◽  
Treatment Alternatives

Class II malocclusion has a high incidence in the population, which may compromise smile aesthetics, occlusion function and stability. Skeletal Class II may affect facial aesthetics and upper airway volume. Class II malocclusion is routinely associated with skeletal Class II condition, having as treatment alternatives the use of Extra Buccal Appliance (EBA) or removable or fixed propulsor appliance. This article describes a case of a patient who did not accept the use of EBA and so it was fitted a Flex Developer propulsor for Class II correction and discussed the advantages and disadvantages of therapeutic alternatives for Class II correction.

scholarly journals Steering the Mandible in the Right Direction : Forsus Case Series

2021 ◽  
pp. 030157422110054
Author(s):  
Prachi Gohil ◽  
Sonali Mahadevi ◽  
Bhavya Trivedi ◽  
Neha Assudani ◽  
Arth Patel ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Case Series ◽  
Treatment Compliance ◽  
Class Ii ◽  
Skeletal Class ◽  
Skeletal Class Ii ◽  
Technological Advances ◽  
Functional Appliances ◽  
The Right ◽  
Mandibular Retrognathia

We are in the process of discovery of new vistas for technological advances in terms of various appliances with a vision of making orthodontic treatment compliance free as well as successful. Due to improved technology, the enigma of treating the Class II syndrome is palliated. “Out of the box” thinking has become a norm to treat certain situations that were not corrected in noncompliant patients. Fixed functional appliances are valuable tools introduced to assist the correction of skeletal Class II malocclusion with mandibular retrognathia at the deceleration stage of growth for achieving stable results. In this direction a case series is reported of patients having the above conditions and undergoing orthodontic treatment using a Forsus FFA. Joining hands with technology is a win-win situation for both the patient and the orthodontist.

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