Management of Class II Hyperdivergent Mandible by Surgically Altering Occlusal Plane Pattern through Counterclockwise Rotation of Mandible

ABSTRACT Objective To investigate the occlusal configurations of the hyperdivergent skeletal Class II malocclusion and their alterations during the camouflaging treatment in an attempt to identify occlusal changes that might be related to mandibular counterclockwise rotation. Materials and Methods Cephalograms of 126 subjects with hyperdivergent skeletal Class II malocclusion and 126 subjects with a clinically normal skeletal pattern were chosen. Several measurements were calculated and compared between the groups. To examine the effects of treatment, two groups were established according to mandibular rotation: counterclockwise rotation (CCR) and the opposite clockwise rotation (CR). After 40 subjects were excluded, the other 86 Class II subjects were assigned to CCR (n = 22) and CR (n = 64). Their pretreatment (T1), posttreatment (T2), and postretention (T3) cephalograms were obtained. Measurement changes (T3-T1) were analyzed in each group and compared between groups. Results Compared with the normal skeletal pattern, the cant of the occlusal plane (OP) of the study subjects was significantly steeper and the vertical heights of the incisors were significantly larger for the malocclusion. Compared with the changes in CR, there was a prominent reduction of the OP canting with remarkable intrusion of the maxillary incisor in CCR. Conclusion Increased OP canting with overerupted incisors is evident in the hyperdivergent skeletal Class II malocclusion. During the camouflaging treatment, reduction of OP canting could occur. It was accompanied by mandibular counterclockwise rotation and intrusion of the maxillary incisor.

Download Full-text

Effect of occlusal plane control procedure on hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients

The Angle Orthodontist ◽

10.2319/041416-308.1 ◽

2016 ◽

Vol 87 (2) ◽

pp. 293-299

Author(s):

Xiaolong Li ◽

Qing Zhao ◽

Rui Zhao ◽

Meiya Gao ◽

Xiaolei Gao ◽

...

Keyword(s):

Hyoid Bone ◽

Class Ii ◽

Occlusal Plane ◽

Control Procedure ◽

Skeletal Class ◽

Counterclockwise Rotation ◽

Pharyngeal Airway ◽

Skeletal Class Ii ◽

Mandibular Plane ◽

Lateral Cephalograms

ABSTRACT Objective: To evaluate the effect of occlusal plane control on the hyoid bone position and pharyngeal airway of hyperdivergent skeletal Class II patients during orthodontic treatment. Materials and Methods: Cephalograms of 47 hyperdivergent skeletal Class II subjects with occlusal plane control (OPC), and another 50 subjects without occlusal plane control (NOPC) were selected to compare the effects of the occlusal plane control procedure. Lateral cephalograms before treatment (T1), immediately after treatment (T2), and an average of 12 months after treatment (T3) were obtained, and 17 measurements were analyzed in each group and compared between groups. Results: With respect to the T2−T1 changes, the sagittal discrepancies in both groups were alleviated. In the OPC group, both the occlusal and mandibular plane angles decreased, accompanied by anterior and superior movement and counterclockwise rotation of the hyoid bone. The overall changes from T3 to T1 in each group exhibited trends similar to that induced by treatment. As for pharyngeal airway space alterations, no significant difference in OPC group was presented throughout treatment or retention periods. Conclusions: The customized occlusal plane control procedure was effective for hyperdivergent skeletal Class II patients: The occlusal plane rotated counterclockwise, followed by a counterclockwise rotation of the mandibular plane. The hyoid bone moved anteriorly and superiorly, accompanied by its counterclockwise rotation. However, this procedure did not induce significant alteration of the pharyngeal airway space.

Download Full-text

Impact of counterclockwise rotation of the occlusal plane on the mandibular advancement, pharynx morphology, and polysomnography results in maxillomandibular advancement surgery for the treatment of obstructive sleep apnea patients

Sleep And Breathing ◽

10.1007/s11325-020-02279-8 ◽

2021 ◽

Author(s):

Mariana Christino ◽

Pedro Pileggi Vinha ◽

Ana Célia Faria ◽

Denny Marcos Garcia ◽

Francisco Veríssimo de Mello-Filho

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Mandibular Advancement ◽

Occlusal Plane ◽

Counterclockwise Rotation ◽

Maxillomandibular Advancement ◽

Obstructive Sleep

Download Full-text

Significance of the cant of the posterior occlusal plane in Class II division 1 malocclusions

European Journal of Orthodontics ◽

10.1093/ejo/18.1.27 ◽

1996 ◽

Vol 18 (1) ◽

pp. 27-40 ◽

Cited By ~ 27

Author(s):

K Fushima

Keyword(s):

Class Ii ◽

Occlusal Plane ◽

Division 1 ◽

Class Ii Division 1

Download Full-text

Dental and skeletal changes in patients with mandibular retrognathism following treatment with Herbst and pre-adjusted fixed appliance

Dental Press Journal of Orthodontics ◽

10.1590/2176-9451.19.1.046-054.oar ◽

2014 ◽

Vol 19 (1) ◽

pp. 46-54 ◽

Cited By ~ 1

Author(s):

Fabio de Abreu Vigorito ◽

Gladys Cristina Dominguez ◽

Luís Antônio de Arruda Aidar

Keyword(s):

Phase I ◽

Phase Ii ◽

Class Ii ◽

Initial Position ◽

Occlusal Plane ◽

Mandibular Movement ◽

Fixed Appliance ◽

Lateral Cephalograms ◽

T1 And T2 ◽

Mandibular Retrognathism

OBJECTIVE: To assess the dentoskeletal changes observed in treatment of Class II, division 1 malocclusion patients with mandibular retrognathism. Treatment was performed with the Herbst orthopedic appliance during 13 months (phase I) and pre-adjusted orthodontic fixed appliance (phase II). METHODS: Lateral cephalograms of 17 adolescents were taken in phase I onset (T1) and completion (T2); in the first thirteen months of phase II (T3) and in phase II completion (T4). Differences among the cephalometric variables were statistically analyzed (Bonferroni variance and multiple comparisons). RESULTS: From T1 to T4, 42% of overall maxillary growth was observed between T1 and T2 (P < 0.01), 40.3% between T2 and T3 (P < 0.05) and 17.7% between T3 and T4 (n.s.). As for overall mandibular movement, 48.2% was observed between T1 and T2 (P < 0.001) and 51.8% between T2 and T4 (P < 0.01) of which 15.1% was observed between T2 and T3 (n.s.) and 36.7% between T3 and T4 (P < 0.01). Class II molar relationship and overjet were properly corrected. The occlusal plane which rotated clockwise between T1 and T2, returned to its initial position between T2 and T3 remaining stable until T4. The mandibular plane inclination did not change at any time during treatment. CONCLUSION: Mandibular growth was significantly greater in comparison to maxillary, allowing sagittal maxillomandibular adjustment. The dentoalveolar changes (upper molar) that overcorrected the malocclusion in phase I, partially recurred in phase II, but did not hinder correction of the malocclusion. Facial type was preserved.

Download Full-text

Agenesis of maxillary lateral incisor in an Angle Class II, Division 1 malocclusion patient

Dental Press Journal of Orthodontics ◽

10.1590/2177-6709.20.5.108-117.bbo ◽

2015 ◽

Vol 20 (5) ◽

pp. 108-117

Author(s):

Guilherme Thiesen

Keyword(s):

Class Ii ◽

Lateral Incisor ◽

Occlusal Plane ◽

Angle Class Ii ◽

Anterior Teeth ◽

Angle Class ◽

Division 1 ◽

Maxillary Lateral Incisor ◽

Dentofacial Orthopedics ◽

Class Ii Division 1

The present case report describes the orthodontic treatment of a patient with agenesis of maxillary left lateral incisor and Angle Class II, Division 1 malocclusion. The patient also presented with maxillary midline deviation and inclination of the occlusal plane in the anterior region. Treatment objectives were: correction of sagittal relationship between the maxilla and the mandible; correction of midline deviation, so as to cause maxillary and mandibular midlines to coincide; correction of overbite and leveling of the occlusal plane, so as to create ideal conditions for esthetic rehabilitation of anterior teeth. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO.

Download Full-text