A Cephalometric Evaluation of Soft Tissue Following Maxillary Incisors Retraction

Background: Class 2 Division 1 is the most prevalent type of malocclusion affecting about 32% of Pakistani population. With upper maxillary premolar extraction is one of most frequent treatment choice. Aim: To evaluate the effects of these extractions on soft tissue show variable results depending upon the sex, ethnicity, maxillary arch crowding and pretreatment structure of lips. Methods: In this study pretreatment cephalograms of 106 Class 2 div 1 patients were taken whose treatment plan include extraction of maxillary 1st premolar. Then the second and final cephalograms were taken when retraction of incisors was completed. Mean changes in the position of upper and lower lip were measured with respect to Ricketts E-line before and after completion of retraction of maxillary incisors. Results: After the extraction of premolars there is a significant (P value=0.000) reduction in the lip protrusion of -2.033mm±1.148mm and -1.695mm±1.628mm in both upper and lower lip respectively. Conclusion: Extraction of maxillary premolars cause significant reduction of lip prominence and achieve facial esthetic balance. Keywords: Class 2 div 1, lip position, Premolar Extraction

Sagittal expansion of the maxilla in an adult. A clinical case

Relevance. Skeletal Class III malocclusion is one of the most difficult to correct. Genetics, environmental factors, and postembryonic development influence its etiology. Sagittal expansion of the upper jaw will ensure the correct position of the lower jaw, which in turn will improve the patient's aesthetic parameters and health. The study examines a treatment method using the Fixed anterior growth guidance appliance (FAGGA).Materials and methods. This clinical case presents a 21-year-old male with skeletal class III due to maxillary bone deficiency. The patient refused surgery to increase the size of the upper jaw and opted for orthodontic treatment. The latter was performed using a Fixed anterior growth guidance appliance (FAGGA), followed by a rapid palatal (maxillary) expansion (RME) and brackets. We removed the FAGGA after eight months. The profile and occlusion improved.Results. The change in the inclination and protrusion of the maxillary incisors improved the profile. We received 2mm of space behind the upper right canine and 1.5mm of space behind the left one and the SNA angle increased by 2 degrees. The treatment continues with RME and brackets.Conclusions. An increase in inclination and protrusion of the maxillary incisors and a slight skeletal change improved the aesthetic parameters of the facial area.

Management of the Two Dental Developmental Anomalies in Two Maxillary Incisors for Improved Esthetic Appearance: A Case Report

Introduction: The presence of a developmental dental anomaly in maxillary incisors usually affects esthetic appearance. Therefore, gemination and supernumerary teeth are considered anomalies and need a careful and comprehensive diagnosis and treatment. Case Description: This clinical report presents a 10-year-old girl complaining of the esthetic appearance of her anterior maxillary teeth. Clinical and radiographical examinations revealed a maxillary geminated permanent left central incisor and a supplemental supernumerary permanent right lateral incisor. The treatment has been performed in different stages, including preventive, conservative, surgical, and orthodontic treatments. Thus, the large geminated incisor has been restored to its normal shape, and the problem of anterior incisor crowding resolved through alignment. Conclusion: Dental anomalies in the anterior segment are common and need time during treatment. Selective grinding for the large geminated incisor and the extraction of the supplemental tooth followed by orthodontic treatment may be the right decisions that a dental practitioner may consider during the management of such cases.