Analysis of the Changes in Occlusal Plane Inclination in a Class II Deep Bite “Teen” Patient Treated with Clear Aligners: A Case Report

Background: Optimal management of hypodivergent growing patients demands a strict control of vertical dimension and to exploit the growth potential. If a deep bite malocclusion causes a traumatic contact between the upper and lower incisors and affects the facial appearance, an early interceptive treatment is recommended. The aim of this case report is to outline the clinical management of the occlusal plane of a growing Class II division 1 deep bite patient treated with aligners and Class II elastics. Methods: The treatment lasted 11 months and was divided into two phases. Treatment goals included improvement of the soft tissue profile and basal bone relationships through an increase in the mandibular third of the face and a sagittal advancement of the mandible. The correction of the curve of Spee involved intrusion of the mandibular incisors and extrusion of the mandibular premolars. Results: The cephalometric analysis at the end of the treatment displayed significant differences in the skeletal and occlusal pattern along with aesthetic improvements. Conclusion: The final cephalogram showed a consistency between the planned tooth movement and the clinical results. Although definitive recommendations must be withheld until longer follow-up is available, the patient presented here shows that the treatment protocol yielded positive mandibular growth.

THE ANALYSIS OF THE PREVALENCE OF DENTAL ANOMALIES IN UZHHOROD SCHOOLCHILDREN

The health of the oral cavity is an important component of the overall physical, mental and social well- being of each person. It is known that untimely detection and treatment of patients with dentoalveolar anomalies can lead not only to social maladaptation of this category of people but also to an increase in the risk of developing a carious process, periodontal diseases, as well as dysfunction of the temporomandibular joint. The presence of a dentoalveolar anomaly in a child can lead to a social disadvantage of patients among peers, as well as loss of active career growth in young and mature age. The incidence rate may vary considerably depending not only on the country of research but also on its region, as well as sex and age of the studied categories of people. The patients' parents specify the type and duration of feeding, the presence of such bad habits as sucking fingers, lips, or the tongue, respiratory features (sleeping with an open mouth), whether a child was followed up by otolaryngologist or neurologist for adenoids, sinusitis, rhinitis, as well as other diseases that can negatively affect the development of the patient's chewing apparatus. In an objective examination, attention was paid to the disturbance of nasal breathing, visually evaluated the amplitude and TMJ movement range. With an increase in age in the examined children there was a de- crease in the prevalence of deep bite, while the frequency of detecting mesial, open bite, as well as the dis- placement of dental arches from the middle line, increased. Rotated teeth, as well as disturbance of interdental gaps was detected more frequently with age while diastems were detected less frequently. The sharp decrease in the frequency of dental anomalies is observed in the transition from the II period of a variable bite (11-13 years) to the period of a constant bite (14-17 years). The study showed that regular check-ups are the most effective methods for identifying patients with tooth anomalies in schoolchildren and can significantly reduce the number of patients who need this type of treatment with an adequate orthodontic care management. The purpose of the study is to analyze the prevalence of dentoalveolar anomalies in schoolchildren of Uzhgorod. Material and methods. The study involved 339 schoolchildren in Uzhgorod. An analysis of the prevalence of dentoalveolar anomalies was carried out in three age groups: the first period of the mixed bite (6–9 years), the second period of the mixed bite (10–13 years), and the permanent bite (14–17 years). Results. It has been shown that dentoalveolar anomalies occur in the majority (78.6%) of school-age children. The most common anomalies of the teeth position (47.1%) and anomalies are the ratios of dental arches (37.3%). Anomalies in the size of the jaws (11.5%) and dentoalveolar anomalies of functional origin (4.1%) occur less often. However, 70.4% of all dentoalveolar anomalies are combined. Dentofacial anomalies were observed in children aged 10 to 13 years (II period of a shifting bite) more often. A sharp decrease in the frequency of dentoalveolar anomalies is observed during the transition from the II period of a mixed bite (11-13 years) to the I period (14-17 years) of a permanent bite. Conclusion. The study showed that medical examinations and preventive examinations are the most effective methods for identifying patients with dentoalveolar anomalies in schoolchildren and, with the adequate orthodontic care management, can significantly reduce the number of patients requiring this type of treatment.

INTRUSION ARC IN ORTHODONTIC:

The intrusion arch is a device for orthodontic anterior teeth intrusion, having been introduced by Burstone in 1977 for the treatment of deep bite, especially in the case of Class II division 2. But they are based on the origin of malocclusion and the patient's clinical characteristics, such as smile line, vertical dimension, predicted growth, among others. Use of this arc is governed by the principles of mechanical intrusion, which include obtaining a pure no intrusion proclination movements, therefore, necessary for successful treatment. Among these we can highlight to get a constant magnitude of force and the choice of point of application of force in the anterior segment, which would determine whether the motion would be pure intrusion or intrusion inclined. The mechanical stability of this is making it more advantageous in the treatment of deep bite in relation to treatment with extrusion of posterior teeth, which is notoriously prone to relapse. Thus, based on the principles of mechanics and its stability, several authors have developed some type of intrusion arches, using the original biomechanics, but differing mainly in the type of alloy wire and the point of application of force to the center of resistance to achieve the goals of the treatment

Pengaruh Kebiasaan Buruk Oral terhadap Malrelasi Gigi pada Anak Panti Asuhan Usia 7-13 Tahun

Pertumbuhan dan perkembangan gigi anak turut dipengaruhi oleh pertumbuhan dan perkembangan fisik serta mental anak. Kebiasaan buruk oral merupakan suatu kebiasaan yang ditandai dengan durasi sedikitnya enam jam sehari dan dapat menyebabkan malrelasi gigi apabila frekuensi dan intensitasnya cukup tinggi. Anak yang tidak memiliki orangtua atau keluarga, atau tinggal di panti asuhan biasanya kurang mendapatkan kasih sayang yang cukup. Munculnya kebiasaan buruk oral merupakan salah satu cara mereka untuk mendapatkan kenyamanan. Penelitian ini bertujuan untuk melihat pengaruh kebiasaan buruk oral terhadap malrelasi gigi pada anak usia 7-13 tahun yang tinggal di Panti Asuhan Nurul Haq Yogyakarta. Desain penelitian ini adalah observasional analitik dengan pendekatan cross-sectional. Sebanyak 26 anak dilakukan pemeriksaan untuk melihat relasi giginya, kemudian dilakukan wawancara mendalam, dan pencetakan rahang. Data dianalisis menggunakan uji chi-square. Prevalensi mengisap ibu jari sebesar 30.7%; menggigit jari sebesar 11.5%; menggigit kuku, bibir, prolonged bottle-feeding, dan bruxism sebesar 7.7%; dan bernapas lewat mulut 3.8%. Prevalensi protrusi sebesar 23.1%; open bite sebesar 15.4%; deep bite sebesar 11.5%; dan cross bite sebesar 7.7%. Signifikansi nilai uji chi-square sebesar 0.008 (p0.05). Kesimpulan dari hasil penelitian ini adalah terdapat pengaruh kebiasaan buruk oral terhadap malrelasi gigi pada anak panti asuhan usia 7-13 tahun.

Prevalence of Malocclusions in Autistic Patients in Isfahan

Introduction: Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders diagnosed by impairments in social interaction and communication with repetitive and restrictive stereotyped behavioral patterns. The Prevalence of autism has been reported to be increased in recent years. This study aimed to assess the prevalence of different types of malocclusion among ASD patients in Isfahan in 2018. Materials & Methods: In a descriptive and cross-sectional trial, 92 ASD patients were studied in the age range of 7-18 years at the center for autism patients in Isfahan. Clinical oral examinations of patients are taken to assess the involved malocclusions (Cl I, Cl II and Cl III malocclusions) and malocclusion traits (deep bite, open bite and cross bite) by an educated dental student under the supervision of an orthodontist under natural light. The data are reported using frequency and percentage indices. Results: Class I malocclusion had the highest prevalence 54.3% (50) among ASD patients and the prevalence of class II and class III were found to be 19.6% (18) and 7.6% (7) respectively. The frequency of malocclusions traits of deep bite, cross bite and the open bite were 27.2% (25), 18.5% (17) and 7.6% (7) respectively. Among of the total patients, 65.2% (60) showed normal bite and 18/5% (17) showed Normal occlusion. Conclusion: ASD patients showed class I, class II and class III malocclusions from the most to least frequency and the most frequent malocclusion traits were also deep bite, cross bite and open bite respectively.

A comprehensive review on loops in orthodontics

Extraction therapies are commonly done in patients with protrusion and/or crowding which demands a thorough understanding of biomechanics. Two basic types of space closing mechanics are friction/sliding and frictionless/loop mechanics. In the former, the wire and position of the bracket are important factors in tooth movement but the simplicity of friction mechanics is offset by the binding between bracket and archwire and may be associated with undesirable side effects such as uncontrolled tipping and deep bite. In frictionless mechanics, specially designed springs are used which provides the required moment to force ratio (M/F ratio) in three dimensions and they are more predictable and versatile. An electronic literature search was conducted via google scholar, PubMed, and dental associations’ of different countries’ website using the key word “Loops” and “Frictionless mechanics.Different configuration of loops have been used in orthodontic treatment and a comprehensive review of types of loops commonly used in retraction has been highlighted in this article.: Provide appropriate messages of about 35-50 words to be printed in centre box:In frictionless mechanics, specially designed springs are used which provides the required moment to force ratio in three dimensions and they are more predictable and versatile. Different configuration of loops have been used and a comprehensive review of types of loops commonly used in retraction has been highlighted in this article.

Deleterious Oral Habits Related to Vertical, Transverse and Sagittal Dental Malocclusion in Pediatric Patients

Background: Mixed dentition is currently the stage with the highest prevalence of malocclusion, therefore, the objective was to determine the relationship of dental malocclusions in the vertical, transverse, sagittal planes with deleterious habits in pediatric patients. Methods: A cross-sectional analytical study was carried out in 155 children aged 6 to 12 years attended at the clinic of the Dentistry School of The National University of San Marcos in 2017. Results: Of the patients evaluated, 45.3% were identified with vertical malocclusion, 52.0% with sagittal malocclusion and 13.6% with transverse malocclusion. The most frequent type of malocclusion in the vertical plane was anterior deep bite (22.2%), in the transverse plane the Bis a Bis Bite (7.1%) and the Anterior Crossbite (6.5%) were less frequent. Finally, in the sagittal plane, Class II division 1 (20%) and Class III (20.7%) are frequent. Among the most common deleterious habits, anteroposition (58.7%) and mixed breathing (51.0%) were observed in contrast to the habit of retroposition, lip sucking and mouth breathing, which were the least frequent. Considering age and sex, children who have an atypical swallowing habits are more likely to have malocclusion in all three planes of space. Conclusions: It is concluded that there is an association between the deleterious habits with the different types of malocclusion in the different planes of the space, being the atypical swallowing a habit that should be diagnosed early and treated interdisciplinary.

Impact of malocclusion severity on the quality of life of non-white adolescents

The aim of this study was to evaluate the impact of malocclusion severity on the oral health-related quality of life (OHRQoL) of non-white adolescents. A cross-sectional study was conducted with 585 non-white Brazilian adolescents (12-15 years). The Dental Aesthetic Index (DAI) was used for the clinical assessment of malocclusion and Oral Health Impact Profile (OHIP-14) on OHRQoL. Deep bite and transverse occlusal relationships were assessed in association with the DAI. The adolescents with DAI 3 and 4 were distributed into 4 groups: G1 - individuals without transverse occlusal relationships or deep bite; G2 - individuals with only posterior crossbite; G3 - individuals with only deep bite; and G4 - individuals with Brodie bite. The backward stepwise procedure was used to select variables on each level, eliminating variables with a p≤0.20. From the logistic regression analyses, the adjusted odds ratios were estimated with the respective 95% confidence intervals. The adolescents with severe malocclusion divided into the G2, G3 and G4 showed p-value of 0.0501, 0.1475, and 0.5407, respectively, but did not remain in the final model. Malocclusion severity had no impact on the OHRQoL of non-white adolescents.