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.

DETERMINATION OF NORMATIVE CEPHALOMETRIC PARAMETERS ACCORDING TO THE STEINER METHOD FOR UKRAINIAN YOUNG MEN AND YOUNG WOMEN WITH DIFFERENT FACE TYPES

In Ukrainian young men (n=49) or young women (n=76) with orthognathic occlusion with different face types, numerous reliable and tendencies of differences of cephalometric parameters by the Stainer method were established. Among the indicators belonging to the second group (indicators of the upper and lower jaws according to the Steiner method), significant differences were found only between young women with a very wide face and other types of faces. Among the indicators belonging to the third group (indicators by the Steiner method that characterize the position of each individual tooth relative to each other, cranial structures and soft tissue profile of the face), more pronounced differences are also found between young women with very wide faces and other facial types; among young men – with representatives with a wide face compared to the middle and narrow face types. Among the cephalometric parameters belonging to the second group of indicators, the expressed manifestations of sexual dimorphism of cephalometric parameters are established only for linear indicators; among the parameters belonging to the third group of indicators, the manifestations of sexual dimorphism are established for both linear and angular indicators.

Nasolabial Angle in Profiles Perceived as Attractive: A Scoping Review

Context: The nose and lips area play an important role in facial appearance and nasolabial angle (NLA) can be considered as a determinant factor for attractiveness. The perception of beauty and attractiveness is vastly influenced by media and thus, can change with trends over time. The aim of this study was to conduct a systematic review of literature on NLA in faces perceived as attractive over time and in different ethnic groups. Evidence Acquisition: This study was performed following preferred reporting items for systematic reviews and meta-analyses extension for Scoping Reviews (PRISMA-ScR) guideline. We conducted an electronic search using PubMed, Scopus, and Embase databases with the employment of MeSH and free text terms "beauty"[MeSH], "esthetics"[MeSH], "soft tissue", "nasolabial angle", "attractive" and "cephalometric analysis". The inclusion criteria were studies that indicated facial attractiveness by a panel of at least 10 judges, evaluated the soft tissue profile characteristics, and reported the preferred NLA. Results: The search results revealed 271 related articles, of which 21 studies investigated NLA as a conducive factor in profile attractiveness and were included in the review. The range of preferred NLA was 86° to 107° for men and 84° to 123.12° for women. Conclusions: The most pleasing lip position and subsequently NLA is influenced by variables including the observer and subject’s gender, and their ethnic background as well as time. Over all, NLA in faces perceived as attractive is more obtuse in women than men. Compared to white norms, NLA is more acute among Chinese and African-Americans, while amongst Iranian women, it is not distinctly far from North American Caucasians. Over the course of time, preferred NLA has significantly changed in women but has been unwavering in men.

Extraction vs. Nonextraction on Soft-Tissue Profile Change in Patients with Malocclusion: A Systematic Review and Meta-Analysis

Objectives. We aimed to summarize the current evidence regarding the impact of extraction vs. nonextraction in orthodontic treatment on patients’ soft-tissue profile with malocclusion. Methods. Between April 30th and November 30th, 2020, we searched PubMed and SCOPUS for published papers from inception to November 2020 using “orthodontic,” “extraction,” “nonextraction,” and “Malocclusion.” Included studies were summarized, and relevant data were extracted and analyzed using Review Manager 5.4. Results. Pooled data from four controlled trials demonstrated a nonsignificant difference between extraction and nonextraction in terms of SNA ( MD = 0.50 , 95% CI: -0.37, 1.38; p = 0.26 ), SNB ( MD = 0.11 , 95% CI: -1.23, 1.44; p = 0.88 ), FMA ( MD = 1.82 , 95% CI: -2.39, 6.02; p = 0.40 ), IMPA ( MD = 0.06 , 95% CI: -8.83, -8.94; p = 0.99 ), overjet ( MD = − 1.47 , 95% CI: -6.21, 3.26; p = 0.54 ), and overbite ( MD = 0.50 , 95% CI: -1.40, 2.40; p = 0.60 ). On the other hand, the extraction method significantly increased the ANB compared with the nonextraction group ( MD = 0.78 , 95% CI: 0.25, 1.31; p = 0.004 ). Conclusion. The current evidence demonstrated that nonextraction protocols for orthodontic treatment are a safe and effective alternative to extraction protocols; individually tailored treatment strategies should be applied. More randomized controlled trials are critically needed to safely make an evidence-based treatment conclusion.

1353 Accuracy of Surgical movements in the Le Fort I Osteotomy

Introduction The Le Fort I osteotomy is a surgical procedure planned by a joint orthognathic team aiming to correct skeletal discrepancies of the maxilla, with subsequent soft tissue profile changes of the patient. We undertook a retrospective case series analysis of patients receiving Le Fort I surgery at a UK teaching hospital over the last four years to assess the accuracy of Le Fort I surgical movements, by comparing the actual maxillary movement with planned surgical movements. Method A retrospective analysis of patients receiving Le Fort I surgery over a 4-year period, 2016-2020, was completed. Pre- and post-surgical lateral cephalograms were traced to determine postoperative anterior maxillary movements, and these were compared to the original orthognathic plan. Based on a literature review, we created a locally established standard of surgical movement to be within 2mm of planned movement on the lateral cephalogram trace for a satisfactory outcome. Results 91% of patients undergoing Le Fort I surgery (n = 11) had postoperative maxillary movement within 2mm of the surgical plan, and the mean difference between planned and surgical movements was 1.13mm. Conclusions Our retrospective analysis shows there is good surgical accuracy demonstrated of Le Fort I maxillary advancement movements compared to their original plan. Following this, we will continue to monitor and maintain this high standard for optimal patient outcome.

Dental Implant Abutments and Their Selection - A Review

Dental implants have become the most promising and accepted prosthetic alternative to missing teeth. Innovative and technological advances in implant dentistry have improved the performance and long term prognosis of dental implants. The growing demand for dental implants has led many manufacturers to enter the industry. With this growth in implant dentistry various implant brands and their components are made available in the markets that vary in terms of design and other features. Success of implant restorations is related to various components involved with the prosthesis. Implant abutment is the link between implant and restoration; right selection of this abutment is vital for the success of implant prosthesis. There are varieties of implant abutments available in the market. Clinician should have adequate knowledge about these abutments and various factors that affect abutment selection, to choose the right one. Each implant case is different and clinician should be able to identify requirements of every individual case and choose the best suitable abutment available in the market. These abutments vary in implant abutment connection, material, type of retention, and fabrication methods. Though the ideal concept is prosthetically driven implant placement, many times anatomical features, esthetic requirements, soft tissue profile, axial load distribution, malpositioned implants, and many other patient factors do not allow ideal implant placement. Such cases can be managed by careful selection of abutments by assessing the clinical requirements, thus offering better treatment outcome. This paper is an attempt to contemplate various factors affecting abutment selection, and throw light on various implant abutments available in the market, thus guiding the clinician in abutment selection. Hence this article summarizes complete information about the implant abutments, including introduction, types, selection, and different abutments available in market. KEY WORDS Abutment Material, Implant Abutments, Implant Abutment Connection, Prosthesis Retention