Bimaxillary Protrusion - A Case Report

Correction of a severe bimaxillary protrusion with maximum anchorage can be challenging. This case report describes the treatment of a girl with a bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars. The total treatment time was 18 months. Her dental proclination and facial appearance was significantly improved.

Evaluation of patient’s perception and experience towards anterior microimplants for intrusion: A questionnaire study

Introduction: Implants have gained popularity in orthodontics because they facilitate maximum anchorage with minimum patient cooperation. However, some orthodontists avoid using implants because perception and experience of patients towards such anchorage systems is questionable and is not been fully reported.Aim and objectives: To evaluate the patient’s perception and experience towards the treatment with anterior microimplants for intrusion of anterior teeth using questionnaire.Materials and methods: After considering the inclusion and exclusion criteria, Participants who are undergoing orthodontic treatment with anterior implants for the intrusion of the maxillary anterior teeth was selected for the study. Questionnaire which was validated from ten respondents and subject experts will be given to each participant and asked to fill it. After collection of filled questionnaire, all the data was subjected to statistical analysis.Results: Most of the patients had enough confidence on their orthodontist and did not think to take a second opinion when an anterior implant was recommended. Majority of the patients were concerned to know regarding advantages and disadvantages of anterior microimplant and inquired about the time for the placement of anterior microimplant. More patients were worried about how long the anterior microimplant will remain inserted in their mouth and had fear of local anesthesia. On loading of microimplant, most of the patients felt pressure at the implant and few felt pain.Conclusion: The procedure was pleasant and comfortable for large number of patients and they did not felt pain after placement of anterior microimplant. Majority of the patients were satisfied with the treatment and would recommend it to other patients. Highest number of patients got used to the anterior implant by day 7 followed by day 15. An average acceptable time period for the anterior microimplant was 12 months. The overall perception and experience by the patients to the placement of anterior microimplant can be rated as expected and good.

The influence of surface treatment over the stability of orthodontic mini-implants

Mini-screws have brought new perspectives on the prognosis of the orthodontic treatment due to their ability to provide maximum anchorage and minimum compliance from the patient. Biomaterials used for mini-implant manufacturing are stainless steel, chrome-cobalt alloy, commercially pure titanium and grade 5 titanium alloy. These materials influence the type of cellular response in the host tissue, the stability of the device and, finally, the clinical success. Recent research has met the need for clinicians to enhance the stability of these devices through a series of changes to the surface which is in direct contact with bone. This paper aims to analyze the methods used as a surface treatment for orthodontic mini-implants and to evaluate their influence on the stability of these devices. This paper is a synthesis of existing data in the literature, based on inclusion in the analysis of full-text scientific articles relevant for the chosen topic.

Penguatan Penjangkaran pada Perawatan Gigi Berjejal dengan Pencabutan Gigi Premolar Kedua menggunakan Alat Cekat Begg

Perawatan gigi berjejal biasanya membutuhkan pencabutan gigi untuk mendapatkan ruang yang akan digunakan untuk pengaturan gigi. Pencabutan gigi premolar kedua membutuhkan penguatan penjangkaran (anchorage reinforcement) pada segmen posterior. Evaluasi perawatan gigi berjejal dengan pencabutan gigi premolar kedua menggunakan alat cekat Begg. Pasien perempuan usia 18 tahun mengeluhkan gigi depan atas dan bawah berjejal. Karies besar terdapat pada tonjol palatinal gigi premolar kedua kiri atas. Diagnosis pasien adalah maloklusi Angle kelas I, hubungan skeletal kelas I, jarak gigit 2,8 mm, tumpang gigit 3 mm, crowding anterior dan posterior, serta pergeseran garis inter insisivus rahang bawah ke kiri sebesar 2 mm. Pengukuran indeks iregularitas Little menunjukkan nilai 12,6 (berjejal berat). Perhitungan determinasi lengkung dan metode Kesling menunjukkan toleransi pergerakan molar rahang atas ke mesial sebesar 1,2 mm pada sisi kanan dan kiri (penjangkaran maksimum). Pasien dirawat menggunakan alat cekat Begg dengan pencabutan keempat gigi premolar kedua. Empat gigi molar kedua disertakan sebagai gigi penjangkar untuk memperkuat keempat gigi molar pertama. Hasil pengukuran pergerakan gigi molar pertama ke mesial setelah perawatan selama 29 bulan menggunakan metode dari Ziegler dan Ingervall menunjukkan terjadi pergerakan gigi molar ke mesial sebesar 1,2 mm pada sisi kanan dan 0,7 mm pada sisi kiri. Nilai indeks iregularitas Little adalah 1,9. Gigi molar kedua sebagai komponen penguat penjangkar efektif untuk meminimalkan anchorage loss pada perawatan gigi berjejal dengan pencabutan gigi premolar kedua menggunakan alat cekat Begg. ABSTRACT: Anchorage Reinforcement in Orthodontic Treatment of Crowded Second Premolar Extraction Case Using Begg Appliance. Orthodontic treatment for crowded teeth may need a tooth extraction. The extraction of second premolars may need anchorage reinforcement in posterior segment. To evaluate the treatment progress of crowded teeth with second premolars extraction uses Begg appliance. An 18 year old female patient complained of her crowded teeth in upper and lower arch. The case was Angle class I malocclusion with class I skeletal pattern, with over jet 2.8 mm and over bite 3 mm. The crowded teeth were present in anterior and posterior segments. There was dental midline discrepancy, with the lower arch midline shifted 2 mm to the left. Little Irregularity Index scored 12.6 (severely crowded). Arch length determination and Kesling’s set up model assesment show that a maximum anchorage was necessary. The patient was treated using Begg appliance and four second premolars were extracted. The four second molars were included as anchor teeth. After 29 months of treatment, the movement of maxillary first molars was measured using the method from Ziegler and Ingervall. The mesial movement of right maxillary first molar was 1.2 mm and 0.7 mm for maxillary first molar. Little Irregularity Index scored 1.9. Adding second molars as ancor teeth was effective to minimize anchor loss in orthodontic treatment using Begg appliance with second premolars extraction.

Horizontal and vertical changes in anchor molars after extractions in bimaxillary protrusion cases

Objective To evaluate changes in the anchor molar position (horizontal, vertical) after retraction in bimaxillary protrusion maximum anchorage cases. Materials and Methods Thirty patients requiring maximum anchorage after extraction of the first premolars were selected for this study. The second molars were banded in both arches along with trans-palatal arch in the maxillary arch and lingual arch in the mandibular arch. En mass retraction was done using sliding mechanics. Horizontal and vertical positions of the anchor first molars were evaluated cephalometrically before and after orthodontic retraction. Results In the horizontal plane, maxillary first molars showed net mesial movement of 1.72 mm, and there was a statistical difference between the pre- and post-values (P < 0.001). The mandibular molars showed a net horizontal movement of 2.26 mm, and there was a statistically significant difference between the pre- and post-values (P < 0.001). In the vertical plane, there was vertical movement of the maxillary anchor molars by a net value of 0.95 mm which was statistically significant (P < 0.001). The mandibular anchor molars moved vertically by a net value of 0.45 mm. This difference was statistically not significant. Conclusion There was anchorage loss seen in both the planes (horizontal, vertical) of the maxillary anchor molars. In the mandibular anchor molars, there was anchorage loss seen only in the horizontal plane. No anchorage loss was seen in the vertical plane.

A case report palatal implant for molar distalization

Implants obtained popularity in Orthodontics by to make easy the maximum anchorage with the minimal patient׳s compliance. In this context, osseointegrated implants has been frequently used as auxiliaries of orthodontic treatments, substituting in some cases inter maxillaries elastics and extra oral appliances. These implants show as advantage a independence in opposite the patient׳s compliance, the anchorage possibility in periodontal loss cases, over there an esthetic improvement and the comfort propitiated, showing more expected results. This article approach the orthodontic treatment of a clinic case of Class II, division 1 malocclusion, non-extraction accomplished and with palatal implant to distalization of latter teeth.

Class I malocclusion with severe double rotrusion treated with first premolars extraction

Angle Class I malocclusion with bimaxillary protrusion is characterized by severe buccal tipping of incisors, which causes upper and lower lip protrusion. First premolars extraction is recommended to reduce facial convexity as a result of anterior teeth retraction, which keeps canines and first molars in key to occlusion. In order to yield orthodontic results that are compatible with ideal esthetic and cephalometric outcomes, the space closure phase needs to be carried out with overbite and incisors torque control. The majority of cases also requires maximum anchorage of posterior teeth. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as a requirement for the title of certified by the BBO.