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At least 235 records · Page 13Linked to original sources

PubMed1984

Treatment of Class II deep bite by orthodontic and surgical means.

Conventional orthodontic correction of the Class II deep-bite deformity with a decreased lower anterior facial height tendency can be mechanically difficult, inefficient and, in many instances, impossible. Orthodontic treatment alone of either adults or adolescents with such deformities frequently can neither increase lower anterior facial height sufficiently to achieve ideal facial proportions nor achieve long-term occlusal stability. Despite the need for surgical intervention to achieve satisfactory occlusal and esthetic results, many patients with such deformities are still being treated in clinical practice by traditional orthodontic procedures, with less than ideal esthetic and/or occlusal results. The challenge to achieve efficient and stable treatment of this deformity has been met by the use of various surgical techniques in combination with orthodontic treatment. This combined surgical-orthodontic approach can provide increased treatment efficiency, long-term stability, and optimal esthetic results. The proper sequencing and correct selection of orthodontic mechanotherapy are essential to ensure the desired results. This article purposes to detail basic problems involved in diagnosis and treatment planning for the combined surgical-orthodontic approach to patients exhibiting Class II deep bite and decreased lower facial height. Orthodontic and surgical treatment objectives are explained, and representative case reports are presented and discussed to illustrate this method of treatment. Extraction patterns, control of the transverse dimension, arch wire selection, auxiliary wires, elastics, and extraoral appliance use are described. Surgically, the dentofacial disharmony associated with this deformity may defy treatment by surgical advancement of the mandible only. Genioplasty, Le Fort I osteotomy, symphyseal osteotomy, anterior or total mandibular subapical osteotomy, body osteotomy, submental lipectomy, and rhinoplasty are adjunctive procedures that are described and may be used in concert with mandibular advancement surgery.

Adult↗

PubMed1992

Class III malocclusion: surgery or orthodontics?

The pre-treatment lateral cephalograms of two groups of 20 subjects with severe Class III malocclusions were compared. One group had been considered suitable for orthodontic correction by the diagnosing clinician and the other offered orthognathic surgery. The most significant differences between the groups were in angle ANB, M/M ratio (P less than 0.001), lower incisor inclination and Holdaway angle (P less than 0.01). Threshold values for angle ANB and lower incisor angulation below which surgery was almost always carried out were--4 and 83 degrees, respectively.

Adolescent↗

PubMed1992

Orthodontic treatment of a Class II division 1 malocclusion exhibiting significant maxillary arch length deficiency: a case report.

The orthodontic correction of a Class II Division I malocclusion with significant maxillary arch length deficiency and a blocked-out maxillary cuspid is reported. The case was successfully completed on a non-extraction basis using extraoral cervical headgear anchorage and compressed coil springs to gain necessary maxillary arch length. No intermaxillary elastics or functional appliances were used. Favorable patient cooperation and facial growth were instrumental in achieving good results.

Child↗

PubMed2006

Morphological and clinical considerations of first and second permanent molar eruption disorders.

Tooth eruption is a complex biological process which starts from the site of development in the jaw bone until the teeth reach their final functional position in the chewing plane. Various factors can disturb this process. Besides mechanical obstacles on the eruption path, a pathological position or axial orientation of the tooth germ, morphological aberrations of the tooth or pathological alterations of the periodontium, primary disorders of the eruption mechanism may lead to complete or partial retention of the tooth in the jaw bone. These morphological features bear upon the prognosis of orthodontic correction which is dependent upon the underlying cause. First and second molars are rarely affected by eruption disorders, with a prevalence of 0.01 to 0.08 per cent, however, marked consequences for function such as posterior open bite or elongation of the antagonists may result. Following an overview of pathogenetic factors of tooth eruption disorders, selected cases of impacted first and second permanent molars are presented with respect to their morphological causes.

Child↗

PubMed1998

Treatment of patients with asymmetries using asymmetric mechanics.

The orthodontic correction of dental asymmetries is often considered a difficult and challenging process, primarily because of misdiagnosis and poorly planned treatment mechanics. A careful differential diagnosis together with a thorough treatment plan can ensure successful treatment outcomes in the management of these malocclusions. In this article, key elements of differential diagnosis and treatment planning are reviewed. Different treatment strategies, including an analysis of the side effects associated with the use of these appliance systems, are described. This approach will help the clinician to best adapt treatment mechanics to a given malocclusion.

Dental Arch↗

PubMed1993

Class III malocclusion: the post-retention findings following a non-extraction treatment approach.

A retrospective, cephalometric study was made of a group of 28 successfully treated, Class III, Skeletal III children, who were considered suitable for orthodontic correction of their malocclusions. All had undergone non-extraction therapy, involving a combination of upper incisor proclination and headgear to an intact mandibular dentition and were available for review at least 2 years after all treatment and retention had ceased. Only girls over the age of 16 years and boys above 18 years of age at the post-retention recall were included. Data were examined at the beginning and end of active treatment, and at least two years out of retention. Where differences between the sexes were apparent, data for each sex were given separately. Where no significant differences were seen, data were pooled. Overjet correction was achieved by a combination of upper and lower incisor movement with no alteration in overbite. This was accompanied by a downward and backward repositioning of the mandible, redirecting, rather than restricting mandibular growth. Post-retention, demonstrable skeletal development occurred in both male and female faces. Normal patterns of facial growth reasserted themselves, reversing many treatment effects. The mandible reverted to a more horizontal direction of development, but because no growth restriction had occurred during treatment, no 'catch-up' growth of the lower jaw could be shown. Mandibular growth exceeded that of the maxilla, and since upper and lower incisor inclinations remained unaltered, both overbite and overjet reduced. Reflecting the underlying growth pattern, the lips became more retrusive.

Adolescent↗

PubMed1995

Cephalometric evaluation of surgical-orthodontic treatment of skeletal Class III malocclusion.

The stability of combined surgical-orthodontic correction of Class III malocclusions was evaluated. Changes at surgery and at 1-year postsurgery were observed in a sample of 13 patients undergoing mandibular setback by bilateral sagittal split osteotomy. The average posterior movement of the chin at surgery was 7.27 mm at point B, 6.39 mm at pogonion, and 5.72 mm at menton. Changes from postsurgery to 1-year follow-up revealed statistically significant differences in horizontal measurements, in which a forward movement of the mandible at point B, pogonion, and menton indicated a relapse tendency. Although vertical changes were minimal, soft tissue points followed relapse of the chin to the same extent. Because rigid internal fixation was not able to prevent relapse, technical refinements should be investigated to improve the stability of bilateral sagittal split osteotomy if the absence of maxillary deficiency contraindicates the use of bimaxillary surgical procedures.

Adult↗

PubMed1999

Root resorption: another long-term outcome.

Case history is presented of an indigenous Zambian girl. Initial surgical repositioning is shown and at a later stage when the tooth had erupted into the nasolabial vestibule and an orthodontic correction was performed. Surgical trauma as well as orthodontic forces may have precipitated root resorption; however, the aim of saving a tooth has been achieved.

Child↗

PubMed1965