BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lip...BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.展开更多
BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatmen...BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.展开更多
Aim To determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire （MEAW） technique on postpeak Class Ⅱ Division 1 patients. Methodology In this retrospectiv...Aim To determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire （MEAW） technique on postpeak Class Ⅱ Division 1 patients. Methodology In this retrospective study, 16 postpeak Class Ⅱ Division 1 patients successfully corrected using a non-extraction and MEAW technique were cephalometrically evaluated and compared with 16 matched control subjects treated using an extraction technique. Using CorelDRAW software, standardized digital cephalograms preand post-active treatments were traced and a reference grid was set up. The superimpositions were based on the cranial base, the mandibular and the maxilla regions,and skeletal and dental changes were measured. Changes following treatment were evaluated using the paired-sample t-test. Student＇s t-test for unpaired samples was used to assess the differences in changes between the MEAW and the extraction control groups. Results The correction of the molar relationships comprised 54% skeletal change （mainly the advancement of the mandible） and 46% dental change. Correction of the anterior teeth relationships comprised 30% skeletal change and 70% dental change. Conclusion The MEAW technique can produce the desired vertical and sagittal movement of the tooth segment and then effectively stimulate mandibular advancement by utilizing the residual growth potential of the condyle.展开更多
Objective: To evaluate the effects of the Chinese Ni-Ti coil-springs appliance on distalization of maxillary molars and the reciprocal effects on the anchorage teeth. Methods:Twenty-four adolescent patients(12 boys,12...Objective: To evaluate the effects of the Chinese Ni-Ti coil-springs appliance on distalization of maxillary molars and the reciprocal effects on the anchorage teeth. Methods:Twenty-four adolescent patients(12 boys,12 girls) with Class Ⅱ malocclusion were selected and the coil-springs appliance was used during the treatment. Pre- and postdistalization lateral cephalometric radiographs were analyzed and compared. Results: The average time for the correction of Class Ⅱ molar relationship was 4.6 months. And the mean distance of molar distalization was 4.4 mm. The Chinese Ni-Ti coil-springs also demostrated less tipping and better bodily movement of maxillary molars. Conclusion: This study suggests that the Chinese Ni-Ti coil-springs appliance distalizes the upper molar significantly, while there is no remarkable loss of anchorage because of patients’ wearing headgear with J hooks at night and Class Ⅱ elastics in the day time.展开更多
Background Many cases of ClassⅡdeformities have been reported to be treated with prefabricated appliances.The aim of this study was to distinguish the clinical effect of traditional custom-made appliances and prefabr...Background Many cases of ClassⅡdeformities have been reported to be treated with prefabricated appliances.The aim of this study was to distinguish the clinical effect of traditional custom-made appliances and prefabricated appliances in the treatment of ClassⅡdivision 1 malocclusion.Therefore,soft and hard tissue changes following treatment of ClassⅡdivision 1 malocclusion using the twin-block(TB)appliance was compared to that using the Myofunctional Research Company(MRC)appliance(K1+K2)combined with oral myofunctional treatment(OMT)(MRC+OMT).Methods The study included 22 children(6 boys and 16 girls aged 9–11 years)with ClassⅡdivision 1 malocclusion along with mandibular retrognathism with a 5–12 mm overjet,basic normal maxillary status,and stage 2 or 3 cervical vertebral maturation(CVM).Participants were randomly assigned into two groups,the TB group and the MRC+OMT group for 12 months.Standardized lateral cephalograms were used to assess skeletal,dental,and soft tissue changes from pre-to post-treatment.Independent t-tests were used to compare the initial and final cephalometric status and tissue changes between the groups.Results The TB and MRC+OMT groups resulted in different degrees of lateral changes;however,improvements of skeletal and soft tissue indices were significantly greater in the TB group than in the MRC+OMT group.Conclusion TB was more effective than MRC+OMT in treating children aged 9–11 years with ClassⅡdivision 1 malocclusion.However,further research using custom-made appliances with OMT is recommended,and further investigations are needed to confirm these findings.展开更多
Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane D...Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane Database of Systematic Review were searched using specific inclusion criteria to obtain applicable articles. All pertinent references were also examined for acceptability. Results: A total of 20 articles were identified using the inclusion criteria. The prevalence of Angle class III malocclusion ranged from 0 to 26.7% in different populations reported in the literature examined. Meta-regression analysis showed no statistically significant association between prevalence rates and the method of assessment, age group and year of the study. However, much of the study-to-study variation (approximately 40%) could be explained by population. Conclusion: These results suggest that the prevalence of Angle class III malocclusion varies greatly within different races and geographic regions. Chinese and Malaysian populations have a higher prevalence of Angle class III malocclusion compared to other racial groups, while Indian populations have a lower prevalence than all other racial groups examined.展开更多
Objective： To discuss possible relationships between class In malocclusion and perioral forces by measuring the pressure from the lips and the tongue of children with class nI malocclusion. Methods： Thirty-one child...Objective： To discuss possible relationships between class In malocclusion and perioral forces by measuring the pressure from the lips and the tongue of children with class nI malocclusion. Methods： Thirty-one children with class In malocclusion were investigated and their perioral forces were measured at rest and during swallowing under natural head position by a custom-made miniperioral force computer measuring system. Results： The resting pressures exerted on the labial side and palatine side of the upper lett incisor, as well as the labial side and lingual side of the lower lett incisor, were 0 g/cm^2, 0 g/cm^2, 0.57 g/cm^2 and 0.23 g/cm^2, respectively. Correspondingly, the swallowing forces were 2.87 g/cm^2, 5.97 g/cm^2, 4.09 g/cm^2 and 7.89 g/cm^2, respectively. No statistical difference between muscular pressure and gender existed. During swallowing, the lingual forces were significantly higher than the labial forces （P〈0.01）, however, at rest there was no significantly different force between these two sides. Compared to the normal occlusion patients, children with class Ⅲ malocclusion had lower pedoral forces. The upper labial resting forces （P〈0.01）, the lower labial resting forces （P〈0.05） and all the swallowing pressures from the lips and the tongue （P〈0.01） showed statistical differences between the two different occlusion conditions. Meanwhile, no significant difference was found for the resting pressure from the tongue between class Ⅲ malocclusion and normal occlusion. Conclusion： Patients with class Ⅲ malocclusion have lower perioral forces and this muscle hypofunction may be secondary to the spatial relations of the jaws. The findings support the spatial matrix hypothesis.展开更多
The effects of Tip-Edge plus appliance in the treatment of Angle Ⅱ1 malocclusion and the mechanism were investigated. Fifty-two Angle Ⅱ1 children, aged from 12.3-14.2 years, with mandibu- lar retrusion in permanent ...The effects of Tip-Edge plus appliance in the treatment of Angle Ⅱ1 malocclusion and the mechanism were investigated. Fifty-two Angle Ⅱ1 children, aged from 12.3-14.2 years, with mandibu- lar retrusion in permanent dentition were selected and treated with Tip-Edge plus appliance. Lateral cephalometric films taken before and after treatment were analyzed. The arithmetic mean and standard deviation were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change. Results showed that the average treatment time was 16 months. Normal overjet and overbite were established with retroclination of upper incisors and proclination of lower incisors. U1-NA was decreased by 15.4° （P〈0.01）. ANB and Y axial angle were decreased significantly （P〈0.05） Soft tissue measurements showed that FCA and UL-E were decreased dramatically （P〈0.05）, and LL-E was increased significantly （P〈0.05）. Remarkable soft tissue change was noted after the treatment and convex facial profile changed to the straight profile. In conclusion, Tip-Edge plus technique can quickly and efficiently correct anterior bite and lateral outlook.展开更多
Objective: The aim of this study was to compare the effect of face mask (FM) and Maxillary Bite Block (BB) in skeletal class III patients during mixed dentition with control group of the same class during their growth...Objective: The aim of this study was to compare the effect of face mask (FM) and Maxillary Bite Block (BB) in skeletal class III patients during mixed dentition with control group of the same class during their growth. Materials & Methods: Forty-two patients were selected based on clinical and cephalometric examination, with age ranged from 6 to 8 years according to definite criteria. Patients were classified into two groups: treated and control groups;all records were taken for every patient. Lateral cephalometric films were traced before and after treatment and analyzed. Results: Intermaxillary skeletal variables showed significant improvement in the treated group with an average increase of ANB angle (Maxilo mandibular difference angle) of 3.14°and an average increase in wits appraisal 2.15 mm. Conclusion: The study concluded that, treatment with face mask and maxillary bite block induced significant dentoskeletal changes.展开更多
Class III malocclusion associated with skeletal anterior open bite pattern in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Conventionally, several treatment alternatives a...Class III malocclusion associated with skeletal anterior open bite pattern in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Conventionally, several treatment alternatives are available such as tooth extraction, molar intrusion, and absolute anchorage system or orthognathic surgical correction. Although correction with surgery may be the most effective and stable way, many patients refused surgical treatment plan because of the costs and traumas it may bring. We reported a nonsurgical orthopedic treatment of 22-year-old male with severe skeletal anterior open bite, dental Class III malocclusion, posterior crossbite and a high mandibular plane angle. The patient refused surgery and extraction. So we formulated a treatment plan consisting of using rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, Class III elastics to correct the canines, premolars, and molars relationship, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct open bite. In this case, without suffering of surgery, the posterior crossbite was ideally corrected, and ideal overjet and overbite relationships and functional occlusion were all achieved. The patient obtained satisfactory occlusal as well as functional and stable results.展开更多
基金Supported by Medical Science Research Project Plan by Health Commission of the Hebei Province,No.20220063.
文摘BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.
文摘BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.
文摘Aim To determine cephalometrically the mechanism of the treatment effects of non-extraction and multiloop edgewise archwire （MEAW） technique on postpeak Class Ⅱ Division 1 patients. Methodology In this retrospective study, 16 postpeak Class Ⅱ Division 1 patients successfully corrected using a non-extraction and MEAW technique were cephalometrically evaluated and compared with 16 matched control subjects treated using an extraction technique. Using CorelDRAW software, standardized digital cephalograms preand post-active treatments were traced and a reference grid was set up. The superimpositions were based on the cranial base, the mandibular and the maxilla regions,and skeletal and dental changes were measured. Changes following treatment were evaluated using the paired-sample t-test. Student＇s t-test for unpaired samples was used to assess the differences in changes between the MEAW and the extraction control groups. Results The correction of the molar relationships comprised 54% skeletal change （mainly the advancement of the mandible） and 46% dental change. Correction of the anterior teeth relationships comprised 30% skeletal change and 70% dental change. Conclusion The MEAW technique can produce the desired vertical and sagittal movement of the tooth segment and then effectively stimulate mandibular advancement by utilizing the residual growth potential of the condyle.
文摘Objective: To evaluate the effects of the Chinese Ni-Ti coil-springs appliance on distalization of maxillary molars and the reciprocal effects on the anchorage teeth. Methods:Twenty-four adolescent patients(12 boys,12 girls) with Class Ⅱ malocclusion were selected and the coil-springs appliance was used during the treatment. Pre- and postdistalization lateral cephalometric radiographs were analyzed and compared. Results: The average time for the correction of Class Ⅱ molar relationship was 4.6 months. And the mean distance of molar distalization was 4.4 mm. The Chinese Ni-Ti coil-springs also demostrated less tipping and better bodily movement of maxillary molars. Conclusion: This study suggests that the Chinese Ni-Ti coil-springs appliance distalizes the upper molar significantly, while there is no remarkable loss of anchorage because of patients’ wearing headgear with J hooks at night and Class Ⅱ elastics in the day time.
文摘Background Many cases of ClassⅡdeformities have been reported to be treated with prefabricated appliances.The aim of this study was to distinguish the clinical effect of traditional custom-made appliances and prefabricated appliances in the treatment of ClassⅡdivision 1 malocclusion.Therefore,soft and hard tissue changes following treatment of ClassⅡdivision 1 malocclusion using the twin-block(TB)appliance was compared to that using the Myofunctional Research Company(MRC)appliance(K1+K2)combined with oral myofunctional treatment(OMT)(MRC+OMT).Methods The study included 22 children(6 boys and 16 girls aged 9–11 years)with ClassⅡdivision 1 malocclusion along with mandibular retrognathism with a 5–12 mm overjet,basic normal maxillary status,and stage 2 or 3 cervical vertebral maturation(CVM).Participants were randomly assigned into two groups,the TB group and the MRC+OMT group for 12 months.Standardized lateral cephalograms were used to assess skeletal,dental,and soft tissue changes from pre-to post-treatment.Independent t-tests were used to compare the initial and final cephalometric status and tissue changes between the groups.Results The TB and MRC+OMT groups resulted in different degrees of lateral changes;however,improvements of skeletal and soft tissue indices were significantly greater in the TB group than in the MRC+OMT group.Conclusion TB was more effective than MRC+OMT in treating children aged 9–11 years with ClassⅡdivision 1 malocclusion.However,further research using custom-made appliances with OMT is recommended,and further investigations are needed to confirm these findings.
文摘Objective: This study seeks to review current and relevant literature on global Angle class III malocclusion prevalence. Materials and Methods: The electronic databases PubMed, ISI Web of Knowledge, and the Cochrane Database of Systematic Review were searched using specific inclusion criteria to obtain applicable articles. All pertinent references were also examined for acceptability. Results: A total of 20 articles were identified using the inclusion criteria. The prevalence of Angle class III malocclusion ranged from 0 to 26.7% in different populations reported in the literature examined. Meta-regression analysis showed no statistically significant association between prevalence rates and the method of assessment, age group and year of the study. However, much of the study-to-study variation (approximately 40%) could be explained by population. Conclusion: These results suggest that the prevalence of Angle class III malocclusion varies greatly within different races and geographic regions. Chinese and Malaysian populations have a higher prevalence of Angle class III malocclusion compared to other racial groups, while Indian populations have a lower prevalence than all other racial groups examined.
基金Project (No.2002ZX040) supported by the Health Bureau of Zhejiang Province,China
文摘Objective： To discuss possible relationships between class In malocclusion and perioral forces by measuring the pressure from the lips and the tongue of children with class nI malocclusion. Methods： Thirty-one children with class In malocclusion were investigated and their perioral forces were measured at rest and during swallowing under natural head position by a custom-made miniperioral force computer measuring system. Results： The resting pressures exerted on the labial side and palatine side of the upper lett incisor, as well as the labial side and lingual side of the lower lett incisor, were 0 g/cm^2, 0 g/cm^2, 0.57 g/cm^2 and 0.23 g/cm^2, respectively. Correspondingly, the swallowing forces were 2.87 g/cm^2, 5.97 g/cm^2, 4.09 g/cm^2 and 7.89 g/cm^2, respectively. No statistical difference between muscular pressure and gender existed. During swallowing, the lingual forces were significantly higher than the labial forces （P〈0.01）, however, at rest there was no significantly different force between these two sides. Compared to the normal occlusion patients, children with class Ⅲ malocclusion had lower pedoral forces. The upper labial resting forces （P〈0.01）, the lower labial resting forces （P〈0.05） and all the swallowing pressures from the lips and the tongue （P〈0.01） showed statistical differences between the two different occlusion conditions. Meanwhile, no significant difference was found for the resting pressure from the tongue between class Ⅲ malocclusion and normal occlusion. Conclusion： Patients with class Ⅲ malocclusion have lower perioral forces and this muscle hypofunction may be secondary to the spatial relations of the jaws. The findings support the spatial matrix hypothesis.
基金supported by grants from the National Natural Science Foundation of China(No.81100776)Army Medical Research "12th Five-Year Plan" project(CWS11J118)
文摘The effects of Tip-Edge plus appliance in the treatment of Angle Ⅱ1 malocclusion and the mechanism were investigated. Fifty-two Angle Ⅱ1 children, aged from 12.3-14.2 years, with mandibu- lar retrusion in permanent dentition were selected and treated with Tip-Edge plus appliance. Lateral cephalometric films taken before and after treatment were analyzed. The arithmetic mean and standard deviation were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change. Results showed that the average treatment time was 16 months. Normal overjet and overbite were established with retroclination of upper incisors and proclination of lower incisors. U1-NA was decreased by 15.4° （P〈0.01）. ANB and Y axial angle were decreased significantly （P〈0.05） Soft tissue measurements showed that FCA and UL-E were decreased dramatically （P〈0.05）, and LL-E was increased significantly （P〈0.05）. Remarkable soft tissue change was noted after the treatment and convex facial profile changed to the straight profile. In conclusion, Tip-Edge plus technique can quickly and efficiently correct anterior bite and lateral outlook.
文摘Objective: The aim of this study was to compare the effect of face mask (FM) and Maxillary Bite Block (BB) in skeletal class III patients during mixed dentition with control group of the same class during their growth. Materials & Methods: Forty-two patients were selected based on clinical and cephalometric examination, with age ranged from 6 to 8 years according to definite criteria. Patients were classified into two groups: treated and control groups;all records were taken for every patient. Lateral cephalometric films were traced before and after treatment and analyzed. Results: Intermaxillary skeletal variables showed significant improvement in the treated group with an average increase of ANB angle (Maxilo mandibular difference angle) of 3.14°and an average increase in wits appraisal 2.15 mm. Conclusion: The study concluded that, treatment with face mask and maxillary bite block induced significant dentoskeletal changes.
文摘Class III malocclusion associated with skeletal anterior open bite pattern in adults can be a challenging orthodontic problem, especially for the nonsurgical treatment. Conventionally, several treatment alternatives are available such as tooth extraction, molar intrusion, and absolute anchorage system or orthognathic surgical correction. Although correction with surgery may be the most effective and stable way, many patients refused surgical treatment plan because of the costs and traumas it may bring. We reported a nonsurgical orthopedic treatment of 22-year-old male with severe skeletal anterior open bite, dental Class III malocclusion, posterior crossbite and a high mandibular plane angle. The patient refused surgery and extraction. So we formulated a treatment plan consisting of using rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, Class III elastics to correct the canines, premolars, and molars relationship, reverse curve of the nickel-titanium wire combined with anterior vertical elastics to intrude molars and correct open bite. In this case, without suffering of surgery, the posterior crossbite was ideally corrected, and ideal overjet and overbite relationships and functional occlusion were all achieved. The patient obtained satisfactory occlusal as well as functional and stable results.
