Orthodontic-surgical treatment for severe skeletal class Ⅱ malocclusion with vertical maxillary excess and four premolars extraction: A case report

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.

Dry Heat Treatment Reduces the Occurrence of Cladosporium cucumerinum, Ascochyta citrullina, and Colletotrichum orbiculare on the Surface and Interior of Cucumber Seeds

Dry heat treatment has been identifie as a method for disinfecting seed-borne pathogens in vegetable seeds. This study demonstrated that three seed-borne pathogens of cucumber(Cladosporium cucumerinum that causes scabs, Ascochyta citrullina that results in gummy stem blight,and Colletotrichum orbiculare that induces anthracnose) could be effectively eradicated from cucumber seeds by dry heat treatment. In vitro growth of these three pathogens was inhibited by dry heat treatment at 70 °C for 40 min. These pathogens were inactivated after exposing infected seeds to 70 °C dry heat for at least 90 min. Seed infection was significant y reduced by exposing the seeds to 70 °C dry heat for at least 40 min. Seed moisture content and germination were slightly reduced after 70 °C heat treatment for 40–120 min. Seed vigor remained at a high level after dry heat treatment at 70 °C for 90 min. In conclusion, 70 °C dry heat treatment for 90 min was determined to be the optimal method for eradication of C. cucumerinum, Didymella bryoniae, and C. orbiculare from cucumber seeds.