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
This clinical report describes the management of a patient who was diagnosed with amniotic band sequence (ABS) complicated with severe skeletal malocclusion, associated with severe muscle weakness. The patient was a 2...This clinical report describes the management of a patient who was diagnosed with amniotic band sequence (ABS) complicated with severe skeletal malocclusion, associated with severe muscle weakness. The patient was a 23-year-old male who underwent treatment in our hospital to improve chewing, phonation, and swallowing difficulties caused by severe abnormality of the maxillofacial skeleton. We evaluated chewing, swallowing and language functions preoperatively, and started muscle function and oral rehabilitation therapy. We performed 2-jaw osteotomy after preoperative orthodontic treatment. The patient continued with postoperative orthodontic treatment and oral rehabilitation. Postoperatively, the patient showed improved maxillofacial morphology, but was unable to attain sufficient improvement of masticatory and language functions due to atrophy and poor development of the masticatory muscles. These results suggest that obtaining sufficient therapeutic effect on oral functions is not possible if the masticatory muscles are not sufficiently strong due to atrophy or hypoplasia.展开更多
目的:探讨成人骨性Ⅲ类错牙合畸形患者的舌肌功能运动状况,观察舌功能运动对骨性Ⅲ类错牙合畸形骨性和牙性特征产生的影响。方法:选取2020年1月-2022年6月笔者医院口腔科的骨性Ⅲ类错牙合畸形患者89例,测量最适张口(Comfortable mouth o...目的:探讨成人骨性Ⅲ类错牙合畸形患者的舌肌功能运动状况,观察舌功能运动对骨性Ⅲ类错牙合畸形骨性和牙性特征产生的影响。方法:选取2020年1月-2022年6月笔者医院口腔科的骨性Ⅲ类错牙合畸形患者89例,测量最适张口(Comfortable mouth opening,CMO)的切牙间距离、舌尖上抬至切牙乳头(Tongue tip extended to the incisive papilla,TIP)的切牙间距离、舌体吸附至腭部(Lingual-palatal suction,LPS)的切牙间距离,计算舌前部的活动度(Mobility of the anterior one-third of the tongue,TRMR-TIP=TIP/CMO),舌后部的活动度(Mobility of the posterior two-thirds of the tongue,TRMR-LPS=LPS/CMO),将舌活动度分为四级。通过头颅侧位片和模型分析测量骨性和牙性指标。比较各分级间舌功能活动度与骨性Ⅲ类错牙合畸形骨性和牙性特征的关系。结果:舌前后部活动度三级(低于平均水平)、四级(显著低于平均水平)的SNB、L1-MP比一级(显著高于平均水平)、二级(平均水平)大;舌前后部活动度一级、二级的Go-Gn-SN°比三级、四级大;舌后部活动度一级、二级的上颌尖牙间宽度、上颌磨牙间宽度、下颌尖牙间宽度比三级、四级大;舌后部活动度三级、四级的下颌磨牙间宽度比一级、二级大,差异均有统计学意义(P<0.05)。结论:舌活动度越小,下颌前突越严重,下颌骨向后下旋转趋势越小,下前牙越唇倾。随着舌后部活动度减小,下颌磨牙间宽度增大,上颌尖牙和上颌磨牙间宽度、下颌尖牙间宽度减小。展开更多
BACKGROUND In growing patients with skeletal discrepancies,early assessment of functional factors can be vital for the restoration of normal craniofacial growth.AIM To compare airway volumes in patients with mandibula...BACKGROUND In growing patients with skeletal discrepancies,early assessment of functional factors can be vital for the restoration of normal craniofacial growth.AIM To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship,thereby assessing the association between cephalometric variables and airway morphology.METHODS Cone-beam computed tomography volume scans,and lateral cephalograms,3-dimensional airway volume and cross-sectional areas of 120 healthy children(54 boys and 66 girls mean age 15.19±1.28)which were done for orthodontic assessment were evaluated.The subjects were divided into 2 groups based on the angle formed between point A,Nasion and point B(ANB)values and cephalometric variables(such as anterior and posterior facial height,gonial angle etc.)airway volumes,and cross-sectional measurements were compared using independent t tests.Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.RESULTS Means and standard deviations for cephalometric,cross-sectional,and volumetric variables were compared.ANB,mandibular body length and facial convexity were statistically highly significant(P<0.01)whereas condylion to point A,nasal airway and total airway volume(P<0.05)were statistically significant.The nasal airway volume and the superior pharyngeal airway volume had a positive correlation(P<0.01),nasal airway was correlated to middle(P<0.05)and total airway superior had a relation with middle(P<0.05),inferior and total airway(P<0.05),middle was related to all other airways;inferior was also related to all the airways except nasal.Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume(P<0.05).Additionally,ANB angle was significantly correlated with total airway volume and superior airway(P<0.05).CONCLUSION The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.展开更多
BACKGROUND Correcting severe skeletal class III malocclusion with facial asymmetry in adults through orthodontic treatment alone is difficult.CASE SUMMARY In this case report,we describe orthodontic treatment and lowe...BACKGROUND Correcting severe skeletal class III malocclusion with facial asymmetry in adults through orthodontic treatment alone is difficult.CASE SUMMARY In this case report,we describe orthodontic treatment and lower incisor extraction without orthognathic surgery for a 27-year-old man with a transverse discrepancy.The extraction sites were closed using an elastic chain.The use of intermaxillary elastics,improved super-elastic Ti-Ni alloy wire,and unilateral multibend edgewise arch wire was crucial for correcting facial asymmetry and the midline deviation.CONCLUSION After treatment,the patient had a more symmetrical facial appearance,acceptable overjet and overbite,and midline coincidence.The treatment results remained stable 3 years after treatment.This case report demonstrates that a minimally invasive treatment can successfully correct severe skeletal class III malocclusion with facial asymmetry.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This clinical report describes the management of a patient who was diagnosed with amniotic band sequence (ABS) complicated with severe skeletal malocclusion, associated with severe muscle weakness. The patient was a 23-year-old male who underwent treatment in our hospital to improve chewing, phonation, and swallowing difficulties caused by severe abnormality of the maxillofacial skeleton. We evaluated chewing, swallowing and language functions preoperatively, and started muscle function and oral rehabilitation therapy. We performed 2-jaw osteotomy after preoperative orthodontic treatment. The patient continued with postoperative orthodontic treatment and oral rehabilitation. Postoperatively, the patient showed improved maxillofacial morphology, but was unable to attain sufficient improvement of masticatory and language functions due to atrophy and poor development of the masticatory muscles. These results suggest that obtaining sufficient therapeutic effect on oral functions is not possible if the masticatory muscles are not sufficiently strong due to atrophy or hypoplasia.
文摘目的:探讨成人骨性Ⅲ类错牙合畸形患者的舌肌功能运动状况,观察舌功能运动对骨性Ⅲ类错牙合畸形骨性和牙性特征产生的影响。方法:选取2020年1月-2022年6月笔者医院口腔科的骨性Ⅲ类错牙合畸形患者89例,测量最适张口(Comfortable mouth opening,CMO)的切牙间距离、舌尖上抬至切牙乳头(Tongue tip extended to the incisive papilla,TIP)的切牙间距离、舌体吸附至腭部(Lingual-palatal suction,LPS)的切牙间距离,计算舌前部的活动度(Mobility of the anterior one-third of the tongue,TRMR-TIP=TIP/CMO),舌后部的活动度(Mobility of the posterior two-thirds of the tongue,TRMR-LPS=LPS/CMO),将舌活动度分为四级。通过头颅侧位片和模型分析测量骨性和牙性指标。比较各分级间舌功能活动度与骨性Ⅲ类错牙合畸形骨性和牙性特征的关系。结果:舌前后部活动度三级(低于平均水平)、四级(显著低于平均水平)的SNB、L1-MP比一级(显著高于平均水平)、二级(平均水平)大;舌前后部活动度一级、二级的Go-Gn-SN°比三级、四级大;舌后部活动度一级、二级的上颌尖牙间宽度、上颌磨牙间宽度、下颌尖牙间宽度比三级、四级大;舌后部活动度三级、四级的下颌磨牙间宽度比一级、二级大,差异均有统计学意义(P<0.05)。结论:舌活动度越小,下颌前突越严重,下颌骨向后下旋转趋势越小,下前牙越唇倾。随着舌后部活动度减小,下颌磨牙间宽度增大,上颌尖牙和上颌磨牙间宽度、下颌尖牙间宽度减小。
文摘BACKGROUND In growing patients with skeletal discrepancies,early assessment of functional factors can be vital for the restoration of normal craniofacial growth.AIM To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship,thereby assessing the association between cephalometric variables and airway morphology.METHODS Cone-beam computed tomography volume scans,and lateral cephalograms,3-dimensional airway volume and cross-sectional areas of 120 healthy children(54 boys and 66 girls mean age 15.19±1.28)which were done for orthodontic assessment were evaluated.The subjects were divided into 2 groups based on the angle formed between point A,Nasion and point B(ANB)values and cephalometric variables(such as anterior and posterior facial height,gonial angle etc.)airway volumes,and cross-sectional measurements were compared using independent t tests.Pearson’s correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables.RESULTS Means and standard deviations for cephalometric,cross-sectional,and volumetric variables were compared.ANB,mandibular body length and facial convexity were statistically highly significant(P<0.01)whereas condylion to point A,nasal airway and total airway volume(P<0.05)were statistically significant.The nasal airway volume and the superior pharyngeal airway volume had a positive correlation(P<0.01),nasal airway was correlated to middle(P<0.05)and total airway superior had a relation with middle(P<0.05),inferior and total airway(P<0.05),middle was related to all other airways;inferior was also related to all the airways except nasal.Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume(P<0.05).Additionally,ANB angle was significantly correlated with total airway volume and superior airway(P<0.05).CONCLUSION The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.
基金China Medical University and Hospital,Taichung City,Taiwan,No.DMR-111-044.
文摘BACKGROUND Correcting severe skeletal class III malocclusion with facial asymmetry in adults through orthodontic treatment alone is difficult.CASE SUMMARY In this case report,we describe orthodontic treatment and lower incisor extraction without orthognathic surgery for a 27-year-old man with a transverse discrepancy.The extraction sites were closed using an elastic chain.The use of intermaxillary elastics,improved super-elastic Ti-Ni alloy wire,and unilateral multibend edgewise arch wire was crucial for correcting facial asymmetry and the midline deviation.CONCLUSION After treatment,the patient had a more symmetrical facial appearance,acceptable overjet and overbite,and midline coincidence.The treatment results remained stable 3 years after treatment.This case report demonstrates that a minimally invasive treatment can successfully correct severe skeletal class III malocclusion with facial asymmetry.
