Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders:A case report and review of literature

BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.

Simple and effective method for treating severe adult skeletal class II malocclusion: A case report

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.

Severity of dentofacial deformity, the motivations and the outcome of surgery in skeletal Class Ⅲ patients

Objective To study the relationship between severity of skeletal Class Ⅲ malocclusion and the patient's emotional status, as well as motivation for seeking surgical correction and satisfaction with the outcome of the surgery Methods One hundred and forty consecutive Chinese patients with skeletal Class Ⅲ malocclusion who had been treated with a combined orthodontic and surgical approach were studied Sixty seven percent (40 males and 54 females) responded to a questionnaire Fifty four percent had two jaw deformities, 32% mandibular hyperplasia and 14% maxillary hypoplasia Surgical procedures: 77% received two jaw surgeries, 15% maxillary advancement and 8% mandibular setback This was a retrospective study based on questionnaires with numerical scale ranked answers (0: not at all; 1: a little; 2: moderately; 3: quite a bit; and 4: extremely) Results ANB angle was significantly negatively correlated with feelings about the nickname related to their facial problems (embarrassment: r =-0 30, P <0 01; worn out r =-0 32, P <0 01; angry r = -0 24, P <0 05) ANB angle also had a significant negative correlation with the reasons for having the surgery (pressure from their friends: r =-0 21, P <0 05, and referred by physician: r =-0 24, P <0 05) Changes in life style as a result of surgery were significantly negatively correlated with the ANB angle before treatment, positive influence on relationships with the opposite sex ( r =-0 25, P <0 05), positive influence in social activiies ( r =-0 22, P <0 05) Conclusion The psychological status before surgery and the outcome following orthognathic surgery in patients with skeletal Class Ⅲ malocclusion were closely related to severity of the malocclusion

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.

Orthodontic camouflage versus orthognathic surgery: A comparative analysis of long-term stability and satisfaction in moderate skeletal Class III

Objective: The purpose of this study was to compare long-term stability and satisfaction between orthodontic camouflage and orthognathic surgery in treatment of moderate skeletal Class III adults. Materials and Methods: A total of 25 adults females who had been treated with orthodontic camouflage for Class III malocclusions were recalled at least 3 years post-treatment to evaluate stability and satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in 21 patients with the same Class III problems who had bimaxillary surgical correction. Results: In the camouflage patients, small mean changes in skeletal landmark positions occurred over the long term, although the changes were generally much smaller than in the surgery patients. Dental changes in the surgery group were more severe than those in the camouflage group. The camouflage patients reported fewer functional or temporomandibular joint problems than did the surgery patients. Both groups reported similar levels of overall satisfaction with treatment. Conclusion: The results suggest that both camouflage and surgical treatment in moderate skeletal Class III adults can achieve satisfactory outcomes and provide long-term stability. If patients do not readily accept surgery because of potential surgical complications or financial difficulties, camouflage treatment may be an effective alternative treatment.

Improved super-elastic Ti–Ni alloy wire intrusion arch for skeletal class Ⅱ malocclusion combined with deep overbite:A case report

BACKGROUND Treatment for deep overbite cases can be difficult. This case report presents some techniques with improved super-elastic Ti–Ni alloy wire(ISW) for deep overbite correction.CASE SUMMARY A 21-year-old woman had a chief complaint of flaring maxillary teeth. Orthodontic evaluation revealed a skeletal class Ⅱ malocclusion and a convex profile appearance. A deep overbite with palatal impingement and large overjet were also noted. Bilateral maxillary first premolars were extracted, and spaces were closed using a closed-coil spring and elastic chain. The deep overbite was corrected by applying the ISW curve and ISW intrusion arch. Intermaxillary elastics was used to adjust the intermaxillary relationship. Active treatment took approximately 3 years, and the appearance and dentition alignment noticeably improved.CONCLUSION The use of the ISW technique in a case of skeletal class Ⅱ malocclusion with deep overbite achieved a desirable result, and the patient was satisfied with the treatment outcome.

Improved super-elastic Ti-Ni alloy wire for treating adult skeletal class III with facial asymmetry:A case report

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.

Class Ⅲ过氧化物酶在植物中的作用及其研究进展

过氧化物酶广泛存在于各种有机体中,根据其结构和功能可分为不同的类型,其中ClassⅢ过氧化物酶是植物体内特有的一个多基因家族.ClassⅢ过氧化物酶的功能多样,能够参与生长素的代谢、细胞壁的延伸和加厚、活性氧和活性氮的代谢以及植物的抗病作用等各种生理活动.目前对ClassⅢ过氧化物酶的940个物种中的6 000条序列都已经进行了注释,包括其存在的物种、组织类型以及细胞中的定位等.该文对国内外近年来有关ClassⅢ过氧化物酶的结构特征及其在植物体内的功能等进行综述.

大豆class Ⅲ酸性内切几丁质酶基因及其启动子表达方式

利用实时定量PCR方法,检测大豆class Ⅲ酸性内切几丁质酶基因在大豆各组织中的表达,结果显示该基因在大豆根、茎、叶中的表达活性低,而花和种子中的相对表达活性极高。利用PCR方法,克隆大豆class Ⅲ酸性内切几丁质酶基因5’端上游2 000bp序列,命名为CP。在线启动子预测软件分析,结果表明CP序列中含有多种典型的种子特异表达元件和花特异表达的元件,如SEF4 motif、E-box、G-box、(CA)n、AACA、ACGT、CCAA;52-box、ntp303-box、GTGA、TACPyAT box。推测大豆class Ⅲ酸性内切几丁质酶基因启动子具有调控下游基因在花和种子中大量表达的特性。

多曲方丝弓技术矫治成人骨性ClassⅢ错[牙合]

目的 :观察MEAW技术矫治成人骨性ClassⅢ错软硬组织的变化特点 ,确定其治疗机制和评价临床掩饰性治疗效果。方法 :选择成人骨性ClassⅢ类错 11例 ,用MEAW技术在 0 .0 2 2× 0 .0 2 8标准方丝系统上矫治 8～ 12个月 ,比较矫治前后头影测位片。结果 :矫治前后ANB角平均增加 2° ,SnNsBs平均增加 4° ,ODI增加 ,APDI变小。结论 :MEAW技术矫治成人骨性反 ,由于ODI增加 ,APDI变小 ,软组织侧貌改善明显 ,达到很好的掩饰性治疗目的。

紫花苜蓿几丁质酶ClassⅢ基因克隆及生物信息学分析

本文根据截叶苜蓿(Medicago truc atula)几丁质酶ClassⅢ基因(GenBank:AY294484.1)的全长序列设计引物,通过RT-PCR的方法得到紫花苜蓿(Medicago sative)几丁质酶ClassⅢ的核酸序列,命名为MsChiⅢ,在NCBI中的登录号为FJ872918。利用生物信息学软件分析MsChiⅢ,预测氨基酸序列的等电点、二级结构和三级结构,并构建系统发育树。结果显示该核酸序列全长为953bp,包括完整的开放阅读框,编码301个氨基酸,等电点为8.212。该序列所编码的蛋白属于几丁质酶18家族的内切酶,分布于细胞间隙,并含有几丁质酶18家族的特征序列——LGDVDFDIE,并预测MschiⅢ可能是一种具有几丁质酶和溶菌酶的双功能酶。

Prognostic value of vascular endothelial growth factor receptor 1 and classⅢβ-tubulin in survival for nonmetastatic rectal cancer

AIM To assess the long-term prognostic value of vascular endothelial growth factor receptor 1(VEGFR1)and classⅢβ-tubulin(TUBB3)mRNA expression in nonmetastatic rectal cancer.METHODS A total of 75 consecutive patients with non-metastatic rectal cancer from March 2004 to November 2008 were analyzed retrospectively at our institute.The mRNA expressions of VEGFR1 and TUBB3 were detected by multiplex branched DNA liquid-chip technology.The Cutoff Finder application was applied to determine cutoff point of mRNA expression.SPSS software version 22.0was used for analysis.RESULTS The median follow-up was 102.7 mo(range,6-153.6).Theχ~2 and Fisher’s exact tests showed that VEGFR1expression was related to lymph node metastasis(P=0.013),while no relationships between TUBB3 and clinicopathological features were observed.Univariate analysis showed that T stage,lymph node metastasis,tumor differentiation,VEGFR1 and TUBB3 mRNA expression were correlated to overall survival(OS)(P=0.048,P=0.003,P=0.052,P=0.003 and P=0.015,respectively).Also,lymph node metastasis and VEGFR1expression independently influenced OS by multivariate analysis(P=0.027 and P=0.033).VEGFR1 expression was positively correlated with TUBB3(P=0.024).The patients with low expression of both TUBB3 and VEGFR1 presented a better OS(P=0.003).In addition,the receiver operating characteristic analysis suggested that the combination of lymph node metastasis and VEGFR1 had a more favorable prognostic value(P<0.001).CONCLUSION VEGFR1 expression and lymph node metastasis independently and jointly affect survival.Moreover,low expression of VEGFR1 and TUBB3 presented a better OS in patients with non-metastatic rectal cancer,which might serve as a potential prognostic factor.

儿童Class Ⅲ高角型错前牵引矫治前后侧貌美学分析及影响

目的:分析上颌前方牵引矫治儿童Class Ⅲ类错治疗前后软组织变化的侧貌美学相关性探讨。方法:选取就诊于我所正畸科8～12岁Class Ⅲ高角型前牙反患儿14例,采用上颌铸造式固定前牵引矫治6～8个月,治疗前后拍摄头颅定位侧位片,对正畸前后侧貌进行美学评价,并对侧貌美学指标的相关性进行探讨。结果:上颌前牵引矫治后患者的软组织侧貌有显著改善,美学测量指标与颌骨的改建以及软组织的厚度有较明显的关系。结论:上颌前牵引矫治对Class Ⅲ类错患者的侧貌美观有明显改善,但对于垂直性骨面型无法改善。

骨性Ⅲ类患者双颌正颌手术后上气道形态变化与颌骨移动量的相关性研究

目的通过锥形束计算机断层扫描(cone beam computer tomography,CBCT)探究骨性Ⅲ类错(牙合)畸形患者双颌手术后上气道形态变化,以及颌骨移动与气道变化的关系。方法本研究纳入44例Ⅲ类双颌手术患者(男性21例,女性23例)。采集患者术前及术后3~6个月内CBCT数据,使用Dophin3D 11.95软件行测量分析。采用配对t检验、非参数Wilcoxon秩和检验分析上气道手术前后变化。采用Pearson相关系数分析气道变化与颌骨移动量的相关性。结果术后患者的上气道容积、正中矢状面纵截面积、最小横截面积明显减少(P<0.01)。口咽区容积变化量与B点的变化量相关(P<0.05)。随B点后退量的增加,上气道容积降低的显著性增加,当B点后退量>7 mm时,上气道各区域容积均显著降低(P<0.01),同时患者气道最小横截面积的危险程度显著升高(P<0.01)。结论骨性Ⅲ类双颌手术可降低患者的上气道容积。术后上气道容积减少量与B点后退量相关。当行大量下颌后退(>7 mm)时,可造成上气道容积的显著减低,增加OSAHS患病风险。对上气道有狭窄倾向的患者,应适当调整方案以减少气道风险。

PERFORMANCE ANALYSIS OF POWER SAVING CLASS OF TYPE Ⅲ IN IEEE 802.16E WITH USER INITIATED TRAFFIC

A novel method for analysing the performance of power saving class of Type III in IEEE 802.16e is proposed, which is applicable to design, maintenance and management for mobile wireless metropolitan area network. Considering the memoryless nature of user initiated packet arrival, a Geom/G/1 queue model with multiple vacations and setup period is built to capture the principle for the power saving class of Type III. By using an embedded Markov chain method and the boundary state variable theory, we obtain the queueing measures such as queueing length, waiting time and busy cycle in steady state. Correspondingly, we derive explicitly the performance measures for the power saving class of Type III in terms of handover ratio, energy saving ratio, and average packet response time. Based on numerical results, we develop a cost function to determine numerically the optimal length of sleep window and the minimal cost with different offered loads.

成人骨性Ⅲ类偏颌牙齿倾斜度的三维测量分析

目的研究成人骨性Ⅲ类偏颌畸形的牙齿三维位置特征。方法收集骨性Ⅲ类错[牙合]畸形患者锥形束CT(CBCT)资料、导入Invivo 5.2图像处理软件,以头影测量ANB角(上-下牙槽座角,由上齿槽座点A.subspinale、鼻根点N.nasion和下齿槽座点B.supramental构成的角)小于0°、上下第一磨牙至少一侧呈近中关系以及颏下点至正中矢状面的距离﹥2 mm作为骨性Ⅲ类偏颌畸形标准筛选出偏颌患者38例,偏颌牙弓的左右两侧以颏下点偏向的一侧为偏斜侧(作为偏斜侧组,S组),另一侧为非偏斜侧(作为非偏斜侧组,NS组),筛选非偏颌患者34例作为对照组(N组)。测量各组被检者的牙齿颊舌向、近远中向倾斜角以及牙冠垂直向高度。结果S组上颌第一前磨牙、第一磨牙较N组颊倾(P<0.05),下颌尖牙、第一前磨牙、第一磨牙较N组舌倾(P<0.05),上颌的尖牙、第一前磨牙、第一磨牙较NS组颊倾(P<0.05),下颌较NS组舌倾(P<0.01);S组上颌第一磨牙近远中向倾斜角小于N组(P<0.05)、大于NS组(P<0.05);S组上下颌第一前磨牙、上颌第一磨牙牙冠垂直高度小于N组(P<0.05),上颌的尖牙、第一前磨牙、第一磨牙牙冠垂直高度小于NS组(P<0.05)。结论骨性Ⅲ类偏颌畸形患者偏斜侧牙齿在三维方向上都发生了代偿,偏斜侧上颌牙相对颊向倾斜、下颌牙相对舌向倾斜、上颌磨牙相对直立、上颌牙冠垂直高度相对偏低。

上颌前方牵引联合螺旋扩弓器对替牙期骨性Ⅲ类错[牙合]颌面软硬组织的影响

目的在上颌前方牵引的基础上给予骨性Ⅲ类错[牙合](替牙期)患儿螺旋扩弓器进行扩缩处理治疗,观察疗效以及对患儿牙颌面软硬组织的影响。方法按随机数表法将2021年1月至2022年12月信阳市中心医院诊治的60例替牙期骨性Ⅲ类错[牙合]患儿分两组。对照组30例采用上颌前方牵引治疗,联合组30例在上颌前方牵引的基础上给予螺旋扩弓器治疗,评估两组临床疗效,对比两组治疗前后颌面结构、上气道间隙及三维指标。结果联合组临床有效率(86.67%)较对照组(63.33%)更高,差异有统计学意义(P<0.05)。联合组治疗后颌面结构相关指标上下颌突差(ANB)、下颌平面角(FH-MP)、下面高(ANS-Me)、腭平面角(SN-PP)较对照组更高,上中切牙的突度(L1-MP)较对照组更低,差异有统计学意义(P<0.05)。联合组治疗后上气道间隙指标鼻咽直径(PNS-R)较对照组更高,差异有统计学意义(P<0.05)。联合组治疗后上气道三维指标鼻咽段最小截面积(NP area)、鼻咽段最小截面积处冠状径(NP cor.)、鼻咽段最小截面积位置矢状径(NP sag.)、鼻咽段容积(NP volume)较对照组更高,差异有统计学意义(P<0.05)。结论上颌前方牵引联合螺旋扩弓器疗效确切,可有效促进替牙期骨性Ⅲ类错[牙合]患儿颌面结构及上气道状态恢复,改善颌面软硬组织状态。

骨性Ⅲ类偏颌畸形牙骨特征、分类及治疗相关研究进展

随着人们对美学需求的增加,偏颌畸形逐渐成为一项重要的临床问题。骨性Ⅲ类偏颌畸形不仅会影响面部美观,同时会对口腔功能产生不良影响。偏颌畸形的成因复杂,表现多样,在硬组织方面主要表现为面部各单元的空间位置不对称、颌骨形态不对称以及牙列代偿性变化等。基于偏颌患者综合颌面特征的分类对于诊断、治疗和手术计划至关重要。该文旨在对骨性Ⅲ类偏颌畸形的牙骨特征、分类和治疗研究进展进行综述,为临床诊断和治疗提供参考。

成人骨性Ⅱ类与Ⅲ类错畸形伴异常垂直骨面型的颏联合形态研究

目的研究异常垂直骨面型的成人骨性Ⅱ类与Ⅲ类错的颏联合形态是否存在差异。方法选择109例中国成年女性骨性错畸形患者为研究对象,根据垂直骨面型和矢状骨面型分为4组:高角骨性Ⅱ类组30例,高角骨性Ⅲ类组25例,低角骨性Ⅱ类组29例,低角骨性Ⅲ类组25例。拍摄X线头颅侧位片,测量颏联合形态相关指标,观察并比较4组的颏联合形态。结果成人骨性Ⅱ类与骨性Ⅲ类错的颏联合存在形态差异,但整体厚度和高度差别不大。高角组中,骨性Ⅱ类比骨性Ⅲ类有较大的下牙槽高度、较小的颏突度和基骨高度(P<0.01);低角组中,骨性Ⅱ类比骨性Ⅲ类有较大的下牙槽高度(P<0.05)和下牙槽顶部厚度(P<0.001)。矢状骨面型相同时,高角组比低角组有较小的颏厚度、颏突度和较大的颏联合总高度(骨性Ⅱ类组P<0.001,骨性Ⅲ类组P<0.05),并且更易出现下牙槽基部薄于顶部的葫芦形颏部(P<0.01)。结论异常垂直骨面型的成人骨性Ⅱ类与骨性Ⅲ类错畸形者,颏联合形态存在差异,垂直骨面型对颏联合形态的影响大于矢状骨面型,高角骨性错畸形者移动下切牙的正畸风险较大。

快速扩弓联合前方牵引矫治乳牙期,替牙期安氏Ⅲ类错的垂直向变化分析

目的：本文旨在研究乳牙期,替牙期前牙反[牙合]患者经过扩弓前方牵引联合治疗后垂直向硬组织变化的特征,为临床治疗提供指导依据。方法：收集临床反[牙合]病例67例,分别按照性别,年龄分组,比较矫治前后各组间垂直向头影测量数据的变化。所得数据采用SPSS11.0统计软件进行配对t检验和Scheffe’s多因素方差分析,比较组间差异。分3个方面比较：1）在同一年龄组内,不同性别的治疗前后差别;2）不考虑年龄因素,不同性别的治疗前后差别;3）不考虑性别,不同年龄的治疗效果差别。结果：在3-6岁组,垂直向头影测量数据：FMA,GoGn-SN,面轴角,ANS-Me呈显著性差别。6-9岁组垂直向差异有轻微差别,其中GoGn-SN无显著性差别。9-12岁组,除了ANS-Me,其余的垂直向测量均无显著性差别。结论：ClassⅢ反的治疗应该尽早治疗。3-6岁组的治疗前后数据呈显著性差别。而大于9岁的患者其垂直向前后治疗效果没有统计学差别。