• Title/Summary/Keyword: Anterior Open-Bite

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Three-dimensional evaluation of the pharyngeal airway space in patients with anterior open bite

  • Seong-Sik Kim;Yong-Il Kim;Soo-Byung Park;Sung-Hun Kim
    • The korean journal of orthodontics
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    • v.53 no.6
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    • pp.358-364
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    • 2023
  • Objective: This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion. Methods: The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of -3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1-3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson's correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite. Results: The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS. Conclusions: The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.

A CLINICAL CASE OF ALLOPLASTIC CONDYLE REPLACEMENT WITH CONDYLAR PROSTHESIS IN SEVERE DEGENERATIVE JOINT DISEASE (심한 퇴행성 악관절 질환 환자에서 보철성 과두를 이용한 하악과두 재건술의 치험례)

  • Jeon, Yong-Min;Kim, Chang-Hyun;Cha, Jeong-Seop;Min, Kyung-Gi;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.162-167
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    • 2010
  • This is a case report about patient who had suffered from degenerative joint disease and treated by TMJ reconstruction with condylar prosthesis. The patient visited Korea University An-am hospital on 2007 complaining symptom about both TMJ pain, mouth opening limitation and open bite. From CT view there was severe resorption of both condylar head, therefore condylar prosthesis reconstruction was planned. After 3D RP model analysis for preparation, the patient was operated under general anesthesia for condylar prosthesis reconstruction and the symptom was alleviated. (increased mouth opening, reduced anterior open bite, full mouth occlusal contact achieved) Follow up was carried out monthly, but after this, patient refused follow up. After 26 months from the operation, the patient revisited for anterior open bite. In clinical evaluation, occlusal contact was remained, but anterior open bite was relapsed. From cephalometry analysis, severe resorption of glenoid fossa was found. Therefore, Autogenous disc reconstruction with alloplastic material was planned on August 2009. After another surgery, condylar prosthesis was regained its normal position in glenoid fossa, and occlusion was recovered properly.

TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA (상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례)

  • Kim, Yoon-Ji;Lee, Kyu-Hong;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

ORTHOPEDIC AND SURGICO-ORTHODONTIC TREATMENT IN THE LONG FACE (Long Face(open-bite) 환자의 수술 교정 치료)

  • Baik, Hyoung Seon
    • The korean journal of orthodontics
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    • v.19 no.3
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    • pp.147-160
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    • 1989
  • Long face patients are characterized by excessive anterior facial height, lip incompetence at rest, anterior open bite, and gummy smile. A major problem is an inferior rotation of the posterior maxilla and upper molars. Long face patients have been the most difficult for orthodontist to treat successfully. In growing patients, the methods for impeding excessive vertical growth have been used high pull head gear, functional appliance, and combined type of two. One significant improvement comes from using a full arch splint to deliver force to the maxilla more vertically. In adult patients, orthodontic camouflage treatment is biomechanically difficult and doesn't work when the problem is primarilly vertical. Surgical maxillary impaction provides a means for successfully treating most of problems. Also, superior reposition of the chin via a mandibular inferior border osteotomy is effective in decrease of lower anterior facial height and correction of the poor chin-lip balance. Post-surgical stability and the physiologic response are good. The coordinated orthodontic and surgical treatment is necessary for solution the difficult skeletal deformity.

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Occlusal Change as a Sequela of Anterior Disc Displacement without Reduction of Temporomandibular Joint: Case Reports (관절원판전위와 갑작스런 교합변화가 발생한 환자의 임상증례 및 원인에 관한 보고)

  • Hur, Yun-Kyung;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.107-115
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    • 2011
  • We report 4 patients who developed change of occlusion which seemed to be related to anterior disc dislocation without reduction, but there was no distinct evidence of condylar destruction or collapse. They experienced sudden occurrence of occlusal change, anterior open bite in 2 patients, lateral CR-CO discrepancy in 1 patient, and anteroposterior CR-CO discrepancy in 1 patient. Also, this report is to find out if there is a relation between sudden occurrence of occlusal change and anterior disc dislocation without reduction.

Full-mouth rehabilitation in an amelogenesis imperfecta patient with anterior open bite using CAD/CAM system (전치부 개방교합을 보이는 법랑질형성부전증 환자의 CAD/CAM system을 이용한 전악 수복 증례)

  • Lee, Sang-Hoon;Yi, Yang-Jin;Jo, Deuk-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.4
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    • pp.410-418
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    • 2017
  • Amelogenesis imperfecta characterized as abnormally formed enamel is caused by a defect of unique group of genes. Patients affected by this disease might have difficulties in social and psychological aspects due to non-esthetic teeth as well as functional problems caused by enamel detachment and tooth wear from their early ages. Adult patients with amelogenesis imperfecta can be treated with full-mouth restorations, which make functional and esthetic rehabilitations of severely worn tooth. However, the anterior open bite and lack of occlusal clearance for posterior teeth restorations due to compensatory extrusion are the intervening factors in the prosthetic treatment. Therefore, the determination of anterior tooth lengths, vertical dimension, and anterior guidance should be set carefully. Recently, computer-aided design and computer-aided manufacturing (CAD/CAM) techniques help systematic approaches and enable dentists to reduce time-consuming procedures in the diagnosis and treatment of full-mouth rehabilitation. This case report demonstrates the successful full mouth rehabilitation using a CAD/CAM system in a young adult patient with amelogenesis imperfecta and anterior open bite.

CLINCAL ANALYSIS OF SKELETAL STABILITY AFTER BSSRO FOR CORRECTION OF SKELETAL CLASS III MALOCCLUSION PATIENTS WITH ANTERIR OPEN BITE (전치부 개방교합을 동반한 골격성 제3급 부정교합 환자에 대한 양측 하악지 시상분할 골절단술후 안정성에 관한 임상적 분석)

  • Kim, Hyun-Soo;Kwon, Tae-Geon;Lee, Sang-Han;Kim, Chin-Su;Kang, Dong-Hwa;Jang, Hyun-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.152-161
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    • 2007
  • This study was conducted to patients visited oral maxillo-facial surgery, KNUH and the purpose of the study was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction treated by skeletal Class III malocclusion patients with open bite versus non-open bite. This retrospective study was based on the examination of 40 patient, 19 males and 21 females, with a mean age 22.3 years. The patients were divided into two groups based on open bite and non-open bite skeletal Class III malocclusion patients. The cephalometric records of 40 skeletal Class III malocclusion patients (open bite: n = 18, non-open bite: n = 22) were examined at different time point, i.e. before surgery(T1), immediately after surgery(T2), one year after surgery(T3). Bilateral sagittal split ramus osteotomy was performed in 40 patients. Rigid internal fixation was standard method used in all patient. Through analysis and evaluation of the cephalometric records, we were able to achieve following results of post-surgical stability and relapse. 1. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in maxillary occlusal plane angle of pre-operative stage(p>0.05). 2. Mean vertical relapses of skeletal Class III malocclusion patients with open bite were $0.02{\pm}1.43mm$ at B point and $0.42{\pm}1.56mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.12{\pm}1.55mm$ at B point and $0.08{\pm}1.57mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in vertical relapse(p>0.05). 3. Mean horizontal relapses of skeletal Class III malocclusion patients with open bite were $1.22{\pm}2.21mm$ at B point and $0.74{\pm}2.25mm$ at Pogonion point. In skeletal Class III malocclusion patients with non-open bite, $0.92{\pm}1.81mm$ at B point and $0.83{\pm}2.11mm$ at Pogonion point. There was no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in horizontal relapse(p>0.05). 4. There were no significant statistical differences between open bite and non-open bite with skeletal Class III malocclusion patients in post-surgical mandibular stability(p>0.05). and we believe this is due to minimized mandibular condylar positional change using mandibular condylar positioning system and also rigid fixation using miniplate 5. Although there was no significant relapse tendency observed at chin points, according to the Pearson correlation analysis, the mandibular relapse was influenced by the amount of vertical and horizontal movement of mandibular set-back(p=0.05, r>0.304).

A CASE REPORT OF ANTERIOR OPEN-BITE (전치부 Open-bite의 치험일례)

  • Jang, Sang-Heon;Lee, Mi-Dae;Nam, Dong-Seok;Yang, Won-Sik;Jo, Hui-Won
    • The Journal of the Korean dental association
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    • v.13 no.9
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    • pp.823-828
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    • 1975
  • We have effectually treated 22 years girl who had complained of an aterior open-bite. Treatment was based on non-extracted and multibanded technigue at the use of horizontal loop with 0.016 inch green Elgiloy wire. Anteior cross elastics, C1Ⅲ intermaxillary elastics, occasicnally C1.Ⅱ elastics were used. when vertical discrepancy was corrected, we changed the arch wire making use of 0.018 ×0.022 inch rectangular wire with 1st. and 2nd. order bend. After 12mons. the ideal arch wire with tie back loop was placed for stabilizing arch. Nearly after 20 months bands were removed and placed retainer.

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Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report (급성 비정복성 관절원판 변위에 따른 급성 교합변화의 증례)

  • Jung, Jae-Kwang;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.205-211
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    • 2012
  • A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.