• Title/Summary/Keyword: skeletal stability

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Camouflage treatment by backward rotation of the mandible for a severe skeletal Class III malocclusion with aplastic anemia: A case report

  • Choi, Dong-Soon;Lee, Dong-Hyun;Jang, Insan;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.362-371
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    • 2022
  • Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

Implant Placement in Growing Adolescents : a Literature Review (성장기 소아 청소년 환자에서의 치과 임플란트 식립)

  • Shin, Hyun-Seung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.3
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    • pp.270-274
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    • 2015
  • Although there are a number of studies on the treatment planning and the prognosis of dental implants, limited studies provide the information on the implant placement on growing adolescents. The aim of this review is to discuss the use of dental implants in growing patients and the impact of skeletal and dentoalveolar growth on the long-term stability of implants. The general information regarding skeletal growth of maxilla and mandible would be briefly reviewed and the general treatment options would be discussed.

Surgery-first Approach for Facial Asymmetry with Transverse Discrepancy Using Hyrax-type Palatal Expansion Appliance

  • Youn-Kyung Choi;Sung-Hun Kim;Yong-Il Kim
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.87-98
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    • 2023
  • This report presents a case of successful treatment of skeletal Class III malocclusion with transverse discrepancy in adult by surgery-first approach. Traditionally dental decompensation is necessary prior to surgery in 2-jaw surgery to correct transverse and rotational discrepancy. However, the hyrax-type palatal expansion appliance was used to improve maxillary expansion accuracy and postoperative stability in this surgery-first approach (segmental Le Fort I osteotomy and mandibular setback surgery). It was established to be an effective means of precisely predicting postoperative occlusion and achieving stable retention after surgery of skeletal Class III malocclusion with maxillary transverse discrepancy.

Evaluation of suitability and stability in a skeletal Class III complete denture patient with flabby tissue: A case report (Flabby tissue를 동반하는 골격성 Class III 환자의 양악 총의치 수복 및 적합성/안정성 평가 증례)

  • Lee, Junsuk;Hong, Seoungjin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.4
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    • pp.295-301
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    • 2018
  • To obtain denture retention, support, and stability in Class III edentulous cases with flat alveolar ridges and extensive flabby tissue is very difficult. The patient was a 72-year-old male who wore ill-fitting 20 year old dentures made by non-medical institutions. There was flabby tissue on the maxillary anterior ridge. The patient showed Angle Class III skeletal relationship with severe protruded mandible. First, temporary dentures were fabricated to restore the masticatory function, and final dentures were made through non- pressure impression technique and careful the arrangement of the posterior resin teeth. Improvement of the retention and stability of the denture during the occlusal force application is reported.

STABILITY OF SIMULTANEOUS MAXILLARY AND MANDIBULAR SURGERY;[Ⅰ]Wire osteosynthesis (상하악 동시 악교정술시 안정성에 관한 연구;[Ⅰ] 강선 고정에 의한 방법)

  • Kim, Yeo-Gab
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.2
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    • pp.9-20
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    • 1990
  • A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.

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Post-operative Stability of Counter Clockwise Rotation of the Mandibular Plane in Skeletal CIII with Anterior Openbite Patients (전치부 개교합을 가진 골격성 3급 부정교합 환자에서 하악의 반시계 방향 회전 시 술 후 안정성)

  • Ryu, Jeong-Min;Ryu, Kyung-Sun;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Yeo-Gab;Ohe, Joo-Young;Park, Seong-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.4
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    • pp.252-259
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    • 2012
  • Purpose: This study evaluated the postoperative stability of counter clockwise rotation of the mandibular plane in anterior openbite patients, who have had one jaw surgery performed. Methods: This study includes patients with skeletal class III malocclusion accompanied by anterior openbite among the patients who have had BSSRO performed, resulting in counter clockwise rotation of the mandibule. We excluded the patients with genioplasty and segmental surgery, and included 23 patients who underwent BSSRO. Results: We found no statistical significance between the amount of counter clockwise rotation in the mandible in the Pearson correlation test. Also, there was no significant difference between Group 1 (< $3^{\circ}$) and Group 2 (> $3^{\circ}$). Conclusion: This study evaluated the amount of horizontal relapse, and the degree of relapse. Stable results were obtained. Although there was no statistical significance between the degree of openbite and the amount of horizontal relapse, the group with a greater amount of openbite had a greater amount of relapse.

Long-term stability of dentoalveolar, skeletal, and soft tissue changes after non-extraction treatment with a self-ligating system

  • Basciftci, Faruk Ayhan;Akin, Mehmet;Ileri, Zehra;Bayram, Sinem
    • The korean journal of orthodontics
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    • v.44 no.3
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    • pp.119-127
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    • 2014
  • Objective: To evaluate the long-term effects of self-ligating brackets (SLBs) on transverse dimensions of arches and skeletal and soft tissues and to quantitatively evaluate the treatment outcome after non-extraction treatment with SLBs. Methods: The sample consisted of 24 (18 female and six male) subjects, with a mean age of $14.23{\pm}2.19$ years, who received treatment with the Damon$^{(R)}$3 appliances. Complete records including cephalometric radiographs and plaster models were obtained before treatment (T1), immediately after treatment (T2), six months after treatment (T3), and two years (T4) after treatment. Digital study models were generated. Twenty lateral cephalometric, six frontal cephalometric, and eight dental cast measurements were examined. The Peer Assessment Rating index was used to measure the treatment outcome. The Wilcoxon test was applied for statistical analysis of the changes. Results: There were significant increases in all transverse dental cast measurements with active treatment. There was some significant relapse in the long term, particularly in maxillary width (p < 0.05). Statistically significant increases were found in nasal (p < 0.001), maxillary base, upper molar, lower intercanine, and antigonial (p < 0.05) widths in T1-T2. Lower incisors were proclined and protruded in T1-T2. Conclusions: SLBs correct crowding by mechanisms involving incisor proclination and protrusion and expansion of the dental arches, without induction of clinically significant changes in hard and soft tissues of the face.

The stability in the adolescent Class III malocclusion treated by fixed appliances (성장기 III급 부정교합의 고정식 교정 치료 후의 안정성)

  • Lim, Yong-Kyu;Lee, Joo-Na;Kim, Joeng-Il;Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.34 no.4 s.105
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    • pp.313-324
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    • 2004
  • The Purpose of this study was to investigate the predictors of relapse in orthodontic treatment of skeletal Class III malocclusion in growing patients. A total of 55 patients were studied and all subjects were divided into two groups according to their stability in the post-treatment stage. Of the sample, 33 patients were included in the stable group and the remaining 22 were assigned to the relapse group. Cephalometric data of the pre-treatment stage was taken and compared between the stable and relapse group. The following results were obtained through t-test: 1. This study presented statistical evidence to show that the major skeletal determinant of prognosis in Class III orthodontic treatment was not anteroposterior discrepancy .but vertical discrepancy, especially within the AB-maxillo mandibular triangle. Vertical angular measurements that showed statistically significant differences were AB-MP and ODI(P<0.01) and the vortical ratio measurements were MP-P/AL and PP-P/AL(P<0.05). 2. Relapse tendency increased with the steep occlusal Plane, especially the steep lower occlusal plane. As to occlusal plane, there were statistically significant differences in OP(L)-PP, OP-PP, AB-OP(L) and Wits appraisal(P<0.05). This study claimed that anteroposterior discrepancy was not necessarily the proper criteria to predict relapse. Vertical discrepancy had a significant effect on post-treatment stability.

POSTOPERATIVE STABILITY OF FIXATION WITH ABSORBABLES IN SIMULTANEOUS MAXILLOMANDIBULAR ORTHOGNATHIC SURGERY (상하악 동시 악교정수술에서 흡수성 고정판을 이용한 골편고정시 술후 안정성에 대한 연구)

  • Park, Jung-Min;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.126-131
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    • 2010
  • Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.