Excessive gingival display treated with two-piece segmental Le Fort I osteotomy : A Case Report

Background. The demand for orthognathic surgery has increased worldwide. Women with jaw deformity tend to have a worse quality of life than men owing to the deformity’s negative effects on body image, low self-esteem, lack of self-confidence, and dissatisfaction with life. Therefore, they wish for more reliable treatment options. Case Description. A woman aged 25 years and 9 months sought treatment for a convex profile and excessive gingival display caused by a skeletal Class II jaw-base relationship. Gingival exposure was up to 6.5 millimeters at full smile. She chose orthognathic surgery, and the authors performed a 2-piece segmental Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. After active orthodontic treatment, the protrusive profile was improved, and an acceptable occlusion and an attractive smile were achieved. Practical Implications. It is hoped that 2-piece segmental Le Fort I osteotomy becomes a common treatment option for patients with protrusive profiles and excessive gingival displays

Clinical application of a 3-dimensional morphometric apparatus for diagnosis and treatment of a Class III patient with facial asymmetry : A pilot study

This article demonstrated the usefulness of a non-contact 3-dimensional (3D) morphometric apparatus in orthodontic diagnosis and treatment evaluation. A female patient, 23 years 6 months of age, had a Class III malocclusion with mandibular deviation. The 3D images taken by a 3D morphometric apparatus figured out her protrusive chin of 6 mm on the deviation side compared to the non-deviation side, and showed a possibility of orthognathic surgery. Before starting of orthodontic treatment, a diagnostic splint was used for 2 months to determine her proper mandibular position. The 3D images retaken for quantitative evaluation showed decrease of the mandibular protrusion by approximately 3 mm, and improvement of facial asymmetry. Then, we decided to treat the patient without orthognathic surgery. After 18 months of active orthodontic treatment with miniscrew anchorage, the mandibular deviation was improved and an acceptable occlusion was achieved. The 3D images at posttreatment demonstrated significant decrease of chin protrusion on the deviation side, and improvement of facial asymmetry. In conclusion, a 3D morphometric apparatus could provide quantitative data of facial asymmetry and chin protrusion and contributed decision making process of treatment planning in a patient with facial asymmetry

Intraoral Vertical Ramus Osteotomy Improved the Stomatognathic Function in an Elderly Patient with Mandibular Protrusion:A Case Report

This article reports the successful surgical-orthodontic treatment of an elderly patient with dentofacial deformity and signs and symptoms of temporomandibular disorder (TMD). The patient was a 63-year-old woman with a concave profile due to mandibular protrusion. To correct skeletal deformities, the mandible was posteriorly repositioned by employing intraoral vertical ramus osteotomy (IVRO) following presurgical orthodontic treatment. After active treatment for 31 months, the facial profile was significantly improved and satisfactory occlusion was achieved. In addition, TMD symptoms of clicking sounds on the left side and difficulty in mouth opening were resolved. Regarding the findings of magnetic resonance imaging, anterior disc displacement in the opening phase was improved in the temporomandibular joint on the left side. Furthermore, stomatognathic functions were also improved without any aggravation of age-related problems. In conclusion, surgical repositioning of the mandible using IVRO leads to both morphological and functional improvements even in elderly patients

シカ キョウセイヨウ アンカー スクリュー マイニュウジ ノ アンテイセイ ニ カンスル セイタイリキガクテキ ケンキュウ

Objective: The purpose of this study was to evaluate the influence of placement angle and force direction on the primary stability of orthodontic miniscrews by analyzing a novel three-dimensional finite element model (FEM) approximating the real interface between the screw and surrounding bone. Materials and Methods: Three-dimensional finite element models were made with 6-mm-long miniscrews in diameters of 1.2mm. Four insertion angles ranging from 0° (perpendicular to the bone surface) to 45° were examined. A load with 2N was applied to the center of the screw head in four directions (upward, downward and on the right and left sides). Results: For miniscrews at the same insertion angle, the stress was the highest (or lowest) under the downward (or upward) force condition. The stress increased as the insertion angle decreased, except under the upward force condition. An analysis of the stress distribution in the surrounding bone showed that the most of the stress was absorbed in the cortical bone. Conclusions: The stress distribution around the miniscrew and surrounding bone during the application of orthodontic force is closely related to the force direction, and insertion angle

シカ キョウセイヨウ アンカー スクリュー マイニュウジ ノ アンテイセイ ニ カンスル セイタイリキガクテキ ケンキュウ

Objective: The purpose of this study was to evaluate the influence of placement angle and force direction on the primary stability of orthodontic miniscrews by analyzing a novel three-dimensional finite element model (FEM) approximating the real interface between the screw and surrounding bone. Materials and Methods: Three-dimensional finite element models were made with 6-mm-long miniscrews in diameters of 1.2mm. Four insertion angles ranging from 0° (perpendicular to the bone surface) to 45° were examined. A load with 2N was applied to the center of the screw head in four directions (upward, downward and on the right and left sides). Results: For miniscrews at the same insertion angle, the stress was the highest (or lowest) under the downward (or upward) force condition. The stress increased as the insertion angle decreased, except under the upward force condition. An analysis of the stress distribution in the surrounding bone showed that the most of the stress was absorbed in the cortical bone. Conclusions: The stress distribution around the miniscrew and surrounding bone during the application of orthodontic force is closely related to the force direction, and insertion angle

シカ キョウセイヨウ アンカー スクリュー マイニュウジ ノ アンテイセイ ニ カンスル セイタイリキガクテキ ケンキュウ

Objective: The purpose of this study was to evaluate the influence of placement angle and force direction on the primary stability of orthodontic miniscrews by analyzing a novel threedimensional finite element model (FEM) approximating the interface between the screw and surrounding bone. Materials and Methods: Three-dimensional finite element models were made with 6-mm-long miniscrews in diameters of 1.2 mm. Four insertion angles ranging from 0̊ (perpendicular to the bone surface) to 45̊ were examined. A load with 2 N was applied to the center of the screw head in four directions (upward, downward and on the right and left sides). Results: For miniscrews at the same insertion angle, the stress was the highest (or lowest) under the downward (or upward) force condition. The stress increased as the insertion angle increased, except under the upward force condition. An analysis of the stress distribution in the surrounding bone showed that the most of the stress was absorbed in the cortical bone. Conclusions: The stress distribution around the miniscrew and surrounding bone during the application of orthodontic force is closely related to the force direction, and insertion angle