Early treatment of a class III malocclusion using mini maxillary protractor: A case report

Bu vaka raporu 12 yaşındaki Sınıf III maloklüzyona sahip bir hastanın tedavisini anlatmakta ve tedavi sonuçlarını tartışmaktadır. Hastaya pozitif overjet sağlanıncaya kadar apareyini günde en az 20 saat kullanması söylendi. Maksiller protraksiyon ile ön çapraz kapanış düzeltildikten sonra, Sınıf I kanin ve molar ilişkiyi sağlamak ve orta hat sapmasını düzeltmek için edgewise sabit mekanikleri kullanıldı. Maksiller protraksiyon için tedavi süresi 6 ay, toplam tedavi süresi ise 18 aydı. Maloklüzyonun düzeltilmesi hem iskeletsel hem de dişsel değişiklikler ile sağlandı.This case report describes the treatment of a patient aged 12 years with a Class III malocclusion using a modified maxillary protractor and discusses the results of the treatment. The patient was instructed to wear the appliance at least 20 hours a day until a positive overjet was achieved. After the overcorrection of the anterior crossbite with protraction therapy, edgewise fixed appliances were used to correct the midline discrepancy and to establish Class I canine and molar relationships. Treatment time for maxillary protraction was 6 months, and the total treatment time was 18 months. Correction of the malocclusion was accomplished with both skeletal and dental changes

A Comparison of Conventional and Computerized Cephalometric Methods

Aim:The aim of the present study was to compare the conventional method of manual cephalometric analysis with a computerized cephalometric analysis method.Subjects and Method:Lateral cephalometric radiographs of 31 patients (15 males and 16 females) were traced by two methods: (1) conventional; (2) computerized [Nemo Ceph NX 2006 (Nemo Tec, Madrid, Spain)] cephalometric analysis program. Four dental, 7 skeletal, and 3 soft tissue parameters, were measured by one investigator. Intra-class correlation coefficients were performed for both methods to assess the reliability of the measurements according to Houston method. The measurements determined by each method were compared with a paired t-test.Results:The correlation coefficient between the first and second measurements ranged from 0.77 to 0.95 (average: 0.86) for the conventional method and from 0.79 to 0.97 (average: 0.91) for the computerized method. The results of paired t-test showed that significant differences were observed for SNA (°) (P= 0.000), SNB (°) (P= 0.033), ANB (°) (P= 0.037), Witts appraisal (mm) (P= 0.001), FMA (°) (P= 0.026), Overbite (mm) (P= 0.000), U1-PP (°) (P= 0.026), and UL-E (mm) (P= 0.000).Conclusion:Intra-obsserver reliability for both methods was acceptable. Significant differences between conventional and computerized methods were observed for SNA, SNB, ANB, Witts appraisal, FMA, Overbite, U1-PP, and UL-E

Skeletal Age Assessment According to The Greulich and Pyle Atlas in Different Skeletal Malocclusions

Aim:To compare the skeletal age (SA) of the patients with and without different sagittal skeletal malocclusions of the jaws and to compare differences between males and females.Subjects and Methods:The sample comprised 120 patients (mean age 12.00±1.10) referred to our clinic. SA from the conventional roentgenograms of left hands and wrists by using the atlas of GP standards for each gender and skeletal class was estimated. The comparisons among the skeletal classes were done by means of the one way ANOVA test for both genders. Tukey post hoc test was used to determine the individual differences. The mean differences between the SA and chronological age (CA) of the subjects in each group were tested by means of paired t-test.ResultsMean SA for females with Class I, II, and III malocclusions were advanced 0.43, 0.22, and 0.61 years than mean CAs, respectively (P=0.051, P=0.228, and P=0.003). The mean difference between CA and SA for males with Class I, II, and III malocclusions were −0.14, −0.35, and 0.24 years, respectively (P=0.502, P=0.028, and P=0.088). The mean difference for males with Class II (−0.35±0.65) and Class III (0.24±0.59) malocclusions was statistically significant.Conclusion:These results suggest that patients with different skeletal malocclusions may have a different rhythm of skeletal maturation from that of children without malocclusions

Effects of The Maxillary Molar Distalization with Zygoma-Gear Appliance on Maxillary Third Molars

Aim:The aim of the present study was to evaluate the effects of a newly produced appliance, named as Zygoma-Gear Appliance (ZGA), on maxillary third molars. We also investigated the effects of ZGA on skeletal, dentoalveolar, and soft tissue measurements.Subjects and Methods:The study group included 10 patients (mean age: 18.3±1.8 years) treated with ZGA system supported with zygomatic anchorage miniplates. The changes due to the distalization were evaluated from the lateral cephalometric films taken before and after distalization by means of Paired t-test.Results:The mean treatment period to achieve a Class I molar relationship was 7.9±3.1 months. The distalization amount of the maxillary molar teeth was 3.8±2.1 mm (p 0.05).Conclusions:Maxillary molar distalization without anchorage loss was achieved with ZGA. Maxillary third molars were slight affected by the distalization force

Condylar Asymmetry in Patients with Unilateral Mandibular Second Premolar Agenesis

Aim:To investigate the condylar and ramal vertical asymmetry in patients with unilateral mandibular second premolar agenesis.Subjects and Methods:Study group included 58 patients (25 female, 33 males) with unilateral mandibular second premolar agenesis and a control group of 57 patients (41 females, 16 males); both with Class I skeletal and dental relationship. Condylar, ramal, and condylar plus ramal heights were computed in both side and compared by means of paired t-test. Additionally, the asymmetry indices in the study and control groups were compared by means of the Student's t-test.Results:No statistically significant sex difference was found for any of the asymmetry indices and thus the data for males and females were pooled for statistical analyses. According to the side comparison, the condylar, ramal, and condylar plus ramal heights were smaller in the agenesis side than in the normal side for the study group. However, this difference was not statistically significant. Regarding to the asymmetry indices, the patients with unilateral mandibular second premolar agenesis had more asymmetric condyles than did the control group (p < .01).Conclusion:Although condylar, ramal, and condylar plus ramal heights were smaller in the agenesis side than in the normal side for the study group, this difference was not statistically significant

Effects of maxillary protraction for early correction of class III malocclusion

WOS: 000330836700012PubMed ID: 23460730This prospective study investigated the skeletal, dental, and soft-tissue effects of a mini maxillary protractor appliance in class III subjects with maxillary retrusion and mandibular protrusion and compared these changes with those of untreated, well matched control sample with normal occlusions. Twenty patients with class III malocclusion (mean age 11.10.8 years) and 20 subjects with normal occlusion (mean age 10.90.4 years) were included to this study. The class III subjects were treated with the mini maxillary protractor appliance, and the others were used as control subjects. Paired t-test and Students t-test were used to determine the within- and between-group differences, respectively. In the study group, the maxilla moved forward (SNA, 2.0 degrees and AY, 2.4mm) (P 0.05). The mandible displaced backwards and downwards (SNB, 1.1 degrees; SND, 0.9 degree; BY, 0.9mm and PogY, 0.3mm; P < 0.001). These movements in the maxilla and mandible caused a significant improvement in intermaxillary sagittal relationship (ANB, 3.0 degrees; Convexity, 6.3 degrees; Wits, 4.6mm; P < 0.001). The maxillary incisors moved forward (2.2 degrees) while the mandibular ones backward (1.9 degrees). The improvement in overjet was 5.0mm, and 66.1 per cent of this change (3.3mm) was skeletal (AY; 2.4mm and BY; 0.9mm), and the remaining (1.7mm) dentoalveolar (U1NA; 0.9mm and L1-NB; 0.8mm). The change in LsE measurement was more in the study group (2.1mm), and the difference between the groups was statistically significant (P < 0.001)

Effects of the functional regulator III on profile changes in subjects with maxillary deficiency

WOS: 000284638800023PubMed ID: 20453006The results of the Student's t-test showed that the treatment group had a concave facial profile when compared with the controls. At the end of treatment, the maxilla and surrounding soft tissues showed significant anterior movement (P < 0.001 and P < 0.01, respectively), whereas mandibular growth was restricted. The vertical dimensions increased, the upper incisors proclined, and the lower incisors retroclined significantly (P < 0.001). The FR-3 appliance produced significant improvements in the hard and soft tissues of Class III subjects with a concave profile

Effects of the functional regulator III on transversal changes: a postero-anterior cephalometric and model study

WOS: 000297311400021PubMed ID: 21062966Studies assessing the transversal treatment changes caused by the functional regulator III (FR-3) are limited in number. This clinical study was planned to analyse the transversal effects of the FR-3 appliance therapy. The treatment group consisted of 17 patients (8 males and 9 females) with Class III malocclusion, who were treated with the FR-3 appliance. The control group consisted of 17 subjects (7 males and 10 females) with a normal occlusion. Mean ages of the subjects were 10.73 and 10.66 years in the treatment and control groups, respectively. Postero-anterior radiographs and stone casts were obtained before (T1) and after (T2) treatment/ observation. The results of the Student's t-test comparing initial values showed that maxillary dentoalveolar and skeletal widths are significantly larger in the control group than those in the treatment group. At the end of the treatment, significant transverse increments occurred only at the dentoalveolar level of the maxilla. The transversal changes in the mandible were not statistically significant. Buccal shields of FR-3 did not stimulate the growth of maxillary apical base but caused an enhanced and supplementary widening of maxillary dental and alveolar structures

Homology and heterology of cephalometric landmarks: Methodological consequences

WOS: 000352010700022PubMed ID: 25056094With interest I read the study ‘Effects of maxillary protraction for early correction of class III malocclusion’ by Celikoglu and Oktay (1). The authors should be complimented for careful work. Apparently, much effort was taken to avoid traditional pitfalls in the (prospective) collection of study subjects and controls, in reporting measurement technique and in statistical procedures

Comparison of Root Resorption Between Self-Ligating and Conventional Brackets After a 4 Month of Orthodontic Treatment

Aim:The aim of the present study was to compare external apical root resorption (EARR) on maxillary and mandibular anterior teeth of the patients undergoing a four month of initial orthodontic treatment with self-ligating and conventional brackets.Subjects and Method:Thirty-one patients aged from 13 to 22 years were randomly divided into two groups. The patients in groups 1 and 2 were orthodontically treated during the initial leveling and alignment for the 4-month period with self-ligating and conventional brackets with 0.022 inch slots, respectively. EARR scores determined according to Malmgren index were examined before and after treatment by means of panoramic films and statistical comparison between the groups were compared by means of Pearson chi-square test.Results:Irregular root contour (score 1) was observed in 17 teeth of the 8 patients prior to the treatment. No teeth showed the scores of 2 and 3. Therefore, the root resorption due to the orthodontic treatment was considered present if score 2 or higher were registered. In the self ligating group, only 1 patient (1/14; 7.1%%) showed minor root resorption with score 2 in the mandibular left lateral incisor. In the conventional bracket group, 1 patient (1/17; 5.9%%) showed minor resorption (score 2) in the maxillary right and left central incisors after a 4-month of orthodontic treatment. Score 3 was not detected in any of the patients examined (p>0.05).Conclusion:In both groups, only one patient had minor resorption (EARR score: 2) after a 4-month orthodontic treatment with no statistically significant difference