Management of an Adult with Spaced Dentition, Class III Malocclusion and Open-bite Tendency

The aim of this case report was to present the orthodontic treatment of an adult with spaced dentition, Class III malocclusion, and open-bite tendency. A 28.4-year-old adult woman was concerned about the unesthetic appearance of her spaced dentition localized at both upper and lower arches while smiling. She had a mild tongue thrust, hypertropic upper frenum, and mild speech difficulty while pronouncing “s”. Her profile was straight with prominent lips. Molar relationship was Class III on both sides. Anterior teeth were in an end-to-end relationship. Lower dental midline was deviated to the left side. Cephalometric analysis revealed a skeletal Class III relationship with hyperdivergent facial pattern. The treatment plan included myotherapeutic exercises for the tongue thrust habit and a diagnostic set-up for closure of diastemas. A strict retention protocol was followed combined with gingivoplasty, fiberotomy, and frenectomy procedures. All spaces were closed successfully, adequate overbite and overjet relationships were obtained, and tongue thrust habit and speech difficulty while pronouncing “s” were eliminated. Clinical and cephalometric results indicated the maintenance of the treatment outcome at 6-months post-retention period

Maxillary protraction in adult cleft lip and palate by a rigid external distraction device with dentoskeletal anchorage

Objective: The objective is to evaluate the effects of maxillary distraction osteogenesis (DO) in an adult patient with unilateral cleft lip and palate (UCLP) by using a rigid external distraction (RED) device with dentoskeletal anchorage. Method: 31-year-old male patient with UCLP with severe maxillary hypoplasia, dolichofacial growth pattern, negative overjet and 1.5 mm openbite. After pre-surgical orthodontic treatment, an intra-oral appliance was modified to prevent extrusion of the molars and clockwise rotation of the mandible. Stainless steel plates were soldered bilaterally to the intra oral appliance at the level of canines. During surgery, miniplates were inserted in the maxillary segment and fixed to the plates of the intra oral appliance with screws. Results: The mean distraction length was 12 mm immediately after DO. SNA increased from 73o to 82o after distraction. A significant advancement of the maxilla and correction of the sagittal Class III skeletal relationship was achieved. The vertical position of the mandible and the face was kept stable, and the soft tissue profile became more balanced. Conclusion: This intra oral appliance design achieved desired skeletal changes during maxillary protraction with RED device in dolichofacial CLP patient. Occlusion and facial profile changes was found to be stable in 1-year follow-up.PubMe

Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi

Amaç: Bu çalışmanın amacı obstrüktif uyku apne sendromu (OUAS) olan erişkin erkek hastaların kraniofasiyal morfolojik özellikleri değerlendirmektir. Gereç ve Yöntem: Çalışmada 80 erkek hastanın (60 sefalogramları değerlendirildi. Bireyler Grup 1: horlama (AHİ5); Grup 2: hafif OUAS (5AHİ15); Grup 3: orta OUAS(15 AHİ30) ; Grup 4: şiddetli OUAS (AHİ30) olarak değerlendirildi. Sefalogramlar üzerinde hyoid, dil kökü ve yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini belirleyen ölçümler yapıldı. Gruplar arasındaki farklar normal dağılım gösteren değişkenlerde tek yönlü varyans analizi ve Duncan testiyle, normal dağılım göstermeyen değişkenlerde Kruskal düzeltmesi uygulanarak Mann Whitney U testiyle yapıld

Management Of An Adult With Spaced Dentition, Class Iii Malocclusion And Open-Bite Tendency

The aim of this case report was to present the orthodontic treatment of an adult with spaced dentition, Class III malocclusion, and open-bite tendency. A 28.4-year-old adult woman was concerned about the unesthetic appearance of her spaced dentition localized at both upper and lower arches while smiling. She had a mild tongue thrust, hypertropic upper frenum, and mild speech difficulty while pronouncing “s”. Her profile was straight with prominent lips. Molar relationship was Class III on both sides. Anterior teeth were in an end-to-end relationship. Lower dental midline was deviated to the left side. Cephalometric analysis revealed a skeletal Class III relationship with hyperdivergent facial pattern. The treatment plan included myotherapeutic exercises for the tongue thrust habit and a diagnostic set-up for closure of diastemas. A strict retention protocol was followed combined with gingivoplasty, fiberotomy, and frenectomy procedures. All spaces were closed successfully, adequate overbite and overjet relationships were obtained, and tongue thrust habit and speech difficulty while pronouncing “s” were eliminated. Clinical and cephalometric results indicated the maintenance of the treatment outcome at 6-months post-retention period.PubMe

Tooth Color Change Due To Different Etching And Debonding Procedures

Objectives: To compare the effects of different etching techniques, 12-, 24-bladed tungsten carbide burs, and polishing discs on tooth color changes during orthodontic treatment. Materials and Methods: 59 individuals (mean age: 15.20 +/- 1.59 years) were divided into four groups: 37% phosphoric acid and adhesive primer was used in Groups I and II whereas self-etch primer was used in Groups III and IV for enamel preparation. After orthodontic treatment, residual adhesives were cleaned with 12-bladed tungsten carbide burs in Groups I and III, while 24-bladed tungsten carbide burs were used in Groups II and IV. All teeth were polished with medium and fine Sof-Lex XT discs (3M ESPE, St Paul, Minnesota). Color measurements were taken from upper incisors and canines at pretreatment (T0), after cleaning with tungsten carbide burs (T1) and polishing with discs (T2). Wilcoxon test was used for evaluation of L*, a*, b* changes and Kruskal-Wallis for intergroup comparison of color changes. Results: L*, a*, b* values, except a* at Groups I, II, IV, and b* at Group III, changed significantly (P < .05). Groups III and IV showed significantly different color alterations from T0 to T1 (P < .05). After polishing, tooth color alterations were not significantly different among the groups. Conclusions: In self-etch bonding groups, a 12-bladed tungsten carbide bur caused less color change than the 24-bladed tungsten carbide bur. Orthodontic treatment resulted with visible and clinically unacceptable tooth color alterations regardless of the enamel preparation and clean-up techniques. Polishing reduced the effect of tungsten carbide burs, but did not affect the total influence of orthodontic treatment on the tooth color.WoSScopu

The Genetic Basis Of Facial Skeletal Characteristics And Its Relation With Orthodontics

Successful treatment of any orthodontic problem depends on an appropriate diagnosis of its etiology. It is well known that the genetics, as well as environmental factors, play an important role on the etiology of skeletal anomalies. Recent studies and advances in genetic sciences allowed the orthodontists to better understand the effects of genetics on the etiology of dentofacial characteristics and pathologies which in turn supported the effects of the genes in the development of dentofacial complex. In orthodontic practice, the genetic basis of a skeletal anomaly should also be considered during the diagnosis. Therefore orthodontic treatment plan should be chosen accordingly. However, further genetic studies are required to clearly determine all the specific genes leading to a particular skeletal variability caused by the polygenic nature of craniofacial traits. This article includes the current information on the association between orthodontics and genetics, an outline of the evidence based impact of heredity on dentofacial development as a review of the etiological factors of skeletal anomalies from the genetic point of view.PubMe

Shear Bond Strength Of Orthodontic Brackets Bonded Using Conventional Vs One And Two Step Self-Etching/Adhesive Systems

Objective: To assess and compare the effects of one- and two-step self-etching primer and adhesive with conventional acid-etching and bonding system on the shear bond strength of orthodontic brackets. Materials and Methods: The one-step self-etching primer and adhesive used was Clearfil tri-S bond, the two-step fluoride-releasing antibacterial self-etching primer and adhesive was Clearfil Protect Bond, and the fluoride-releasing conventional acid-etching and bonding system was Kurasper F Bond. Brackets were bonded to defect-free human premolars (n = 14 per group) according to each manufacturer's recommendations by using light-cured bracket adhesive Kurasper F Paste with a light-emitting diode of a light-curing unit. The specimens were stored in deionized water at 37 degrees C for 48 hours and then tested in shear with a universal testing machine at a crosshead speed of 5 mm/min until the brackets debonded. The mode of failure of the brackets was determined by a modified adhesive remnant index. Results: Mean shear bond strength values were 9.00 MPa for Kurasper F Bond, 9.55 MPa for Clearfil Protect Bond, and 9.48 MPa for Clearfil tri-S Bond. One-way analysis of variance detected no statistically significant difference among groups (P = .98, P > .05). The predominant failure for the three groups was at the bracket-adhesive interface leaving less than 25% of the adhesive on the bracket base. Conclusions: One-step self-etching adhesive and two-step fluoride-releasing antibacterial self-etching adhesive have sufficient mechanical properties for the bonding of orthodontic brackets.Wo