Angle Class III malocclusion with anteroposterior and vertical discrepancy in the final stage of growth.
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ABSTRACT:
SUBMITTER: Arruda MBP
PROVIDER: S-EPMC5525452 | biostudies-other | 2017 May-Jun
REPOSITORIES: biostudies-other
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Project description:Bone-anchored maxillary protraction (BAMP) is effective for skeletal Class III malocclusion. However, infection, screw and plate loosening, and device failures occur with conventional plates. This pilot prospective study analyzed the feasibility of individualized BAMP using preoperative simulation and 3D titanium printing in patients referred by the orthodontic department for four BAMP miniplates. Preoperative cone beam computed tomography data were analyzed using CAD/CAM software to fabricate the individualized 3D-printed BAMP device. The customized plates were printed using selective laser sintering and inserted onto the bone through an adjunct transfer jig. The accuracy of preoperative simulation and actual placement of the BAMP device were tested by superimposing simulated positioned digital images and postoperative computed tomography data. The growth modification effect depended on superimposition of lateral cephalograms and comparative changes in SNA, SNB, ANB, and Wits. Two male patients were finally included in the study. BAMP decreased the ANB difference (-4.56 to -1.09) and Wits appraisal (-7.52 to -3.26) after 2 years. Normal measurement indices for sagittal and vertical growth indicated successful growth modification. The mean accuracy between preoperative simulation and actual surgery was 0.1081 ± 0.5074 mm. This treatment modality involving preoperative simulation and 3D titanium printing for fabricating and placing customized BAMP devices precisely at planned locations is effective for treating skeletal Class III malocclusion.
| S-EPMC8619151 | biostudies-literature
Project description:The role played by genetic components in the etiology of the Class III phenotype, a class of dental malocclusion, is not yet understood. Regions that may be related to the development of Class III malocclusion have been suggested previously. The aim of this study was to search for genetic linkage with 6 microsatellite markers (D1S234, D4S3038, D6S1689, D7S503, D10S1483, and D19S566), near previously proposed candidate regions for Class III. We performed a two-point parametric linkage analysis for 42 affected individuals from 10 Brazilian families with a positive Class III malocclusion segregation. Analysis of our data indicated that there was no evidence for linkage of any of the 6 microsatellite markers to a Class III locus at = zero, with data supporting exclusion for 5 of the 6 markers evaluated. The present work reinforces that Class III is likely to demonstrate locus heterogeneity, and there is a dependency of the genetic background of the population in linkage studies.
| S-EPMC6761732 | biostudies-literature
Project description:Introduction:The occlusal plane is very important in the stomatognathic and aesthetic dentofacial system. Manipulation of the occlusal plane plays an important role in class III malocclusion correction. For this reason, the strategy in establishing the diagnosis, prognosis and treatment plan becomes more complex, so a more comprehensive analysis of the occlusal plane inclination as a parameter of diagnosis is needed for more effective and efficient treatments. Aim:The aim of this study was to determine the comparison of occlusal plane inclination between class III and class I malocclusions and to knowing the correlation of occlusal plane inclination in class III malocclusions with the direction of facial growth. Materials and Methods:Samples were secondary lateral cephalograms collected at the Universitas Airlangga (UNAIR) Dental Hospital in October 2017-2018. Cephalograms were traced using the OrthovisionTM software; then, the Mann-Whitney comparative statistical test (p<0.05) was carried out followed by the canonical correlation test. Results:Differences in class III and class I malocclusions were found in the OP-AB and OP-FH angles. The OP-AB angle is the occlusal plane inclination which has the strongest correlation compared to others. OP-AB angle is strongly correlated with horizontal growth parameter, especially theSNB. The OP-AB angle is also correlated with vertical growth parameters: the Y axis and the Facial axis. Conclusion:The OP-AB angle is a parameter that can distinguish between class III and class I malocclusions. The OP-AB angle has a strong correlation with vertical and horizontal growth directions.
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Project description:Objective:The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods:A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results:Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions:MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.
| S-EPMC7500573 | biostudies-literature
Project description:Williams-Beuren syndrome (WBS) is a rare genetic condition that affects approximately 1 in every 20,000 - 50,000 live births. WBS children have specific skeletal deformities, dental malformations and rare lingual muscle dysfunction. The need for orthodontic and orthognathic therapy has arisen and has been considered a real clinical challenge even for experienced professionals, once it requires a complex and individualized treatment plan. This study reports a case of orthopedic expansion of the maxilla, in which a modified facial mask was used for protraction of the maxillary complex associated with clockwise rotation of the maxilla. In addition, special considerations about treatment time and orthopedic outcomes are discussed.
| S-EPMC4373022 | biostudies-literature
Project description:Background Mandibular prognathism (MP) is a craniofacial deformity resulting from the combined effects of environmental and genetic factors. Although various linkage and genome-wide association studies for mandibular prognathism have identified multiple strongly associated regions and genes, the causal genes and variants responsible for the deformity remained ambiguous. Aim This research work was aimed to study the association between polymorphism rs10850110 of the MYO1H gene and skeletal class-III malocclusion in our local population. Materials and Methods Thirty patients with skeletal class III due to mandibular prognathism in the study group and 30 patients with skeletal class I in the control group were selected for this study. These patients were from both sexes and above age 10 years. Based on the cephalometric values, patients were categorized into study and control groups. SNB (angle between sella, nasion and point B at nasion) greater than 82 degrees with an ANB (angle between point A, nasion and point B at nasion) of less than 0 degrees in the study group and ANB (angle between point A, nasion and point B at nasion) of 2 to 4 degrees in the control group were categorized. The polymorphism (rs10850110) of the MYO1H gene was genotyped using polymerase chain reaction and restriction fragment length polymorphism. Associations were tested with SNP exact test using SNPstats software. Results The single-nucleotide polymorphism rs10850110 showed a statistically significant association with mandibular prognathism. The G allele of marker rs10850110 (5' of myosin1H - MYO1H ) was overrepresented when compared with the "A" allele in mandibular prognathism cases ( p < 0.0001), and this was very significant. Conclusion These results suggest that the rs10850110 polymorphism of the MYO1H gene is associated with an increased risk for mandibular prognathism.
| S-EPMC8635817 | biostudies-literature
Project description:The treatment of skeletal Class III malocclusion in adolescents is challenging. Maxillary protraction, particularly that using bone anchorage, has been proven to be an effective method for the stimulation of maxillary growth. However, the conventional procedure, which involves the surgical implantation of mini-plates, is traumatic and associated with a high risk. Three-dimensional (3D) digital technology offers the possibility of individualized treatment. Customized miniplates can be designed according to the shape of the maxillary surface and the positions of the roots on cone-beam computed tomography scans; this reduces both the surgical risk and patient trauma. Here we report a case involving a 12-year-old adolescent girl with skeletal Class III malocclusion and midface deficiency that was treated in two phases. In phase 1, rapid maxillary expansion and protraction were performed using 3D-printed mini-plates for anchorage. The mini-plates exhibited better adaptation to the bone contour, and titanium screw implantation was safer because of the customized design. The orthopedic force applied to each mini-plate was approximately 400-500 g, and the plates remained stable during the maxillary protraction process, which exhibited efficacious orthopedic effects and significantly improved the facial profile and esthetics. In phase 2, fixed appliances were used for alignment and leveling of the maxillary and mandibular dentitions. The complete two-phase treatment lasted for 24 months. After 48 months of retention, the treatment outcomes remained stable.
| S-EPMC7500574 | biostudies-literature
Project description:The aim of this systematic review is to compare the effect on the upper airways of orthopedic treatment for skeletal Class III malocclusion with untreated controls. Nine databases were searched up to August 2020 for randomized or nonrandomized clinical trials comparing orthopedic Class III treatment (facemask or chin-cup) to untreated Class III patients. After duplicate study selection, data extraction, and risk of bias assessment (Risk Of Bias In Non-randomized Studies - of Interventions [ROBINS-I]), random-effects meta-analyses of Mean Differences (MDs)/Standardized Mean Differences (SMD) and 95% Confidence Intervals (CIs) were performed, followed by the Grading of Recommendations Assessment, Development and Evaluation assessment evidence-quality. A total of 10 papers (9 unique nonrandomized studies) with 466 patients (42.7% male; average age 9.1?years) were finally included. Limited evidence indicated that compared to normal growth, maxillary protraction with facemask was associated with increases in total airway area (n = 1; MD = 222.9 mm2; 95% CI = 14.0-431.7 mm2), total nasopharyngeal area (n = 4; SMD = 1.6; 95% CI = 1.2-2.0), and individual airway dimensions (upper-airway MD = 2.5 mm; lower-airway MD = 2.1 mm; upper-pharynx MD = 1.6 mm; lower-pharynx MD = 1.0 mm; all n = 6). Subgroup/meta-regression analyses did not find any significant effect-modifiers, while the results were retained 2-5 years postretention. Our confidence in these estimates was, however, very low, due to the inclusion of nonrandomized studies with methodological issues. Limited data from 2 chin-cup studies indicated smaller benefits on airway dimensions. Existing evidence from controlled clinical studies on humans indicates that maxillary protraction for skeletal Class III treatment might be associated with increased airway dimensions, which are, however, mostly minor in magnitude.
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Project description:Current phenotypic characterizations of Class III malocclusion are influenced more by gender or ethnic origin than by raw linear skeletal measurements. The aim of the present research is to develop a Class III skeletal malocclusion sub-phenotype characterization based on proportional cranial measurements using principal component analysis and cluster analysis. Radiometric data from 212 adult subjects (115 women and 96 men) of southern European origin affected by Class III skeletal malocclusion were analyzed. A total of 120 measurements were made, 26 were proportional skeletal measurements, which were used to perform principal component analysis and subsequent cluster analysis. The remaining 94 supplementary measurements were used for a greater description of the identified clusters. Principal component analysis established eight principal components that explained 85.1% of the total variance. The first three principal components explained 51.4% of the variance and described mandibular proportions, anterior facial height proportions, and posterior-anterior cranial proportions. Cluster analysis established four phenotypic subgroups, representing 18.4% (C1), 20.75% (C2), 38.68% (C3), and 22.17% (C4) of the sample. A new sub-clustering of skeletal Class III malocclusions that avoids gender influence is provided. Our results improve clinicians' resources for Class III malocclusion and could improve the diagnostic and treatment approaches for this malocclusion.
| S-EPMC7565379 | biostudies-literature
Project description:In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed.
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