1/11. Treatment of a Class II division 1 anterior open bite malocclusion.A case report of an 11-year-old Caucasian female who presented with a Class II div I anterior open bite malocclusion. Overjet is 6 mm and the anterior open bite 2 mm. There was a history of digit sucking till she was eight years old. She was successfully treated by non-extraction with pre-adjusted Edgewise appliances and high-pull headgear for a period of 27 months.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/11. Correction of severe vertical maxillary excess with anterior open bite and transverse maxillary deficiency.patients requiring correction of large anterior open bites have historically been among the most challenging treatments for orthodontists. Adding to that fundamental challenge for the adult patient in this case was vertical maxillary excess, a severe transverse maxillary deficiency as well as an arch length inadequacy, even though the patient had prior orthodontic treatment. The prior orthodontist had included arch expansion and extracted four first bicuspids, which limited current treatment options. Various treatment modalities that have traditionally been used to correct transverse maxillary deficiency and the accompanying arch length inadequacy include extractions, labial and buccal dental tipping, segmental maxillary osteotomies, and rapid maxillary expansion with or without surgical assistance. Transverse maxillary distraction osteogenesis is a modification (ie, using a latency period and specific rate and rhythm of distraction) of the surgically assisted rapid maxillary expansion technique developed 25 years ago. This case demonstrates the relationship of transverse maxillary deficiency as well as vertical maxillary excess to apertognathia. Considerations regarding the use of segmental maxillary osteotomy vs transverse distraction osteogenesis are discussed. This case report illustrates the benefit of a team approach using transverse maxillary distraction osteogenesis, effective orthodontic mechanics, and orthognathic surgery to correct a severe dentofacial deformity.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/11. Treatment of severe mandibular prognathism in combination with maxillary hypoplasia: case report.We performed a Le Fort I osteotomy and sagittal split ramus osteotomy (Obwegeser-Dal Pont) combined with mandibular anterior segmental osteotomy without tooth extraction for a patient with severe mandibular prognathism accompanied by a hypoplastic maxilla, anterior open bite and normal anterior mandibular vertical dimension. The results of facial appearance and occlusion were excellent. This combined surgical method appears to be satisfactory for treating severe mandibular prognathism with hypoplastic maxilla.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/11. Nonsurgical treatment of adult open bite using edgewise appliance combined with high-pull headgear and class III elastics.This case report describes the effect of a combination of high-pull headgear and Class III elastics on the nonsurgical treatment of an adult open bite. The 19-year 1-month-old Japanese female presented with the anterior open bite of 4.0 mm and mild crowding. She had a skeletal Class II but a Class III molar relationship due to a severe proclination of the mandibular dental arch. Unilateral congenital missing premolars caused a discrepancy between the facial and dental midline. After extraction of two premolars and the impacted mandibular third molars, nonsurgical therapy was performed using the standard edgewise appliance combined with a high-pull headgear and Class III elastics. The successful treatment outcome and stability of the final occlusion indicates that a combination of high-pull headgear and Class III elastics is one of the effective devices in the nonsurgical treatment of open bite and, is especially helpful in uprighting the mandibular dental arch.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
5/11. rehabilitation of a hemophiliac with implants: a medical perspective and case report.A patient suffering from classical hemophilia had previous surgery for ankylosis of the right temporomandibular joint. This was replaced by a costochondral graft and an overlay of temporalis muscle. A bilateral sagittal split was performed for a micrognathic mandible and a sleep apnea problem. That procedure solved the sleep apnea; however, it resulted in a prognathic mandible and an anterior open bite. The lower anterior teeth were periodontally involved with impaired alveolar support. The restricted opening of the oral cavity of 18 mm between maxillary and mandibular centrals and the potential danger of bleeding complicated the surgical and restorative procedures. The patient was prepared medically on each of 4 occasions with factor viii replacement concentrate, and oral antifibrinolytic therapy (tranexamic acid). The treatment of choice was the extraction of the remaining lower incisors and their replacement with an implant-supported temporarily cemented retrievable fixed prosthesis. Serial extractions and chairside temporization provided the surgeon with precise guides for implant placement, and enabled the patient to enjoy unimpaired function through periods of healing and osseointegration.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
6/11. An adult case of skeletal open bite with a large lower anterior facial height.Control of the height of posterior dentoalveolar regions is of great importance for the correction of skeletal open bite. Traditionally, second premolar extraction facilitates the closure of open bite by inducing a counterclockwise mandibular rotation without molar intrusion. This article reports treatment for a 24-year six-month-old female patient with an open bite and large anterior facial height. She complained of occlusal disturbances and difficulty of lip closure because of the open bite. Overjet and overbite were 3.0 mm and -3.0 mm, respectively. To correct open bite and crowding, the bilateral extraction of the maxillary and mandibular second premolars plus multibracket appliances for mesial movement of the molars was selected as the treatment plan. After a two-year treatment, an acceptable occlusion was achieved, the lower anterior facial height was decreased, and the lips showed less tension in a lip closure. An acceptable occlusion was maintained without recurrence of the open bite during a three-year retention period, indicating a long-term stability of the occlusion. The results of this treatment indicated that the correction of open bite with no or less molar intrusion or incisor extrusion is of great importance for achieving stable occlusion and avoiding the relapse of open bite.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
7/11. Class II deep bite faces: one-phase or two-phase treatment?Timing is the key for successful and stable results in Class II patients. Most low-angle patients are treated during the mixed dentition in two phases: orthopedics, then orthodontics. The vertical discrepancy differentiates the patient who will need extraction, the high-angle case, from those who should be treated through nonextraction, the low-angle case. Treatment of these latter patients necessitates expansion of the soft tissues. In the authors' practice, 70% of cases are treated nonextraction. This new concept for Class II treatment makes the Class II mechanics less traumatic because the occlusal correction requires less anchorage preparation. Most low-angle cases treated with two-phase treatment do not require surgical procedures. orthodontics for tomorrow will necessitate more concept and less mechanics.- - - - - - - - - - ranking = 3keywords = extraction (Clic here for more details about this article) |
8/11. Nonsurgical and nonextraction treatment of a skeletal class III adult patient with severe prognathic mandible.AIM: A patient with a skeletal Class III malocclusion, prognathic mandible, anterior open bite, large tongue, and temporomandibular disorders is presented. Treatment objectives included establishing a stable occlusion with normal respiration, eliminating temporomandibular disorder symptoms, and improving facial esthetics through nonextraction and nonsurgical treatment by creating a favorable perioral environment, restoring the harmony to the tongue and perioral environment, improving masticatory muscle function, and creating adequate tongue space for establishment of normal respiration. SUBJECT AND methods: The patient was a Japanese adult male, who had previously been advised to have orthognathic surgery, with tongue-size reduction. An expansion plate was used to expand the maxillary dentoalveolar arch. Distalization of the mandibular arch was achieved by reduced excessive posterior vertical dimension, through uprighting and intruding the mandibular posterior teeth and rotating the mandible slightly counter-clockwise. The height of the maxillary alveolar process and the vertical height of symphysis were increased slightly. The functional occlusal plane was reconstructed by uprighting and intruding the posterior teeth with a full-bracket appliance, combined with a maxillary expansion plate, with short Class III and vertical elastics in the anterior area. myofunctional therapy involved sugarless chewing gum exercises. RESULTS: The excessive posterior vertical occlusal dimension was reduced slightly, creating a small clearance between the posterior maxilla and mandible. At the same time, the interferences in the posterior area were eliminated by the expansion of the maxillary dentoalveolar arch. As a result, the laterally displaced mandible moved to a more favorable jaw relationship, with distalization of the mandibular arch. The functional occlusal plane was reconstructed and an almost-normal overjet and overbite were created. Adequate tongue space for normal respiration was established during the early stage of treatment, by 7 months. A stable occlusion, with adequate posterior support and anterior guidance, was established and maintained at more than 4 years posttreatment.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
9/11. Nonsurgical correction of an adult skeletal class III and open-bite malocclusion.This case report presents an adult skeletal Class III and open-bite malocclusion case treated without surgical intervention using fixed edgewise technique, reverse headgear, and Class III and anterior box elastics. The patient was a 16-year-old Turkish female who had completed her growth and development. She had a four mm open bite, maxillary retrognathia, a crossbite in the anterior and left posterior, and hypoplasia of the maxillary laterals. In addition, the patient's first molars had previously been extracted because of caries, and extraction spaces were present. We applied a Roth edgewise appliance and a reverse headgear to be used at night only for the first six months. The objective in using a reverse headgear was to displace the maxillary teeth toward the mesial and to rotate the maxilla in a clockwise direction. In the mandible, we retracted the mandibular incisors and canine teeth and moved the second molars mesially toward the first molar extraction space. There would thus be no need for any prosthetic restoration in the mandible. At the end of treatment, we obtained a Class I dental relationship, an ideal occlusion relationship, and an esthetic dental and facial relationship. Treatment of the patient was completed in 20 months.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
10/11. Nonextraction treatment of an open bite with microscrew implant anchorage.A 16-year-old girl with an anterior open bite was treated with nonextraction therapy that included intrusion of the maxillary and mandibular posterior teeth with microscrew implants. Implants (diameter, 1.2 mm; length, 8 or 6 mm) were placed into alveolar bone near the posterior teeth and used as anchorage for intrusive force. To prevent adverse side effects of buccoversion or linguoversion of the posterior teeth during intrusion, a transpalatal bar and a lingual arch were placed. The 3-mm anterior open bite was corrected in 11 months of treatment, after intrusion of the maxillary and mandibular posterior teeth and autorotation of the mandible. The posterior intrusion relapsed in the early stage of retention, at 8 months; thereafter, no obvious relapse was evident in the vertical position of the molars and the FMA. The treatment mechanics of anterior open bite with posterior intrusion by using microscrew implants were effective but still require a proper retention protocol.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
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