1/18. amelogenesis imperfecta: diagnosis and resolution of a case with hypoplasia and hypocalcification of enamel, dental agenesis, and skeletal open bite.A case of amelogenesis imperfecta with hypoplasia, hypocalcification of the enamel, congenital absence of teeth 12 and 22, delayed eruption of tooth 23, edge-to-edge incisal relationship, open bite, and bilateral posterior cross bite at the level of the first and second premolars is presented. Lateral skull teleradiography indicated a Class III skeletal pattern of maxillary origin associated with a dolichofacial pattern with multiple indicators of facial hyperdivergence. The patient presented a major esthetic abnormality of the face and required orthodontic treatment prior to a prosthetic solution with full-coverage metal-ceramic crowns in both the maxilla and the mandible. The diagnosis of cases such as this one and the therapeutic implications from an orthodontic and prosthetic standpoint are reported.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/18. A less-invasive approach with orthodontic treatment in Beckwith-Wiedemann patients.The beckwith-wiedemann syndrome (BWS) is a rare genetic disorder, linked to an alteration on the short arm of chromosome 11 that comprises multiple congenital anomalies. macroglossia is the predominant finding, with subsequent protrusion of dentoalveolar structures, which results in a protruding mandible, anterior open bite, abnormally obtuse gonial angle and increased mandibular length. A less-invasive treatment with orthopaedic appliances in a patient with early tongue reduction is presented. This work summarizes the oral signs linked to macroglossia, and highlights the influence of macroglossia on mandibular growth structures. In our opinion, glossotomy could be carried out in the paediatric patient as a preventive measure in that it curbs the tongue's influence on skeletal growth and dramatically reduces the duration and extensiveness of subsequent treatment.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
3/18. TMJ fractures in children: importance of functional activation of muscles in preventing mandibular asymmetries and facial maldevelopment.Normal development of the mandible as well as some portions of the upper jaw and face are related to good function of the masticatory apparatus: the integrity and interaction of bony and soft-tissue structures may be highly disturbed by injury of the TM joints and result in facial and occlusal disharmonies. When the neuromuscular system is in harmony, the mandibular muscles collectively exert their effect on both position and movement of the jaw and the loading of forces on the TM joints is optimal and balanced. Unfortunately, TMJ fractures may alter completely this balance with loss of the support to the mandible against the temporal component and loss of the functional effect of the lateral pterygoid muscle on the mandible. Disturbances in the harmonious interplay of the masticatory muscles may result in facial alteration and asymmetries. If not treated, the dysplastic patterns of growth continues and worsens during the years.- - - - - - - - - - ranking = 3.0765286415715keywords = mandible, jaw (Clic here for more details about this article) |
4/18. Orthodontic-surgical treatment after posttraumatic bilateral condylectomy of the mandible in an adult patient.A posttraumatic open bite associated with a bird face is reported. Condylectomy was indicated in relation to the plurifragmentary fracture of the condyles with limitation of mandibular movement. Condylectomies were mandatory as a result of delayed maxillofacial surgical treatment, which was related to the poor general condition of the patient after trauma. Functional disorder recovery and aesthetic deformity correction were planned by a team approach between orthodontists and maxillofacial surgeons with the support of a logopedist for the postural-related muscle problems. The main practical and theoretical problems presented by the clinical case were a result of the need to restore the occlusal relations and to avoid recurrence of open bite in this patient. The patient presented a wide alteration of muscular function and a strength fibrotic retraction with alteration in the relationship between upper and lower jaws and retrusion of the mandible associated to open bite. Orthodontic treatment was carried with no impact on the upper and lower axis, avoiding orthodontic correction of the open bite. Surgery corrected both the open bite and the bird face by means of bilateral sagittal split osteotomies. Wiring of the mandibular osteotomies and intermaxillary fixation allowed positioning of the mandibular ramus bilaterally because of the fibrosis and muscular action-related forces without resulting in a similar rotation of the mandible with the risk of recurrence. Myotherapy and logopedic support minimized the risk of recurrence, improved reduction of muscular tension with the resolution of the lip incompetence, and allowed functional recovery of mandibular movements.- - - - - - - - - - ranking = 6.0382643207857keywords = mandible, jaw (Clic here for more details about this article) |
5/18. Indications and procedures for segmental dentoalveolar osteotomy: a review of 13 patients.The authors evaluated the surgical area, indications, and procedures for segmental dentoalveolar osteotomy carried out on 16 jaws in 13 patients treated at the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of medicine, between 1990 and 2001. osteotomy was indicated mainly in cases where tooth repositioning by orthodontic treatment was limited, where social conditions (e.g., age, time, finances) precluded orthodontic treatment, or where revision of orthodontic or surgical treatment was required. In cases of maxillary anterior segmental dentoalveolar osteotomy, the modified Wunderer method was used, where after an incision was made in the palatal mucosa, a mucoperiosteal flap was abraded as much as possible until the area of the osteotomy on the palatal side could be visualized. In maxillary posterior segmental dentoalveolar osteotomy, the operation was carried out in 2 stages because of the risk of necrosis of the bone fragments. In the first stage, an osteotomy was carried out on the vestibular side, since the vestibular gingival pedicle was intact. In the second stage, 3 weeks later, another osteotomy was performed after the palatal mucoperiosteal flap was abraded to visualize the area of the osteotomy as well as that of the maxillary anterior segmental dentoalveolar osteotomy.- - - - - - - - - - ranking = 0.038264320785739keywords = jaw (Clic here for more details about this article) |
6/18. Case report: orofacial characteristics of Hallermann-Streiff Syndrome.BACKGROUND: Hallermann in 1948 and Streiff in 1950 described patients characterised by "bird face", congenital cataract, mandibular hypoplasia, and dental abnormalities. The new syndrome was later defined as Hallermann-Streiff Syndrome (HSS), underlining the differences with regard to Franceschetti's mandibulofacial dysostosis. CASE REPORT: Examination of a white male affected by Hallermann-Streiff Syndrome revealed facial characteristics typical of the "bird face" in HSS. The nose appeared thin, sharp and hooked; the prominence of the chin was absent in the lateral view; a marked microstomia was evident as well. Radiographic records showed aplasia of teeth 14, 13, 12, 22, 24, 35, 34, 33, 32, 31, 41, 42, and 43. As for orthodontic diagnosis, the following dentoskeletal features were assessed: skeletal Class II malocclusion, narrow upper arch, bilateral posterior crossbite, and anterior open bite. Lateral cephalogram showed hypoplasia of the mandible, a typical sign of HSS. The mandible revealed a clockwise rotation growth pattern with an opening of the gonial angle, skeletal anterior open bite, and an excessive vertical dimension of the lower third of the face. Radiographs at the age of 13 years showed an anomaly in shape of the lower right first bicuspid, which appeared with a double crown. TREATMENT: Orthodontic treatment started at 10 years of age with rapid maxillary expansion in the early stages of the mixed dentition, in order to correct the posterior crossbite due to the narrow maxillary arch. A subsequent phase of the orthodontic therapy consisted of a functional appliance with the goal of maintaining the transverse dimension of the dental arches and of controlling the tongue thrust in the anterior open bite. Surgical and prosthetic interventions were scheduled at completion of growth to solve the skeletal discrepancy and for occlusal rehabilitation. FOLLOW-UP: The therapeutic protocol used in the patient presented here was able to reach the orthodontic goals during the developmental ages. Further treatment is planned as there are multiple missing permanent teeth and prosthetic/restorative care is needed until the patient reaches full adulthood.- - - - - - - - - - ranking = 2keywords = mandible (Clic here for more details about this article) |
7/18. temporomandibular joint disc disfigurement and abnormal thickening of the posterior band.Temporomandibular joint (TMJ) disc disfigurement is a common finding associated with various stages of disc displacement and injury. However, in most cases, the clinical diagnosis of disc displacement without reduction may not be readily apparent due to either a delay in patient presentation or lack of early imaging of the disc. The case of a 22-year-old woman with a history of TMJ disorder, seeking treatment for a history of unilateral posterior open bite and bilateral jaw pain, is described.- - - - - - - - - - ranking = 0.038264320785739keywords = jaw (Clic here for more details about this article) |
8/18. Mandibular distraction osteogenesis by sagittal split osteotomy and intraoral curvilinear distraction.Mandibular distraction combining the sagittal split ramus osteotomy and an intraoral curved distractor is efficacious to lengthen the mandibular body and ramus. The sagittal split permits immediate rotation of the proximal segment and lengthening while still providing a large surface interface for regenerative bone. The buried curved distractor enables mandibular lengthening along the normal logarithmic grow spiral as shown by Moss and rickets. In addition, it is well tolerated by the patient and can remain in place for a long duration to provide support. In summary, this combination of surgical techniques provides certain advantages for distraction of the mandible.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
9/18. 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 = mandible (Clic here for more details about this article) |
10/18. Orthopedic approach in the treatment of a skeletal class II division 1 malocclusion with an anterior open bite.The patient presented with a skeletal class II malocclusion characterized by an anterior open bite and maxillary midline deviation. This mixed dentition case was treated orthopedically with MRI appliance to rotate and impact the maxilla. A Bionator was used advance the mandible. The case was completed using Occlus-O-Guide. The result showed that the facial bones and teeth appear in the correct position.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
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