Arch Coordination Research Articles

Alignment for alveolar bone graft and improvement of transverse discrepancy in adult patients with unilateral/bilateral cleft lip and palate

Since 2019, orthodontic treatments of cleft lip and/or palate have been supported by the Korean National In­surance System. Based on the national claim data, more than 30% of fixed orthodontic treatments were provided to adult cleft palate patients. Their maxillary arches frequently were deformed and collapsed, and sometimes needed arch coordination for alveolar bone graft. Therefore, the treatment progress for two patients with uni­lateral/bilateral cleft palate was introduced, presenting improvement of inter-arch horizontal disharmony and dental alignment with fixed orthodontic appliances to enable iliac bone graft and implant prosthesis.

Relationship between forward propulsion and foot motion during gait in healthy young adults

The foot contributes to propulsion and postural stability function by changing its morphology during walking through the truss/windlass mechanisms. We quantified the truss mechanism regarding foot stiffness and the windlass mechanism regarding the movement coordination between the foot arch and metatarsophalangeal (MTP) joint. We aimed to clarify the relationship of these mechanisms with propulsive force and static foot alignment. Forty-eight healthy young adults participated and walked at a comfortable speed. The ground reaction force (GRF), ankle power, and sagittal plane motion of the foot arch and MTP joint were recorded using a three-dimensional motion analysis system. The vertical GRF and foot arch motion were used to quantify foot stiffness as the truss coefficient, and the foot arch and first MTP joint were used to quantify movement coordination as the windlass coefficient. The Foot Posture Index (FPI) and arch height index (AHI) were used to assess static foot alignment. A canonical correlation analysis was performed using the foot- and gait-related index group, and then a single-correlation analysis was performed. The canonical correlation analysis showed that a composite variable consisting of FPI, AHI, and the truss coefficient was related to the anterior GRF (A-GRF) and ankle power. The truss coefficient was positively correlated with A-GRF and ankle power, whereas the windlass coefficient was positively correlated with ankle power. Therefore, the truss and windlass coefficients can be used as indices to evaluate foot function, suggesting that maintaining foot stiffness and foot arch coordination with the first MTP joint is important for propulsion.

TREATMENT OF CLASS I MALOCCLUSION WITH MILD CROWDING AND MIDLINE SHIFT

ABSTRACT Background: The main goal of orthodontic treatment is to obtain a normal relationship of the teeth with facial structures and it is generally accepted that orthodontic treatment will have effects on facial proportion. Nowadays, facial appearance has a big influence on someone's appearance. Aesthetic facial appearance will produce a proportional, harmonious, and youthful facial profile. Case: this case report aims to describe that non extraction orthodontic treatment in class I malocclusion with mild crowding and mildline shift is a treatment with considerable success. Case management: A 19 years old female came with a chief complaint of crowding in upper and lower jaw. Intraoral examination revealed bilateral Class I molar and canine relationship. Patient had crowding in upper and lower jaw, and midline shift in lower jaw. Extra oral findings included a flat profile with competent lips. Cephalometric analysis showed skeletal class I with orthognati maxilla and mandible. Patient was bonded with 0.022-inch MBT brackets orthodontic appliance without extraction. After 20 months of treatment, an ideal arch coordination was achieved, the patient felt confident and satisfied with the treatment outcome. Conclusion: Decision to extract a tooth has to be made, not only by considering the amount of crowding, but also the eventual influence of orthodontic tooth displacement on the soft tissue surface of the face. Keywords: Crowding, Midline shift, Non – extraction.

“Spontaneous” correction capacity of skeletal Class II malocclusions in growing patients after upper and lower arch coordination using fixed appliances: A prospective controlled clinical study

ObjectiveTo determine the effect of arch coordination on the dentoskeletal jaw base relationship and the mandibular growth pattern in growing skeletal Class II patients. Materials and MethodsLeveling, aligning, and upper/lower arch coordination were done in 30 Class II/1 growing patients with preadjusted edgewise fixed appliances. After arch coordination was achieved without transverse discrepancy and occlusal interferences, the 6-month experimental passive observation period was started. The records were compared with 30 untreated patients who served as controls. The initial (T0) and post-coordination+observation (T1) cephalograms of two groups were analyzed and compared using standard cephalometric parameters, Pancherz analysis, and cranial base superimposition. ResultsSagittal maxillary growth in the treated group was slightly restricted, in turn resulting in a decrease in profile convexity. Mandibular sagittal growth did not differ between groups, but the mandible rotated posteriorly in the treated and anteriorly in the control group. The upper incisors were retroclined and retruded in the treated group, resulting in overjet reduction. The lower incisors were intruded in the treated group, leading to overbite reduction. The cephalometric superimposition over the stable structures of the anterior cranial base showed higher prevalence for the forward rotation with forward pogonion position and increased vertical dimension in the control group. ConclusionsUpper and lower arch coordination alone does not seem to affect mandibular growth; however, because of a posterior rotation of the mandible, it does affect the direction of mandibular growth in some patients, although not in the desired therapeutic direction. (ClinicalTrials.in.th: TCTR20170706003).

ISW Treatment for Skeletal Class III Malocclusion with Poor Arch Coordination

ISW Treatment for Skeletal Class III Malocclusion with Poor Arch Coordination

Orthodontic surgical management of a skeletal class III patient with laterognathia

This is a case report of a 17-year-old male patient, with previous orthodontic treatment, who was admitted to the orthodontics clinic for the correction of a skeletal class III malocclusion (Wits -11 mm) due to a combination of maxillary hypoplasia and prognathism that was aggravated by an excessive unilateral laterognathia by excessive unilateral mandibular growth. Dentally the patient presented a class III molar and canine relationship, anterior and bilateral posterior cross bite, and upper and lower crowding, lower midline deviation of 7 mm o the right. Treatment goals were: improve the facial profi le, establish a molar class I, canine class I, to achieve an adequate anterior guidance (overjet, overbite) and dental arch coordination. The treatment was performed in three phases: A) presurgical orthodontic phase: alignment and leveling, dental decompensation, correction of the curve of Spee, and coordination of the upper and lower arches. B) Surgical phase: 2 mm maxillary impaction and advancement of 5 mm; 7 mm mandibular retroposition with Dal Pont technique and a 4 mm advancement genioplasty to improve facial aesthetics. C) Postsurgical phase: detailing and settling of the occlusion, fi nal upper and lower arch correlation. The treatment was fi nished in a period of two years with a successful outcome.

Skeletal Class II division 1 malocclusion treated with twin-block appliance

A 10-year-old female presented with a skeletal Class II relation with 7 mm of overjet, 40% overbite, and bilateral posterior lingual crossbite. Two-phase therapy was planned to correct Class II skeletal relation, overjet, overbite, and to achieve lip competency. Phase I therapy was done with twin-block appliance to advance the retrognathic mandible. Phase II therapy was accomplished with fixed appliance for arch coordination to correct minor displacement and to finalize occlusion. Posttreatment, skeletal Class I relation was achieved. Incisors' inclination was improved, and ideal overjet and overbite with bilateral class I molar relationship was achieved. As the mandible advanced, lip competency, facial convexity, and mentolabial sulcus improved.

Premaxillary Repositioning in the Severe Form of Bilateral Cleft Lip and Palate.

Severe forms of bilateral cleft lip and palate remain a challenging issue. Although nasoalveolar molding dramatically improves overall treatment success, the position of the premaxilla often remains dislocated. The authors attempted to relocate the malpositioned premaxilla into the correct position to obtain the correct three-dimensional (3D) maxillary arch structure and growth. Eight patients with severe bilateral cleft lip and palate were treated with premaxillary osteotomy for premaxilla repositioning. The position of the premaxilla was measured directly using cephalometry. Two raters including orthodontists evaluated the 3D (anteroposterior, transverse, and sagittal) outcomes. Regarding the long-term effects of premaxillary repositioning on midfacial growth, 3D computed tomography scan data were used, including the measurement of the SNA, SNB, and ANB angles according to the time period (T0: preoperative; T1: immediate postoperative; T2: long-term postoperative). All bilateral cleft lips and palates were satisfactorily repaired without any complications, including any premaxillary vascular compromise, nonunion, and occlusal instability. The average visual analog scale scores (0-5) of the anteroposterior, vertical, and transverse dimensions were 3.9, 3.7, and 3.2, respectively. Regarding the effect of premaxillary repositioning on midfacial hypoplasia, the change in the ANB between T1 and T2 was not significant, implying that premaxillary repositioning did not affect the long-term harmony between the maxilla and mandible (ANB of T2-T1: P = 0.1016) based on interim growth data at the time of follow-up and study completion. Premaxillary repositioning effectively corrected the malpositioned premaxilla and repaired the accompanying wide alveolar cleft, achieving successful restoration of maxillary arch coordination. In addition, premaxillary osteotomy after 8 years of age does not seem to cause significant maxillary retrusion.

Orthodontic Management of A Girl With Class Ii Div-2 Malocclusion With Deep Bite & Crowding: A Case Report

We describe the treatment of a girl, age 18 years with Class II div-2 malocclusion with deep bite and crowding. Treatment consisted mainly of bite opening, 1st premolars extractions, canine retraction, arch co-ordination, leveling and alignment with Edgewise fixed appliances by multiloop technique. However the treatment resulted in Class I incisor relation with proper alignment of upper and lower anterior segment, an ideal overjet, overbite and incisor angulations.
 Ban J Orthod & Dentofac Orthop, April 2016; Vol-6 (1-2), P.29-34

European College of Orthodontics: Commission of affiliation and titularisation.

11.11 years; 5/2010. Molar Class II in a fairly brachyfacial setting; maxillary incisor alveolar retrusion, tendency to bimaxillary alveolar retrusion; TSALD; crossbite of 12/42 and almost a scissor bite at 24/34; incisor deep bite. Mixed dentition stage with persistence of 53-55-63-65-75-85 during early treatment. Teeth missing prior to treatment: none. Molar retraction, repositioning of 12, alignment and leveling; arch coordination and correction of the premolar quasi-scissor bite. Cl.II mechanics. Retention using bonded lingual wire on the 6 mandibular anterior teeth and maxillary splint. Extraction of the third molars. Appliances or methods: EOF; straightwire multibracket; Cl.II mechanics. Beginning of treatment: 12.4 years; 10/2010. B. 15.4 years; 10/2013. Twelve was repositioned. Dental Cl.I was achieved. The incisors were torqued. The deep bite was reduced. 36 months. C. POSTRETENTION RECORDS (1YEAR MINIMUM): 16.6 years; 12/2014. The molar occlusion remains stable. The patient must continue to wear his splint and keep the bonded wire. Extraction of the 3rd molars is scheduled. Date of end of retention: 12/2014. Duration of retention: 14 months.

Changes in Profile after Orthognatic Surgery in Skeletal Class III Patients

Background: Treatment of skeletal Class III malocclusion in growing patient with an anterior crossbite and open bite is challenging due to unpredictable results and potentially unfavorable growth. Growth modification in adult patients is not an alternative approach. Objective: Case report of a patient with Class III malocclusion in adult and anterior crossbite and open bite was treated with combine fixed appliances and orthognatic surgery. Treatment procedure: Treatment of anterior cross bite and open bite was completed in two phases. The first phase was to correct the dental alignment align and arch coordination with fixed orthodontic appliance. The second phase was to correct the skeletal discrepancy with orthognatic surgery. Conclusions: Orthognatic surgery is a good approach in treating anterior cross bite and open bite relating to skeletal problems in adult period. Changes in profile and occlusion were very obvious.

European College of Orthodontics

Summary Date of birth: 20/10/1989; sex: female. A. Pretreatment documents (11/2001; 12 yrs 1 m). Diagnosis Class II, Division 2. Treatment Multi-bracket without extractions, with headgear, for alignment, levelling, incisor intrusion, Class II elastics, arch coordination, interdigitation, finishing and retention. B. Post-treatment documents (1/2004; 14 yrs 3 m). Retention Tooth positioner; wire bonded lingually from 33 to 43. C. Documents at end of retention (5/2005; 15 yrs 7 m).

Effect of rapid maxillary expansion on sleep characteristics in children.

Introduction:Rapid maxillary expansion (RME) is an orthopedic treatment procedure routinely used to treat constricted maxillary arches and also a potential additional treatment in children presenting with sleep-disordered breathing (SDB).Aims and Objectives:The main objective of this study was to evaluate the effects of RME on sleep characteristics in children.Materials and Methods:Polysomnography was done on children of 8-13 years of age before expansion (T0), after expansion (T1) and after a period of 3 months after retention (T2). Bonded rapid maxillary expander was cemented in all children. Inter-molar distance was also measured at T0 and T2.Statistical Analysis:Nonparametric Friedman test was used for comparing the averages of sleep parameters at different time period (T0, T1, T2). Wilcoxon signed ranks test was used for comparing the averages of inter-molar width (T0-T2). P < 0.05 were considered as significant.Results:All children showed an improvement in sleep parameters with an increase in sleep efficiency, decreased in arousal and desaturation index after expansion. Total sleep time showed a statistically significant increase after expansion. A statistically significant increase in inter-molar distance was obtained after expansion.Conclusions:Rapid maxillary expansion is a useful treatment option for improving quality of sleep even in normal children without SDB. It also induces widening of the maxilla, corrects posterior crossbites and improves maxillary and mandibular dental arch coordination.

Arch Coordination Does Not Affect the Stability in Class III Orthognathic Surgery Patients

The purpose of this study was to evaluate if the arch coordination manifested by preorthodontics had an effect on the short-term stability after orthognathic surgery by evaluating the B point, menton, overjet, and overbite. The subjects were 10 healthy adult female and male Koreans (mean age, 24.9 years) with insufficient arch coordination and 10 healthy adult female and male Koreans (mean age, 22 years) with sufficient arch coordination. All subjects had sagittal split ramus osteotomy with 1-piece maxillary Le Fort I surgery with/without genioplasty done from the same practitioner at Kyung Hee University Hospital at Gangdong from 2009 to 2011. All arch widths of the maxilla and mandible were measured. Cephalometric tracings of the subjects were made of the presurgical and postsurgical period with a follow-up at 3 months. Relapse was measured according to cephalometric tracing changes using the V-ceph Cephalometric Analysis Software version 5.5(Osstem, Seoul, South Korea). Insufficient arch coordination did not definitively affect the overall treatment outcome. There was significant difference in the horizontal dimensions of the mandible (vertical plane to point B, overjet) in the study group. The study group showed instability in orthodontic factors, whereas skeletal factors were stable. Vertical dimensions (horizontal plane to point B, horizontal plane to menton, overbite) were not statistically significant.

Evaluation of dental and basal arch forms using cone-beam CT and 3D virtual models of normal occlusion

Abstract Objectives: To evaluate the relationship between the mandibular dental and basal arches using CBCT, and to assess the correlation between basal arch dimensions derived from CBCT and 3-dimensional (3D) virtual models in a cohort sample exhibiting normal occlusions. Methods: The facial axis (FA) and root centre (RC) points of mandibular teeth were identified on 32 CBCT images. FA and WALA points were digitised on 3D models of 28 mandibular casts from the same sample. The relationships between dental and basal arch dimensions, and between the two basal depth dimensions derived from RC and WALA points were statistically assessed by Pearson’s correlation. Results: Strong correlations were found between dental and basal intercanine and intermolar arch widths. Also, the basal intercanine width showed a moderate correlation with dental intermolar width and depth. The basal intercanine and intermolar widths measured on 3D models showed moderate correlations with those measurements on CBCT, whereas the basal canine and molar depths showed no correlations. Conclusions: The dental and basal anterior and posterior arch widths were strongly correlated in normal occlusion. No correlations were found between the arch depths measured from WALA points and RC points. Hence, RC points may represent more useable landmarks compared to WALA points in the evaluation of basal arch forms. It is recommended that the relationship between the dental and basal arches is evaluated during treatment planning in order to improve arch co-ordination.

Surgery-First Approach in Class III Open-Bite

Recently, surgical-orthodontic treatment without preoperative orthodontic treatment (known as the surgery-first approach or SFA) has been proposed to improve facial aesthetics from the beginning of treatment, to shorten the entire treatment period, and to take advantage of the regional accelerated phenomenon for orthodontic tooth movement. The SFA concept involves the prediction and simulation of dental alignment, incisor decompensation, and arch coordination using manual setup models. Based on this, decisions regarding the surgical movement of the maxilla and mandible can be made to correct skeletal discrepancies through manual model surgery (MMS). Although several three-dimensional (3D) virtual model surgery (VMS) programs have been introduced to reduce time-consuming manual laboratory procedures and potential errors, these programs still require three-dimensional-computed tomography data and involve complex computerized maneuvers. Because it is difficult to acquire 3D-computed tomographic scans in all cases, a 2.5-dimensional VMS program using two-dimensional lateral and posteroanterior cephalograms and 3D virtual dental models (3Txer version 2.5; Orapix, Seoul, Korea) has been introduced. In addition, because accurate prediction of postoperative orthodontic treatment is crucial for controlling dental alignment, incisor decompensation, arch coordination, and occlusal settling, a new 3D virtual orthodontic treatment system that can construct 3D virtual models, execute a 3D virtual setup, place virtual brackets at predetermined positions, and fabricate transfer jigs with customized bracket base for indirect bonding using a stereolithographic technique has also been developed. The purpose of this article was to introduce the methodology of 2.5-dimensional VMS and 3D virtual postoperative orthodontic treatment using a stereolithographic technique in SFA for a class III open-bite case.

The ‘acrylic technique’ to check arch coordination in orthognathic surgery patients

t p o t i m s b r rch coordination is one of the most important preparatory equirements for orthognathic surgery, the objective being o make certain that the maxillary and mandibular dental rches will fit together well at the time of surgery, with coresponding arch forms and good labial and buccal segment nterdigitation. Inadequate arch coordination can jeopardize he quality of the surgical result. Clinical evaluation of arch coordination can be difficult. n Class II malocclusions, the patient may be asked to posture

Surgery-First Approach in Skeletal Class III Malocclusion Treated With 2-Jaw Surgery

The purpose of this study was to evaluate the surgical movement and postoperative orthodontic treatment (POT) of the surgery-first approach for the correction of skeletal class III malocclusion. The samples consisted of 11 patients with skeletal class III malocclusion who underwent nonextraction treatment and 2-jaw surgery (Le Fort I osteotomy impaction of the posterior maxilla, IPM; bilateral sagittal split ramus osteotomy setback of the mandible). The wafer was removed 4 weeks after surgery. Mean (SD) durations of POT and total treatment were 8.91 (3.14) and 12.18 (3.57) months, respectively. Lateral cephalograms were obtained during the initial examination (T0), immediately after surgery (T1), and after debonding (T2). Sixteen variables were measured. Paired t-test was performed for statistical analysis. The maxilla rotated clockwise, and the nasolabial angle increased by IPM (FH-palatal plane angle, FH-occlusal plane angle, P < 0.01; nasolabial angle, P < 0.05) and well maintained during POT. The mandible was repositioned backward by bilateral sagittal split ramus osteotomy setback of the mandible (SNB, Pog-N perp, P < 0.001) and relapsed forward during POT (SNB, P < 0.01; Pog-N perp, P < 0.05). U1-SN decreased by IPM (P < 0.001) and relapsed labially owing to class III mechanics during POT (P < 0.01); eventually, no significant difference was found between T0 and T2 stages. Although IMPA increased by POT, there was no significant difference between T0 and T2 stages. The mandible seems to relapse forward immediately after wafer removal and before labioversion of the lower incisors. Accurate prediction of POT is crucial in controlling dental alignment, incisor decompensation, arch coordination, and occlusal settling. Long-term wearing and selective grinding of the wafer for labioversion of the lower incisors and use of miniplates/miniscrews to control the inclination of the upper incisor and to prevent relapse of the mandible are needed.

La technique linguale straight wire

The mushroom arch-wire is mainly used in lingual orthodontic treatment but the complicated wire bending it requires affects both the treatment results and the time spent at the chair. The author proposes a new lingual straight wire method (LSW) in order to facilitate arch coordination and simplify the mechanics. The attention paid to the set-up model and bracket positioning and bonding plus the use of the new LSW method will also improve patient comfort.

Overjet at the Anterior and Posterior Segments: Three-Dimensional Analysis of Arch Coordination

To compare the amounts of anatomical overjet measured from facial axis (FA) points with the amounts of bracket overjet measured from bracket slot center (BSC) points. The samples consisted of 27 subjects with normal occlusion whose models were fabricated with a three-dimensional (3D) scanner and the 3Txer program (Orapix Co Ltd, Seoul, Korea). 3D virtual brackets (0.022'' Slot, MBT setup, 3M Unitek, Monrovia, Calif) constructed with a 3D-CAD program were placed on an FA point with the 3Txer program. The arch dimension and the amounts of overjet from FA and BSC points were measured. Paired t-tests and analysis of variance (ANOVA) tests were used for statistical analysis. No significant difference in arch width and depth was observed between FA and BSC points. Although the amounts of overjet measured from FA points showed homogenous distribution, a tendency to decrease from the anterior segment (2.3 mm) to the posterior one (2.0 mm) was noted. However, the amounts of overjet measured from BSC points were variable, especially in the premolar and molar areas. Significant discrepancies in the amounts of overjet in most of the areas between FA and BSC points (more than P < .05), except the lower second premolar and second molar areas, were reported, even though insets and offsets are part of the prescription for the base of straight-wire appliance (SWA) brackets. The hypotheses that the amount of overjet measured from BSC points was 3 mm through the whole segments and that distribution of the amounts of overjet from BSC points was the same as that from FA points were rejected.