Orthodontic Camouflage Treatment Research Articles

Surgical and Camouflage Orthodontic Treatment of Anterior Open Bite: Comparison of Profile Attractiveness.

To evaluate the profile's attractiveness between the different protocols for treating the anterior open bite. The sample comprised 39 patients with anterior open bite treated with or without extractions, divided into two groups: The surgical group (G1) comprised 21 subjects (10 males, 11 females) with a mean initial age of 21.86 years (SD = 5.09), treated with fixed orthodontic appliance followed by orthognathic surgery, for a total mean period of 2.53 years (SD = 0.61). The mean overbite was -5.01 mm (SD = 2.50); The camouflaged group (G2) comprised 18 subjects (9 males, 9 females), with a mean initial age of 20.47 years (SD = 4.19), treated only with fixed orthodontic appliance, for a total mean period of 2.56 years (SD = 0.94). The mean overbite was -4.28 mm (SD = 1.15). Lateral photographs from pretreatment and posttreatment were used. These photographs were evaluated by 46 laypeople and 67 dentists, who rated the attractiveness of each profile from 0 (most unattractive profile) to 10 (most attractive profile). Intergroup comparisons were performed with independent t-tests. Both groups presented improvement in the profile attractiveness with treatment (p < 0.001). Before treatment, the profile of the surgical group was significantly less attractive than the profile of the camouflaged group (p < 0.001). The surgical presented a more attractive profile at the final stage than the camouflaged group (p < 0.001). The surgical group showed a greater improvement in profile attractiveness with treatment than the camouflaged group (p < 0.001). In the final stage, the surgical presented a more attractive and greater improvement in profile attractiveness than the camouflaged group. The laypeople and dentists judged similarly the initial profile attractiveness.

Active vertical control with skeletal anchorage for optimizing facial profile in a severe Class II high-angle protrusion case.

This case report describes the nonsurgical management of a patient with a Class II skeletal pattern, retrognathic mandible, steep mandibular angle, maxillary vertical excess, and lip incompetence. The treatment approach involved orthodontic mechanics supported with skeletal anchorage to achieve maximal intrusion and retraction of the dentition. A novel elastic hanging rack appliance, supported by midpalatal miniscrews, was used. A maximal anchorage setup for active vertical control on both arches was illustrated. Significant improvement in the facial profile was achieved with optimal occlusion. Cephalometric analysis revealed successful incisor retraction and intrusion, as well as a forward rotation of the mandible. The treatment outcome illustrates the impact of active vertical control on orthodontic camouflage treatment for severe protrusion.

Evaluation of the facial profile of skeletal Class III patients undergoing camouflage orthodontic treatment: a retrospective study.

To identify objective metrics for evaluating the esthetics of facial profiles in skeletal Class III patients undergoing camouflage orthodontic treatment. Eighty Asian-Chinese patients classified as skeletal Class III were included. Thirty cephalometric measurements of pre- and posttreatment cephalograms were analyzed. Ten orthodontists assigned visual analog scale (VAS) scores to the pre- and posttreatment profiles based on standardized lateral photographs. Correlations between subjective VAS scores and objective measurements were assessed using Pearson correlation and stepwise multiple linear regression analysis. Lower incisor (L1) protrusion, nasolabial angle, lower lip-E line distance, SNB angle, and L1 to AP plane were significantly correlated with VAS scores of pretreatment profiles of skeletal Class III patients. Factors such as retraction of the lower incisor, increased interincisal angle and overjet, reduction of lower lip-E line distance, as well as augmentation of the Z angle and nasolabial angle were significantly correlated with the changes in VAS scores post-camouflage orthodontic treatment. Stepwise multiple linear regression analysis revealed that pretreatment nasolabial angle, changes in the lower lip-E line distance, and pretreatment Pog-NB distance were the key factors influencing the posttreatment facial profile esthetics of skeletal Class III patients with camouflage orthodontic treatment. Several cephalometric measurements correlate with subjective facial esthetic evaluations of skeletal Class III patients. Changes in lower lip prominence, the pretreatment nasolabial angle, and Pog-NB distance are the main factors related to facial esthetics in skeletal Class III patients after camouflage orthodontic treatment.

Orthodontic camouflage treatment of a hyperdivergent adolescent patient with anterior open bite and TMD: a case report

BackgroundIn orthodontics, anterior open bite is a common malocclusion that recurs frequently. Because the causes of anterior open bite are so varied, medical professionals must create customized treatment programs for each patient based on their unique etiology. Through the lowering of the posterior teeth, closure of the anterior teeth gap, and cooperation with intermaxillary traction, the treatment plan outlined in this case study sought to achieve a stable occlusion.Case presentationThis case report aims to describe an orthodontic camouflage treatment of a 15-year-old female patient with anterior open bite, arch width discrepancy and a history of temporomandibular joint disorder. The patient was treated with intermaxillary vertical elastics and the multiple edgewise arch wire (MEAW) approach. A satisfactory occlusion with a neutral molar relationship was attained after 29 months of orthodontic therapy. The condylography recording showed that this patient’s occlusion tended to be more stable both before and after our treatment. The purpose of this case study is to provide an overview of an orthodontic camouflage treatment for a female patient, who had a history of temporomandibular joint disease, anterior open bite, and arch width disparity.ConclusionsOur results demonstrated that more attention should be paid to levelling the occlusal plane, intrusion of the molars, decompression of temporomandibular joints and the etiology factors of malocclusion during the orthodontic period for those patients with anterior open bite.

Quantitative evaluation of vertical control in orthodontic camouflage treatment for skeletal class II with hyperdivergent facial type

BackgroundIn this study, we sought to quantify the influence of vertical control assisted by a temporary anchorage device (TAD) on orthodontic treatment efficacy for skeletal class II patients with a hyperdivergent facial type and probe into the critical factors of profile improvement.MethodsA total of 36 adult patients with skeletal class II and a hyperdivergent facial type were included in this retrospective case–control study. To exclude the effect of sagittal anchorage reinforcement, the patients were divided into two groups: a maxillary maximum anchorage (MMA) group (N = 17), in which TADs were only used to help with anterior tooth retraction, and the MMA with vertical control (MMA + VC) group (N = 19), for which TADs were also used to intrude the maxillary molars and incisors. The treatment outcome was evaluated using dental, skeletal, and soft-tissue-related parameters via a cephalometric analysis and cast superimposition.ResultsA significant decrease in ANB (P < 0.05 for both groups), the retraction and uprighting of the maxillary and mandibular incisors, and the retraction of protruded upper and lower lips were observed in both groups. Moreover, a significant intrusion of the maxillary molars was observed via the cephalometric analysis (− 1.56 ± 1.52 mm, P < 0.05) and cast superimposition (− 2.25 ± 1.03 mm, P < 0.05) of the MMA + VC group but not the MMA group, which resulted in a remarkable decrease in the mandibular plane angle (− 1.82 ± 1.38°, P < 0.05). The Z angle (15.25 ± 5.30°, P < 0.05) and Chin thickness (− 0.97 ± 0.45°, P < 0.05) also improved dramatically in the MMA + VC group, indicating a better profile and a relaxed mentalis. Multivariate regression showed that the improvement in the soft tissue was closely related to the counterclockwise rotation of the mandible plane (P < 0.05).ConclusionsTAD-assisted vertical control can achieve intrusion of approximately 2 mm for the upper first molars and induce mandibular counterclockwise rotation of approximately 1.8°. Moreover, it is especially important for patients without sufficient retraction of the upper incisors or a satisfactory chin shape.

Orthognathic surgery: a significant tool for reassessment

More than 15years of experience in orthodontic-surgical collaboration has allowed the authors to identify some situations in which a new perspective is needed. Although it may seem easy to refer a patient to a maxillo-facial surgeon in cases of major dysmorphoses, this can lead to yet other dilemmas: a loss of results at the end of a developmental growth stage, an adult requesting a return to treatment after a camouflage orthodontic treatment or a non-cooperative child in an interceptive and preventive treatment phase. Then, a comprehensive process of reassessment becomes compulsory. In the form of an editorial, this article describes various cases encountered in the authors' practice. The aim is not to point out the imperfections of our humanity, but simply to open our eyes to diagnostic elements that are missed, whether in the initial phase or during reassessment. As it is far from ideal to keep offering similar therapies that lead to the same pitfalls, it is time for a shift in the paradigm.

TADS assisted camouflage orthodontic treatment of class ii malocclusion in a non-growing patient- A case report

In individuals with Class II malocclusions, there is an anteroposterior discrepancy between the maxillary and mandibular dentitions, which may or may not be accompanied with a skeletal discrepancy, the most effective treatment option to eliminate is by modified three-piece base arch combined with TADS for simultaneous deep bite correction and en masse retraction.The present case report showcases the treatment results and biomechanics involved for en masse retraction and intrusion of anterior teeth using three-piece intrusion arch and temporary anchorage device.The modified three-piece base arch combined with TADS is effective in controlled translation and intrusion of anteriors and would be a preferable mechanotherapy in low angle case with deep bite, proclined anteriors and Class II malocclusion.

Orthodontic treatment of an open bite after splint therapy for a patient with idiopathic condylar resorption

In the treatment of orthodontic patients with idiopathic condylar resorption, symptoms of temporomandibular joint disorders and constantly changing occlusions caused by an instability of mandibular position make it difficult for orthodontists to confirm definitive orthodontic diagnosis and treatment plans. Therefore, these patients' temporomandibular joint (TMJ) structures need to be stabilized with splint therapy before active tooth movement to identify and maintain the true mandibular position. For some idiopathic condylar resorption patients, orthognathic surgery can cause further resorption on the vulnerable condyles of the mandible; thus, effective orthodontic camouflage treatment after joint stabilization should be considered. During the orthodontic camouflage treatment, adverse loads on the TMJ structures, which could change the position of condyles, should be avoided, and TMJ-friendly mechanics must be applied.

Perceived Effects of Orthognathic Surgery versus Orthodontic Camouflage Treatment of Convex Facial Profile Patients.

Increased facial profile convexity has a common occurrence in the population and is a primary reason for seeking orthodontic treatment. The present study aimed to compare the perceived changes in facial profile appearance between patients treated with combined orthognathic/orthodontic treatment versus only orthodontic camouflage treatment. For this reason, 18 pairs of before- and after-treatment facial profile photos per treatment group (n = 36 patients) were presented to four types of assessors (surgeons, orthodontists, patients, laypeople). Ratings were recorded on 100 mm visual analogue scales depicted in previously validated questionnaires. All rater groups identified minor positive changes in the facial profile appearance after exclusively orthodontic treatment, in contrast to substantial positive changes (14% to 18%) following combined orthodontic and orthognathic surgery. The differences between the two treatment approaches were slightly larger in the lower face and the chin than in the lips. The combined orthodontic and orthognathic surgery interventions were efficient in improving the facial appearance of patients with convex profile, whereas orthodontic treatment alone was not. Given the significant influence of facial aesthetics on various life aspects and its pivotal role in treatment demand and patient satisfaction, healthcare providers should take these findings into account when consulting adult patients with a convex facial profile.

Class III orthodontic camouflage: A case of non-growing patient using conventional appliances

This case report details the successful orthodontic camouflage treatment of a 21-year-old female with Angle's Class III malocclusion, characterized by skeletal and dental features. The patient opted against orthognathic surgery and, instead, underwent mandibular first premolar extraction for camouflage treatment. The case highlights the careful consideration of treatment options, including the decision to maintain a Class III molar relationship. The treatment achieved satisfactory results in skeletal, dental, and soft tissue aspects, demonstrating the viability of camouflage treatment for mild to moderate Class III malocclusions. The absence of established guidelines underscores the importance of personalized treatment planning for such cases.

Outcome differences after orthodontic camouflage treatment in hypo- and hyperdivergent patients – A retrospective cephalometric investigation

ObjectivesTo compare differences in outcome in skeletal and dental parameters in hypo- and hyperdivergent Class II patients after extraction of upper first premolars and comprehensive orthodontic treatment.Materials and methods37 Class-II-patients with dental camouflage treatment were divided into a hypo- (n = 18) or a hyperdivergent (n = 19) group depending on the mandibular plane angle (hypo: < 34° or hyper: ≥ 34°). Lateral cephalograms were available before (T1) and after (T2) treatment and were analyzed with customized measurements. Data from a growth survey served as a control and were used to calculate the actual treatment effect. Data were analyzed by one-sample Student’s t-tests and independent Student’s t-tests. Statistical significance was set at p < 0.05.ResultsThe measurements showed similar changes in both groups. The effects were mainly dentoalveolar. Hypodivergent patients showed an almost equal increase in anterior and posterior facial height, while hyperdivergent patients only showed an increase in anterior facial height.ConclusionsIn hyperdivergent patients, the anterior facial height increases despite camouflage treatment. This indicates a tendency towards bite opening and backward rotation of the mandible. Hypodivergent patients do not experience deepening of the bite.Clinical relevanceIn hyperdivergent patients with upper first premolars extraction the anterior facial height increased differently than in hypodivergent patients. This should be considered if a bite opening is a possible contraindication to treatment.

Re-Orthodontic Treatment Combined with Orthognathic Surgery in an Adult Class III Malocclusion Patient Undergone Camouflage Orthodontic Treatment

Re-Orthodontic Treatment Combined with Orthognathic Surgery in an Adult Class III Malocclusion Patient Undergone Camouflage Orthodontic Treatment

Orthodontic Camouflage Treatment of Skeletal Class III Patient with Transverse Discrepancy and Congenital Missing of Lower Second Premolars

Orthodontic Camouflage Treatment of Skeletal Class III Patient with Transverse Discrepancy and Congenital Missing of Lower Second Premolars

Quantitative Analysis for Effect of Orthodontic Treatment on Body Posture and Its Correlation With Cervical Posture in Skeletal Class II Malocclusion – A Clinical Study

AIM: To quantitatively evaluate and compare the body posture and its correlation with cervical posture and plantar pressure in subjects with skeletal class II malocclusion, before and after camouflage orthodontic treatment. MATERIALS AND METHODS: 18 subjects were considered for the study and subjected to lateral cephalograms and body posture analysis before and after camouflage orthodontic treatment. Cranio-cervical angles were compared before and after treatment using paired T test. A force platform was designed to accommodate the feet with pressure sensors placed at hallux, first metatarsal and medial calcaneus regions to record the loading pressure. The plantar pressure distribution values were correlated with the cranio-cervical angles. RESULTS: There is statistically significant difference (p value &lt;0.05) in the ANB angle, GoGn/OPT angle between pre and post camouflage orthodontic therapy indicating over extension of the head over the spinal column. Post treatment Pearson correlation coefficient indicates that the cervical curvature (OPT/CVT angle) has a negative correlation with the plantar pressure at medial calcaneus region. However, high statistical significance was found in the plantar pressure distribution before and after orthodontic treatment at all three regions. CONCLUSION: Cervical curvature increased after camouflage orthodontic therapy, indicating over extension of the cervical spine. Plantar pressure reduced in the hallux, first metatarsal and medial calcaneus regions. The recorded value at the hallux region elicited considerable reduction indicating a shift in the plantar pressure from the most anterior region to the central region.

Class III Malocclusion Camouflage Treatment Using a Conventional Orthodontic Appliance in a Non-Growing Patient

The treatment of skeletal and dental Class III malocclusions is a challenge for orthodontists, and one of the treatment alternatives for a non-growing patient is orthodontic camouflage treatment. Different approaches may result in different outcomes; therefore, a proper diagnosis and treatment plan are needed to avoid undesirable effects. In this case, a 21-year-old female patient presented with a skeletal Class III malocclusion, with a normal maxilla, prognathic mandible, moderate crowding, and an acceptable facial profile. The treatment modality for orthodontic camouflage treatment was a conventional orthodontic appliance with the extraction of mandibular first premolars to resolve crowding. At the end of the treatment, a Class I canine and incisor relationship was achieved while maintaining a Class III molar relationship. After 25 months of treatment, the patient had a more pleasant smile with improved functional occlusion.

Improved Super-elastic Ti-Ni Alloy Wire for Nonsurgical Treatment of Skeletal Class III Malocclusion Combined with Anterior Crowding and Anterior Crossbite Case

The article reported the use of improved super-elastic Ti-Ni alloy wire (ISW), which was developed by Tokyo Medical and Dental University, to correct a case of skeletal Class III malocclusion combined with anterior crowding and anterior crossbite. An 18-year-old male with a chief complaint of poor dental alignment and protruded lower incisors showed up in our clinic for treatment. Clinical examination revealed skeletal Class III facial profile. Anterior crowding and anterior crossbite could be also noted. Because the patient refused orthognathic surgery, we tried camouflage orthodontic treatment. First, we used ISW crossbite arch to eliminate the anterior interference in order to observe the change of the mandibular position. After that, we use ISW multiloop edgewise arch wire (MEAW) technique and intermaxillary elastics to achieve midline correction and adequate overjet with the bite raising process. The treatment was finished with the improvement of facial appearance and a stable occlusion.

Non-Surgical Camouflage Treatment of a Skeletal Class III Patient with Anterior Open Bite and Asymmetry Using Orthodontic Miniscrews and Intermaxillary Elastics

This case report presents the non-surgical orthodontic camouflage treatment of an 18-year-old male patient with skeletal Class III asymmetry and severe anterior open bite. The anterior open bite was corrected by extrusion of the maxillary and mandibular anterior teeth and clockwise and counterclockwise rotation of the maxillary and mandibular occlusal plane, respectively, using intermaxillary Class III elastics between the maxillary posterior buccal miniscrews and mandibular canines and anterior vertical elastics between the maxillary and mandibular canines. Class III dental relationships and dental asymmetry were corrected via unilateral distalization of the mandibular dentition on the left side using a closed coil spring between the buccal shelf screw and hook. The patient’s smile esthetics and dental relationship were improved with a more favorable facial profile, and facial asymmetry was slightly alleviated after orthodontic camouflage treatment. The total treatment time was 15 months. A modified wraparound retainer with a scalloped labial bow, tongue crib, and tooth positioner was used simultaneously to prevent the potential relapse.

The Lower Lip Profile Change During Total Distalization of the Mandibular Dentition

Objectives: This study aimed to determine the factors influencing the lower lip profile during Class III lower total arch distalization camouflage treatment. Methods: The cohort included 45 patients diagnosed with skeletal class III malocclusion. These patients underwent camouflage orthodontic treatment with lower arch total distalization. Lateral cephalograms were taken at the pretreatment and posttreatment stages. Cephalometric measurements were analyzed to unravel the influencing factors of the lower lip profile. This study defined new variables, i.e., CK and CKA, for detailed soft tissue analysis. Results: Novel soft tissue measurements presented in this study showed statistically significant changes after treatment. The CK angle and L1 to A Pog, L1 to NB, and IMPA were statistically correlated. Simple regression analysis was performed between variables. The formula was ΔCKA = 0.79(Δ L1 to NB) -1.6, and multiple regression resulted in ΔCKA = 0.5(Δ L1 to NB) – 0.42 (‘LL to Eline’, before treatment). Conclusion: The present study provided evidence that the lower lip evaluations, including the novel CKA and CKHA, were significantly related to the mandibular incisor position during total distalization of the mandibular dentition. The results demonstrated that clinically significant lip retraction could be obtained. Therefore, non-extraction with distalization must be suggested as the first treatment option in mild skeletal class III malocclusion patients.

Interdisciplinary orthodontic camouflage treatment with extraction of fractured maxillary central incisor and tooth substitution to treat skeletal bimaxillary protrusion- A case report

Malformed or fractured central incisors with poor prognosis could be the choice of teeth for extraction when space is required for orthodontic treatment. This case report refers to a 14-year-old girl who had a fractured upper left central incisor associated with bimaxillary protrusion. She expressed her concern to correct her dental appearance and enhance her smile aesthetics. The patient had class I malocclusion with bimaxillary proclination and severe crowding in the lower arch. Due to the increased space requirement, extraction of teeth was required as part of orthodontic treatment. Patient had a class 2 skeletal profile with prominent upper front teeth and therefore increased space requirement in the upper arch in order to retract the prominent teeth to achieve favourable aesthetics. The choice of teeth for extraction were 14,34,44 and 21. In the second quadrant the central incisor was extracted due to its poor prognosis, and the lateral incisor, canine and first premolar were substituted for the central incisor, lateral incisor and canine respectively. In the lower dental arch the first premolars were extracted. The end of treatment objectives- class 1 molars, canines, incisors were achieved with greatly improved smile aesthetics. KEYWORDS Interdisciplinary orthodontics, Teeth substitution, Poor prognosis, Incisor extraction.

Non-Surgical Treatment of Class II Division 1 Malocclusion in an Adult Patient with a Missing Lower Lateral Incisor Tooth: A Case Report

Class II Division 1 malocclusion is clinically more widespread than any other form of malocclusion and can be managed in a variety of ways, taking into account variables such as patient compliance, age, and anteroposterior disparity. Orthodontic camouflage treatment, aimed at masking the underlying skeletal discrepancy, is an acceptable option for most patients. This typically involves the extraction of two maxillary premolars in cases without mandibular arch crowding, or the extraction of two maxillary and two mandibular premolar teeth when crowding is present. The present case report aimed to discuss the successful treatment of a unique case involving a 19-year-old adult female patient with Class II Division 1 malocclusion, a missing mandibular left lateral incisor, and an overjet of 7 mm. Since the patient declined surgical and prosthetic treatment, an alternative, novel, and unorthodox method of camouflage treatment was employed, which involved the extraction of maxillary first premolars combined with symmetrical incisor space closure. The achieved treatment outcomes included a functionally and aesthetically acceptable occlusion, reduced overjet, and an improved soft tissue profile.