Camouflage Treatment Research Articles

Combined Use of Retraction and Torque Arch with Mini-Screws: A Cephalometric Study

Our objective was to investigate and quantify the treatment of micro-implant-aided retraction and torque (R&T) arch on dentofacial structures. Twelve patients (mean age 21.2 years) who required orthodontic camouflage treatment were included in the study. Following the canine distalization, mini-screws were placed between maxillary first molars and second premolars, and R&T arch was applied for the retraction of incisors. The vertical retraction arms of the arch were adjusted between the apex of the lateral incisor and the alveolar bone so that the retraction force passed through the center of resistance of four incisors and forced the incisors to bodily retraction. Closed coil-springs applying 150 gr of force were used to retract the incisors. The retraction period lasted for 217±34 days. SNA and NV-A decreased (p<0.05), indicating alveolar bone remodeling around Point A. The reduction in the SNA caused a statistically significant decrease in the ANB (p<0.01). SN/1, NA/1, NA-1, and overjet decreased significantly (p<0.01), depending on the retrusion of the incisors. The distances from the apex and incisal point of the central incisor to the SV reference plane also decreased significantly (p<0.01), revealing a nearly parallel movement of the incisors. Anchorage loss of the molars and decrease in nasolabial angle were not significant (p>0.05). A combined use of R&T arch with mini-screws is an effective method to retract the incisors without anchorage loss. The type of movement is nearly parallel.

Vertical control with TADs: Procedures and protocols

Treatment of the vertical dimension of the face is one of the most challenging areas in orthodontics. The vertical disparities manifests either as deep overbite or open bite and the skeletal and dentoalveolar component defining the discrepancy are subjected to a myriad of arrangement. The treatment for skeletal vertical problems in nongrowing individuals includes dentoalveolar camouflage or orthognathic surgery. The advent of temporary anchorage devices has augmented the scope of camouflage treatment. The simplicity of the clinical procedure in the placement of TADs has rendered it a popular choice for controlling the anchorage; however, the biomechanical variations associated with its use are quite difficult and challenging. The aim of this article is to emphasize the protocols and procedures involved in using TADs for controlling the vertical dimension. The state of the current evidence in terms of treatment outcome and stability is presented.

Assessment of the Effect of Simulated Rhinoplasty and Genioplasty on the Facial Profile Attractiveness of Patients with a Convex Face

This study was performed to evaluate the effect of rhinoplasty and genioplasty on facial profile attractiveness assessed by orthodontists and laypersons. In this study, posttreatment cephalo-grams of 30 class II patients with convex profile and nasal hump who had undergone camouflage treatment were traced. These profile outlines were modified by computer software to simulate rhinoplasty and genioplasty. Then, all these outlines were converted into silhouettes. There were four groups: no modification, rhinoplasty (R), genioplasty (G), and rhinoplasty plus genioplasty (RG). Esthetic assessment of all patients was done by two panels: six orthodontists and six laypersons. Data were analyzed using Friedman's and Wilcoxon's test with a significance level of 0.05. The highest mean esthetics scores belonged to RG (3.9 ± 0.6), followed by R (3.5 ± 0.5), G (2.4 ± 0.5), and the initial image of the patients (2.13 ± 0.5). There was a significant improvement following all surgeries as determined by all evaluators (p < 0.001), except for orthodontists who did not find genioplasty more esthetic than no modification (p = 0.139). The mean score of esthetics by orthodontists was more than laypersons in all groups (p > 0.05). Both rhinoplasty and genioplasty improved the attractiveness of the patients' facial profiles. The greatest improvement in the facial profile attractiveness in convex faces was observed after simultaneous nasal hump elimination and chin argumentation procedures. Although both rhinoplasty and genioplasty could improve patients' profile, the best result is achieved when combination of them is used for treatment of convex facial profile patients.

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Camouflage treatment of Angle's Class III malocclusion in a young adult

A case report is presented of a class III malocclusion with a class III skeletal pattern with prognathic maxilla and mandible in relation to cranium and prognathic mandible in relation to maxilla. The smile was unesthetic as there was a generalised spacing and the maxillary teeth were retroclined and mandibular proclined with more exposure of mandibular teeth. Camouflage treatment was carried out by closure of all the spaces and correcting anterior crossbite.

Correction of Class II Malocclusion with Skeletal Deep Bite

ABSTRACT Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetics, functionality, and stability. Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Insertion of fixed functional appliance was not possible due to prominent root apices and thin mandible cortical plates. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion. How to cite this article Kumar D, Singh V, Solanki R, Sharma R, Yadav A. Correction of Class II Malocclusion with Skeletal Deep Bite. Int J Clin Dent Res 2017;1(1):32-36.

Camouflage treatment of a skeletal class III malocclusion with tooth transposition using a non-surgical approach: case report

Treatment of class III malocclusion in growing subjects is achallenging part of contemporary orthodontic practice. Many treatment approaches can be found in the literature regarding orthopedic, orthodontic treatment or even surgery for class III malocclusions. We present a case report of a 12-year-old male patient, skeletal class III who was treated with Edge-Wise appliances. Treatment was successful with the need of neither extractions nor surgery. There was a tooth transposition of a premolar and maxillary canine. We usedintermaxillary elastics to correct the anterior crossbite. The objective of this clinical case is to demonstrate the importance of knowledge in the management of the patient at appropriate ages, as well as of the apparatology and auxiliaries in orthodontics for each particular case.Favorable results were obtained, obtaining bilateral class I molar and canine, as well as complete uncrossing of the anterior bite assisted with dental camouflage.

Unpredictability of soft tissue changes after camouflage treatment of Class II division 1 malocclusion with maximum anterior retraction using miniscrews.

To compare soft and hard tissue responses based on the degree of maxillary incisor retraction using maximum anchorage in patients with Class II division 1 malocclusion. This retrospective study sample was divided into moderate retraction (<8.0 mm; n = 28) and maximum retraction (≥8.0 mm; n = 29) groups based on the amount of maxillary incisor retraction after extraction of the maxillary and mandibular first premolars for camouflage treatment. Pre- and posttreatment lateral cephalograms were analyzed. There were 2.3 mm and 3.0 mm of upper and lower lip retraction, respectively, in the moderate group; and 4.0 mm and 5.3 mm, respectively, in the maximum group. In the moderate group, the upper lip was most influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.94). The lower lip was most influenced by posterior movement of B-point (β = 0.84) and the cervical point of the mandibular incisor (β = 0.83). Prediction was difficult in the maximum group; no variable showed a significant influence on upper lip changes. The lower lip was highly influenced by posterior movement of the cervical point of the maxillary incisor (β = 0.50), but this correlation was weak in the maximum group. Posterior movement of the cervical point of the anterior teeth is necessary for increased lip retraction. However, periodic evaluation of the lip profile is needed during maximum retraction of the anterior teeth because of limitations in predicting soft tissue responses.

Lip line changes in Class III facial asymmetry patients after orthodontic camouflage treatment, one-jaw surgery, and two-jaw surgery: A preliminary study.

To evaluate the effects of orthodontic camouflage treatment (OCT), one-jaw surgery, and two-jaw surgery on the correction of lip line cant (LLC) and to examine factors affecting the correction of LLC in Class III craniofacial asymmetry patients. A sample of 30 Class III craniofacial asymmetry patients was divided into OCT (n = 10), one-jaw surgery (n = 10), and two-jaw surgery (n = 10) groups such that the pretreatment LLC was similar in each group. Pretreatment and posttreatment cone-beam computed tomography scans were used to measure dental and skeletal parameters and LLC. Pretreatment and posttreatment measurements were compared within groups and between groups. Pearson's correlation tests and multiple regression analyses were performed to investigate factors affecting the amount and rate of LLC correction. The average LLC correction was 1.00° in the one-jaw surgery group, and in the two-jaw surgery group, it was 1.71°. In the OCT group it was -0.04°, which differed statistically significantly from the LLC correction in the other two groups. The amount and rate of LLC correction could be explained by settling of skeletal discrepancies or LLC at pretreatment with goodness of fit percentages of approximately 82% and 41%, respectively. Orthognathic surgery resulted in significant correction of LLC in Class III craniofacial asymmetry patients, while OCT did not.

Camouflage treatment of an adult female patient with skeletal Class III malocclusion: A case report

Camouflage treatment of an adult female patient with skeletal Class III malocclusion: A case report

BÜYÜME VE GELİŞİMİ TAMAMLANMIŞ OLAN SINIF III BİR HASTANIN İSKELETSEL ANKRAJ KULLANARAK KAMUFLAJ TEDAVİSİ (OLGU SUNUMU)

The aim of the present study is to present skeletal and dental treatment outcomes of a nongrowing patient with skeletal Class III malocclusion treated using skeletal anchorage. A 15 year-old female patient had applied to our clinic for orthodontic treatment with chief complaint of her lower teeth being protrusive. Clinic and radiographic examination of the patient showed that she had a straight profile with dental and skeletal Class III relationship. Since she had straight profile, edge to edge anterior tooth relationship and, chose compensation therapy choice, we decided to treat Class III malocclusion using miniplates inserted on zygomathic buttress for the use of Class III elastics. After leveling of maxillary and mandibular teeth, intermaxillary class III elastics between miniplates and lower canines were applied for 6 months. After 15 months of total treatment time, Class I canine and molar relationships were established. Orthodontic camouflage treatment of a nongrowing patient was successfully performed in a short time with miniplate anchorage

Orthodontic Camouflage Treatment of Class II Malocclusion in Non-growing Patient - A Case Report

The prevalence of skeletal Class II malocclusion is high amongst Asian population. Various treatment modalities have been presented for the treatment of Class II malocclusions in adult patients. We come across many adult patients who desire a costeffective and non-surgical correction and they accept dental camouflage as a treatment option to mask skeletal discrepancy. This case report presents a 26-year-old non-growing female who had a skeletal Class II malocclusion with prognathic maxilla and retrognathic mandible with an overjet of 7 mm, severe crowding, but did not want surgical treatment. We considered the camouflage treatment by extracting upper first premolars. Following the treatment, a satisfactory result was achieved with an acceptable static and functional occlusion, facial profile, smile and lip competence with patient satisfaction.

Orthodontic camouflage treatment in skeletal Class II patient

Orthodontic camouflage is a method of correcting malocclusion without involving the correction of skeletal problem. Planned extraction of some teeth will help us achieve favorable dental occlusion. The challenge lies in proper diagnosis and case selection so as to decide on dental camouflage as a treatment option in skeletal discrepancy cases. Case of Class II malocclusion with severe crowding, vertical growth pattern and Class II skeletal base with ANB 6° has been discussed. Treated with four premolar extractions and finished the case with Class I canine and molar relationship. Planned extraction of indicated teeth to bring about dental compensation and camouflage the underlying skeletal discrepancy gives an overall improvement in facial esthetics, occlusion and also satisfaction to the patient.

A study of Class III treatment: orthodontic camouflage vs orthognathic surgery

Abstract Aim To evaluate the differences in pretreatment and post-treatment characteristics of Class III patients treated with orthodontic camouflage or orthognathic surgery, and to compare the range of skeletal, dental and soft tissue changes that are likely to occur with treatment, with particular reference to the influence of extractions on the resultant incisor angulations. Method Pretreatment and post-treatment cephalograms of 31 Class III orthodontically-camouflaged patients and 36 Class III surgical patients (without genioplasty) were obtained from one specialist practice. From the surgical group, 26 pre-surgical lateral cephalograms were also obtained. Inclusion criteria for the two groups were at least three of the following: (1) an ANB angle of 1 degree or less, (2) a Wits appraisal less than -4 mm, (3) an incisal overjet ≤0 mm, and (4) a Class III molar relationship. All lateral cephalograms were traced and digitised and a number of skeletal, dental and soft tissue variables were measured. The camouflage and surgical groups were also divided into premolar extraction and non-extraction subgroups to allow for a specific analysis of extraction effects. Results Before treatment, the surgical group demonstrated, on average, a more severe skeletal discrepancy and increased dental compensations, compared with the orthodontically camouflaged group. After treatment, the mean SNA angle was greater, the ANB angle was more positive, the Wits appraisal was closer to ideal and the lower incisors were less retroclined in the surgery group. There was a small mean reduction in horizontal chin projection in the surgery group compared with a small increase in the camouflage group. The mentolabial fold and the lower lip curve were deeper, on average, and the lips less retrusive after surgery. There was a mean increase in upper incisor proclination during treatment in both the surgical and camouflage groups with a greater increase in the camouflage group. There was a significant reduction in upper incisor proclination and a subsequent greater increase in the ANB angle associated with upper premolar extractions in the surgical group compared with the non-extraction group. Lower premolar extractions in the camouflage group resulted only in a deeper mentolabial fold compared with those treated without lower extractions. Conclusions Class III patients selected for surgical treatment are likely to have more severe pretreatment dental and skeletal discrepancies than those selected for camouflage treatment. Surgical treatment is associated with significant decompensation of the lower incisors but, ultimately, not the upper incisors. Class III patients treated with either camouflage or surgery treatment are likely to finish with slightly proclined upper incisors. Generally, surgical treatment results in greater skeletal change, involving normalisation of the skeletal base relationship, a reduction in chin prominence, fuller lips, and a more favourable lip and chin contour.

Camouflage treatment of skeletal Class III malocclusion with asymmetry using a bone-borne rapid maxillary expander

This case report presents the successful use of palatal mini-implants for rapid maxillary expansion and mandibular distalization in a skeletal Class III malocclusion. The patient was a 13-year-old girl with the chief complaint of facial asymmetry and a protruded chin. Camouflage orthodontic treatment was chosen, acknowledging the possibility of need for orthognathic surgery after completion of her growth. A bone-borne rapid expander (BBRME) was used to correct the transverse discrepancy and was then used as indirect anchorage for distalization of the lower dentition with Class III elastics. As a result, a Class I occlusion with favorable inclination of the upper teeth was achieved without any adverse effects. The total treatment period was 25months. Therefore, BBRME can be considered an alternative treatment in skeletal Class III malocclusion.

Two-phase treatment in a patient with a skeletal Class III malocclusion: Early orthopedic treatment and subsequent camouflage treatment with temporary anchorage devices

In this case report, we describe the outcome of a two-phase orthodontic approach used to treat a 4-year and 8-month-old girl who exhibited excessive negative overjet and skeletal Class III jaw relationship. In Phase I treatment, growth modification using a protraction headgear appliance was used to normalize maxillomandibular growth. A forward growth of the maxilla and a normal overjet were achieved. During pubertal growth period, a skeletal Class III jaw relationship persisted due to differential jaw growth. A Phase II camouflage treatment with the help of temporary anchorage devices (TADs) was used to distalize the mandibular dentition. Good occlusion and facial esthetics were achieved, and the outcome has been maintained for 2 years after completion of the active treatment.

Perawatan Ortodontik Gigitan Terbuka Anterior

Perawatan gigitan terbuka anterior telah lama dianggap sebagai tantangan bagi ortodontis. Prevalensi gigitan terbuka anterior antara 3,5% hingga 11% terdapat pada berbagai usia dan kelompok etnis, serta ada sekitar 17% pasien ortodonti memiliki gigitan terbuka. Stabilitas hasil perawatan gigitan terbuka anterior sangat sulit, karena adanya kombinasi diskrepansi anteroposterior dengan gigitan terbuka skeletal sehingga dibutuhkan tingkat keterampilan diagnosis dan klinis yang tinggi. Etiologi gigitan terbuka anterior sangat kompleks karena dapat melibatkan skeletal, dental, dan faktor-faktor habitual. Eliminasi faktor etiologi merupakan hal yang penting dalam perawatan gigitan terbuka anterior. Berbagai cara perawatan untuk koreksi gigitan terbuka anterior diantaranya bedah ortognatik dan perawatan ortodontik kamuflase, seperti high-pull headgear, chincup, bite blocks, alatfungsional, pencabutan gigi, multi-loop edgewise archwires dan mini implan. Stabilitas hasil perawatan adalah kriteria yang paling penting dalam menentukan cara perawatan gigitan terbuka anterior.Orthodontic Treatment of Anterior Open Bite. An anterior open bite therapy has long been considered a challenge to orthodontist. The prevalence of anterior openbite range from 3,5 % to 11% among various age and ethnic groups and it has been shown that approximately 17% of orthodontic patients have open bite. Stability of treatment result of anterior open bite with well-maintained results is difficult, because the combination of anteroposteriorly discrepancy with skeletal open bite requires the highest degree of diagnostic and clinical skill. The etiology is complex, potentially involving skeletal, dental and habitual factors. The importance of an anterior open bite therapy is to eliminate the cause of the open bite. Various treatment modalities for the correction of an anterior open bite have been proposed, orthognatic surgery and orthodontic camouflage treatment such as high-pull headgear, chin cup, bite blocks, functional appliances, extractions, multi-loop edgewise arch wires and mini implant. The stability is the most important criterion in deciding the treatment method for anterior open bite malocclusion.

Dental Class III Camouflage Treatment Using Miniscrew Anchorage

ABSTRACT In this case report, the treatment of a moderate Class III malocclusion by miniscrews is presented. A 17-year-old female patient with a chief complaint of crowding had Class III dental relationship. Cephalometric analysis demonstrated a Class II skeletal relationship with a high angle vertical pattern. The aim was to correct the skeletal and dental relationships with orthognathic surgery; however, the patient refused the operation. So it was decided to perform camouflage treatment, which consisted of lower posterior stripping and uprighting of the same teeth by the help of miniscrews placed into the interdental spaces between the mandibular first and second molars. At the end of the treatment, Class I molar and canine relationships were achieved, and the crowding was eliminated. The patient's profile was not negatively affected. The outcome was stable after 1 year of retention. This case report shows that miniscrew anchorage successfully aided in the correction of a dental Class III malocclusion ...

Camouflage Treatment of a Severe Open Bite Case

Skeletal open bite is a complex and multifactorial anomaly. There are many reasons for the occurrence of open bite, including skeletal abnormal growth pattern; dental, respiratory, neurologic, and habitual factors; and tongue posture and function. Anterior open bite is one of the most difficult problems to treat in orthodontics. Various treatment modalities for the correction of an anterior open bite have been proposed such as extrusion of anterior teeth using intermaxillary elastics, multiloop edgewise archwire technique developed by Kim, inhibition of molar eruption using bite blocks and high-pull headgear during growth, and extraction therapy. The most effective treatment option in adult patients is the repositioning of both the maxilla and mandible through a surgical correction. Although satisfactory results can be achieved with orthognathic surgery, the complexity, risks and costs of surgery are disadvantages of the surgical treatment. With the advent of skeletal anchorage, a number of studies were released to introduce the treatment of anterior open bite by intrusion of maxillary posterior teeth. This report presents the treatment and long-term stability of an adult case of a severe anterior open bite treated by means of extraction of the 4 first molars.

Orthodontic camouflage management of a class II malocclusion with excessive overjet- A case report

In orthodontic practice various treatment modalities have been presented for the treatment for the class II, div 1malocclusions. Recently a large number of young adults have been seeking shorter, cost effective and a non surgical correction of Class II malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy .This case report presents one such case, a 15years old growing male who has Class II div I malocclusion with sever maxillary incisor proclination, convex profile ,high mandibular plane angle, incompetent lips, increased overjet&amp; overbite, over retained upper left deciduous canine ,impacted upper left canine and a supernumerary tooth in canine region. We considered the camouflage treatment by extracting the upper right first premolar, left impacted canine, deciduous canine and supernumerary tooth. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, acceptable smile, competent lip and stable treatment results. DOI: http://dx.doi.org/10.3329/updcj.v3i1.17984 Update Dent. Coll. j: 2013; 3 (1): 41-45