Canine Relationship Research Articles

Does midline coincidence of upper and lower teeth affect smile aesthetics?

The extraction of single mandibular incisor has always led to debate regarding midline and smile esthetics. The current case report describes the effect of mesiodens in worsening the Class II Division 1 malocclusion and its correction by extraction of mesiodens, upper first premolars, and single mandibular incisor. Satisfactory functional and esthetic results were achieved with well-settled Class II molar, Class I canine relationship, ideal overjet, and overbite. Two years postretention records show stable results.

Facial asymmetry correction with surgical-orthodontic treatment. Case report

A case report of a 19-year-old female patient who attendedthe Orthodontics Department, Faculty of Dentistry, NationalAutonomous University of Mexico without any apparent pathological data is hereby presented. Upon interrogation, the patient referred to have had a previous surgical replacement of the left ear lobe. Physical examination revealed a severe facial asymmetry with mandibular deviation to the left side, straight profile, upper lip retrusion and gibbous nose. Intraorally the patient showed crowding, non-coincident dental midlines, squared arches and class III molar and canine relationship with left crossbite. Radiographically all dental organs were present and mandibular asymmetry could beobserved. Cephalometric analysis showed skeletal a class III due to maxillary retrusion, vertical growth pattern, left laterognathia, proclination of upper incisors and upper lip retrusion. Treatment consisted of three phases: 1 presurgical orthodontics with 0.018” slot Alexander appliances and an archwire sequence suitable to the problem that the patient presented. Subsequently, surgical phase 2 was initiated with a sagittal osteotomy for bilateral laterognathia correction. During phase 3, postsurgical orthodontics, the case was detailed, muscular patterns were corrected and the occlusion was settled. Treatment was completed in 36 months. The profile and facial harmony were improved, the positive smile was maintained and the crossbite corrected. Bilateral canine and molar class I was obtained, the dental midlines were centered and arch form was improved as were the overbite and overjet.

Challenges and Rewards of Human–Canine Relationships

Challenges and Rewards of Human–Canine Relationships

Características oclusales de los niños de 5 años del municipio de andes (Antioquia, Colombia)

Introduction: The occlusal alterations are a frequent problem in the primary dentition, their identification from early age, allow to recognize variations in the normal characteristics, which can influence the development of permanent occlusion. Objective: to establish the occlusal characteristics in primary dentition, in children 5-year-old of Andes municipality, Colombia . Materials and methods: One hundred twenty five children were evaluated by a clinical visual inspection of the relationship between the dental components. Prevalence for each occlusal characteristic was calculated and the combined frequencies of alterations were also estimated. Results: Class I canine relationship in 84% and Class II in 12% were found. The horizontal and vertical overbite were normal in 60.8% and 58.4% respectively, and 6.4% had posterior cross bite. None occlusal alteration was found in 48.8% of children; while 3.2% had alteration in the four occlusal characteristics evaluated. There were no statistically significant differences in occlusal characteristics by sex. Conclusion: The presence of occlusal alterations, in a greater proportion than the national average, requires implementing in the municipality actions for its detection and treatment that contribute to adequate craniofacial growth and development.

Treatment of a Class II Division I malocclusion using miniscrews: A case report

This case report describes the use of temporary anchorage devices for an 18-year-old Indian girl with a skeletal Class II malocclusion. Class II skeletal base indicating a vertical growth pattern with prognathic maxilla and orthognathic mandible in relation to the anterior cranial base, bilateral Angle's Class II molar and canine relationship with proclined and forwardly placed upper and lower incisors with an overjet of 7 mm and an overbite of 2 mm, and a convex soft tissue profile with an acute nasolabial angle and potentially competent lips. The treatment includes the extractions of the maxillary first premolars and mandibular second premolars, fixed appliance mechanotherapy, miniscrew-aided maxillary anterior retraction, and protraction of mandibular molars. The Angle's Class II Division I malocclusion, proclined upper and lower anteriors, overjet of 7 mm, and convex soft tissue profile with potentially competent lips were corrected. The crowding and rotation along with proclined incisors were corrected significantly improving patient's facial profile. The trending use of implants in orthodontics for everyday troublesome and complicated protocols is comparatively much efficient and quicker with the aids of mini-implants.

Treatment of an Adult with Skeletal Class III and A Hemimandibular Elongation A Multidisciplinary Approach.

An adult male patient aged 21-year-old reported with the chief complaint of forwardly placed chin and deviation of chin towards the left side. The patient had an asymmetric face (shifted to left) with leptosoprosopic face form. On profile examination patient had a mild concave profile. The facial midline was not coincident with dental midline as chin was deviated towards left [Table/Fig-1]. Class III molar and canine relationship on right side and Class I molar, canine relation on left side was seen. There was an edge to edge overbite and overjet [Table/Fig-1].

Management of Adult Transverse Malocclusion with Surgically Assisted Rapid Palatal Expansion.

An-18-year old male patient reported to the Department of Orthodontics, SVS Institute of Dental Sciences, Mahabubnagar, with a chief complaint of irregularly placed upper and lower front teeth and restless sleep. On extra oral examination the patient presented with mild convex profile, competent lips and normal nasolabial angle and mentolabial sulcus with no gross asymmetry. Intraoral examination showed severe crowding in both the arches, Class I molar and canine relationship bilaterally, narrow maxillary arch, blocked out upper right canine, upper right lateral incisor and posterior unilateral cross bites, upper midline shifted to right side by 3mm. Cephalometric examination showed that patient exhibited Class I skeletal jaw bases (ANB: 20) with normal mandibular plane angle (FMA: 260), upright upper anteriors (UI-SN: 1020) retroclined lower anteriors (LI-MP: 720), with normal nasiolabial angle (1080) as shown in [Table/Fig-1]. Model analysis suggested 7mm expansion is possible in the upper arch and 5mm of space can be gained in the lower arch.

Predictive factors of sagittal stability after treatment of Class II malocclusions.

To determine the existence of factors permitting the prediction of sagittal stability after orthodontic treatment in patients with Angle Class II malocclusion. PubMed, EMBASE, and the Cochrane Library were searched up to March 2015. Inclusion criteria were longitudinal studies with at least 10 subjects investigating associations between at least one factor and stability, with an average minimum follow-up period of 2 years; stability measured using posttreatment sagittal dental changes; and orthodontic treatment including removable and/or fixed appliances with or without extractions. Two reviewers independently selected and assessed the quality of the articles. The search strategy resulted in 1372 articles, of which 17 met the inclusion criteria. Large changes during treatment in molar and canine relationships were the only two factors found to be positively associated with relapse, but with limited evidence. Fourteen factors were found not to be predictive of relapse, also with limited evidence. These factors included treatment characteristics, patient pretreatment characteristics, and final posttreatment characteristics. There is currently limited evidence to support the influence of factors predictive of sagittal stability following Class II malocclusion treatment. More high-quality prospective studies are needed, and functional factors possibly affecting relapse also need to be further assessed.

Management of skeletal Class III malocclusion with unilateral crossbite on a growing patient using facemask-bonded rapid palatal expander and fixed appliances

Facemask (FM) and bonded rapid palatal expander (RPE) are part of growth modification treatments for correcting skeletal Class III pattern with retrognathic maxilla. This orthopaedic treatment is usually preceded by fixed appliances to achieve aesthetic dental alignment and improve interdigitation. This case report reviews treatment of Class III malocclusion with unilateral crossbite in a 12-year-old boy using FM and bonded RPE, followed by fixed appliances. Choice of FM and bonded RPE was in line with indication which was mild Class III malocclusion with retrognathic maxilla. Execution of treatment was made considering treatment biomechanics and patient cooperation. This orthopaedic treatment was followed by orthodontic treatment specifically aimed to correct unilateral crossbite, canine relationship yet to reach Class I, lower midline shift, as well as unintended dental consequences of using bonded RPE, namely posterior open bite and deepening curve of spee. Posttreatment facial profile and smile are more esthetic. Occlusion is significantly improved both functionally and aesthetically.

Occlusal characteristics in 3-year-old children--results of a birth cohort study.

BackgroundAim of this prospective study was to determine prevalence of malocclusion and associated risk factors in 3-year-old Thuringian children.MethodsSubjects (n = 377) were participants in a regional oral health programme, a birth cohort study with the aim to prevent caries (German Clinical Trials Register DRKS00003438). Children received continuous dental care since birth. Occlusal characteristics (overjet, overbite, anterior open bite, canine relationship and posterior crossbite) were measured at the age of 3 years by one calibrated clinician using a vernier caliper (accuracy 0.1 mm; Münchner Modell 042-751-00, Germany). A regular parent survey was conducted to assess risk factors for development of malocclusion.ResultsThree hundred seventy seven children (mean age 3.31 ± 0.70 years; 52.5 % male) were examined. Children had a mean overjet of 2.4 ± 0.8 mm and the mean overbite was 0.8 ± 1.2 mm; 58.8 % of the children had a normal overjet ≤3 mm and 88.8 % a normal overbite with < {scriptscriptstyle raisebox{1ex}{2}!left/ !raisebox{-1ex}{3}right.} overlap. Prevalence of malocclusion was 45.2 % (10.9 % anterior open bite, 41.2 % increased overjet ≥3 mm, 40.8 % Class II/III canine relationship, 3.4 % posterior crossbite). All children who sucked the thumb had a malocclusion. Children who used a pacifier had greater odds of having a malocclusion at age of 3 years than children without pacifier use (OR = 3.36; 95 % CI: 1.87–6.05). Malocclusion and dental trauma were associated, but not statistically significant (OR = 1.83; 95 % CI: 0.99–3.34; p = 0.062). Malocclusion was not associated with gender, migration background, low socioeconomic status, preterm birth, special health care needs, breathing or dietary patterns (p > 0.05).ConclusionsNon-nutritive sucking habits were important risk factors for development of a malocclusion in the primary dentition.

Comparison of anchorage reinforcement with temporary anchorage devices or a Herbst appliance during lingual orthodontic protraction of mandibular molars without maxillary counterbalance extraction.

BackgroundOrthodontic protraction of mandibular molars without maxillary counterbalance extraction in cases of aplasia or extraction requires stable anchorage. Reinforcement may be achieved by using either temporary anchorage devices (TAD) or a fixed, functional appliance. The objective was to compare the clinical effectiveness of both methods by testing the null-hypothesis of no significant difference in velocity of space closure (in mm/month) between them. In addition, we set out to describe the quality of posterior space management and treatment-related factors, such as loss of anchorage (assessed in terms of proportions of gap closure by posterior protraction or anterior retraction), frequencies of incomplete space closure, and potential improvement in the sagittal canine relationship.MethodsTwenty-seven subjects (15 male/12 female) with a total of 36 sites treated with a lingual multi-bracket appliance were available for retrospective evaluation of the effects of anchorage reinforcement achieved with either a Herbst appliance (nsubjects = 15; 7 both-sided/8 single-sided Herbst appliances; nsites = 22) or TADs (nsubjects = 12; 2 both-sided; 10 single-sided; nsites = 14). Descriptive analysis was based on measurements using intra-oral photographs which were individually scaled to corresponding plaster casts and taken on insertion of anchorage mechanics (T1), following removal of anchorage mechanics (T2), and at the end of multi-bracket treatment (T3).ResultsThe null-hypothesis was rejected: The rate of mean molar protraction was significantly faster in the Herbst-reinforced group (0.51 mm/month) than in the TAD group (0.35). While complete space closure by sheer protraction of posterior teeth was achieved in all Herbst-treated cases, space closure in the TAD group was achieved in 76.9 % of subjects by sheer protraction of molars, and it was incomplete in 50 % of cases (mean gap residues: 1 mm). Whilst there was a deterioration in the canine relationship towards Angle-Class II malocclusion in 57.14 % of space closure sites in TAD-treated subjects (indicating a loss of anchorage), an improvement in canine occlusion was observed in 90.9 % of Herbst-treated cases.ConclusionSubjects requiring rapid space closure by molar protraction in combination with a correction of distal occlusion may benefit from using Herbst appliances for anterior segment anchorage reinforcement rather than TAD anchorage.

SINIF II DİVİZYON 1 MALOKLUZYONA SAHİP BİR HASTANIN SERVİKAL HEADGEAR VE SABİT ORTODONTİK APAREYLER İLE TEDAVİSİ: OLGU SUNUMU

The aim of the present study is to present the treatment outcomes of a patient with a dental Class II Division 1 malocclusion who was treated by cervical headgear and followed by fixed orthodontic appliance. A 12 year-old female patient visited to our clinic for orthodontic treatment due to the chief of protrusive maxillary dentition and diastema. Intraoral examination of patient showed that she had Class II Division 1 malocclusion with an overjet of 5.5 mm and an overbite of 2.5 mm. Arc length discrapancies were +0.5 mm in maxilla and +3 mm in mandible. Extraoral examination showed that she had convex profile and no asymmetry. Treatment plan was bilateral maxillary molar distalization to achieve Class I molar and canine relationship. The patient chose using cervical headgear for maxillary molar distalization after describing the treatment choices including tooth extraction and maxillary molar distalization techniques with and without temporary anchorage devices. An orthodontic force of 300 g per side was applied for 6 months period. Evaluation of plaster models after distalization period showed that maxillary molars were distalized 4 mm for the right side and 5 mm for the left side. After the distalization period, fixed appliances were performed for 12 months. Total treatment duration was 18 months. At the end of treatment, Class I molar and canine relationships with ideal overjet and overbite were achieved. The treatment of the Class II Division 1 malocclusion was successfully performed using cervical headgear for maxillary molar distalization and followed by fixed appliances

Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition.

BackgroundEarly transition from breastfeeding and non-nutritive sucking habits may be related to occlusofacial abnormalities as environmental factors. Previous studies have not taken into account the potential for interactions between feeding practice, non-nutritive sucking habits and occlusal traits. This study assessed the effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition in 3–6-year-old children in Peking city.MethodsThis cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior crossbite, posterior crossbite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple logistic regressions were applied to analyze the associations.ResultsIt was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR = 3.13; 95% CI = 1.11–8.82; P = 0.031) and no maxillary space (OR = 1.63; 95% CI = 1.23–2.98; P = 0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR = 4.21; 95% CI = 1.85–9.60; P = 0.0002). Children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of a class II canine relationship compared with those who were bottle-fed for up to 18 months. Non-nutritive sucking habits were also found to affect occlusion: A prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit associated with excessive overjet and absence of lower arch developmental space.ConclusionBreastfeeding duration was shown to be associated with the prevalence of posterior crossbite, no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a digit-sucking habit were more likely to develop an open bite.

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.

Cephalometric Norms for Kuwaiti Adults: A preliminary study

PurposeTo establish for the first time cephalometric norms for adult Kuwaitis with normal class I occlusion according to ethnic group and gender, and to compare the findings to the previously published norms of the Caucasoid. Materials and methodsEight hundred adult Kuwaiti subjects were screened at two locations. The inclusion criteria were: Kuwaiti adults born to parents, and grandparents of pure Arab or Persian heritage; esthetically pleasing faces; angle class I molar and canine relationships; all permanent teeth present; irregularity index of less than 4mm; and no history of orthodontic treatment or plastic surgery. Lateral cephalometric radiographs were taken by one investigator then traced and analyzed using twenty-nine angular, and linear measurements. Independent sample t-test was used to assess the inter-ethnic and the inter-gender differences. The results were then statistically compared to the norms of the Caucasoid. ResultsA total of 56 adult subjects were included. Several significant differences were noted between the Kuwaiti Arab and the Kuwaiti Persian ethnic groups. The most noteworthy differences were observed for the angles SNA and SNB and for the mean total lengths of the maxilla and mandible. When compared to the Caucasoid, statistically significant differences were noted in all mean dental and soft tissue measurements between the pooled Kuwaiti population and the Caucasoid. ConclusionThere are some fundamental variations in the craniofacial structure of Arabs, and Persians of the adult Kuwaiti population. These differences should be considered in larger future studies to establish clinical norms for orthodontic patients in Kuwait.

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 ...

Occlusion and occlusal characteristics of primary dentition in North Indian children of East Lucknow region

To determine occlusion and occlusal characteristics of the primary dentition in North Indian school-going children of East Lucknow region. A cross-sectional study was conducted on 453 participants in the age group of 3-6 years. Participants were selected randomly and occlusal relationship was assessed based on Baume's classification. Various other occlusal characteristics were also recorded and assessed based on clinical and photographic evaluation. The data were then subjected to statistical analysis. Out of 453 participants examined, results revealed 62.3% had flush terminal plane; 31.3% mesial step molar relationship and 6.4% distal step molar relationship. It was also observed that 91.6% had Class I canine relationship, 93.4% primate spaces, 69.5% physiologic spaces. Amongst other occlusal characteristics, increased overbite and crowding were prevalent. Association of various occlusal characteristics and oral habits with respect to primary molar relation was also assessed. Chi-square test was performed to carry out statistical analysis. p value <0.05 was taken as statistically significant. It was found that flush terminal plane relationship with spacing and Class I canine relationship predominated. Further prospective studies are required to provide an insight into patterns of occlusal relationship and its changes in Indian children.

Occlusal Characteristics of Primary Dentition in Sudanese Children in Khartoum State

Objective: To determine the occlusal characteristics feature of primary dentition in a group of Sudanese children.Methods: A sample of 381 children age 3-5 years old, randomly selected from kindergartens in Khartoum Stat. Clinical examination was done to all children fulfil the inclusion criteria in the teacher office and in natural day light. Prevalence of different types of terminal plane, types of primary canine relationship and spacing of the primary dentition were assessed.Results: Flush terminal plane was the most prevalent type of terminal plane (72.2%). Class I canine relationship was the most common type of primary canine relationships (95%). In the upper arch primate space and physiological spaces were present in 90.3% and 82.4% of the children, respectively. Nevertheless, the lower arch showed primate spaces in 70.1% and physiological spaces in74.8% of the children.Conclusion: Large number of the examined children in had flush terminal plane and spacing primary dentition that forecasts development of normal occlusion in their permanent dentition.Background: Occlusal relationships in the primary dentition play an important role in the consequential final occlusion in permanent dentition. Therefore, good knowledge of occlusal relationships in children is essential for dental practitionersDesign: A descriptive, cross-sectional study done in randomly selected kindergartens in Khartoum State to determine the occlusal characteristics of primary dentition in a group of Sudanese children.

Evaluation of skeletal and dentoalveolar components in Syrian females with a gummy smile

Objectives: The objective of this study was to investigate the dentoalveolar and skeletal components contributing to a gummy smile (G.S.) in Syrian females. Materials and Methods: The G.S. group included 20 Syrian females, with an average age of 21.9 ± 3.9 years and a clinically diagnosed G.S. The control group included 20 Syrian females, with an average age of 22.05 ± 2.87 years and an acceptable smile. All subjects had Class I molar and canine relationships. Lateral cephalometric radiographs of all subjects were taken under similar conditions. Total cephalometric parameters measured included 11 angular measurements, 12 linear measurements and 7 ratios between the linear measurements. Results: Statistically significant increases in the total anterior facial height, lower anterior facial height, dentoalveolar heights and facial diversion angles were observed in the G.S. group as opposed to the control group. Conclusion: There was an obvious role played by the skeletal and dentoalveolar components in occurrence of a G.S. in Syrian females and these must be considered during orthodontic treatment planning.

Impacted Maxillary Central Incisors Associated with Bilateral Mesiodentes: A Case Report

The purpose of this paper was to present the surgical exposure and orthodontic treatment of an 11-year-old boy with horizontally impacted permanent maxillary central incisors associated with bilateral mesiodentes. Panaromic and upper anterior occlusal radiographs showed horizontally impacted maxillary central incisors, vertically impacted molariform mesiodens, and rotated mesiodens located at the site of the maxillary right central incisor. The treatment plan included extraction of the erupted mesiodens, surgical extraction of the impacted mesiodens, surgical exposure of the permanent central incisors, and orthodontic traction and alignment to achieve a normal occlusion. After 14 months of treatment, the central incisors erupted into the oral cavity. The impacted maxillary central incisors were successfully positioned to their proper alignment via surgical crown exposure and orthodontic traction. Ideal overjet, overbite, and Class I molar and canine relationships were also achieved. At the completion of treatment, the exposed incisors exhibited an acceptable gingival contour and attached gingiva. After 2 years of follow-up, a stable occlusion was maintained with only minor relapse at the right central incisor.