Overbite Research Articles

Deep bite and dental crowding in a growing patient treated using invisalign first: a case report

Deep bite and dental crowding in a growing patient treated using invisalign first: a case report

Ortodontska terapija funkcionalnim aparatima

Functional appliances are key to success in early orthodontic therapy. Their application is most useful in the period of a pre-puberty and pubertal growth spurt, in order to achieve facial aesthetics and improve the patient's health. The aim of treatment with functional appliances is to act on the muscles and ligaments, thereby influencing the movement and growth of the lower jaw forward, when it comes to the distal bite. The devices are used to correct malocclusions in all three spatial planes: sagittal, vertical, and transferal. In the sagittal dimension, the distal bite is corrected and Angle class I occlusion is established. In the transferal dimension, appliances are used to expand the dental arches. In the vertical dimension, appliances are used to correct an open or deep bite. Most often, mobile functional appliances are used, which consist of special upper and lower parts, such as the Twin block and the "M" block. Other types of functional devices have been used for many years, they consist of one part and their disadvantage is discomfort for patients and the impossibility of use in the presence of septal deviation or any other airway obstruction (activator and all its modifications, as well as Bionator). Recently, fixed functional appliances are also used, the advantage of which is that they do not depend on the cooperation of the patient and that they hold the mandible in an anterior position for 24 hours, achieved on the basis of an adequately taken construction bite. Their application is not conditioned by the puberty growth spurt but can be used by post-adolescents and young adults. In the production of functional appliances, the most important thing is to take a good construction bite, which determines how the muscle power will be transferred to the tissues, teeth, and jawbone. They determine the course of treatment and its duration. Muscle activation is performed in sagittal, transverse, and vertical directions, individually for each patient depending on the type of device.

Prevalence of malocclusion and orthodontic treatment needs among adolescents in Najran City, Saudi Arabia.

To determine the prevalence of malocclusions and the need for orthodontic treatment in a sample of school-going adolescents in the Najran city, Kingdom of Saudi Arabia (KSA). This cross-sectional study was conducted among 1094 school-going Saudi male adolescents. The age range of the sampled adolescents was 13-18 years, and none of them had any history of orthodontic treatment. A survey chart related to malocclusion was designed and filled up after clinical examination by a single experienced and calibrated examiner. The need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). The present study's findings demonstrated 61.2% of the samples with Angle's Class I malocclusions, 27.5% with Class II, and 11.4% of samples with Class III malocclusion. A significant difference was observed between the different classes of malocclusion (P < 0.001). Most samples presented normal overjet, crossbite, and no reverse overjet, deep bite, or open bite. The number of samples with no treatment need was 573 (52.37%), with slight treatment in 185 (16.91%) samples, moderate treatment needs in 123 (11.24%) samples, and severe and extreme treatment needs were 109 (9.96%) and 104 (9.50%), respectively. A significant difference was observed between the samples with no or slight treatment need (grades 1 and 2), moderate need (grade 3), and definite treatment need (grades 4 and 5) (p < 0.001). The prevalence of malocclusion and IOTNs among the sample of school-going adolescents in the Najran city was 47.63%. However, 9.63% of those samples required immediate attention for orthodontic treatment.

Multidisciplinary Management in a Patient with Hemifacial Microsomia and Microglossia

Hemifacial Microsomia (HFM) is second most common congenital craniofacial anomaly following cleft lip and palate. On contrary, microglossia is a very rare congenital anomaly. To the best of our knowledge, HFM associated with microglossia has not been reported in the literature. This is a case report of a 13-year-old girl who presented with features of hemifacial microsomia, blindness, microglossia, hypodontia, bilateral transposition between upper first premolar and canine, anterior crowding and deep bite. Her treatment was started with fixed orthodontic appliance and arches were aligned by maintaining the transposed position of the teeth. After completion of orthodontic treatment, maxillary right and left first premolars were contoured into lateral incisor and canine, respectively, to have satisfactory functional and aesthetic outcome.

Identification of Malocclusion by Dental Undergraduate Students: A Cross-sectional Study

Introduction: Health is multifaceted and influenced by a variety of variables. Along with dental caries, periodontal and gingival disorders, malocclusion is one of the most prevalent dental issues. It can impair oral health by increasing the prevalence of dental caries, periodontal diseases, and temporomandibular disorders, as well as predispose to oral habits in the majority of cases. Hence, knowledge about the need for treatment and the correct time of commencement is essential for treating malocclusion. Aim: To assess the level of understanding of dental undergraduate students in the identification of malocclusion. Materials and Methods: A cross-sectional study was conducted on 150 final-year dental undergraduate students from private dental colleges who were randomly chosen. A pre-tested questionnaire with closed-ended questions was given to every participant, and their knowledge levels were evaluated on the same day after the collection of completed questionnaires. The questionnaire contained intraoral and extraoral photographs of patients with malocclusions. Students were asked questions about the identification of various malocclusions, and the data was analysed as frequency (n) and percentages (%). Results: Questionnaire responses by a total of 150 dental undergraduate students, (48 males and 102 females) with a mean age of 21±2 years were analysed. The majority of students were able to identify Angle’s Class-I (n=139, 92.7%), Class-II (n=103, 68.7%), and Class-III (n=122, 81.3%) malocclusions, as well as canine relationships (n=136, 90.7%). The majority of students had no difficulty in recognising transverse malocclusions, such as posterior crossbite (n=103, 68.7%) and scissors bite (n=99, 66%), as well as common malocclusions like crowding, spacing, midline shift, and deep bite. Conclusion: Most of the students were familiar with the diagnosis of malocclusion. However, knowledge regarding the type of appliance to be used and the age of starting treatment was lacking.

Germectomy (Therapeutic Enucleation) of First Bicuspids and Eruption Guide to Treat Dental Crowding without Using Orthodontic Treatment. Case Report

Germectomy (enucleation) of the first bicuspids has shown to be an effective treatment in the management of dental crowding in mixed dentition because it produces intraosseous decongestion of the dental mass between permanent canines and second bicuspids. This provides early available space for the autonomic eruption without interference from the first bicuspid to the permanent canine which erupts into a highly stable position within the dental arch, facilitating and accelerating orthodontic treatment (if required) which would be terminating before the difficult adolescent age. This procedure differs from the orthodontic treatment of extracting the first bicuspids after they erupt when they are already facing a frank crowding, mature periodontal ligament, and deformity of the alveolar process. In our opinion, Germectomy of first bicuspids will replace serial extractions during which time the treating specialist will concentrate on preventive eruption guidance and the management of habits in general such as tongue, thumb, lips, and mouth breathing, in addition to performing Functional orthopedics of the jaws as in deep bites, deficiency or maxillary protrusion among others.

Differences in ingestive behavior between grazing goats and sheep at the bite scale.

This study aimed to clarify the differences in ingestive behavior between goats and sheep at the bite scale. Animals were allowed to graze a feeding station of bahiagrass (Paspalum notatum Flügge) with two sward heights (short and tall) to two levels of bite depletion (20 and 40 bites). Ingestive behavior variables, which represent the rate and mass of bites and chews, intake rate, bite dimensions, and bite placement characteristics, were quantified. The interspecies difference in ingestive behavior became obvious at the short sward. Goats reduced the inter-bite distance and maintained bite overlapping but took deeper bites than sheep at the short sward, resulting in slightly greater bite mass. These behavioral changes with efficient chewing may be helpful to maintain the intake rate at the short sward. Sheep maintained their inter-bite distance regardless of the sward height and decreased overlapping bites at the short sward. These behavioral characteristics in sheep in response to sward height may partly compensate for the decrease in the bite mass at the short sward, although it may not always maintain the intake rate. Thus, the present study suggests that goats and sheep implement different bite scale ingestive behaviors, including bite placement, when they eat short swards.

An Evaluation of Asymmetrical T-Loop Effects in Deep Bite Cases with Finite Element Analysis

An Evaluation of Asymmetrical T-Loop Effects in Deep Bite Cases with Finite Element Analysis

Fixed Prosthodontic Treatment of Patient with Anterior Deep Bite- A case report

The condition of oral cavity greatly influences the patient's dental care and treatment. In prosthodontic treatments, the anatomy and arrangement of the teeth is one of the factors that must be considered in order to be able to plan a treatment design. Deep bite with larger overlap of the maxillary and mandibular incisors make the lateral load borne by the teeth become greater. This can cause damage to the tooth and periodontal tissues, as well as failure of the denture. This article reports on the treatment of edentulous of the tooth 21 with deep bite with convetional brigde PFM. Clinical examination showed that there was an overlap between the upper central incisors and the lower incisors by 5 mm and there was a toothwear defect in the form of attrition on teeth 31 and 41. The patient was planned to have a 3 unit conventional bridge made with porcelain fused to metal with a metal backing design to reduce the thickness of the preparation in palatal area and minimize contact with opposing teeth. At the insertion, the patient's occlusion is checked and evaluated so that there are no premature contacts and occlusal interference during centric and eccentric movements. The patient is satisfied with the results of the treatment. Treatment with fixed partial denture in deepbite must be well designed and planned to achieve successful treatment.

Detection and effectiveness of treatment of myofascial pain and temporomandibular joint pathologies in adult patients with orthodontic pathology

BACKGROUND: At the orthodontists clinic, patients with pain in the maxillofacial region and internal disorders of the temporomandibular joint (TMJ) are not uncommon. These pathological conditions are characterized by the complexity of interdisciplinary therapy and frequent recurrence.&#x0D; AIM: To analyze the detectability and effectiveness of treatment of myofascial pain disorders and internal disorders of the TMJ in adult patients with dental anomalies.&#x0D; MATERIAL AND METHODS: Case histories of 300 adult patients with dental anomalies who underwent examination and treatment in a multidisciplinary dental clinic were retrospectively analyzed. The study included patients who received orthodontic treatment for at least 5 years. The prevalence and structure of internal disorders of the TMJ and myofascial pain disorders were assessed, and their correlation was analyzed.&#x0D; RESULTS: Orthodontic treatment was more often needed by patients with myofascial pain (71.5%), followed by those with myofascial facial pain syndrome (28.3%). In these patients, internal TMJ disorders and maxillary anomalies of class II according to Engl with unilateral distal occlusion, deep bite, and class I with crowding of teeth were more often detected. Internal TMJ disorders with concomitant myofascial pain disorders in the form of myofascial pain were observed in 82.4% of the patients. Myofascial pain disorders without internal TMJ disorders were registered in 17.4% of the patients. The overall effectiveness of the treatment of internal TMJ disorders and myofascial pain disorders was 46.4%, no lasting improvement was observed in 35.7%, deterioration was recorded in 17.8%, and relapses were noted in 60.7%. In the treatment of myofascial pain disorders without internal TMJ disorders, the overall effectiveness of treatment was 5.5%; stabilization, 50.0%; and deterioration, 44.4%.&#x0D; CONCLUSION: Myofascial facial pain is very difficult to treat. The combination with internal TMJ disorders creates significant and sometimes insurmountable difficulties in the orthodontic treatment of adults. All these forces specialists to look for new approaches to optimizing orthodontic treatment of TMJ pathology and myofascial pain disorders.

Effectiveness evaluation of the interdisciplinary approach in the treatment of patients with iatrogenic functional disorders of the maxillofacial area associated with primary deep bite according to the dynamics of changes in electromyographic studies

The aim of our work is to improve the quality of comprehensive orthodontic treatment by searching for the most favorable conditions and terms necessary for the implementation of the adaptive capacity of the body at the stages of reconstructive manipulations in patients with occlusal disorders of the dentofacial system resulting from dental interventions.Material and methods. A prospective group clinical study was carried out. Groups were formed due to the total clinical sample of 105 patients, age range 18-45 years (mean age 29.9±6.1 years) with iatrogenic functional prosthetic disorders complicated with a primary deep bite. Three clinical groups were identified. The first included 37 patients with predominantly muscular symptoms, the second - 42 patients with dysfunction of the temporomandibular joints, and the third included 26 patients who, in addition to muscle and / or joint symptoms, had primary neurogenic disorders. In order to compare the effectiveness of treatment, each of the clinical groups was divided into 2 subgroups depending on the treatment algorithm used; namely, the first subgroup included patients who were treated according to the scheme developed by us, and the second subgroup included patients treated according to the generally accepted method.Results. There was a decrease in the amplitude of bioelectrical activity and a reduction in the time of the activity period, and, accordingly, the approximation of the activity coefficient to one in patients with vertical abnormalities, aggravated by crowding of the teeth, occurred already at the stage of splint therapy.Conclusions. Our studies allow us to predict both the duration of treatment and the amount of occlusal correction combined with the reconstruction of the position of the lower jaw and the improvement of the general somatic state of the patient's body.

Sagittal Positional Changes of the Mandible Following Alignment and Levelling of Class II Division 2 Cases: An Observational Study in Decelerating Stages of Adolescent Growth Spurt.

Introduction The objective of this observational study is to compare the dental and skeletal changes that occur following the release of incisor locking in class II division 2 patients in the decelerating phase of the adolescent growth spurt. Materials and methods Lateral cephalograms of 17 subjects with skeletal class II and division 2 malocclusion, taken at the pre-treatment (T1) and post-leveling and alignment (T2) phases, were analyzed. All these patients were treated with non-extraction methods in the initial stage. A total of 25 skeletal and dental parameters, which included linear and angular measurements, were evaluated. Statistical analysis A pairedt-test was used to compare the difference in the dimensional values between (T1)and(T2) points of the time period. The results were considered statistically significant atBonferroni adjustedp<0.002. Results A statistically significant positional change was noted in the condylar position both in the vertical and sagittal directions, resulting in sagittal changes of the mandible in the forward direction. The deep bite was relieved by vertical changes in the dental structures in both the posterior and anterior segments. Growth changes in the vertical direction were also noted but not conclusive. Conclusions There was a definite horizontal shift of the mandible, improving maxillo-mandibular relations following the unlocking of the bite in class IIdivision 2 patients. This shift is mostly attributed to the condylar repositioning in the forward and downward directions.

Intrusion of mandibular incisors using single mini-implant –A finite element study

A deep bite is a complex orthodontic problem that is a common feature of many malocclusions. Depending on the diagnosis, a deep overbite can be corrected. Mini implants can be used for the true intrusion of anterior teeth. FEA is a computer based numerical simulation technique used to calculate deflection, stress and displacement. To analyze stress distribution pattern and displacement of mandibular incisors when intrusive forces are applied using three dimensional finite element analysis. To compare intrusion of lower anterior teeth when ‘V’ pattern force and straight vertical pattern force are applied. A three dimensional finite element model was constructed to simulate mandibular teeth, periodontal ligament and alveolar bone. The displacement of individual tooth (central and lateral incisors) on three-dimensional planes and the von Mises stress distribution were compared. Intrusive forces when applied to four mandibular anterior teeth remarkable tipping of the labial segment was seen when straight vertical elastics were used as compared to the ‘V’ shaped elastics. Within the limits of this study, predictable intrusion with minimum labial tipping is seen using single implant using V pattern elastics.

PREVALENCE AND STRUCTURE OF DENTAL ANOMALIES AMONG SCHOOL AGE CHILDREN IN KARAGANDA REGION

Objective: The purpose of this study is to determine the prevalence and structure of dentoalveolar anomalies (DNA) in school-age children living in the Karaganda region. Materials and methods: a study was conducted of 300 schoolchildren aged 12-14 living in the Karaganda region. Statistical data results are processed in SPSS software version 16.0. Results and discussions. After the examination, the following data were obtained: the incidence of dentoalveolar anomalies was 68%, the number of children with orthognathic bite was 42%; out of 58% of children, the following types of bites are noted: level bite (16%), distal bite (15%), deep bite (14%), cross bite (7%), open bite (6%) and mesial or prognathism (4% ).At the same time, the structure of dentoalveolar anomalies is presented as follows: anomaly in the position and eruption of individual teeth (47%), malocclusion (42%) cases. Conclusion. In the course of the study, the prevalence and structure of dentoalveolar anomalies was determined.

Management of central diastema with high-frenulum labialis

Objective: To explain the management of the central diastema case in a patient with high- frenulum labialis. Methods: Using a conventional Orthodontic appliance MBT system. This method is selected to orthodontically corrected central diastema while eliminating deep bites and other existing malposition in this case. Results: Central diastema and deep bite corrected, as well as other malposition. However, the frenulum labialis which was planned to undergone frenectomy was postponed to avoid an open gingival embrasure (black triangle). Conclusion: Correction of central diastema done by using a conventional orthodontic appliance MBT system. However, the disposal of frenulum labialis should not always be done, because it should consider the possibility of the emergence of gingival embrasure (black triangle) after the Labialis frenulum was discarded.

Passivation of Bi2Te3 Topological Insulator by Transferred CVD‐Graphene: Toward Intermixing‐Free Interfaces

AbstractThe investigation, and ultimate application, of topological insulators, typically involve exposure to ambient conditions or their integration with metals, which lead to surface oxidation or material intermixing. X‐ray photoelectron spectroscopy (XPS) measurements that demonstrate passivated and intermixing‐free interfaces in the topological insulator Bi2Te3 by means of dry‐transferred CVD graphene are reported. After air exposure, no traces of Bi2Te3 oxidation are found. Furthermore, it is demonstrated that graphene acts as a very efficient metal and chalcogen diffusion barrier in Bi2Te3/graphene/permalloy (Py) heterostructures, which are relevant for spintronics. Such results are in stark contrast with the significant surface degradation observed in bare Bi2Te3 under ambient conditions and the deep BiTe bonding disruption that occurs in Bi2Te3/Py heterostructures. These findings provide a new approach to control and engineer topological insulator interfaces for spintronic applications and a new platform to investigate the combined use of graphene and topological insulator Dirac states.

RELATIONSHIP BETWEEN SKELETAL ANGULAR PARAMETERS IN PATIENTS WITH OVERBITE AND PROFILE OF THEIR FACIAL SOFT TISSUES

Introduction. One of the most important tasks in the modern orthodontics is to achieve complete function and satisfactory harmonization of facial appearance. Orthodontists rely on the implementation of objective measurements to develop a treatment plan and evaluate its results. Therefore, it is important to clarify the relationship between subjective ratings of facial attractiveness based on photographs and objective measurements.&#x0D; Materials and methods. The analysis was carried out using the certified software for orthodontists Audax Ceph 6.0. A total of 15 cephalograms of patients were examined. The participants included 7 (48.3%) men and 8 (51.7%) women aged from 12 to 33 years. All patients had occlusion pathology in the vertical plane diagnosed retrospectively.&#x0D; Statistical data processing was carried out using special software IBM SPSS Statistics 22. To find out the statistical significance, one-way analysis of variance ANOVA was carried out. Results and discussion. Having analyzed cephalograms, the degree of severity of vertical anomalies was determined. The Bjork index varied from 375 to 400. Statistical research revealed that this indicator does not depend on the sex (p=0.5), but depends on the type of pathology. The Over Bite index varied from 7 to 10. We have found the dependence of this index on the sex (р=0.040). In 43% of cases, this index is detected to be normal in men, while in women there is a deviation from the normal in all cases. The NL-NSL index does not depend on the sex and the type of pathology (р=0.5) in both cases. The ML-NSL indicator does not depend on the sex (p=0.8), however, in 86% of cases, this index deviates from the normal in the individuals with overbite. While in cases of deep incisor overbite, this indicator deviates from the normal in 12.5% of the participants (р=0.002). Conclusion. Thus, based on the data obtained by cephalograms of patients with a vertical bite anomaly (deep bite and deep incisor overlap) in the orthodontic software Audax Ceph, we have revealed that the Bjork index always remains within the normal range in patients with deep incisor overbite, however, almost always pathologically changed in patients with a deep bite.

Overbite recognition and factors affecting esthetic tolerance among laypeople.

To determine recognition ability and the levels of esthetic tolerance of deep bite and anterior open bite (AOB) among laypeople and investigate the factors affecting levels of tolerance. Using a questionnaire, laypeople (N = 100) were examined, and overbite was measured. They were tested for whether they recognized deep bite and AOB. Esthetic tolerance thresholds for deep bite and AOB were selected by incremental depiction in grayscale images. Stepwise logistic regression analyses were used to quantify the effect of recognition and other factors (age, sex, education level, occupation, history of orthodontic treatment, interest in orthodontic treatment or retreatment, and overbite presence) affecting the tolerance of overbite problems (α = 0.05). Of the participants, 55% and 94% recognized deep bite and AOB, respectively. Participants with a deep bite were significantly more likely to esthetically tolerate deep bite compared with those without a deep bite (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.29-9.89). Participants who recognized a deep bite problem had significantly lower esthetic tolerance to deep bite compared with participants who did not recognize a deep bite (OR, 0.17; 95% CI, 0.06-0.45). None of the other eight chosen factors significantly affected the tolerance level of AOB (P > .05). Participants with a deep bite or those who did not recognize a deep bite had significantly higher esthetic tolerance of deep bite than those without or those who recognized the problem (P < .05).

Dynamic analysis of the body's balance with the aid of PODATA platform in patients with vestibular disorders and malocclusions

Introduction : Human posture is linked to a certain stable anatomic position between head, body, and upper and lower limbs. Posturology is the science for the human posture. The connections between the vestibular, ocular, stomatognathic, postural, and proprioceptive systems are studied due to their muscular chains interconnections. Aim : The present research aims to study the characteristics of the body’s balance in patients with vestibular disorders and orthodontic malocclusions, utilizing the PODATA platform. Materials and Methods : A total of 83 patients in the time period November–July 2022 were included. All patients filled out written informed consent forms in order to participate. The study received approval by the Medical University of Varna’s Ethics Committee. Patients were also provided with questionnaires in order to assess their symptoms. An ENT specialist and a dentist examined all patients. Patients were divided into several diagnostic groups. Results : When examined on the platform, patients shifted the center of gravity (CoG) of the body more often backwards and to the right side. Most patients with a shift of CoG backwards and to the right had a temporomandibular disorder (TMD) on the left side. Female patients were more affected than male ones. In patients who also had a vestibular disorder, CoG of the body was more often shifted backwards and to the right. Thirty-one had a malocclusion. Patients with a change of the middle line and deep bite were the most prevalent and they shifted CoG backward and to the right or only backwards. Conclusion: The presented study confirmed that there is a connection between the postural, stomatognathic and vestibular systems. Disorders in either of the systems results in consecutive changes in the others.

Molar impaction patterns and skeletal malocclusions

Objectives: Impacted teeth fail to erupt fully into the oral cavity within the expected time due to interferences with the jaw bone, adjacent tooth, or even the gingivae. The third molar impaction frequency is related to space deficiency in dental arches. This study investigated different patterns of third molar impaction in various skeletal malocclusions in anteroposterior and vertical dimensions.&#x0D; Materials and methods: In this study, 362 panoramic and lateral cephalograms of the patients with orthodontic treatment indications were verified and investigated. The malocclusion type was determined and diagnosed using lateral cephalogram tracing.&#x0D; Results: 39.2% of the patients were male, and 60.8% were female. The mean age of all the patients was 19.2 years; 35.6% of patients exhibited deep bite, and 32% had class II malocclusion. 44.5% of patients had two impacted third molars, and 23.5%, 20.7%, and 11.3% had four, one, and three impacted third molars, respectively. The frequencies of the mesio-angular pattern were 80.8% and 83.5% in the left and right quadrants of the mandible, respectively. The disto-angular pattern frequencies in the left and right quadrants of the maxilla were 91.1% and 93.3%, respectively.&#x0D; Conclusion: The current study revealed that the highest incidence of third molar impaction was in the deep bite and class II malocclusions. The most common pattern of impaction was mesio-angular and disto-angular in the mandible and maxilla, respectively. Statistical analysis showed no significant relationship between the numbers and patterns of third molar impaction and skeletal malocclusion types.&#x0D;