Dentoalveolar Compensation Research Articles

Unilateral condylar hyperplasia treated with simultaneous 2-jaw orthognathic surgery and posterior segmental osteotomy.

A 25-year-old woman presented with left condylar hyperplasia, canting-type facial asymmetry, mandibular prognathism, and arch width discrepancy. Bone scintigraphy confirmed the inactive status of the condyle, and the temporomandibular joint functioned within the normal range; thus, orthognathic surgery without condylectomy was performed. To correct facial asymmetry successfully through orthognathic surgery, sufficient dentoalveolar decompensation must be achieved in the presurgical orthodontic phase. In cases of canting-type facial asymmetry, teeth on the nondeviated side are extruded as dentoalveolar compensation. Therefore, vertical decompensation is required for intrusion of the extruded teeth. A miniscrew and resin build-ups were used for the intrusion of teeth, and posterior segmental osteotomy was simultaneously performed with orthognathic surgery for further intrusion. The canting-type facial asymmetry was notably corrected through successful vertical decompensation and close cooperation between orthodontists and maxillofacial surgeons. After 2 years of retention, the treatment results remained stable.

Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion: About A Case Report

Class III skeletal malocclusions are considered to be ones of the most challenging deformities for orthodontists, they may present several forms, among which maxillary deficiency is the most frequent. This type of malocclusion is usually treated with combination of orthodontics and orthognathic surgery in order to obtain an adequate occlusion and facial esthetics. This report presents the treatment of a young female patient aged 16 years and 4 months with Class III skeletal malocclusion, and a severe anterior crowding with palatal displacement of the maxillary lateral incisors and ectopic canines, as well as an Angle Class I molar relationship occlusion on both sides associated with significant dento-alveolar compensation : The upper incisors were proclined while the lower incisors were vertical, and a maxillary midline shift .Clinical examination has also revealed a retrusive maxilla, underdeveloped cheekbones, and a flat facial profile. The treatment was performed in three phases: first, presurgical orthodontic preparation including extraction of the maxillary first premolars and mandibular second premolars in order to perform the orthodontic decompensation, secondly, orthognathic surgery which consists of maxillary advancement to improve soft-tissue projection of the midface, and finally, orthodontic finishing for the conclusion of the case. At the end of the treatment, the main objectives were successfully achieved, providing the patient with adequate masticatory function, pleasant facial esthetics and especially better self-esteem.

A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

Evaluation of the stability of treatment with Herbst appliance associated with Hyrax expander and fixed orthodontics through counterpart analysis: A longitudinal follow-up study.

The aim of this study was to evaluate the stability of treatment with a Herbst appliance associated with Hyrax expander (Stage I), followed by fixed appliances (Stage II) and follow-up for an average of 4 years after Stage II, on dentoskeletal facial structures. This study involved 50 adolescents with Angle Class II division 1 malocclusion associated with mandibular retrognathism: Treated Group (TG-25) and Control Group (CG-25). Lateral cephalometric radiographs were taken: T1, immediately before Stage I (TG) or at the beginning of the follow-up period (CG); T2, at the end of Stage I (TG) or the follow-up period (CG); T3, at the end of Stage II (TG); and T4, on average, 4 years after Stage II (TG). Enlow's counterpart analysis and some cephalometric measurements were evaluated. Parametric and non-parametric tests were used (P≤ 0.05). The ramus alignment variables (P< 0.001), SNB (0.040), ANB (<0.001), 1.PP (P= 0.015), 1.MP (P< 0.001), ms/RLp (P< 0.001), mi/RLp (P< 0.001) and S-LS (P= 0.005) showed differences between TG and CG from T1 to T2. Longitudinally, there were differences in ramus alignment, P= 0.003, T1 > T2 < T3=T4; SNB, P= 0.016, T1 < T2=T3=T4; ANB, P< 0.001, T1 > T2=T3=T4; 1.MP, P< 0.001, T1 < T2=T3=T4; ms/RLp, P= 0.002, T1=T2 < T3=T4; mi/RLp, P< 0.001, T1 < T2=T3=T4; S-LS, P< 0.001, T1 > T2=T3=T4 and S-LI, P= 0.003, T1=T2=T3 > T4. The nasomaxillary complex (MCF/PM alignment) tended to a retrusive effect to compensate the degree of mandibular retrusion. The protrusive effect of the lower facial third was evident after the Herbst stage and did not remain stable in the follow-up. The dentoalveolar compensation and improvement in facial profile remained stable.

Treating Gnathic form of Mesial Occlusion in Early Adolescence Patients: A Clinical Trial

AIM: The aim of the study was to evaluate the early and late results of the non-surgical orthopedic treatment efficiency in 12–14 years old children with the gnathic forms of mesial occlusion by the dentoalveolar compensation utilizing a permanent device with a palatal expanding screw. METHODS: The study enrolled 26 patients aged 12–14 years who underwent orthopedic treatment by the dentoalveolar compensation using a permanent device with a palatal expanding screw. Late treatment results aged 4–6 years were analyzed for 21 patients by cephalometric indices, five patients were excluded from the study due to change of residence. The comparison group included 20 patients of the same age and diagnosis who received orthopedic treatment with a face mask. RESULTS: The method of treatment utilizing a permanent apparatus with a palatal expanding screw showed better results than the facemask therapy. More pronounced changes of the general growth vector of the facial skeleton toward the maxilla normalization were noted. The anteroposterior relations between the jaw bases were normalized, the normal position of the upper and lower incisors was achieved, a stable interincisal angle was formed, and the aesthetics of the facial profile significantly improved. CONCLUSIONS: Using a fixed apparatus with a palatal expanding screw has significantly improved patients’ morphological, physiological, and esthetic performance. The evaluation of late results (from 4 to 6 years) showed normal development of the dentistry system in 90.5% of cases that allowed avoiding surgical intervention in these patients after the end of skeletal growth.

The influence of orofacial functions on sagittal growth and development of occlusion

Introduction. Orthodontics experience has shown that dental compensation of some skeletal irregularities is under the positive influence of external factors. During sagittal development of cranial base and dental arches, they can be placed in relationship of I, II or III skeletal and dentoalveolar class. Malocclusion may be caused by a skeletal irregularity. Despite that, normal occlusion can be achieved by dentoalveolar compensation. The aim of this study was to investigate the influence of orofacial functions on maxillary and mandibular growth, as well as occlusion development in sagittal plane. Material and method. This study consisted of 60 male and female adolescents (average age 15.9). Types of respiration and deglutition were clinically determined. Molar relation and length of dental arch were evaluated from study models. On the lateral cephalograms the following parameters were measured: angles SNA, SNB, ANB, I/SpP and i/MP. Results showed that 78.8% of patients with regular orofacial functions and 11.1% of patients with irregular functions had developed molar class I. Patients with skeletal Class I and Class III and irregular orofacial functions, had protrusion of upper incisors in 88.9% (I) and 80% (III) and high length of maxillary dental arches in 58.8% (I) and 70%(III). Conclusion. There is relationship between orofacial functions and dental compensation of sagittal skeletal irregularities.

A retrospective long-term comparison of early RME-facemask versus late Hybrid-Hyrax, alt-RAMEC and miniscrew-supported intraoral elastics in growing Class III patients

To compare the long-term dentoskeletal effects of early treatment with banded or bonded RME (Rapid Maxillary Expansion)-Face Mask (RME-FM) versus late treatment with bonded Hybrid-Hyrax, alt-RAMEC (Alternate Rapid Maxillary Expansion and Contraction) and intraoral Class III elastics anchored to miniscrew-reinforced-Lower-lingual-Arch (alt-RAMEC-HH-LLA) in growing, maxillary retrognathic patients. Two groups were matched at long-term follow-up retrospectively. Patients received either early RME-FM (n=16, 5 males, 11 females, age T1: 6.5±0.9 years, age T2: 15.8±2.5 years) or late alt-RAMEC-HH-LLA (n=15, 7 males, 8 females, age T1: 12.52±0.94 years, age T2: 16.8±0.9 years). Total follow-up was 9.2±2.3 years and 4.2±0.2 years respectively, including fixed appliances to compete treatment. Both treatments resulted in Class III correction except one unsuccessful case of alt-RAMEC-HH-LLA. Active maxillary protraction was 1.6±0.5years with RME-FM and 0.5 years with alt-RAMEC-HH-LLA being significantly shorter (P<0.001). Values at T2 estimation with multivariate linear regression for correlated multiple outcomes, conditional on baseline estimates, age and sex showed alt-RAMEC-HH-LLA inducing significantly more retroclined lower incisors (mean: -6.11°; 95%CI: -10.66, -1.57; P=0.01), less overbite (mean: -1.28mm; 95%CI: -1.79, -0.761; P<0.001), less maxillo (Co-A)- (mean: -4.54mm; 95%CI: -7.91, -1.16; P=0.01) mandibular (Co-Gn) (mean: -10.5mm; 95%CI: -17.45, -3.55; P=0.003) projections/size, more open gonial angle (mean: 4.93°; 95%CI: 2.27, 7.59; P<0.001), and less S-N length (mean: -5.04mm; 95%CI: -6.57, -3.51; P<0.001). Patients treated with either early RME-FM or late Alt-RAMEC-HH-LLA had comparable overall post-pubertal skeletal and overjet corrections. However, the late Alt-RAMEC-HH-LLA showed less correction of dentoalveolar compensations and in particular of the mandibular incisors. The overbite, maxillary and mandibular projection and size were lower and the gonial angle was more open.

Masseter muscle thickness and treatment outcomes in children with Class II division 1 malocclusion.

To investigate if treatment outcome in patients with Class II division 1 malocclusion treated by a variety of approaches is affected by masticatory muscle capacity. Seventy-four children with Class II division 1 malocclusion were included in the present study. These were divided into 54 children (10.4 ± 1.6 years of age) treated with fixed appliances including headgear and/or Class II intermaxillary elastics, 12 children (9.9 ± 1.9 years of age) treated with functional appliances and 8 children treated with fixed appliances and other means of treatment. Ultrasonographic masseter muscle thickness measurements were taken before treatment, while lateral cephalograms were taken before and after treatment. Multivariate linear regression analysis was used to assess the association between masseter muscle thickness and treatment outcomes, as well as the gonial angle and treatment outcomes. In children with Class II division 1 malocclusion treated by means other than functional appliances, treatment outcome is not associated with masseter thickness. This may be the case since the application of intermaxillary forces and torque application may offset the functional component in tooth movement. Outcomes following functional appliance treatment may be partly determined by the masticatory muscles. During functional treatment, children with a weaker masticatory system show greater dentoalveolar compensation. This is however not maintained during the second phase of fixed appliance treatment.

Identifying cortical plate inclination as a parameter to re-assess transverse discrepancies in untreated adults with different vertical facial heights-A retrospective CBCT study.

To determine the inclination angles of buccal, palatal cortical plates and assess its harmony with existing molar buccolingual inclination in adults with different vertical facial heights. The aim of this study was to identify the role of cortical plate inclination as a diagnostic tool for determining alveolar support in adults with transverse discrepancies. One-hundred and fifty seven CBCTs (50-Hypo-divergent, 51-Normo-divergent and 56-Hyper-divergent growth patterns) of untreated adults were utilized. Cross-sectional slices with respect to the maxillary first molar were taken as orientation landmarks in defined reference planes. Inclination angles for the first molar, buccal and palatal cortical plate were determined with respect to the palatal plane. ANOVA and Post Hoc Tukey's HSD test were carried out to determine significant differences between groups. Molar inclination was significantly greater in hyper-divergent groups compared to normo-divergent and hypo-divergent groups (P<.05). Greater variation between molar inclination and cortical plate inclination (buccal and palatal) was seen in hyper-divergent groups (P<.05). Hypo-divergent and normo-divergent groups showed almost similar molar and cortical plate inclinations; however, there was a significant difference between the buccal and palatal cortical plates (P<.05). Cortical plate inclination is in agreement with molar inclination in hypo- and normo-divergent groups when compared to hyper-divergent groups. In adults with decreased/normal facial heights, greater balance and harmony is observed between the dental and alveolar substructures in the posterior region. In adults with increased facial heights, a greater amount of dentoalveolar compensation is seen with respect to the molar and its surrounding bone support.

Class II correction by maxillary en masse distalization using a completely customized lingual appliance and a novel mini-screw anchorage concept \u2013 preliminary results

BackgroundThe aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized lingual appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects.Methods This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05).ResultsNinety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected.ConclusionsThe technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.

Vertical stability of different orthognathic treatments for correcting skeletal anterior open bite: a systematic review and meta-analysis.

Several orthognathic procedures have been applied to correct skeletal anterior open bites (SAOB). Which method is most stable has been debated and no consensus has been reached and there is no conclusive evidence for clinicians to use. To analyse whether maxillary, mandibular, or bimaxillary surgery provides a better stability. A systematic search was conducted up to December 2020 using PubMed, EMBASE, Medline, Scopus, Web of Science, Cochrane CENTRAL, and Google Scholar. We made direct comparisons among the controlled trials and also made indirect comparisons via subgroup analysis on the aspects of occlusional, skeletal, and dento-alveolar stability to assess the overall stability of each method. Finally 16 cohort studies were identified. At the occlusional level, pooled change in overbite was 0.21 mm in maxillary surgery, 0.37 mm in bimaxillary surgery, and -0.32 mm in mandibular surgery. At the skeletal level, pooled sella-nasion-Point A angle (SNA) was -0.12 degrees in bimaxillary surgery, -0.37 degrees in maxillary surgery and -0.20 degrees in mandibular surgery. The sella-nasion to palatal plane angle (SNPP) relapsed to a statistically significant degree in all samples received single maxillary surgery. Relapse of the sella-nasion-Point B angle (SNB) was 0.47 degrees in mandibular setback, -1.8 degrees in mandibular advancement, and -0.48 degrees in maxillary surgery. The Sella-Nasion to mandibular plane angle (SNMP) relapsed more in procedures involving bilateral sagittal split osteotomy than in other procedures. As for dento-alveolar changes, intrusion of molars and extrusion of incisors took place in most patients. Bimaxillary surgery produced the most beneficial post-operative increase in overbite, maxillary surgery led to a lesser but still positive overbite change, and mandibular surgery correlated with some extent of relapse. Skeletally, bimaxillary surgery was more stable than maxillary surgery at both SNA and SNPP; SNB was more stable in mandibular setback than advancement; and SNMP was unstable in both mandibular and bimaxillary surgeries versus maxillary surgery with comparable surgical changes. Dento-alveolar compensation helped maintain a positive overbite. CRD42020198088.

Herbst Appliance palatally anchored in the treatment of dental class II malocclusion

In this case report, Authors describe the correction of a class II malocclusion using only an Herbst appliance palatally anchored with miniscrews. Before sagittal correction in the same appliance we applied a palatal screw to obtain maxillary expansion. The device were removed after 12 months of treatment. The final result included the correction of Class II malocclusion by lower dentoalveolar compensation mainly. The lip function favorite the spontaneous correction of upper frontal torque with consequent improvement of facial esthetics. After a follow up of 12 months the clinical result is satisfactory in terms of occlusion and esthetics. This clinical case showed a simple orthopedic and dentoalveolar approach to correct transversal discrepancy, dental class II malocclusion and also frontal proclination only with one appliance in a very short treatment time.

The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol. Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies. Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation. Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

Tratamento de má oclusão de Classe III subdivisão com mordida cruzada posterior unilateral através da técnica multiloop edgewise archwire (MEAW) – relato de caso

The aim of this study was to report a clinical case of treatment of Class III subdivision malocclusion with unilateral posterior crossbite using the Multiloop Edgewise Archwire (MEAW) technique. A 19-year-old male patient reported mandibular prognathism as the main complaint. He had Angle Class III malocclusion, unilateral posterior crossbite on the right side, top bite in the anterior region, non-coincident midlines and facial asymmetry. Due to the patients refusal of surgical treatment, dentoalveolar orthodontic compensation was proposed. The MEAW technique associated with 3/16” intermaxillary elastics were used. At the end of the treatment, a Class I occlusal relationship between canines and molars, correction of the unilateral posterior crossbite and coincidence between the midlines was obtained. The MEAW technique was effective in correcting Class III subdivision malocclusion and unilateral posterior crossbite.

Algorithm for treatment of patients with class II malocclusion rejecting orthognathic surgery

Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.

Orthodontic camouflage treatment using a passive self-ligating system in skeletal Class III malocclusion

Background: The treatment options for adults with skeletal Class III malocclusion can be dentoalveolar compensation, also known as orthodontic camouflage, or orthognathic surgery. Camouflage treatment can be carried out with teeth extractions, distalisation of the mandibular dentition, and use of Class III intermaxillary elastics. However, intermaxillary elastics as anchorage has its own risk–benefit. Purpose: To explain that camouflage treatment with teeth extractions can be performed in a mild to moderate skeletal Class III malocclusion using intermaxillary anchorage with elastics, while minimising the deleterious effects and achieving a satisfactory treatment outcome. Case: Our patient was a 25-year-old female who had a skeletal Class III pattern, with normal maxilla and a protruded mandible. She had a straight facial profile with a Class III canine and molar relationship on her right and left sides. Anterior crossbite was also present with crowding on both the maxilla and the mandible. Case Management: The treatment plan was carried out with dentoalveolar compensation by extracting teeth. Extraction of the lower first premolars was conducted to eliminate the crowding and correct the anterior crossbite. The mandibular incisors were retroclined and the maxillary incisors were proclined with dentoalveolar compensation. Passive self-ligating system was used with standard torque prescription, intermaxillary anchorage, and no additional appliances for anchorage control. Class I canine and incisor relationship were both achieved at the end of the treatment, while maintaining the Class III molar relationship. Conclusion: Orthodontic camouflage treatment in an adult patient using a passive self-ligating system and intermaxillary anchorage can improve facial profile and improve dental occlusion.

Tratamento de Classe II utilizando Propulsor mandibular PowerScope II: Relato de caso clínico

A Classe II de Angle, além de ser uma das más oclusões mais procuradas para tratamento, é também um grande desafio para os ortodontistas. Quando um paciente se apresenta com deficiência mandibular e ainda em fase de crescimento, os aparelhos funcionais, geralmente, são escolhidos para a correção deste problema. Porém, em algumas situações, a falta de colaboração do paciente no uso destes aparelhos, especialmente os removíveis, podem comprometer o resultado do tratamento ortodôntico. Com a evolução dos aparelhos propulsores mandibulares, vários modelos funcionais começaram a surgir no mercado e, dentre estes, o PowerScope, um propulsor fixo híbrido. Entretanto, um dos efeitos esperados de todos os propulsores, sejam eles removíveis ou fixos, além da remodelação dento-alveolar, é a inclinação labial excessiva dos incisivos inferiores. Desta forma, o objetivo desse estudo foi demonstrar o uso do PowerScope II, na correção de Classe II de Angle em um paciente de 12 anos com deficiência mandibular, braquifacial e com incisivos superiores e inferiores vestibularizados. Após planejamento detalhado, optou-se por utilizar aparatologia fixa com prescrição Roth 0,022”, seguida pelo PowerScope II e mini parafusos inferiores bilaterais, como forma de ancoragem, para conter a vestibularização excessiva dos incisivos inferiores. Ao fim do tratamento o paciente manteve o perfil convexo com correção da má oclusão pela compensação dentoalveolar e conseguiu um bom controle de inclinação dos incisivos inferiores. Assim, pode-se concluir que a utilização desse dispositivo associado aos mini parafusos de ancoragem permitem uma abordagem conservadora em tratamentos de Classe II.

Features of the structure of the alveolar process in patients with gnatic form of mesial occlusion

Aim. To assess the size of the alveolar ridge / part of the jaws in patients with gnathic mesial occlusion of the dentition.Materials and methods. A study was carried out, during which we determined the structural features of the alveolar ridge of the upper and lower jaws of 50 adult patients (from 18 to 44 years old), and also studied the presence / absence of the relationship of this parameter with the inclination of the teeth.Results. The smallest thickness of the alveolar bone in the upper jaw was observed in the area of the mesio-buccal root of the first molars and in the area of the first premolars and canines. The smallest thickness of the alveolar bone in the lower jaw was observed in the area of the vestibular surface of the first and second premolars, canines and incisors. The greatest thickness of the alveolar bone is observed in the distal-buccal region of the second molars.Conclusions. A natural mechanism promotes dentoalveolar compensation, while maintaining the amount of bone in the region of the vestibular and lingual alveolar bones to maintain the integrity of the periodontium.

Correlation between Dentoalveolar Heights and Vertical Skeletal Patterns in Class I Malocclusion in Ethnic Javanese.

Objectives Vertical proportions of the face are important determining factors for diagnosis and planning appropriate orthodontic treatment. Orthodontic patients have different vertical and sagittal skeletal discrepancies, as well as associated varying degrees of dentoalveolar compensations. Dentoalveolar is a functional component of the jaw; it plays a role in occlusal dynamics and forms sagittal and vertical maxilla–mandibula relationships. This study aims to analyze the relationship between dentoalveolar heights and several vertical skeletal patterns in patients with Class I malocclusion in ethnic Javanese. Materials and Methods The sample consisted of lateral cephalograms of 75 patients (18 samples were male, and 57 were female). Determined by inclusion and exclusion criteria, the participants were selected from an initial sample of 196 patients with skeletal Class I malocclusion (sella–nasion–A and B [ANB] = 1–4 degrees). Cephalometric analysis was performed using OrthoVision2017 digital software. This analysis measured upper anterior dental height (UADH), upper posterior dental height (UPDH), lower anterior dental height (LADH), lower posterior dental height (LPDH), ANB angle, sella–nasion and mandibular plane (SN-MP), sella–nasion and palatal plane (SN-PP), palatal plane and mandibular plane (PP-MP), Frankfort horizontal plane and mandibular plane (FH-MP), sella to gonion (S-Go), articulare to gonion (Ar-Go), nasion to menton (N-Me), nasion to anterior nasal spine (N-ANS), and anterior nasal spine to menton (ANS-Me). Pearson correlation test was used to assess correlations among all variables ( p < 0.05). Results Significant correlations were observed between dentoalveolar heights and SN-MP, S-Go, Ar-Go, N-Me, and ANS-Me ( p < 0.05). Conclusions Patients with Class I malocclusion in ethnic Javanese exhibit a significant correlation between dentoalveolar and vertical skeletal patterns. UPDH and/or LPDH have a significantly positive correlation with SN-MP, S-Go, Ar-Go, N-Me, and ANS-Me. The orthodontic correction of the decreased or increased facial height included either the extrusion or intrusion of the anterior or posterior teeth in different ways.

Quantifying changes in incisor inclination before and after orthodontic treatment in class I, II, and III malocclusions

BackgroundThis study was designed to determine if orthodontic treatment significantly changes the upper incisor position in Class I, II, and III dental and skeletal malocclusions. MethodsNinety nonextraction-treated patients were included in this retrospective cohort study and divided into three groups: Class I, Class II, and Class III. All cephalometric measurements (ANB, Wits, U1-PP, U1-SN, U1-NA, U1 perpendicular to FH and U1-L1) were taken using the Dolphin Management and Imaging Software, Version 05.05.5070.221436 (United States and Canada). ResultsThe posttreatment values of ANB, Wits appraisal, U1-NA mm, U1-FH mm, IMPA and U1-L1° are statistically significant (P < 0.05) among the Class I, II, and III when compared with the normal values. Also ANB° changes after orthodontic treatment in Class I, II, and III were statistically significant with the greater changes in Class III malocclusion. ConclusionsThere is a significant amount of dento-alveolar compensation for the maxillary incisors not only in patients with Class II and III but also in Class I malocclusions that underwent nonextraction treatments.