Ideal Overjet Research Articles

Effects of two-phase treatment with functional appliances versus one-phase treatment with pre-molar extraction in Class II div 1 monozygotic twins: A case study

The aim of the study was to compare the skeletal, dental, or soft-tissue outcomes of a one-phase camouflage treatment with pre-molar extraction versus a two-phase treatment with combined twin-block high-pull headgear followed by fixed orthodontic treatment in monozygotic twins. 12-year-old male monozygotic twins presented to the dental clinic with complaints about their anterior teeth. Cephalometric analysis of the patients revealed skeletal Class II malocclusion and a long facial type. Extraoral examination of the patients revealed incompetence of lip seal and a convex profile. In Patient 1, the use of a high pull headgear combined with a twin block to correct skeletal anteroposterior and vertical malocclusions with growth modification and then fixed orthodontic treatment was planned. Patient 2 did not comply with the treatment, complaining that the use of the device could cause esthetic problems and difficulties in use. Therefore, camouflage treatment with extraction of four pre-molars was planned as another treatment option for Class II patients in Patient 2. With the camouflage treatment, the patient continued to grow normally. The combined treatment with twin block and a high pull occipital headgear resulted in inhibition of maxillary growth and a reduction in the severity of the skeletal Class II malocclusion, but the mandibular changes were similar in both patients at the end of treatment. Despite the different treatment modalities, both twins achieved a Class I canine-molar relationship and ideal overjet and overbite. Patients can close their lips with improved soft-tissue profiles. The criteria for the choice of treatment depend entirely on the requirements of the patient.

A study on the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction

Objective: To investigate the arthroscopic temporomandibular joint disc reduction on the outcome of orthodontic patients with anterior disc displacement without reduction. Methods: From January 2012 to December 2021, forty treated orthodontic patients with anterior disc displacement without reduction (unilateral/bilateral) and no obvious articular cartilage absorption were selected from Department of Orthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were (17.5±3.8) years old (12-25 years old), including 8 males and 32 females. Twenty patients who had completed arthroscopic temporomandibular joint disc reduction were included in the control group, and twenty patients with untreated temporomandibular joint disc were included in the experimental group. Model measurement (including overjet, etc.), cephalometric analysis (including ANB angle, which was formed by subspinale, nasion and supramental, etc.) and temporomandibular joint magnetic resonance imaging (including measurement of the condyle height of the displacement sides) were used to compare the difference of two groups. Objective grading system was used to evaluate the efficacy of orthodontic treatment. Results: The overjet of the experimental group and the control group after orthodontic treatment was (2.19±0.76) and (1.92±0.94) mm, respectively. Both two groups achieved ideal overjet with no statistical difference (t=1.02, P=0.314). The ANB angle difference before and after treatment in the control group (-1.97°±2.87°) was greater than that in the experimental group (0.09°±1.82°), and the difference was statistically significant (t=2.72, P=0.010). The variation of condyle height before and after treatment was (0.30±1.11) mm in the experimental group and (0.82±1.25) mm in the control group, with no statistical significance (t=1.80, P=0.076). The post-treatment objective grading system scores of the experimental group and the control group were 21.00 (16.00, 24.00) and 21.00 (17.00, 25.00), respectively, which had no statistical difference (U=0.24, P=0.808). Conclusions: In orthodontic patients with anterior disc displacement without reduction and no obvious articular cartilage absorption, whether displaced discs are repositioned after arthroscopic surgery has no significant effect on the orthodontic treatment outcome.

Composite Bite Blocks—An Indigenous, Simple, Fixed Class II Corrector

Fixed functional appliances are used at either the fag end of the growth spurt or after the completion of the same. We orthodontists are yet to come across an appliance which satisfies all the ideal requirements for a fixed functional appliance. Most disadvantages of the fixed functional appliances such as increase in lower anterior facial height, proclination of lower anteriors, constant breakages, and huge expenses were taken into consideration in the basic designing of this ingenious appliance. In this article, a simple fixed functional appliance was designed to function along with fixed appliance therapy to stimulate mandibular growth. After the initial leveling and aligning, 0.019 × 0.025 stainless steel posted arch wires were placed. The bite jumping blocks were fabricated in the upper and lower arches with light cure blue composite. Using indirect bonding trays they were bonded in position. The case finished in an ideal overjet and overbite with a balanced face. Cephalometric values demonstrate an advancement of the mandible.

ASSOCIATION BETWEEN BOLTON'S RATIO AND OVER JET DEVIATION IN CLASS II MALOCCLUSION AMONG SOUTH INDIAN POPULATION- A RANDOMIZED CONTROLLED TRIAL

Introduction: The aim of this study is to analyze the difference in the incidence of tooth size discrepancies using boltons ratio in class II malocclusion with varying overjet. The study groups consists of Group I: normal occlus Materials And Methods: ion with ideal overjet and overbite (control), Group II: Class II div.1 with less than 5mm overjet Group III: Class II div.1 with more than 5mm overjet. The anterior and overall tooth size ratio was calculated for each sample as described by Bolton and included in statistical analysis. The mean anterior and Results: overall Bolton ratio of the normal occlusion group (78.8 and 91.88) is slightly greater than the original value. Class II malocclusion with overjet greater than 5mm showing a lowest anterior ratio, the overall ratio for the class II malocclusion group is almost same. Inter proximal Conclusion: slicing may be recommended in the anterior segment to eliminate the interarch discrepancy especially in increased overjet

A case report on growth modification using facemask therapy in the management of class III malocclusion in a young patient

Background: In a growing patient, orthopaedic treatment of skeletal Class III malocclusion is critical because it can prevent future orthodontic and surgical procedures. Graber’s stated that early treatment by growth modification during the eruption of incisors or before the maxillary incisors become locked behind the mandibular counterparts is more advantageous. Case Description: This case report describes the treatment of a child aged 10 years with skeletal Class III malocclusion. The treatment plan was carried out with the use of a facemask and the results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar, and canine relationship, an ideal overjet and overbite. Conclusion: Thus, growth modification, if done in properly selected cases, alleviates the need for future orthodontic and surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.

Autotransplantation for the correction of unfavorably impacted canines

The canine is diagnosed as impacted when its normal eruption time is significantly exceeded compared to the contralateral canine or the premolars. This case report presents, a female patient 14 years old with bilaterally impacted maxillary canines, retained maxillary deciduous canines, and proclination and spacing of the upper and lower anteriors and peg laterals. The treatment objective was to create a more ideal overjet and overbite relationship, place the impacted canines into position, and improve facial profile. Fixed orthodontic treatment was done with PEA “0.022 × 0.028” ORMCO, MBT prescription. After leveling, aligning, and space closure, extraction of bilaterally retained deciduous canines and autotransplantation of the unfavorably impacted canines were done. To enhance esthetics, composite restoration was done on the peg laterals. The total treatment time was 2 ½ years and the treatment objectives were achieved due to excellent patient cooperation. Facial harmony was good, and proclination and spacing were corrected.

A case of maxillary protrusion and excessive overjet treated successfully by implantation of a temporary anchorage device

This case report describes the treatment of a 15-year-old girl showing Angle’s Class II Division 1 malocclusion with maxillary prognathism and marked labial inclination of the maxillary anterior teeth, which was characterized by a large overjet, overjet occlusion, and mild crowding in the lower jaw. Our treatment completed without root resorption as a result of the combined use of a wire mechanism and anchors has rarely been reported before. The left and right maxillary first premolars were extracted, a temporary anchorage device (TAD) was used for space closure, and oral hygiene maintenance guidance was provided. The total treatment time was approximately 2 years and 7 months. Ideal overjet and overbite relationships were established, and the facial profile improved substantially. The 2-year follow-up assessment showed a morphologically and functionally stable result. For patients with marked maxillary prognathism, orthodontic treatment using TADs enables simultaneous and efficient maxillary anterior tooth retraction and reduction of overjet. Moreover, this treatment has the potential to shorten the treatment duration and contribute to the long-term stability of excessive overjet correction.

Combination of forsus fatigue resistant device and premolar extraction for the management of a skeletal class II malocclusion

Treatment of class II malocclusion requires accurate diagnosis and treatment planning. This case report outlines the successful management of a growing skeletal class II using Forsus fatigue resistant device for correction of skeletal parameters and premolar extractions for correction of dental parameters. The patient’s profile improved significantly with a 4° reduction in ANB angle. An ideal overjet, overbite and molar relation were also attained.

A combined Surgical-Orthodontic treatment in skeletal Class II malocclusion patients

Skeletal Class II malocclusion with mandibular deficiency is one of the most common problems that patients seek treatment. Adult patients with severe skeletal Class II malocclusion need orthognathic surgery for successful treatment. Bilateral sagittal split osteotomy (BSSO) is the most often preferred technique for these patients. This case report briefs about two male patient of age 24 years presented with Class II Skeletal relation, mesoprosopic facial form, horizontal growth pattern and Angle’s Class II div 1 malocclusion who were treated with Bilateral sagittal split osteotomy (BSSO) mandibular advancement. The ideal anteroposterior relation was established along with a Class I molar, incisor, canine relationship and ideal overjet, overbite and the overall facial esthetics were significantly improved. Combined surgical-orthodontic treatment aims to obtain a more harmonious facial, skeletal, dental and soft tissue relationship with an added patient self esteem.

Bolton tooth size analysis in a sample of Sudanese adults

Introduction: A correct proportion between the upper and lower teeth is critical to achieving proper occlusal interdigitation, ideal overjet, and good molar intercuspation at the end of orthodontic treatment. Objectives: To determine the anterior and overall Bolton’s ratio in the Sudanese population, investigate gender differences in tooth size ratios, and to compare these results with Bolton’s original ratio norm. Material and Methods: The sample consisted of dental casts of 104 Sudanese University students with normal occlusion (52 females, 52 males), aged between 16-26 years randomly selected from AL- Neelain University. An electronic digital caliper was used to measure the mesiodistal tooth size of the maxillary and mandibular teeth anterior to the second molars. These measurements were then used to obtain Bolton’s ratio. Mean, range, and standard deviation of the anterior and overall ratios were computed for each subject. T-Tests were used to compare gender differences and to investigate differences between the results of this study and Bolton’s original ratio. Results: Anterior and overall Bolton ratios for males were 78.43±2.44 and 93.901±9.8 and for females were 78.29±2.6 and 91.67±3.3 percent, respectively. There were no statistically significant differences between males and females for the anterior and overall ratios P>0.05. The anterior and overall Bolton’s ratios among Sudanese University students were 78.37 ± 2.54, and 92.79± 7.43 percent, respectively. statistically significant difference between this study and Bolton’s study were found in both anterior and overall ratio P<0.05. Conclusion: Bolton’s mean ratios may not be applicable to Sudanese. Keywords Bolton’s ratio; Sudanese population; tooth-size.

Treatment of Class II div.1 malocclusion with impacted mandibular canine: A case report

Class II malocclusion in nongrowing patient is a great challenge in treatment. Class II div. 1 malocclusion can be the result of a retrognathic mandible, a prognathic maxillary or both. The present article discussed a case of 17 year old female patient presented with Proclined upper anterior, crowding in lower anterior, impacted mandibular canine with increased overjet and overbite, treatment was initiated using fixed orthodontic appliances followed by extraction of upper 1 premolar and retained decidous teeth and exposure of impacted canine. Case was finished with good intercuspation of upper and lower teeth, ideal overjet and overbite were obtained.

Correction of a Class II malocclusion with lateral open bite

This case reports the treatment of a 13-year-old male with Class II malocclusion, mandibular retrusion, lateral open bite, and crowded anterior teeth. Nonextraction approach was used for this patient. Ideal overbite and overjet were achieved. Leveling and aligning with fixed appliance and elastic was applied to correct this case. Rectangular loop was used to achieve mesial tipping and extrusion of the maxillary premolar.

Treatment of anterior open-bite using zygomatic anchorage: a 10-year follow-up case report

Abstract Aim To present the treatment and long-term post-treatment results of an adult case presenting with an Angle Class II anterior openbite malocclusion that involved the use of zygomatic anchorage for the intrusion of the maxillary posterior teeth. Methods A 23-year-old female patient with a bilateral Angle Class II molar and canine relationship, a 4 mm overjet and a 6 mm anterior open-bite was treated using zygomatic anchorage in order to correct the dental and skeletal relationships, and eliminate the anterior open-bite to achieve an ideal overjet, overbite and improved facial aesthetics. Orthodontic brackets were placed on the maxillary and mandibular teeth. Under local anaesthesia, a subperiosteal flap was raised, and two titanium miniplates were bilaterally placed in the zygomatic area. The molars were intruded by applying 400 grams of force to the miniplates via connection to the upper arch wire. Results By intruding the molar teeth using zygomatic anchorage, the anterior open-bite was corrected to achieve an Angle Class I occlusion, an ideal overbite and a harmonious facial profile that were successfully maintained after a 10-year follow-up period.

OCCLUSAL CHARACTERISTICS INCLUDING SPACING AMONG PRESCHOOL CHILDREN: A CROSS-SECTIONAL STUDY

Background: Understanding the association between morphological aspects in the primary dentition and its transition to the permanent dentition provides the possibility of predicting the final permanent occlusion. Study on the occlusal characteristics in deciduous dentition in Nepalese population is limited. This study was aimed to assess the occlusal characteristics and spacing in primary dentition in preschool children.
 Methods: The cross-sectional study was conducted among 432 preschool children around Kathmandu valley after getting permission from Institutional Review Committee of Kath­mandu Medical College and Teaching Hospital. Each child fulfilling the inclusion criteria was enrolled on the study only after their assent and their parent’s consent. The primary molar relation, canine relation, overjet, overbite was assessed using Foster and Hamilton criteria with the teeth in centric occlusion. Primate and physiological spaces were assessed. Data was collected and analysis was done in SPSS version 16.
 Results: Among the participants, (51.9%) were male and (48.1%) female. Primate spaces was seen to be absent on157 (36.3%) children. Physiological space was seen among 190 (44%) children. Flush terminal plane molar relationship was more prevalent among 294 (68%) chil­dren. Class I canine relationship was found in 257(59.5%) children. Ideal overjet was seen in 333 (77.1%) children and ideal overbite was seen among 337(78%) children.
 Conclusions: Favorable characteristics traits were seen in the studied population yet longi­tudinal studies are recommended to predict the possible outcome in permanent dentition.

Occlusal characteristics including spacing among preschool children: a cross-sectional study

Background: Understanding the association between morphological aspects in the primary dentition and its transition to the permanent dentition provides the possibility of predicting the final permanent occlusion. Study on the occlusal characteristics in deciduous dentition in Nepalese population is limited. This study was aimed to assess the occlusal characteristics and spacing in primary dentition in preschool children.
 Methods: The cross-sectional study was conducted among 432 preschool children around Kathmandu valley after getting permission from Institutional Review Committee of Kath­mandu Medical College and Teaching Hospital. Each child fulfilling the inclusion criteria was enrolled on the study only after their assent and their parent’s consent. The primary molar relation, canine relation, overjet, overbite was assessed using Foster and Hamilton criteria with the teeth in centric occlusion. Primate and physiological spaces were assessed. Data was collected and analysis was done in SPSS version 16.
 Results: Among the participants, (51.9%) were male and (48.1%) female. Primate spaces was seen to be absent on157 (36.3%) children. Physiological space was seen among 190 (44%) children. Flush terminal plane molar relationship was more prevalent among 294 (68%) chil­dren. Class I canine relationship was found in 257(59.5%) children. Ideal overjet was seen in 333 (77.1%) children and ideal overbite was seen among 337(78%) children.
 Conclusions: Favorable characteristics traits were seen in the studied population yet longi­tudinal studies are recommended to predict the possible outcome in permanent dentition.

Occlusal Traits of Primary Dentition among Children Visiting a Dental Hospital in Kathmandu, Nepal

Occlusion in deciduous dentition varies among children of different populations and races. Paucity of information in Nepalese literature provided the motive for this study. The objective of this study was to examine the occlusal traits of Primary Dentition among children aged 2-6 year old. A cross-sectional study comprising total of 307 children all having deciduous teeth were included in the study. The dentition was examined using a mouth mirror and explorer under illuminated light in Department of Pedodontics and the data was recorded. All the children were screened for molar and canine relationship, overjet, overbite, spaced and non-spaced dentition. Out of the total, Mesial step terminal plane (62%-left; 58%-right), Flush terminal (33%-left; 36% -right) and Distal step (5%-left; 6%-right) were seen. Most of the children had class I canine relation (83%-left; 84%-right), ideal overjet (68.4%), overbite (63.1%) and spaced dentition. Statistical significant difference was found among the gender with respect to overjet. Presence of spacing was more in maxilla than in mandible which was statistically significant. These findings suggested desirable occlusal characteristics and spacing in primary dentition. However, future longitudinal studies are required to examine whether the transition of these occlusal characteristics will lead to favorable outcome in permanent dentition.

COMBINED ORTHODONTICS AND SURGICAL APPROACH TO CLASS III MALOCCLUSION WITH ANTERIOR OPEN BITE IN ADULTS

Skeletal anterior open bite with Class III malocclusion in adults is one of the most difficult malocclusions to treat. Surgical intervening is a must, along with orthodontics in such complex cases. The most effective treatment option in adult patients with Class III malocclusion and the skeletal anterior open bite is surgical repositioning of the maxilla or both jaws. The present case report describes the treatment protocol for Class III malocclusion with an anterior open bite in adult, a novel orthodontic- surgical approach. A 24-year old male patient with a Class III malocclusion, anterior open bite (skeletal), poor facial aesthetics, mandibular and chin protrusion. The objective was to achieve ideal overjet and overbite, to achieve class 1 incisor, canine and molar relation. To correct anterior open bite and achieve Class I skeletal jaw bases and to achieve esthetically pleasing profile and functionally stable occlusion. Therefore, by correction of the dental and skeletal jaw relationship, we hoped to improve the patient’s self- esteem, confidence and improved oral health quality of life.

Early orthognathic approach combined with SABG for congenital dentofacial deformity-A rare case report

Early orthognathic approach combined with SABG for congenital dentofacial deformity-A rare case report - IJODR- Print ISSN No: - 2581-9356 Online ISSN No:- 2581-9364 Article DOI No:- 10.18231/j.ijodr.2019.008, IP Indian Journal of Orthodontics and Dentofacial Research-IP Indian J Orthod Dentofacial Res

Orthodontic anterior teeth space closure in an adult with posterior long standing fixed partial denture

This is a case report of a 40-year-old female patient with chief complaint of spacing in front teeth. Patient exhibited convex profile, incompetent lips, spacing in anterior maxillary and mandibular teeth. She had maxillary posterior long span fixed partial denture and generalised periodontitis. She was diagnosed as Class I malocclusion with proclined and spaced anterior teeth. Treatment objective include space closure, maintaining class I molar and canine relation, achieving ideal overjet and overbite and functional occlusion. Thorough oral prophylaxis was done prior to start of fixed mechanotherapy. The case was bonded (upper canine to canine and full lower arch) with 022 MBT bracket system. Aligning and levelling was done sequentially with 012,016,17x25 Niti wires. One bracket each side was bonded on the maxillary FPD abutment teeth for anchorage. Space closure was achieved using low forces with elastomeric chain on 19x25 SS wire. Total treatment time was 12 months. Ideal overjet and overbite achieved with functional occlusion. Periodontal condition improved and stable results were achieved. Patient is given fixed retention and removable hawleys retainer with tongue crib in upper arch. In the recent years, there has been an increase in number of adults seeking orthodontic treatment and orthodontists quiite often face patients with periodontal disease. Adult patients should follow regular oral hygiene measure in order to maintain periodontal health during and after active orthodontic therapy.

Evaluation of conformity of preformed orthodontic archwires and dental arch form.

ABSTRACTIntroduction: The alterations in the arch form during treatment are dictated by the dimensions of the archwires. Objective: This study aimed to determine the mean arch dimensions of a sample of Pakistani subjects and to evaluate the conformity of preformed archwires with mandibular arch form. Methods: The dental records of 1,500 adult subjects were evaluated. The mandibular casts of 42 subjects (males = females = 21) with balanced facial profile, Class I occlusion, ideal overjet and overbite were included. Brackets were bonded on all teeth. Arch dimensions were evaluated at canines, first premolars, second premolars, first and second molars, with digital vernier calipers. The arch widths at the level of aforementioned teeth were evaluated on the digitized archwires, using the mean arch depths of the subjects.Results: In males, the archwires were found to be wider at canines and premolars, and significantly narrower at first (p< 0.001, 95% CI = 2.03 - 5.74) and second molars (p< 0.001, 95% CI = 2.29 - 7.73) as compared to the arch dimensions of the mandibular casts. In females, the archwires were significantly narrower at canines (p< 0.001, 95% CI = 1.4 - 3.97), and first (p= 0.02, 95% CI = 0.402 - 4.41) and second molars (p< 0.001, 95% CI = 1.76 - 6.13).Conclusion: No single commercially available archwires evaluated in the present study conformed to the arch dimensions of our subjects. Utilization of the currently available archwires may result in unwarranted modification of arch form, which may lead to unstable post-treatment teeth position.