Inclination Of Occlusal Plane Research Articles

Occlusal Plane and Skeletal Changes After Cervical Headgear Treatment With and Without Lower Utility Arch in Class II Growing Patients.

The purpose of this study was to investigate skeletal and dental changes affecting occlusal plane inclination after cervical headgear treatment with and without lower utility arch. In order to distinguish the orthodontic changes from natural growth a control group was employed.The sample of this study consisted by 20 Class II subjects (10 males, 10 females; mean age 8.54) treated by using cervical headgear, 19 class II children (19 males, 9 females; mean age 8.64) treated with cervical headgear and utility arch, and 21 Class II patients (11 males, 10 females; mean age 8.41) who had no therapy.Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for all the treated groups and at the beginning and at the end of observational period for the control group; cephalometric analysis was carried out in order to seek for the modifications between time points and between groups.Means and standard deviation have been analyzed for all the groups. In order to compare the modification between the time points within the same group the ANOVA test was applied. The ANOVA test was used to compare the mean differences (T2-T1) of 3 groups.The study revealed that there were significant changes in occlusal plane inclination after the different treatment modalities employed instead control group. The treatment with cervical headgear and utility arch is more effective than cervical headgear alone in lowering occlusal plane posteriorly when it is compared with controls.

Comparing Clinical and Radiological Manifestations of Adolescent Idiopathic Condylar Resorption and Juvenile Idiopathic Arthritis in the Temporomandibular Joint

This cross-sectional study compared orofacial manifestations at the time of diagnosis in 2 temporomandibular joint (TMJ) conditions: adolescent idiopathic condylar resorption (ICR) and TMJ involvement from juvenile idiopathic arthritis (JIA). This retrospective study included 19 JIAs, 19 ICRs, and 19 control patients, all treated at the Section of Orthodontics, Aarhus University Craniofacial Clinic, Denmark. From patient files, we retrieved radiological data from cone-beam computed tomographies along with information on symptoms and orofacial function at the time of diagnosis. Validated methodologies were used to evaluate TMJ and dentofacial morphology. We found no statistically significant intergroup differences in severity of deformation of TMJ structures (TMJ deformity) between JIA and ICR patients. However, the ICR group showed significantly greater signs of dentofacial deformity on 4 outcome variables: mandibular inclination, posterior/anterior lower face height ratio, mandibular sagittal position, and mandibular occlusal plane inclination. Significant intergroup differences in clinical presentation were seen in 5 of 20 variables. Thus, the JIA group reported significantly more symptoms of TMJ pain, TMJ morning stiffness, and TMJ pain on palpation during the clinical examination, whereas the ICR group reported significantly more TMJ clicking during function and had a higher proportion of patients with anterior open bite. Cone-beam computed tomography examination showed a similar degree of TMJ deformity in ICR and JIA patients at the time of diagnosis. ICR patients presented with a significantly higher degree of dentofacial deformity than JIA patients and healthy controls, which relates to the timing of the diagnosis. Arthralgia, TMJ morning stiffness, and TMJ palpitation pain were more common in JIA patients, whereas TMJ clicking during function and anterior open bites were more common in ICR patients.

Diagnosing mandibular asymmetry using posteroanterior cephalograms in patients with unilateral and bilateral degenerative joint disease

Objectives: The purpose of this study was to evaluate the possible differences in facial asymmetry between bilateral degenerative joint disease (BDJD) and unilateral degenerative joint disease (UDJD) when compared to asymptomatic controls. Materials and Methods: Posteroanterior cephalograms of 61 pre-orthodontic treatment patients (21 BDJD, 20 UDJD, and 20 controls) were evaluated (young adults, between 12 and 25 years of age) to investigate the inclination of the frontal occlusal plane (FOP) and frontal mandibular plane (FMP) to determine vertical asymmetry. Mandibular dental midline shift (DMS) and mandibular midline shift (MMS) were studied to determine transverse asymmetry. FOP, FMP, MMS, and DMS were compared pairwise between study groups, with multiple comparisons justified by Tukey–Kramer procedure. Correlation analyses were performed to evaluate the relationship between the measures. Mantel–Haenszel Chi-square test was used to evaluate the association between groups and symptom severity. Results: The findings suggest that severity of the vertical mandibular displacement was associated with significant differences between BDJD and control patients, and between UDJD groups and control patients. However, they were no significant differences found between UDJD and BDJD patients, and this may be attributable to a different pattern of load on the ipsilateral and contralateral sides of the TMJ when they were compared to the controls. Moreover, the higher values of FOP and FMP correlated with the mandibular displacement being notably greater when the asymmetry was >3°. A similar tendency of a higher prevalence of mandibular displacement with a higher value of DMS and MMS was observed. Conclusion: Clinical implications of this study apply to patients with asymmetry in vertical and transverse dimensions. These patients should be evaluated for dental, skeletal (condylar changes), and soft-tissue changes before orthodontic and/or orthognathic treatment planning.

The changing of occlusal plane inclination in Class II malocclusion

Background: Camouflage treatment of skeletal Class II malocclusion can be performed using extraction or non-extraction techniques. These treatments can cause changes in occlusal plane. Steep occlusal plane during corrective treatment generally relapses after active orthodontic treatment, resulting in unstable interdigitation. Purpose: This study aims to determine and evaluate changes in occlusal plane inclination in skeletal Class II malocclusion cases using extraction or non-extraction techniques of the permanent maxillary first premolar. Methods: The samples consisted of initial and final cephalometry of 40 adult patients with skeletal Class II malocclusion divided into two groups, namely extraction of the permanent maxillary first premolar and non-extraction group. The inclination of occlusal planes in both groups was measured using the ImageJ software, then the factors associated with these changes were observed. Furthermore, the occlusal plane inclination was compared between the extraction and non-extraction groups by using t-test. Results: The occlusal plane inclination in the non-extraction group increased slightly, while the inclination in the extraction group increased significantly (p = 0.017, p-value < 0.05). However, there was no correlation found in the occlusal plane inclination between the extraction and non-extraction groups (p = 0.07, p-value < 0.05). Conclusion: Class II malocclusion correction with either extraction or non-extraction of the maxillary first premolar increased the inclination of the occlusal plane. This study indicated that control of the occlusal plane inclination is highly essential.

Evaluation of Maxillofacial Characteristics in Individuals with Anterior Open Bite Using Denture Frame Analysis.

The aim of this study was to evaluate the effectiveness of denture frame analysis (DFA) in individuals with anterior open bite who had completed pubertal peak growth (post-peak). This retrospective study was conducted using the cephalometric radiographs and hand-wrist X-rays of 50 individuals with open bite (mean age: 17.33±3 years; 35 female, 15 male) and a control group of 50 individuals without open bite (mean age: 17.38±2.72; 35 female, 15 male). All individuals included in the study were skeletal Class I and had completed or nearly completed skeletal growth. Skeletal and dental measurements pertaining to DFA were done and the data were analyzed using independent samples t test and Mann-Whitney U test. Measurements assessing the vertical dimension showed that GoGn/SN, Frankfurt horizontal (FH)/mandibular plane (MP), palatal plane (PP)/MP, occlusal plane (OP)/MP, and OP-MP/PP-MP measurements were significantly greater in the open bite group (p<0.001). AB/MP angle was significantly larger in the control group (p<0.05). The open bite group had shorter A'-P' (posterior maxillary length; p<0.05) and, therefore, higher A'-6'/A'-P' ratio (p<0.01). Our results suggest that there may be a close association between maxillary OP inclination and mandibular position in individuals with open bite, and that open bite may arise due to maxillary denture base deficiency, especially in the posterior region. DFA may be useful in the differential diagnosis of open bite and in treatment planning, particularly when determining the need for tooth extraction.

Layperson and Dental Professional Perception When Evaluating Their Own Virtually 2D or 3D Simulated Esthetic Discrepancies.

To analyze the perceptions of laypersons, dental students, and dentists regarding disparities of the maxillary dental midline and the occlusal plane (OP) when analyzing their own 2D or 3D clinical simulation. 20 participants per group volunteered (N = 60). Intraoral and facial scans, and a photograph were obtained from each participant. Two simulation groups were created: 2D and 3D groups, which were subdivided into two subgroups. In the first subgroup, the OP was modified by 1-degree increments without changing the maxillary midline. In the second subgroup, the OP was modified by the same increments, but the maxillary midline was altered to match the OP inclination. Participants were asked to rate the simulations on a 1-to-6 scale and a question survey. Ordinal logistic regression (OR) was used to analyze the ratings. Tilt of the OP had the strongest negative effect on the ratings which was further amplified by the dental midline inclination (OR = 0.122). Midline modification alone did not affect the ratings (OR = 0.744). 3D simulations had a stronger positive effect on the ratings compared to 2D simulations. For dental students, the positive rating effect of 3D simulations was similar to dentists. For laypersons, the positive rating effect of 3D simulations compared to the 2D simulations decreased relative to dentists. The survey revealed that 45% of the dentists, 80% of the students, and 50% of the laypersons preferred the 3D simulation. The type of dimensional representation affected the esthetic perception of all participants. 3D simulations obtained higher esthetic ratings for the same esthetic discrepancy than 2D simulations. However, all participants' ratings decreased with increased tilt of the OP and were further decreased with the inclination of the dental midline.

The Occlusal Plane Inclination Analysis for Determining Skeletal Class III Malocclusion Diagnosis.

IntroductionThe occlusal plane is very important in the stomatognathic and aesthetic dentofacial system. Manipulation of the occlusal plane plays an important role in class III malocclusion correction. For this reason, the strategy in establishing the diagnosis, prognosis and treatment plan becomes more complex, so a more comprehensive analysis of the occlusal plane inclination as a parameter of diagnosis is needed for more effective and efficient treatments.AimThe aim of this study was to determine the comparison of occlusal plane inclination between class III and class I malocclusions and to knowing the correlation of occlusal plane inclination in class III malocclusions with the direction of facial growth.Materials and MethodsSamples were secondary lateral cephalograms collected at the Universitas Airlangga (UNAIR) Dental Hospital in October 2017–2018. Cephalograms were traced using the OrthovisionTM software; then, the Mann–Whitney comparative statistical test (p<0.05) was carried out followed by the canonical correlation test.ResultsDifferences in class III and class I malocclusions were found in the OP-AB and OP-FH angles. The OP-AB angle is the occlusal plane inclination which has the strongest correlation compared to others. OP-AB angle is strongly correlated with horizontal growth parameter, especially theSNB. The OP-AB angle is also correlated with vertical growth parameters: the Y axis and the Facial axis.ConclusionThe OP-AB angle is a parameter that can distinguish between class III and class I malocclusions. The OP-AB angle has a strong correlation with vertical and horizontal growth directions.

Evaluation of kinesiography in patients with an inclination of the occlusal plane with crossbite

38 patients with pathology of transversal incisional occlusion and occlusal plane inclination were examined for study the position of the articular disk and the presence of its reposition, including determination of occlusal plane inclination using Hip-plane analyzer, orthopantomogram and telerentgenogram of the head in lateral and direct projections, anthropometric study of plaster models, kinesiography in case of mandibular movement disturbance and TMJ magnetic resonance imaging. Changes characteristic for this type of pathology revealed. The results can be taken into the diagnosis and preparation of a comprehensive treatment plan.

Effectiveness of preoperative orthodontic therapy of an adolescent with skeletal form of mesial occlusion according to X-ray profilometry

The aim of the study is a comparative analysis of the parameters of profile teleradiographs of the head of a teenager in the dynamics of orthodontic preparation for the surgical stage of treatment. Migration of individual teeth at the stage of orthodontic treatment led to the change in the inclination of occlusal plane (Ocp) relative to the jaw base and to the increase of the value of Wits index. In this regard, in order to clarify the volume of interventions at the surgical stage of patients rehabilitation, it is necessary to conduct dynamic comparative analysis of profile teleradiographs of the head obtained before and after the completion of pre-surgical stage of orthodontic treatment. The authors consider it appropriate to analyze the relative position and correspondence of the sagittal dimensions of the upper (NL) and lower (ML) jaws to the anterior section (SN) of the skull base, and to take into account the size of the chin protrusion determining the position of Pg point when measuring the profile angle and facial aesthetics according to Rickets.

Differences in heritability of craniofacial skeletal and dental characteristics between hypo- and hyper-divergent patterns using Falconer's method and principal component analysis.

To investigate the difference in heritability of craniofacial skeletal and dental characteristics between hypodivergent and hyperdivergent patterns. 53 Korean adult monozygotic (MZ) and dizygotic (DZ) twins and their siblings were divided into a hypodivergent group (Group 1, SN-MP < 35°, 17 MZ pairs; 11 DZ and sibling [DS] pairs of the same gender) and hyper-divergent group (Group 2, SN-MP > 35°, 16 MZ pairs; 9 DS pairs of the same gender). A total of 56 cephalometric variables were measured using lateral cephalographs. Craniofacial structures were divided into anteroposterior, vertical, dental, mandible, and cranial base characteristics. Falconer's method was used to calculate heritability (h2 > 0.8, high). After principal component analysis (PCA), the mean h 2 value of each component was calculated. Group 1 exhibited high heritability values in shape and position of the mandible, vertical angular/ratio variables, cranial base shape, and maxillary incisor inclination. Group 2 showed high heritability values in anteroposterior position of the maxilla, intermaxillary relationship, vertical angular variables, cranial base length, and mandibular incisor inclination. Occlusal plane inclination showed high heritability in both groups. Although vertical structure presented a high overall mean h 2 value in Group 1, there were no structures that exhibited a high overall mean h 2 value in Group 2. PCA derived 10 components with 91.2% and 92.7% of cumulative explanation in Groups 1 and 2, respectively. It is necessary to estimate or predict growth according to vertical pattern for providing differential diagnosis and orthodontic/orthopedic treatment planning.

Association of anterior and posterior occlusal planes with different Angle and skeletal classes in permanent dentitions : Alateral cephalometric radiograph study.

ObjectivesMalocclusions affect about two-thirds of the population and orthodontic treatment is justified in 65% of these. However, the associations between anterior and posterior occlusal plane (AOP, POP) inclinations and Angle classification are lacking.Patients and methodsIn a retrospective study, lateral cephalometric radiograph tracings of 230 previously untreated Caucasians, aged 13 to 49 years, yielded inclines of the bisector occlusal plane, AOP, and POP. All inclinations were referenced to the Sella-Nasion line and the Frankfort horizontal and were assigned to the Angle classification as well as skeletal groups (retrognathic, neutral, prognathic). Quantile regressions were calculated.ResultsIn the skeletal groups the angles between Sella-Nasion line and both AOP and POP were significantly different between the groups (p < 0.01), showing steep inclines in skeletal class II and flat inclines in skeletal class III. The angles Frankfort horizontal-to-POP and Frankfort horizontal-to-AOP showed the same trends but only the latter differed significantly between the groups (p = 0.02). Among the Angle groups, AOP inclinations did not differ significantly for both reference planes whereas POP inclinations were significantly different (p = 0.01 to Frankfort horizontal, p = 0.02 to Sella-Nasion). Angle class I patients showed the flattest POP.ConclusionOcclusal plane inclines, measured to Sella-Nasion, were more consistent than those referenced to Frankfort horizontal. Sella-Nasion related anterior and posterior occlusal plane inclinations were steep in skeletal class II and flat in skeletal class III patients over all quantiles. Using the Angle classification, anterior and posterior occlusal plane inclinations did not follow this principle.

Hemimandibular Hyperplasia Correction by Simultaneous Orthognathic Surgery and Condylectomy Under Digital Guidance

Orthognathic surgery with simultaneous condylectomy under digital guidance has been proved to be a feasible method to treat hemimandibular hyperplasia (HH). The objective of this study was to evaluate the effects and precision of correction of HH by use of this method. This was a case-series study. Fourteen patients with HH who had undergone simultaneous bimaxillary orthognathic surgery and condylectomy from January 2016 to April 2017 were included in this study. Presurgical virtual treatment planning was performed, transferred to the operation room, and realized with the assistance of surgical navigation and 3-dimensionally printed occlusion splints. Postoperative computed tomography data were used to analyze improvement in facial symmetry and verify the accuracy of the surgical procedure. All patients exhibited satisfactory clinical effects; facial asymmetry was corrected as expected. Postoperative validation showed that the presurgical planning had been achieved more precisely on the unaffected side than on the affected side. Moreover, bilateral mandibular proximal segments showed a tendency for outward rotation compared with the presurgical planning model. Furthermore, when we assessed facial symmetry compared with the presurgical model, deviation of all midline landmarks was less than 2mm, occlusal-plane inclination was less than 1mm, and the asymmetry index of paired landmarks was remarkably decreased after surgery (P<.01). Orthognathic surgery with simultaneous condylectomy under digital guidance is a realistic and precise method for treatment of HH. Surgical results can be validated during surgery by virtual navigation. However, movement of each bone segment cannot be accurately controlled as planned before surgery.

A regularity changes occlusal plane inclination in the case of treatment of distocclusion by fixed individual lingual appliance

To assess the direction of rotation and the degree of change in inclination of the occlusal plane in cases with distocclusion. The study included 56 patients, of which 44 were female and 12 were male, with distal occlusion of the dentition and deep overbite. We studied the position of the occlusal plane, relative to the geometric center of the Ramus - point Xi in two groups of patients: 50% with occlusal Biteplanes and 50% without occlusal Biteplanes in the upper canine's brackets. In both groups, the position of the occlusal plane, relative to the point Xi, has improved: in the first - by 1.2 mm, the second - by 2.4 mm. The comparison of the dataset shows automatical improving of position of the occlusal plane in both groups. The most pronounced changes, detected in the treatment with lingual braces, shows Biteplane group.

CLINICAL ASPECTS AND ORTHODONTIC TREATMENT TACTICS IN INCLUDED DENTAL DEFECTS CASES COMBINED WITH DENTITION DEFORMATION

Research results of clinical aspects of dentition deformation in cases with included dental defects and different structures of maxillofacial region are presented in the article. Toque and angulation teeth abnormality on the side of the dentition defect, resizing of the dental row, changing of the occlusal plane inclination, dentition ratio abnormality all of these are the main symptoms. The combination of dental row deformation sings depends on the structure type of maxillofacial region. The orthodontic treatment tactics of patients with dentition deformation and included dental defects are justified subject to the comprehensive rehabilitation.

Three-dimensional morphological characterization of malocclusions with mandibular lateral displacement using cone-beam computed tomography

Objective: The purpose of this study was to evaluate the morphologic characteristics of MLD malocclusions using 3D imaging.Materials and methods: MLD characteristics were examined using CBCT data in 40 subjects. A 3D Cephalometric analysis was developed to describe the spatial position of the mandible and temporal bones.Results: Vertical dental heights were shorter and the posterior occlusal plane (POP) presented a steeper sagittal inclination on the shifted side (the side of the laterally displaced bony chin) than on the contralateral side. (p < 0.01). The MLD was related to a superiorly inclined POP Cant in the same direction (r = 0.82; p < 0.01). The shifted side condyle was dislocated medially and was smaller. Temporal bone sagittal inclination showed a more forward and medial inclination on the contralateral side (p < 0.01).Conclusions: A unilateral decrease in the vertical height of the dentition and the subsequent steeper occlusal plane inclinations correlated with (1) mandibular rotational displacement and condylar lateral displacement, (2) mandibular and condylar morphologic changes (3) changes in temporal bone position.

Cephalometric study of the position of ala-tragus line in relation to Frankfort horizontal plane and occlusal plane among Ludhiana population

Introduction: The inclination of occlusal plane (OP) is determined by paralleling the OP to ala-tragus line. Inspite of its wide acceptability, the exact location of tragal point on ala-tragus line is unclear. In addition, morphologic features vary among various ethnic groups. Therefore, it is important to evaluate the exact reference point on tragus among Ludhiana population. Aim: The aim of this study is to determine the posterior reference point of the ala-tragus line that forms the most parallel line with the natural OP among Ludhiana population. Methodology: Digital lateral cephalograms were taken in 100 dentulous Angle's Class I subjects of 18–30 age group. Stainless steel balls were attached to ala of the nose (A) and three points that corresponded to superior (S), middle (M), and inferior (I) points on the tragus of ear. The angle formed by each line (SA, MA, and IA planes) with Frankfort horizontal (FH) plane and OP were measured on all tracings of cephalograms. Results: The mean angular value of IFH (angle between IA-FH planes) was the closest to the Cant of OP, and the mean angular value of IOP (angle between IA plane and OP plane) was the least compared to angles MOP (angle between MA-OP planes) and SOP (angle between SA-OP planes). Conclusion: The inferior point marked on tragus is the most appropriate point for marking ala-tragus line among Angle's Class I subjects of Ludhiana.

Factors associated with occlusal plane inclination in adults

Factors associated with occlusal plane inclination in adults

Fabrication of Single Complete Denture Using Customized BOPA

Proper occlusal plane is an essential consideration to fabricate single complete maxillary denture. The determination of the occlusal plane can have profound effect on the short and long term success of a restorative case. To determine the appropriate occlusal curve for individual patients and to compare the deviation of the clinical occlusal curve with the ideal ones, we have fabricated customized BOPA. The inclination of occlusal plane straightly governs the balance of occlusion in complete denture. Any changes, even the slightest bit in the plane of occlusion will modify both the physical and functional relationship of the oral musculature, which will result in an alteration in the comfort, function as well as the aesthetic value.

Surgical correction without bone grafts of maxillofacial asymmetric deformities in patients treated for unilateral temporomandibular joint ankylosis

With the inclusion criteria of patients confirmed and the therapeutic effects and stability evaluated, this article presents the clinical value of bimaxillary orthognathic surgery without bone graft of maxillofacial asymmetric deformities in patients treated for unilateral temporomandibular joint (TMJ) ankylosis. From 2008 to 2012, 12 patients with dentomaxillofacial asymmetric deformities secondary to unilateral TMJ ankylosis who had undergone TMJ reconstruction as the primary surgery were included in the study. Preoperatively, all patients had compensatory occlusal plane and maxillary inclination <10° and mandibular advancement <15mm according to computer-assisted 3-dimensional surgical simulation and prediction. Patients received LeFort I osteotomy and bilateral sagittal split rami osteotomy without bone graft, and genioplasty. Pre- and postoperative and long-term radiographic examinations were done to evaluate the therapeutic effects. Maxillofacial asymmetry and abnormal occlusions in patients were clearly improved in the parameters of facial appearance and occlusion as recorded pre- and postoperatively and long term. All patients obtained satisfactory results and were stable in the 36- to 50-month follow-up period. The bimaxillary orthognathic treatment protocol without bone grafts described in this study can provide stable improvement in facial appearance and occlusion of secondary dentomaxillofacial deformities in appropriate patients with unilateral TMJ ankylosis.

Class II malocclusion with accentuated occlusal plane inclination corrected with miniplate: a case report.

ABSTRACTIntroduction: A canted occlusal plane presents an unesthetic element of the smile. The correction of this asymmetry has been typically considered difficult by orthodontists, as it requires complex mechanics and may sometimes even require orthognathic surgery. Objective: This paper outlines the case of a 29-year-old woman with Class II malocclusion, pronounced midline deviation and accentuated occlusal plane inclination caused by mandibular deciduous molar ankylosis. Methods: The patient was treated with a miniplate used to provide anchorage in order to intrude maxillary teeth and extrude mandibular teeth on one side, thus eliminating asymmetry. Class II was corrected on the left side by means of distalization, anchored in the miniplate as well. On the right side, maxillary first premolar was extracted and molar relationship was kept in Class II, while canines were moved to Class I relationship. The patient received implant-prosthetic rehabilitation for maxillary left lateral incisor and mandibular left second premolar. Results: At the end of treatment, Class II was corrected, midlines were matched and the canted occlusal plane was totally corrected, thereby improving smile function and esthetics.