Protrusion Cases Research Articles

Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis.

Because the number of adult patients seeking orthodontic treatment is increasing, orthodontists are becoming more likely to encounter patients with adult periodontitis. However, it is sometimes difficult to establish anchorage because of poor periodontal tissues in patients with adult periodontitis. This article reports the successful use of skeletal anchorage to treat a maxillary protrusion case complicated by severe adult periodontitis. A female patient aged 50 years seven months showed a skeletal Class II jaw base relationship. A spacing of five mm in the upper anterior teeth with an overjet of 7.5 mm and overbite of four mm was observed. She had generalized horizontal bone loss in both arches, with vertical bone loss in the posterior segment. After periodontal treatment, miniplates were placed in the zygomatic process, and retraction and intrusion of the maxillary incisors were performed. After active treatment for 21 months, the upper incisors had been inclined 9.5 degrees lingually, intruded two mm at the apex, and good anterior occlusion was achieved. Acceptable occlusion and periodontal tissue were maintained after a retention period of two years. Our results suggest that skeletal anchorage is useful for retraction and intrusion of upper incisors in cases of maxillary protrusion with severe adult periodontitis.

Lever-arm and mini-implant system for anterior torque control during retraction in lingual orthodontic treatment.

Anterior torque control during retraction is difficult to achieve with lingual orthodontic treatment. This article describes the use of a lever-arm and mini-implant system as absolute anchorage for controlled retraction of the anterior teeth during lingual orthodontic treatment and evaluates 2 protrusion cases treated with this system. Various clinical situations are discussed and analyzed from a biomechanical standpoint. Mini-implants are needed to control the point of force application in the posterior area and produce en masse retraction with no anchorage loss. When the length of the lever-arm is adjusted to the position of the mini-implant, the desired line of action of the retraction force with respect to the center of resistance of the anterior segment is selected. Controlled retraction of the anterior teeth was achieved with no loss of anchorage. The mini-implant, in conjunction with the lever-arm, is useful not only for absolute anchorage but also for anterior torque control during retraction in lingual orthodontic treatment.

Maxillary Protrusion Cases Treated with Functional Appliances

Maxillary Protrusion Cases Treated with Functional Appliances

上顎前歯部歯槽骨切り術による鼻部・上唇部軟組織側貌の変化 矯正単独症例との比較

The purpose of this study was to investigate soft tissue changes in the nose and upper lip following maxillary alveolar osteotomy. The subjects selected for this study were 20 maxillary protrusion cases, which underwent two different treatment modalities: A surgical group, consisting of 10 subjects treated with a combination of maxillary alveolar osteotomy and orthodontic treatment, and an orthodontic group, consisting of 10 subjects treated with only orthodontic treatment after 4 bicuspids were extracted.For each patient, lateral cephalograms before and after treatment were traced and superimposed, and linear and angular measurements were obtained, and the data from the two groups were compared. We further evaluated the relationship between changes of the hard and soft tissues in each group. The results were as follow:1. After treatment, point A and the prosthion were significantly moved backward, in the surgical group, compared with the orthodontic group.2. There was no significant change of the pronasale in both groups. In the surgical group, subnasale were significantly more retracted than in the orthodontic group. Nasal height increased more in the surgical group than in the orthodontic group. Although there was a significant positive correlation between subnasale and point A retraction in the surgical group, there was no correlation in the orthodontic group.In conclusion, compared with orthodontic treatment, an anterior maxillary osteotomy influences the subnasale by retracting it posteriorly, consequently increasing nasal height and improving the overall facial profile appearance.

Penutupan Ruang Bekas Pencabutan Premolar Satu

The aim of the present study was to investigate the amount of protraction of the anchor teeth (M 1 ), as a result of the retraction of the upper anterior dentition in protrusion cases with extraction of bot upper first premolars, using only upper first permanent molars as anchorage. This condition is surprisingly paid little attention. The data were obtained from pre and post treatment upper dental casts of Class I and Class II malocclusion with protrusion and slight crowding. After ecctraction of two upper first premolars, all patients were treated with fixed appliances. Measurement was gathered by using Coordinate Measuring Machine. The findings from statistical data analysis showed that the closing of the first Premolar extraction space was caused not only by the retraction of the anterior teeth, but also by the protraction of the upper first Molars as big as 40.4%. Compared to both right and left side of the arch, the probabiity of the posterior tooth protraction was even. It was not an anchorage loss investigation but the result indeed would take clinician's more attention to control the anchorage.

Maxillary protrusion cases treated in two phases : Application of 2×4 appliance and facebow headgear

Maxillary protrusion cases treated in two phases : Application of 2×4 appliance and facebow headgear

Socket migration after Charnley arthroplasty in rheumatoid arthritis and osteoarthritis. A roentgen stereophotogrammetric study.

Socket migration and rotation in the Charnley total hip replacement were evaluated by roentgen stereophotogrammetric analysis in 23 patients with rheumatoid arthritis and 23 patients with osteoarthritis. The two groups were matched with regard to age and sex. The follow-up time was two years. In the rheumatoid patients socket migration was most prominent in the proximal direction and averaged 0.6 mm at 24 months as compared with 0.1 mm in the osteoarthritic group (p = 0.0003). Within the rheumatoid group a preoperative acetabular protrusion in five patients was associated with increased migration and rotation in all directions. The increased proximal migration in rheumatoid arthritis was consistent (p = 0.0009) even after the exclusion of the five protrusion cases. In the rheumatoid patients there was a correlation between low body-weight and proximal migration, but there was no such correlation in the osteoarthritic group. Our results suggest that socket fixation is less secure in patients with advanced inflammatory arthritis.

A skeletal maxillary protrusion case with two phases treatment : Application of functional appliance

A skeletal maxillary protrusion case with two phases treatment : Application of functional appliance

Dreidimensionale Modellanalyse von regelrechten und dysgnathen Gebissen bei Verwendung der Koordinatenmeßtechnik

In this article results of three-dimensional measurements are compared for normal occlusions, protrusion cases and class III patients. The results were divided into dental measurements values, values related to the jaws and values of the intermaxillary comparison. They were obtained with the help of a three-coordinate measurement device and a computer. The author takes especially the values of intermaxillary comparison into consideration as a new basis for orthodontic diagnosis from cast measurements.

The Treatment of Bimaxillary Protrusion

Thirty bimaxillary protrusion cases, who had four first premolars extracted were compared with thirty Class I malocclusion cases who, likewise, had similar extractions and treatment. The changes, both in incisor relationships and the concurrent soft tissue profiles are documented. During treatment, the inter-incisal angle was increased by 20 degrees and relapsed by 4 degrees post-treatment. The protuberance of the soft tissue profile was significantly reduced by 4 degrees concurrently (Holdaway Angle). It is concluded that worthwhile treatment objectives can be achieved in these cases.

2 Maxillary Protrusion Cases Treated with Surgical-Orthodontic Correction

2 Maxillary Protrusion Cases Treated with Surgical-Orthodontic Correction

Effects of the maxillary protractor on craniofacial growth of patients with complete unilateral cleft-lip and palate as compared with non-cleft mandibular protrusion cases.

Effects of the maxillary protractor on craniofacial growth of patients with complete unilateral cleft-lip and palate as compared with non-cleft mandibular protrusion cases.

九州歯科大学附属病院矯正科を訪れた患者の過去 20 年間の統計的観察

A statistical investigation was performed on 3, 204 patients who received treatment at the Orthodontic Department of Kyushu Dental College during a 20 year period from 1957 to 1976, concerning distributions of sex, age and time of first treatment, kinds of malocclusion, orthodontic appliances used for active treatment, etc., on the basis of the gnathostatic models, x-ray cephalograms and clinical records which were obtained with these patients. The results were as follows : 1) Out of the 3, 204 total number of the patients, male numbered 1, 069 (33.4%), and female 2, 135 (66.6%). In other words, female accounted for two thirds of the total. 2) Analyzed by ages, patients who received first treatment at the age of 8 formed the largest group, and for older age groups, number of the patients was decreasing yearly. This decreasing tendency was particulaly remarkable with male patients. 3) Analyzed by the kinds of malocclusion, the number of mandibular protrusion cases was the largest among the total number of the patients, that of maxillary protrution cases came next and that of crowding cases came third. Total sum of these three cases accounted for about 80% of total number of the patients. 4) The extraction cases accounted for 40.6% of all cases, and the number of these cases showed increasing tendency year by year. 5) In the frequency of using different kinds of orthodontic appliances for treatment, the use of activators ranked top, that of lingual arch appliances ranked second, that of multiband appliances ranked third, that of chin caps ranked fourth and that of plate appliances ranked fifth. There was observed remarkable increase in the use of multiband appliances during the recent ten year period.

The Advantages of Early (Mixed Dentition) Treatment in Class I and Class II Protrusion Cases

The author contends that early correction of protruding anterior teeth, be they Class I, Class II, or Class III is in the best interest of a child’s dental health. This contention is based on the presumption that muscle forces mold the osseous and dental structures of the face, just as muscle forces affect tissues in the rest of the body. Who will deny that lack of muscle function will cause atrophy? Is it not logical to assume that the earlier the facial musculature can function more normally, the more favorably it will affect the rapidly growing facial tissues? At 7 years of age, the cranium has grown to more than 90 per cent of its adult size. However, the mandibular growth from 3 to 7 years of age seems to be far less than half of that which takes place from 7 to 16 years of age. According to Graber,2 the mandibular body length in boys grows more from 7 to 12 years of age than from 12 to 16 years of age. Since a great proportion of this growth occurs between 7 and 12, is it not reasonable to promote proper muscle function at 7 or 8, to take as great as possible advantage of the growth potential of a child, rather than waiting until the child is 12 or 14? It is on this contention that we “rest our case” for early (mixed dentition) orthodontic treatment of incisal discrepancies.

Treatment of Class II, Division 1 (Angle): II. Differential diagnosis and an analysis of mandibular anchorage

This paper has dealt with a differential diagnosis and an analysis of mandibular anchorage in the treatment of Class II, Division 1. With respect to the dentofacial relationship present, Class II, Division 1 was divided into five types: (a) maxillary protrusions; (b) bimaxillary protrusions; (c) structural mandibular retrusions; (d) functional mandibular retrusions; (e) retrusions of the mandibular dental arch. The resistance of the mandible to enforced change does not permit intermaxillary force to change its growth pattern, size, or position in the manner desired. Since many cases of structural mandibular retrusion are the result of a backward divergent face, it is of utmost importance to differentiate between two types of facial profiles: Type I (forward divergent) and Type II (backward divergent). The resistance of the mandible to enforced change, the Type II or backward divergent face, and the factors that make for the stability of the treated denture place limitations upon the forward movement of the mandibular teeth in treatment. Because of these limitations to forward movement of the mandibular teeth in treatment, the anteroposterior malrelationship of the dental arches in maxillary protrusions and structural mandibular retrusions must be corrected by a posterior movement of the maxillary dental arch. Evidence was presented to show that with few exceptions neither mandibular anchorage nor “prepared” mandibular anchorage without extraction can sufficiently resist the pull of intermaxillary force to effect a posterior movement of the maxillary dental arch without the forward movement of the mandibular teeth. The extraction of four first premolars and Tweed mechanics appears currently to be the best treatment for bimaxillary protrusion cases in patients with Type I or forward divergent faces. The extraction of mandibular teeth in an otherwise regular dental arch in maxillary protrusions and structural mandibular retrusions complicates treatment and invites failure. In conclusion, the use of intermaxillary force for the correction of the anteroposterior malrelationship of the dental arches in the treatment of Class II, Division 1 must be limited to the few cases in which the forward movement of the mandibular dental arch is permissible. In the absence of a standard that would identify these cases with precision, the indiscriminate use of intermaxillary force in the treatment of Class II, Division 1 makes the prognosis doubtful.