Adult Protrusion Research Articles

Application of corticotomy associated with customized lingual orthodontics in treatment of severe bimaxillary protrusion in adults

Bimaxillary protrusion is a clinical condition with high prevalence rate, which damages facial esthetics and affects the mental health of patients. Its clinical manifestations include protrusion of lips, overexposure of teeth, vertical and sagittal overdevelopment of alveolar bone in the anterior areas of upper and lower anterior jaws, and so on. The common protocols for the treatment of severe bimaxillary protrusion is orthodontic treatment with exaction of premolars or combined orthognathic-orthodontic treatment. However, either method is of great difficulty. By systematic mechanical design, the author used the treatment system of customized lingual appliances associated with corticotomy to realize the vertical and torque control of the anterior teeth, and obtain the orthodontic treatment effect of both esthetics and health. The clinical strategies for the treatment of severe bimaxillary protrusion were provided.

Evaluation of lateral hard and soft tissue changes following orthodontic treatment of bimaxillary protrusion in adults

Evaluation of lateral hard and soft tissue changes following orthodontic treatment of bimaxillary protrusion in adults

Evaluation of hard and soft tissue changes following orthodontic treatment of bimaxillary protrusion in adults

Evaluation of hard and soft tissue changes following orthodontic treatment of bimaxillary protrusion in adults

Comparative Evaluation of Periodontally Accelerated Osteogenic Orthodontics (PAOO) Versus Conventional Orthodontic Tooth Movement in Adult Patients with Bimaxillary Dentoalveolar Protrusion.

The aim of the study was to comparatively evaluate periodontally accelerated osteogenic orthodontics (PAOO) and conventional fixed orthodontic mechanotherapy in the management of bimaxillary dentoalveolar protrusion in adults. The selected patients were grouped into two groups: Group I: PAOO procedure followed by orthodontic fixed mechanotherapy; Group II: orthodontic fixed mechanotherapy alone. The total treatment time, the quantum of root resorption, and the periodontal status of Group I and Group II were compared. Group I had a shorter treatment time and stable overall periodontal health, both of which were statistically significantly different compared to Group II. Within the limitations of this study, significant statistical differences were found in the clinical and radiographic parameters among the patients treated with PAOO along with conventional fixed orthodontic therapy as compared to the patients treated with orthodontic therapy alone.

Osteologia e morfologia do condrocrânio de Gastrophryne carolinensis (Anura: Microhylidae), com uma revisão da diversidade osteológica dos Microhylidae do Novo Mundo.

Osteology and chondrocranial morphology of Gastrophryne carolinensis (Anura: Microhylidae), with a review of the osteological diversity of New World microhylids. Microhylidae is a large, cosmopolitan anuran family. Recent molecular analyses have demonstrated the monophyly of the family—a conclusion that is supported by the larval morphology, coupled with the unique mode of tongue protrusion in adults, and a suite of osteological and myological characters seemingly associated with this innovation in feeding. Despite this functional constraint, osteological diversity probably exceeds that of any other anuran family, and this diversity is especially evident in the New World microhylids that comprise two clades, Gastrophryninae and Otophryninae. To facilitate comparisons among these clades, we describe the larval chondrocranium, skeletal development, and adult osteology of Gastrophryne carolinensis. We provide a phylogenetic context for these comparisons through a novel phylogenetic analysis of 45 microhylid genera based on data for one mitochondrial and three nuclear loci from previously published studies. Nearly all relationships within the monophyletic Gastrophryninae are resolved with robust support. Based on these results, we found that the larval chondrocrania of gastrophrynines share morphological features that distinguish them from Otophryne and other anurans. Among the adults, all gastrophrynines show evidence of an anterior shift of the jaws that is correlated with specializations in the otic region, and with the alignment of the planum antorbitale, the cartilage wall separating the nasal capsule from the orbits. The

Speedy surgical-orthodontic treatment with temporary anchorage devices as an alternative to orthognathic surgery

We describe a new type of corticotomy-assisted orthodontic treatment called speedy orthodontics for treating severe anterior protrusion in adults. Once medullary bone is deformed after corticotomy, recovery to its original dimension is impossible if the greenstick fractured bone is ossified as it was deformed. Speedy orthodontics describes a protocol to allow movement of dental segments over a shorter time by using a corticotomy and an orthopedic force with temporary anchorage devices. After proper diagnosis and treatment planning, the maxillary first premolars are removed, and then a corticotomy is performed to outline a block of bone around the maxillary anterior teeth under local anesthesia. An interval of 2 weeks is optimal between the labial and lingual corticotomy for sufficient healing and less patient anxiety. The maxillary anterior teeth are fixated into a single unit with the specially designed lingual retractor. A retraction force of 500 to 900 g per side is applied to the lingual retractor and the C-palatal plate placed in the midpalatal area. After anterior bone segment retraction, finishing is performed with full fixed appliances. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained in adults with protrusion treated by speedy orthodontics. This new type of treatment mechanics can be an effective alternative to orthognathic surgery in adults with protrusion.

圧迫骨短縮術の三次元有限要素法による力学解析

Recently, distraction or compression osteogenesis has been used to treat jaw deformities. The anterior alveolar segment of the maxilla and mandible is moved posteriorly en bloc using a skeletal anchorage device combined with corticotomy to shorten the treatment period for maxillary or mandibular protrusion in adults. This method has many advantages. For example, the invasiveness of surgery is slight and the treatment period can be greatly shortened.We studied the effects of orthodontic treatment combined with/without corticotomy for maxillary protrusion compared to that using the three-dimensional finite element method. Three-dimensional models were developed based on the geometrical model reconstructed from computed tomography. To evaluate the mechanical characteristics of these methods, the following three items were compared: 1) the displacement of the anteriortooth, 2) the displacement of the anterior alveolar segment, and 3) the distribution of the stresses. Greater displacement of anterior tooth and segment were achieved with corticotomy, and the stresses concentrated at the region of corticotomy. These findings suggest that orthodontic treatment combined with corticotomy is useful.

Surgical intervention for adult patients with rectal prolapse.

This review describes the pathogenesis, diagnosis, preoperative testing, and surgical decision making involved in the management of full-thickness rectal protrusion in adults. Historic and current procedures are described in detail. No one procedure is favored over others, and selection depends on the individual characteristics of the patient.

Profile changes following orthodontic treatment of bimaxillary protrusion in adults with the Begg appliance.

Thirty-two adult oriental patients aged 18-26 years who sought treatment for their bimaxillary protrusion were treated with the Begg appliance following extraction of four first premolars. A cephalometric study was undertaken to determine the soft tissue changes in lip profile following treatment. Results show that the upper incisors were retracted by 5.6 mm +/- 0.8 mm and the lower incisors by 4.4 +/- 0.8 mm on the average. The nasolabial angle became more obtuse increasing from 80.7 degrees to 90.7 degrees. The upper lip and lower lip lengthened by 1.9 mm and 1.2 mm, respectively. The lower lip to 'E' line reduced from 7.5 mm to 3.7 mm. All the previous changes were statistically significant (p less than 0.01). The upper lip to upper incisor retraction was 1:2.2 while the lower lip to lower incisor retraction was 1:1.4. The correlation coefficients (r) were 0.72 (p less than 0.01) and 0.80 (p less than 0.01), respectively. The changes in the cants of mandibular and occlusal planes were statistically insignificant. This study shows that the Begg appliance has the ability to significantly reduce bimaxillary protrusions and thereby improve facial aesthetics.

Combined orthodontic and surgical management of maxillary protrusion in adults

Combined orthodontic and surgical management of maxillary protrusion in adults