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17 01, 2025

Non-surgical correction of an adult Class II high-angle with occlusal plane cant by four compromised permanent first molars extraction, preadjusted lingual appliance and miniscrews: A case report

2025-01-17T05:52:58+00:00

Int Orthod. 2025 Jan 15;23(2):100965. doi: 10.1016/j.ortho.2024.100965. Online ahead of print.

ABSTRACT

This case report describes a complex full-step asymmetrical Class II division 1 high-angle in an adult patient treated by extraction of compromised first molars with a preadjusted lingual appliance. Since the patient presented severe sagittal and vertical discrepancies combined with an Izard orthofrontal profile with upper lip protrusion, an extraction camouflage was performed with the twofold aim of obtaining ideal occlusal relationship and profile improvement, correcting occlusal plane cant by selective intrusion with interradicular miniscrews. Appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of solving successfully severe sagittal and vertical discrepancies with significant asymmetric component in adult patient without surgical treatment by means of a completely invisible technique, with the extraction of the most compromised teeth in both arches. This report also underlines the need for careful planning during both diagnostic and treatment phases, with appropriate skeletal anchorage management, in order to obtain the best results.

PMID:39818043 | DOI:10.1016/j.ortho.2024.100965

Non-surgical correction of an adult Class II high-angle with occlusal plane cant by four compromised permanent first molars extraction, preadjusted lingual appliance and miniscrews: A case report2025-01-17T05:52:58+00:00
29 11, 2024

Non-extraction camouflage on a fully cooperative full-step class II division 2 adult patient treated with en-masse distalization, class II elastics and preadjusted lingual appliance: A case report

2024-11-29T11:11:27+00:00

Int Orthod. 2024 Nov 27;23(1):100954. doi: 10.1016/j.ortho.2024.100954. Online ahead of print.

ABSTRACT

This article describes one adult bilateral full-step class II case with severe initial upper incisors retroclination successfully treated by a completely invisible lingual appliance. A non-extraction treatment to compensate for the severe sagittal discrepancy was made possible following the excellent patient cooperation with intermaxillary elastics, combined with upper arch en-masse effective distalization with miniscrews. The application of an auxiliary torque spring was essential to increase upper incisors torque during class II mechanics. This case report shows the possibility of obtaining a full-step class II correction in an hypodivergent adult patient with a completely invisible appliance, taking advantage for the patient cooperation, for a more straightforward and faster non-extraction case resolution. It also underlines on the other hand the importance of successfully controlling incisors torque with auxiliaries in cases of severe retroclination in an adult class II malocclusion, in combination with the simultaneous distalization mechanics for monolateral full-step class II correction, by means of a completely invisible appliance.

PMID:39608335 | DOI:10.1016/j.ortho.2024.100954

Non-extraction camouflage on a fully cooperative full-step class II division 2 adult patient treated with en-masse distalization, class II elastics and preadjusted lingual appliance: A case report2024-11-29T11:11:27+00:00
30 10, 2024

Invisible treatment with preadjusted lingual appliance and monolateral space opening for an adult Class II malocclusion with upper lateral incisors agenesis: An ortho-prosthetic case report

2024-10-30T05:51:18+00:00

Int Orthod. 2024 Oct 28;23(1):100937. doi: 10.1016/j.ortho.2024.100937. Online ahead of print.

ABSTRACT

This case report describes the treatment of a Class II malocclusion with upper lateral incisors agenesis in an adult patient, performed by an invisible preadjusted lingual appliance, monolateral space opening and dental Class II correction. The patient had previously been treated by clear aligners with the insertion of an implant in upper right canine position in order to close the remaining space. With the twofold aim of obtaining ideal occlusal relationship and smile aesthetic improvement, it highlights how a fixed orthodontic technique is needed to achieve the planned results, when anterior torque, bodily translations and deep-bite correction are necessary. On the other hand, it underlines how the treatment plan should not be adapted to the limits of the employed appliance, but should aim for the best clinical result for the patient. A prosthetic finalisation was in the end performed in order to obtain the best aesthetic result.

PMID:39471642 | DOI:10.1016/j.ortho.2024.100937

Invisible treatment with preadjusted lingual appliance and monolateral space opening for an adult Class II malocclusion with upper lateral incisors agenesis: An ortho-prosthetic case report2024-10-30T05:51:18+00:00
16 10, 2024

Soft tissue changes during orthopedic therapy: An in vivo 3-dimensional facial scan study

2024-10-16T18:38:05+00:00

Am J Orthod Dentofacial Orthop. 2024 Oct 14:S0889-5406(24)00381-0. doi: 10.1016/j.ajodo.2024.08.016. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim was to compare the soft tissue changes in pretreatment and posttreatment facial scans of patients who had undergone various orthopedic treatments vs a control group of untreated growing patients.

METHODS: Facial scans were performed before (T0) and after (T1) orthopedic treatment in 15 patients prescribed rapid palatal expander (RPE), 15 cervical headgear (HG), and 15 facemasks (FM), as well as 6 months apart in 15 untreated growing patients. After best-fit scan alignment using Geometric Control X software (3D Systems Inc, Rock Hill, SC), a 3-dimensional (3D) analysis of soft tissue changes was performed, comparing 3D reference points (total 22) and 8 areas on T0 and T1 scans. Kruskal-Wallis nonparametric tests and pairwise comparison with Bonferroni’s correction were applied to identify any statistically significant differences among groups (P <0.05). All analyses were conducted with SPSS software (version 28; IBM, Armonk, NY).

RESULTS: At T1, reduced soft tissue projection was found at the nose and upper lip in the HG group, the lower lip in the HG and RPE groups, and the chin in the FM and RPE groups. The RPE group displayed a statistically significant increase in facial divergence, confirmed by gnathion position (RPE vs FM [P = 0.018] and RPE vs control [P = 0.046]), as well as an increase in the soft tissue projection of both cheeks (left cheek in range of 1-2 mm [P = 0.030] and range of 0 to -1 mm [P = 0.022]; right cheek in range of 1-2 mm [P = 0.003] and range -1 to -2 mm [P = 0.001]). There were no clinically significant differences among groups in mandibular right and left body areas.

CONCLUSIONS: The 3D facial analysis revealed significant differences in soft tissues among orthopedic treatments, especially at the upper and lower lip and chin areas, as compared with untreated patients.

PMID:39412468 | DOI:10.1016/j.ajodo.2024.08.016

Soft tissue changes during orthopedic therapy: An in vivo 3-dimensional facial scan study2024-10-16T18:38:05+00:00
31 08, 2024

Compliance with Headgear Evaluated by Force- and Temperature-Sensitive Monitoring Device: A Case-Control Study

2024-08-31T14:46:07+00:00

Bioengineering (Basel). 2024 Aug 5;11(8):789. doi: 10.3390/bioengineering11080789.

ABSTRACT

The aim was to objectively assess compliance in patients prescribed headgear and evaluate the impact of monitoring awareness, treatment duration, gender, and age on compliance levels. A total of 22 patients with Class II malocclusion wore the headgear integrated with the force and temperature sensitive Smartgear monitoring system (Smartgear, Swissorthodontics AG, Cham, Switzerland). Patients were instructed to wear the headgear for 13 h daily over a 3-month period. Randomly, 11 patients were informed that they monitored and 11 were not informed. Data were organized using Microsoft Excel and analyzed using R for statistical estimates, graphs, and hypothesis testing. Smartgear recorded an average daily compliance of 6.7 h. No statistically significant differences were found in cooperation between study group and control group over the 3 months of treatment, regardless of gender and age. However, there was slight greater cooperation in the first month than in the other months, and patients ≤10 years of age had almost 2 h more cooperation than their older counterparts. Moreover, the informed group exhibited an average of 1.1 more hours of cooperation per day than the uninformed group, which may carry clinical significance. This cooperation primarily occurred at night and was found to be statistically significant. Compliance among young patients typically remained lower than the prescribed level, regardless of their gender and psychological maturity. Although an awareness of monitoring does not seem to improve compliance, implementing such systems could still offer dentists a valuable means of obtaining objective information about their patients’ adherence.

PMID:39199747 | DOI:10.3390/bioengineering11080789

Compliance with Headgear Evaluated by Force- and Temperature-Sensitive Monitoring Device: A Case-Control Study2024-08-31T14:46:07+00:00