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Wu J, Jia W, Su X, Zhang K, Huang Y, Lei Y. Three-dimensional analysis of mandibular morphology asymmetry and temporomandibular joint position in patients with unilateral Brodie bite. Orthod Craniofac Res 2024; 27:474-484. [PMID: 38217321 DOI: 10.1111/ocr.12755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2024] [Indexed: 01/15/2024]
Abstract
OBJECTIVE Previous studies have shown unilateral posterior crossbite is associated with mandibular asymmetry in morphology and position. However, it remains unclear whether unilateral Brodie bite plays a similar role in mandibular development. Therefore, this study aims to investigate the morphological and positional symmetry of mandibles in patients with unilateral Brodie bite by three-dimensional anaylsis. METHODS Fourteen patients with unilateral Brodie bite (mean age 18.43 ± 4.24 years) and fourteen sex- and age-matched patients with normal occlusion (mean age 18.07 ± 5.48 years) underwent cone-beam computed tomography (CBCT) scans. 3D surface mesh models of their mandibles were established using Mimics Research 19.0. The surface matching percentage was compared between the original and mirrored mandible by Geomagic Control X software. Furthermore, the dimension and position of the temporomandibular joint (TMJ) were determined for both groups using InVivoDental 5.0. RESULTS For surface-to-surface deviation analysis, the percentage of mismatch in patients with unilateral Brodie bite was significantly higher than the control group at ±0.50 mm, ±0.75 mm, and ±1.00 mm tolerance (P < .001). In patients with unilateral Brodie syndrome, the condyles on the scissors-bite side showed a significantly more anterior position (P = .03), greater medial inclination (P < .01), and larger posterior TMJ space (P = .01) than the non-scissors-bite side. CONCLUSION Patients with unilateral Brodie bite exhibit a more asymmetrical mandibular morphology, with a greater anterior condylar position and posterior joint space on the scissors-bite side, indicating that early diagnosis and treatment may be necessary for patients with unilateral Brodie bite.
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Affiliation(s)
- J Wu
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - W Jia
- Department of Stomatology, The Second People's Hospital of Hunan province, Changsha, Hunan, China
| | - X Su
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - K Zhang
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Y Huang
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Y Lei
- Department of Prosthodontics and Orthodontics, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Pinho T, Rocha D, Gonçalves S, Martins ML. Clear Aligners and Miniscrews in a Scissor Bite Adult Treatment. Case Rep Dent 2024; 2024:8841829. [PMID: 38434769 PMCID: PMC10907105 DOI: 10.1155/2024/8841829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/14/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Scissor bite does not correct spontaneously. It gradually worsens by overeruption, negatively affecting masticatory function. It is intended with this manuscript to evaluate the different treatment strategies to correct this malocclusion in adult patients, exploring treatment with clear aligners, bite ramps, and MS (miniscrews), especially in this case of a patient with unilateral right scissor bite, with high dental compensation in the three planes of space, asymmetrical sagittal dental position, overeruption on the scissor bite condition, and a high mandibular arch constriction and maxillary expansion. A comprehensive literature research was performed from 2002 until March 2023. PubMed and BVS databases were used, with the following keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". Since correcting skeletal asymmetries after the growth completion is challenging, adult patient cases often involve a combined orthodontic-surgical approach. In the present clinical case, the severe limitations to decompensating tooth positions for a surgical treatment, with the necessity to perform lower asymmetric extraction and a must longer orthodontic treatment, were the major reasons to avoid the surgical approach, after the scissor bite correction. In spite of this, the efficiency of the clear aligners and auxiliaries like bite ramps, MS, and elastics in successfully correcting a complex scissor bite in an adult patient was demonstrated, with significant esthetic and functional commitment, demonstrated by the case reliability PAR (peer assessment rating) index.
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Affiliation(s)
- Teresa Pinho
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
- IBMC-Instituto Biologia Molecular e Celular, i3S-Inst. Inovação e Investigação em Saúde, Universidade do Porto, Porto, Portugal
| | - Duarte Rocha
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
| | - Sara Gonçalves
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
| | - Maria Luís Martins
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal
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Li CX, Xie X, Li M, Gong ZC, Nie J, Liu X, Jumatai S. A pilot investigation of condylar position and asymmetry in patients with unilateral posterior scissors-bite malocclusion based on three-dimensional reconstructive imaging technique. BMC Musculoskelet Disord 2023; 24:253. [PMID: 37005598 PMCID: PMC10067181 DOI: 10.1186/s12891-023-06384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE Unilateral posterior scissors-bite (uPSB) malocclusion is common clinically. This study aimed to investigate the condylar morphological alterations and condyle-fossa relationship in patients with uPSB, through cone beam computed tomography (CBCT) and three-dimensional reconstructive imaging technique. METHODS A retrospective study was designed to comparatively analyze 95 patients with uPSB between July 2016 and December 2021. They were divided into three subgroups: 12 to 20, 21 to 30, and ≥ 31 years, according the age distribution. The morphological parameters regarding condyle, fossa, and joint space after three-dimensional reconstruction were measured and analyzed by a series of digital software. SPSS 26.0 software package was performed for statistical analysis on data sets, using paired t-test, one-way analysis of variance, Wilcoxon signed-rank sun test, Kruskal-Wallis H test, and Bonferroni correction. RESULTS The condylar volume (CV) of scissors-bite side was greater than that of the non-scissors-bite side (CV A = 1740.68 ± 559.80 mm3 > CV N = 1662.25 ± 524.88 mm3, P = 0.027). So was the condylar superficial area (CSA) (CSA A = 818.71 ± 186.82 mm2 > CSA N = 792.63 ± 173.44 mm2, P = 0.030), and the superior joint space (SJS) [SJS A = 2.46 (1.61, 3.68) mm) > SJS N = 2.01 (1.55, 2.87) mm), P = 0.018], and the anterior joint space (AJS) (AJS A = 3.94 ± 1.46 mm > AJS N = 3.57 ± 1.30 mm, P = 0.017). The constituent ratios of the different parts of the bilateral condyles were 23% on the posterior slope, 21% on the top, 20% on the anterior slope, 19% on the lateral slope and 17% on the medial slope, respectively. CONCLUSION Due to long-term abnormal occlusion of uPSB, the pathological bite force in temporomandibular joint would cause changes in the shape of the condyle. Among them, CV, CSA, SJS and AJS had significant changes in the scissors-bite status, which has the greatest damage to the posterior slope of the condyloid process.
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Affiliation(s)
- Chen-Xi Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, P.R. China.
| | - Xin Xie
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Mengjia Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Zhong-Cheng Gong
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
| | - Jing Nie
- Department of Orthodontics, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Xu Liu
- Department of Maxillofacial Surgery, Hospital of Stomatology, Key Laboratory of Dental-Maxillofacial Reconstruction and Biological Intelligence Manufacturing of Gansu Province, Faculty of Dentistry, Lanzhou University, Lanzhou, 730013, P.R. China
| | - Sakendeke Jumatai
- Department of Oral and Maxillofacial Radiology, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, China
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Pinho T, Gonçalves S, Rocha D, Martins ML. Scissor Bite in Growing Patients: Case Report Treated with Clear Aligners. CHILDREN 2023; 10:children10040624. [PMID: 37189873 DOI: 10.3390/children10040624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023]
Abstract
Scissor bite (SB.) is a rare malocclusion that is challenging to diagnose and is often associated with a retrognathic mandible and a series of functional and structural abnormalities that negatively affect the patient. This article intends to analyze the treatment approaches applied to growing patients younger than 16 years old, comparing the conventional appliances described in the literature and a clinical case treated with clear aligners with mandibular advancement (MA.). SB is primarily related to skeletal Class I and II, according to Angle classification. In the various cases analyzed, it can also be mentioned as a significant number of cases with SB of dental origin (seven of dental and four of skeletal) in young patients. In children and adolescents who still have growth potential, the therapeutic possibilities are numerous. A comprehensive literature search was manually performed from 2002 until January 2023, in PubMed and BVS databases with the following conjugated keywords: “scissor bite OR brodie bite” AND “malocclusion” AND “treatment OR correction OR therapeutics”. The present case report on a young patient demonstrated the efficiency of the clear aligners with MA to correct an SB, associated with several functional and structural anomalies such as Class II division 1 with an increased overjet and overbite as well as a severe curve of Spee in a hypodivergent biotype.
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Non-surgical adult orthodontic treatment of a unilateral scissor bite. Int Orthod 2022; 20:100667. [DOI: 10.1016/j.ortho.2022.100667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/24/2022] [Accepted: 07/02/2022] [Indexed: 11/20/2022]
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Xie Y, Zeng R, Yan J, Yan T, Tan J. Introducing surface-to-surface matching technique to evaluate mandibular symmetry: A retrospective study. Heliyon 2022; 8:e09914. [PMID: 35855982 PMCID: PMC9287795 DOI: 10.1016/j.heliyon.2022.e09914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/11/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives This study introduced a three-dimensional (3D) surface-to-surface matching technique to evaluate the mandibular symmetry of teenagers and adults with unilateral second molar scissor bite. Methods The targets came from 73 cone-beam computed tomography (CBCT) images with unilateral second molar scissor bite, including teenagers (n = 30) and adults (n = 43). 73 images without scissor bite and matched in sex and age were selected as controls. The scans were developed into 3D mandible models and seven mandibular functional unit models, including condylar process (Co), coronoid process (Cr), mandibular ramus (Ra), mandibular angle (Ma), alveolar process (Ap), mandibular body (Mb) and chin process (Ch). The surface-to-surface matching technique was introduced. 3D deviation analysis and matching percentages calculation were performed and compared to evaluate the symmetry of the mandible. Results Comparisons were made between the study samples and control samples. For teenagers, the matching percentages of the entire mandible (55.31 ± 7.24%), Mb (69.04 ± 9.22%) and Co (65.19 ± 10.67%) in the study group were lower than that of the entire mandible (60.87 ± 6.38%) (P <0.01), Mb (75.0 ± 8.71%) (P <0.05) and Co (70.25 ± 8.20%) (P <0.05) in the control group. While Ap, Ra, Ch, Cr and Ma showed no statistically significant differences (P >0.05). For adults, the matching percentages of the entire mandible (48.88 ± 9.77%), Ap (65.83 ± 11.21%), Mb (64.43 ± 12.03%), Ch (79.17 ± 10.29%), Ra (64.11 ± 9.84%) and Co (61.08 ± 11.64%) in the study group were lower than the entire mandible (59.28 ± 5.49%) (P <0.01), Ap (73.65 ± 9.10%) (P <0.01), Mb (71.66 ± 8.40%) (P <0.01), Ch (83.86 ± 5.59%) (P <0.05), Ra (68.54 ± 7.87%) (P <0.05) and Co (66.20 ± 10.62%) (P <0.05) of the control group. Only Cr and Ma showed no statistically significant differences (P >0.05). Conclusion Mandibular asymmetry was observed in both teenagers and adults with unilateral second molar scissor bite. Moreover, compared with teenagers, more mandibular units of adult patients were affected. Clinical significance Based on the surface-to-surface matching technique, the symmetric and morphological information of the mandible can be converted into visual color maps and quantitative descriptions. This method can bring convenience to the study of the growth of mandible, orthodontic treatment and orthognathic surgery design.
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Affiliation(s)
- Yajuan Xie
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
| | - Runling Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
| | - Jiayin Yan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
| | - Tong Yan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
| | - Jiali Tan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
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Three-Dimensional Distance Mapping Method to Evaluate Mandibular Symmetry and Morphology of Adults with Unilateral Premolar Scissors Bite. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Objective: This study aimed to evaluate the association between unilateral premolar scissors bite and mandibular symmetry of adults via the 3D distance mapping method. (2) Methods: A total of 53 cone-beam computed tomography (CBCT) images of adults with unilateral premolar scissors bite were set as study samples. A total of 53 age- and sex-matched samples without scissors bite were in the control group. Three-dimensional mandibular models and seven mandibular functional units, including condylar process (Co), coronoid process (Cr), mandibular ramus (Ra), mandibular angle (Ma), alveolar process (Ap), mandibular body (Mb), and chin process (Ch) were constructed and mirrored. After superimposition of the original and the mirrored models, 3D distance maps and deviation analysis were performed to evaluate the mandibular symmetry and morphology. (3) Results: In the study group, the matching percentages of the entire mandible (50.79 ± 10.38%), Ap (67.00 ± 12.68%), Mb (66.62 ± 9.44%), Ra (62.52 ± 11.00%), Ch (80.75 ± 9.86%), and Co (62.78 ± 13.56) were lower than that of the entire mandible (58.60 ± 5.52) (p < 0.01), Ap (73.83 ± 8.88%) (p < 0.01), Mb (72.37 ± 8.69%) (p < 0.01), Ra (68.60 ± 7.56%) (p < 0.01), Ch (85.23 ± 6.80%) (p < 0.01), and Co (67.58 ± 10.32%) (p < 0.05) in the control group. However, Cr and Ma showed no significant difference (p > 0.05). (4) Conclusions: The 3D distance mapping method provided a qualitative and quantitative mandibular symmetry and morphology assessment. Mandibular asymmetry was found in adults with unilateral premolar scissors bites. Mandibular functional units, including the alveolar process, mandibular body, mandibular ramus, chin process, and condylar process, showed significant differences, while no significant difference was observed in the coronoid process and mandibular angle.
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Unilateral Scissor Bite Managed with Prefabricated Functional Appliances in Primary Dentition—A New Interceptive Orthodontic Protocol. CHILDREN 2021; 8:children8110957. [PMID: 34828670 PMCID: PMC8621561 DOI: 10.3390/children8110957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/02/2022]
Abstract
A unilateral scissor bite is a type of severe malocclusion in primary dentition that can influence the development of the mandible and face. The present case report describes an interceptive treatment on a 4-year-old girl with a unilateral scissor bite combined with an anterior crossbite, increased reverse overjet, and overbite on a skeletal Class III base. The patient was treated with a new Prefabricated Functional Appliance (PFA) which was modified from a Frankel-III appliance to induce a mandible to move backwards and relieve an occlusion discrepancy of the dental arch, and a functional dental rehabilitation with resin and myofunctional exercises with a PFA which was modified from an oral screen appliance were performed during the treatment. The total treatment time was 11 months and a satisfactory improvement of occlusion and facial esthetics was achieved. This case report presents a new PFA system and treatment protocol in primary dentition which results in a favorable outcome, and the clinical effectiveness of this appliance system warrants further investigation.
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