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Guo F, Lv C, Tang B, Lin L, Zhang C, Zheng J, Zhao T, He H. Functional therapy and adenotonsillectomy clinical trial for class II malocclusion (FACT-II): protocol for a randomised controlled trial. BMJ Open 2024; 14:e079571. [PMID: 38626960 PMCID: PMC11029268 DOI: 10.1136/bmjopen-2023-079571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Class II malocclusion with mandibular retrognathia is a common complication of paediatric obstructive sleep apnoea (OSA), often accompanied by transverse maxillary deficiency. In early orthodontic treatment, a twin block (TB) is a regular functional appliance for correcting this malocclusion. For paediatric OSA, the most common risk factor is adenotonsillar hypertrophy (AHT). Untreated AHT may lead to the persistence and worsening of obstructive sleep-disordered breathing traits, including habitual mouth breathing. Additionally, the clockwise mandibular rotation associated with AHT-induced pharyngeal crowding can undermine the effectiveness and stability of TB treatment. Adenotonsillectomy (T&A) is currently the first-line treatment for paediatric OSA. This proposed trial will investigate the impact of T&A surgery timing on the efficacy and stability of TB functional treatment in children with class II mandibular retrognathia and ATH. METHODS AND ANALYSIS This will be a single-centre, parallel-group, superiority randomised controlled trial with participants randomised to intervention (T&A followed by TB treatment) or control arms (TB treatment followed by T&A) in a 1:1 ratio. A total of 40 patients aged 8-14 years, diagnosed with class II mandibular retrognathia and co-existing ATH-induced OSA, and indicated for both T&A surgery and TB treatment, will be recruited at the School and Hospital of Stomatology, Wuhan University. The primary outcomes will be the changes in the apnoea-hypopnoea index and the point A-nasion-point B angle from baseline to postorthodontic treatment between the two groups. Secondary outcomes will include other dental, skeletal, upper airway and soft tissue changes, as well as subjective sleep-related and oral-related quality of life. Outcome changes within each group and between groups will be analysed. ETHICS AND DISSEMINATION This study is approved by the Ethics Committee of the School and Hospital of Stomatology, Wuhan University (no. 2022-D07). The research findings will be faithfully disseminated through scientific conferences or published articles. TRIAL REGISTRATION NUMBER ChiCTR2200061703 (https://www.chictr.org.cn).
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Affiliation(s)
- Feiyang Guo
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chenxing Lv
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bojun Tang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lizhuo Lin
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Zhang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Zheng
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Zhao
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hong He
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development and Sleep Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Ahmad Z, Krüger K, Lautermann J, Lippert B, Tenenbaum T, Tigges M, Tisch M. Adenoid hypertrophy-diagnosis and treatment: the new S2k guideline. HNO 2023; 71:67-72. [PMID: 37491540 PMCID: PMC10409824 DOI: 10.1007/s00106-023-01299-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/27/2023]
Abstract
Hyperplasia of the pharyngeal tonsils is to be considered pathologic when nasopharyngeal symptoms of mechanical obstruction and/or chronic inflammation occur. Chronic Eustachian tube dysfunction can result in various middle ear diseases such as conductive hearing loss, cholesteatoma, and recurrent acute otitis media. During examination, attention should be paid to the presence of adenoid facies (long face syndrome), with a permanently open mouth and visible tip of the tongue. In the case of severe symptoms and/or failure of conservative treatment, adenoidectomy is usually performed on an outpatient basis. Conventional curettage remains the established standard treatment in Germany. Histologic evaluation is indicated for clinical evidence of mucopolysaccharidoses. Due to the risk of hemorrhage, the preoperative bleeding questionnaire, which is obligatory before every pediatric surgery, is referred to. Recurrence of adenoids is possible despite correct adenoidectomy. Before discharge home, otorhinolaryngologic inspection of the nasopharynx for secondary bleeding should be performed and anesthesiologic clearance obtained.
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Affiliation(s)
- Z Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Bundeswehr Hospital of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
| | - K Krüger
- Institute of General Medicine, Berlin Charité Hospital, Berlin, Germany
| | - J Lautermann
- Department of Otolaryngology-Head and Neck Surgery, Plastic Surgery, Martha-Maria Halle-Dölau Hospital, Halle-Dölau, Germany
| | - B Lippert
- Department of Otolaryngology-Head and Neck Surgery, Plastic Surgery, SLK-Kliniken Heilbronn GmbH am Gesundbrunnen, Heilbronn, Germany
| | - T Tenenbaum
- Department of Paediatric and Adolescent Medicine, Sana Klinikum Lichtenberg, Berlin, Germany
| | - M Tigges
- Department of Otolaryngology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - M Tisch
- Department of Otolaryngology-Head and Neck Surgery, Bundeswehr Hospital of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
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Ahmad Z, Krüger K, Lautermann J, Lippert B, Tenenbaum T, Tigges M, Tisch M. [Adenoids-diagnosis and treatment: the new German S2k guideline]. HNO 2023; 71:285-293. [PMID: 37071194 PMCID: PMC10125940 DOI: 10.1007/s00106-023-01298-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/19/2023]
Abstract
Hyperplasia of the pharyngeal tonsils is to be considered pathologic when nasopharyngeal symptoms of mechanical obstruction and/or chronic inflammation occur. Chronic Eustachian tube dysfunction can result in various middle ear diseases such as conductive hearing loss, cholesteatoma, and recurrent acute otitis media. During examination, attention should be paid to the presence of adenoid facies (long face syndrome), with a permanently open mouth and visible tip of the tongue. In the case of severe symptoms and/or failure of conservative treatment, adenoidectomy is usually performed on an outpatient basis. Conventional curettage remains the established standard treatment in Germany. Histologic evaluation is indicated for clinical evidence of mucopolysaccharidoses. Due to the risk of hemorrhage, the preoperative bleeding questionnaire, which is obligatory before every pediatric surgery, is referred to. Recurrence of adenoids is possible despite correct adenoidectomy. Before discharge home, otorhinolaryngologic inspection of the nasopharynx for secondary bleeding should be performed and anesthesiologic clearance obtained.
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Affiliation(s)
- Z Ahmad
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
| | - K Krüger
- Institut für Allgemeinmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - J Lautermann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, Krankenhaus Martha-Maria Halle-Dölau, Halle-Dölau, Deutschland
| | - B Lippert
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, SLK-Kliniken Heilbronn GmbH - Standort Gesundbrunnen, Heilbronn, Deutschland
| | - T Tenenbaum
- Klinik für Kinder- und Jugendmedizin, Sana Klinikum Lichtenberg, Berlin, Deutschland
| | - M Tigges
- Hals-Nasen-Ohrenklinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - M Tisch
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
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Oku Y, Iwasaki T, Tsujii T, Sakoda-Iwata R, Hisagai S, Ban Y, Sato H, Ishii H, Kanomi R, Yamasaki Y. Effect of palatine tonsil hypertrophy on tongue posture and maxillofacial dentition: A pharyngeal airway computational fluid dynamics study. PEDIATRIC DENTAL JOURNAL 2023. [DOI: 10.1016/j.pdj.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Keitoku M, Yonemitsu I, Ikeda Y, Tang H, Ono T. Differential Recovery Patterns of the Maxilla and Mandible after Eliminating Nasal Obstruction in Growing Rats. J Clin Med 2022; 11:jcm11247359. [PMID: 36555975 PMCID: PMC9783669 DOI: 10.3390/jcm11247359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/01/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Although nasal obstruction (NO) during growth causes maxillofacial growth suppression, it remains unclear whether eliminating the NO affects maxillary and mandibular growth differentially. We aimed to clarify whether eliminating NO can help regain normal maxillofacial growth and to determine the optimal intervention timing. Forty-two 4-week-old male Wistar rats were randomly divided into six groups. Their left nostril was sutured to simulate NO over different durations in the experimental groups; the sutures were later removed to resume nasal breathing. Maxillofacial morphology was assessed using microcomputed tomography. Immunohistochemical changes in hypoxia-inducible factor (HIF)-1α, osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL) of the condylar cartilage were evaluated to reveal the underlying mechanisms of these changes. Maxillary length was significantly lower in rats with NO for ≥5 weeks. In groups with NO for ≥7 weeks, the posterior mandibular length, ramus height, thickness of the hypertrophic cell layer in the condylar cartilage, HIF-1α levels, and RANKL levels were significantly lower and OPG levels and RANKL/OPG were significantly higher than those in the control group. Our findings suggest that eliminating NO is effective in regaining maxillofacial growth. Moreover, the optimal timing of intervention differed between the maxilla and mandible.
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Atar Y, Atar S, Anarat MEA, Berkiten M, Saricam SS, Demirhan E, Mersinlioglu G, Dıraçoğlu D. Effect of adenoid hypertrophy and adenoidectomy on bite force in children: Twelve month follow-up, case-control study. Cranio 2022:1-9. [PMID: 36018777 DOI: 10.1080/08869634.2022.2116526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE The effects of adenoid hypertrophy (AH) and adenoidectomy on maximal bite force (MBF) in patients were evaluated by comparing them with healthy controls. METHODS A total of 118 children diagnosed with AH and undergoing adenoidectomy (Group A), and healthy controls (Group B) were included. The MBF and nasopharyngeal airway passage distance (NAPD) were recorded. RESULTS There was a correlation between NAPD and MBF at the beginning of the study (r = -0.675 and p < 0.001). The initial mean MBF of Groups A and B were 318.37 ± 70.76 N and 344.04 ± 64.14 N, respectively (p = 0.041). However, there was no significant difference between the groups due to the increase in the MBF of Group A at 12 months (p = 0.165). CONCLUSION The MBF may be negatively affected in proportion to decreased NAPD, and it could also be an indicator for monitoring the status of children with AH.
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Affiliation(s)
- Yavuz Atar
- Department of Otorhinolaryngology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Sevgi Atar
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Melis Ece Arkan Anarat
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Mustafa Berkiten
- School of Dentistry, Department of Endodontics, Istanbul Health and Technology University, Istanbul, Turkey
| | - Sabire Sitare Saricam
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Esma Demirhan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Gökhan Mersinlioglu
- Department of Otorhinolaryngology, Private Clinic of Otorhinolaryngology, Istanbul, Turkey
| | - Demirhan Dıraçoğlu
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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Differences of Craniofacial Characteristics in Oral Breathing and Pediatric Obstructive Sleep Apnea. J Craniofac Surg 2021; 32:564-568. [PMID: 33704981 DOI: 10.1097/scs.0000000000006957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Oral breathing (OB) was considered associated with specific craniofacial structures and same for pediatric obstructive sleep apnea (OSA). This study aimed to investigate the differences of craniofacial structures between OB and OSA. METHODS In this retrospective study, 317 children under age 18 years were recruited and divided into OB group, OSA group, and control group. OSA group (15 boys, 4 girls) were referred from qualified sleep center and diagnosed as pediatric OSA with full-night polysomnography. OB group (10 boys, 10 girls) were mostly referral from pediatric or ENT department, some of whom undertook polysomnography and were not OSA. Control group consisted of orthodontic patients within the same period. Lateral cephalograms were obtained in all groups and their parameters were compared with Chinese normal values and each other. RESULTS R-PNS of OB group (18.04 ± 2.49 mm) was greater than OSA group (14.27 ± 4.36 mm) and even control group (16.22 ± 3.91 mm) (P < 0.01). U1-NA was also the greatest in OB group (7.15 ± 2.92 mm), followed by OSA group (4.88 ± 2.66 mm), while control group was the smallest (5.71 ± 2.94 mm) (P < 0.05). In addition, OB group presented the smallest adenoids and tonsils among three groups. Bony nasopharynx development, mandibular length and growth direction of mandible of OB group were all better than OSA group. CONCLUSION Despite of oral breathing, anatomical morphology (well-developed dentoalveolar structures; mild adenotonsillar hypertrophy) might protect children from developing OSA.
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Abstract
The effects of breastfeeding on the occlusion have been much debated, and it is often suggested that breastfeeding facilitates optimal development of the jaws and the dentition, thus preventing the development of a malocclusion. Despite these claims, the evidence is equivocal, and the majority of studies are of low quality and only assess the deciduous dentition. Therefore, at present there is currently no high quality evidence to support claims that breastfeeding has a positive effect on the occlusion, thus the method of feeding should be chosen due to the health benefits and personal preference, not due to any claims regarding occlusal benefits that cannot be substantiated.
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Affiliation(s)
- Kate Parker
- Post-CCST in Orthodontics, Eastman Dental Hospital and Croydon University Hospital
- Consultant Orthodontist, Croydon University Hospital
| | - Matthew Chia
- Consultant Orthodontist, Croydon University Hospital
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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High-efficiency treatment with the use of traditional anchorage control for a patient with Class II malocclusion and severe overjet. Am J Orthod Dentofacial Orthop 2019; 155:411-420. [PMID: 30826044 DOI: 10.1016/j.ajodo.2017.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 11/22/2022]
Abstract
Patients with Class II malocclusion and severe overjet are often dissatisfied with their facial disharmony. Although temporary skeletal anchorage devices (TSADs) are now widely used in orthodontic treatment, traditional anchorage devices should not be overlooked as a treatment option. Proper design of traditional anchorage can achieve 3-dimensional control of incisors and molars as efficiently as TSADs in some patients with severe malocclusion. We used traditional anchorage devices, including a transpalatal arch and a Nance palatal arch, combined with a utility arch to treat an 11-year-old Chinese girl with a skeletal Class II malocclusion and severe overjet. The space was closed in 2 steps to protect molar anchorage. Facial improvement, especially smile esthetics, and Class I molar relationship and overjet correction were achieved in 17 months of treatment. Follow-up records 22 months after treatment show that the results remained stable.
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Abstract
Orthodontics is the dental specialty concerned with the position of teeth and the relationship between the maxilla and mandible. Much evidence regarding the characteristics of normal occlusion during childhood/adolescence, the timely referral of children/adolescents to orthodontic treatment, and the impact of orthodontic outcomes on individuals' physical, functioning, and psychosocial well-being exists in the literature. This body of evidence may be helpful for pediatricians and primary care physicians. For those willing to be skilled providers of health care to children/adolescents, knowledge of basic concepts of oral health may contribute to the communication among physicians, the young individual and their parents/caregivers.
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Affiliation(s)
- Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Maranhão, Belo Horizonte, Minas Gerais 30150-331, Brazil.
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Occasi F, Perri L, Saccucci M, Di Carlo G, Ierardo G, Luzzi V, De Castro G, Brindisi G, Loffredo L, Duse M, Polimeni A, Zicari AM. Malocclusion and rhinitis in children: an easy-going relationship or a yet to be resolved paradox? A systematic literature revision. Ital J Pediatr 2018; 44:100. [PMID: 30134958 PMCID: PMC6106920 DOI: 10.1186/s13052-018-0537-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/07/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The relation between nasal flow and malocclusion represents a practical concern to pediatricians, otorhinolaryngologists, orthodontists, allergists and speech therapists. If naso-respiratory function may influence craniofacial growth is still debated. Chronic mouth-breathing is reported to be associated also with a characteristic pattern of dental occlusion. On the other hand, also malocclusion may reduce nasal air flows promoting nasal obstruction. Hereby, the aim of this review was to describe the relationship between rhinitis and malocclusion in children. METHODS An electronic search was conducted using online database including Pubmed, Web of Science, Google Scholar and Embase. All studies published through to January 30, 2017 investigating the prevalence of malocclusion in children and adolescents (aged 0-20 years) affected by rhinitis and the prevalence of rhinitis in children with malocclusion were included. The protocol was registered at PROSPERO - International prospective register of systematic reviews under CRD42016053619. RESULTS Ten studies with 2733 patients were included in the analysis. The prevalence of malocclusion in children with rhinitis was specified in four of the studies ranging from as high as 78.2% to as low as 3%. Two out of the studies reported the prevalence of rhinitis in children with malocclusion with a rate ranging from 59.2 to 76.4%. CONCLUSION The results of this review underline the importance of the diagnosis and treatment of the nasal obstruction at an early age to prevent an altered facial growth, but the data currently available on this topic do not allow to establish a possible causal relationship between rhinitis and malocclusion.
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Affiliation(s)
- Francesca Occasi
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Ludovica Perri
- Department of Internal Medicine and Medical Specialities, "Sapienza" University of Rome, Rome, Italy.
| | - Matteo Saccucci
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Gabriele Di Carlo
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Gaetano Ierardo
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Valeria Luzzi
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | | | - Giulia Brindisi
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Internal Medicine and Medical Specialities, "Sapienza" University of Rome, Rome, Italy
| | - Marzia Duse
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Pediatric Otorhinolaryngology, "Sapienza" University of Rome, Rome, Italy
| | - Anna Maria Zicari
- Department of Pediatrics, "Sapienza" University of Rome, Rome, Italy
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