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Lorenzoni DC, Barbosa OTDAM, Cury-Saramago ADA, Mattos CT. Class II subdivision treatment and stability with asymmetric Herbst appliance: A case report. Int Orthod 2024; 22:100838. [PMID: 38290193 DOI: 10.1016/j.ortho.2023.100838] [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] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024]
Abstract
Non-surgical treatment of Class II subdivision may involve complex mechanics or asymmetric tooth extraction in its resolution. This report demonstrates the result and the short-term stability of Class II subdivision treated with asymmetrically installed Herbst appliance followed by conventional fixed orthodontic appliance. The approach allowed the correction of the unilateral Class II molar relationship and increased overjet, as well as the deviation of dental midlines, with improvement in lip posture and facial profile. The results remained stable two years after treatment, confirming the treatment success.
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Affiliation(s)
- Diego Coelho Lorenzoni
- Departamento de Odontoclínica, Disciplina de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Niterói, RJ, Brazil.
| | | | | | - Cláudia Trindade Mattos
- Departamento de Odontoclínica, Disciplina de Ortodontia, Faculdade de Odontologia, Universidade Federal Fluminense, Niterói, RJ, Brazil
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Ciavarella D, Lorusso M, Fanelli C, Ferrara D, Laurenziello M, Montaruli G, Esposito R, Tepedino M. Evaluation of occlusal force in Class II subdivision malocclusion. J Oral Rehabil 2024. [PMID: 38797936 DOI: 10.1111/joor.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/15/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Class II subdivision is a malocclusion characterized by dental and functional asymmetry that is difficult to manage. Impaired muscle function can result in asymmetrical growth, leading to occlusal instability. OBJECTIVE(S) The study aimed to assess occlusal force in patients with Class II subdivision malocclusion using Innobyte. Additionally, the discrepancies of force generated at the position of maximum intercuspidation between the left and right sides of the arches were evaluated. METHODS The occlusal force of 66 patients with Class II subdivision malocclusion (group S) was measured and compared with that of 66 patients with Class I (group I) and 66 patients with Class II malocclusion (group II). The S group patients had a Class I molar on the right side and a Class II molar on the left side. ANOVA test, followed by the Games-Howell post hoc test, was performed to compare the mean of the total force among the groups. To assess the difference in force between the right and left arches, one-way ANOVA test followed by Tukey's post hoc comparison was performed. Finally, a boxplot was created to show the trend of occlusal force recorded in the three groups of patients. RESULTS The occlusal force differed significantly among the groups (p < .001). Post hoc Games-Howell analysis showed significant differences as follows: the total force in group S was 165.24 N greater than in group II and in group I was 218.06 N greater than in group II. The difference (right-left) in total force between the groups was statistically significant (p < .001). Tukey's post hoc test showed following significant correlation: in group S was 53.51 N greater than in group II and 63.12 N greater than in group I. CONCLUSIONS Among the analysed groups, patients with Class II malocclusion exhibited the lowest value of occlusal force. In patients with Class II subdivision malocclusion, force asymmetry, characterised by a higher value on the Class I side and a lower value on the Class II side was observed.
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Affiliation(s)
- Domenico Ciavarella
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Mauro Lorusso
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Carlotta Fanelli
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Donatella Ferrara
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Laurenziello
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Graziano Montaruli
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Rosa Esposito
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Foggia, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, Dental School of L'Aquila, University of L'Aquila, L'Aquila, Italy
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Sencak RC, Benavides E, Cevidanes L, Yatabe M, Koerich L, Souki BQ, Ruellas ACDO. Asymmetry in Class II subdivision malocclusion: Assessment based on 3D surface models. Orthod Craniofac Res 2024; 27:267-275. [PMID: 37882502 DOI: 10.1111/ocr.12723] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/24/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION There is currently no consensus in the literature whether the aetiology of a Class II subdivision is dental, skeletal or both. The aim of this study was to identify and quantify skeletal and dental asymmetries in Class II subdivision malocclusions. METHODS CBCTs from 33 Class II subdivision malocclusion patients were used to construct 3D volumetric label maps. Eighteen landmarks were identified. The original scan and associated 3D volumetric label map were mirrored. Registration of the original and mirrored images relative to the anterior cranial base, maxilla and mandible were performed. Surface models were generated, and 3D differences were quantified. Statistical analysis was performed. RESULTS Anterior cranial base registration showed significant differences for fossa vertical difference, fossa roll, mandibular yaw, mandibular lateral displacement and lower midline displacement. Regional registrations showed significant differences for antero-posterior (A-P) mandibular length, maxillary roll, A-P maxillary first molar position, maxillary first molar yaw and maxillary first molar roll. Class II subdivision patients also show an asymmetric mandibular length as well as an asymmetric gonial angle. Moderate correlations were found between the A-P molar relationship and fossa A-P difference, mandibular first molar A-P difference, maxillary first molar A-P difference and maxillary first molar yaw. CONCLUSIONS This study suggests that Class II subdivisions can result from both significant skeletal and dental factors. Skeletal factors include a shorter mandible as well as posterior and higher displacement of the fossa on the Class II side, resulting in mandibular yaw. Dental factors include maxillary and mandibular first molar antero-posterior asymmetry.
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Affiliation(s)
- Regina C Sencak
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Erika Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Bernardo Quiroga Souki
- Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Antonio Carlos de Oliveira Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Silinevica S, Lokmane K, Vuollo V, Jakobsone G, Pirttiniemi P. The association between dental and facial symmetry in adolescents. Am J Orthod Dentofacial Orthop 2023; 164:340-350. [PMID: 37005109 DOI: 10.1016/j.ajodo.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 01/01/2023] [Accepted: 01/01/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Facial aesthetics have become one of the most important objectives of orthodontic treatment. The correction of dental arches should be performed in accordance with the face. This study explored the association between occlusal and facial asymmetries in adolescents, particularly emphasizing a Class II subdivision. METHODS Eighty-one adolescents (43 males, 38 females) with a median age of 15.9 (interquartile range, 15.17-16.33) years were enrolled. Of these patients, 30 had a Class II subdivision (right side, n = 12; left side, n = 18). Three-dimensional facial scans were analyzed using surface- and landmark-based methods. Chin asymmetry was determined using the chin volume asymmetry score. Three-dimensional intraoral scans were analyzed to assess occlusal asymmetry. RESULTS The surface matching scores were 59.0% ± 11.3% for the whole face and 39.0% ± 19.2% for the chin. Chin volume was larger on the right side than on the left side in most patients (n = 51, 63%), and it was associated with a dental midline shift to the corresponding subdivision side. A correlation between dental and facial asymmetries was noted. In addition, the dental midline shifted to the left in patients with a Class II subdivision, regardless of the side, and to the right in those with a symmetrical Class II subdivision. However, several patients did not possess asymmetrical occlusal traits sufficient for statistical analysis. CONCLUSIONS Dental asymmetry was weak but significantly correlated with facial asymmetry.
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Affiliation(s)
- Signe Silinevica
- Department of Orthodontics, Institute of Stomatology, Riga Stradins University, Riga, Latvia.
| | | | - Ville Vuollo
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland; Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu, Finland
| | - Gundega Jakobsone
- Department of Orthodontics, Institute of Stomatology, Riga Stradins University, Riga, Latvia
| | - Pertti Pirttiniemi
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland; Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu, Finland
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Candida E, Grippaudo FR, Romeo C, Tauro R, Blasi A, Grippaudo C. 3D Facial Analysis in Class II Subdivision Malocclusion. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2110281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Class II subdivision is an asymmetric condition presenting a Class I dental occlusion on one side and a Class II on the contralateral one. It presents a midline deviation that may be caused by a monolateral distalization of the mandible (type 1) or a mesialization of one side of the maxilla (type 2). The evaluation of asymmetry based on 2D radiographic records has been demonstrated to be less accurate than the one made using 3D radiographs.
Objective:
The aim of this work is to evaluate the facial asymmetry in a group of patients with Class II subdivision, compared to patients in Class I without evident asymmetry, by using 3D photographs of the face.
Methods:
32 young adults with Class II subdivision were compared to a group of 32 subjects with bilateral Class I molar relationship. 3D photograph of their face was acquired using a stereophotogrammetric camera (3dMDtrio System-3dMD Atlanta, GA, USA). 3D photographs were imported into the Geomagic Software to create mirror 3D photography. Independent T-tests were made to compare facial asymmetries measured on Class II subdivision group with the Class I group.
Results:
The results show that there is a statistically significant difference in landmarks location between the control group and the experimental group regarding the values measured at the level of the lips and the perioral area. The asymmetry was more marked in patients with mandibular midline deviation. This is in line with previous observations with radiographic investigations.
Conclusion:
For a correct assessment of the asymmetry, a study of 3D photographs cannot replace an evaluation by cone beam, but it can be an important aid to estimate possible asymmetries in the perioral area and in the lip area.
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Apostolopoulos K, Palomo JM, Rizzante FAP, Pugliese F. A 3D mirroring and colormap asymmetry study of Class II subdivision patients. Orthod Craniofac Res 2021; 25:429-436. [PMID: 34863033 DOI: 10.1111/ocr.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients with Class II subdivision malocclusion present skeletal and dental asymmetries. The purpose of this study is to assess those asymmetries by 3D mirroring and colormap quantification. METHODS This study analyzed 50 initial CBCTs divided into two groups: Class I (control group) and Class II subdivision (study group) malocclusion patients. CBCTs were oriented and full skull was segmented generating a 3D model. The right side of the 3D models was mirrored, using a midsagittal plane as reference, resulting in a perfectly symmetric skull based on two right sides. Original and mirrored models were superimposed on the unchanged right half, and differences were quantified using a colormap. Eight regions of interest were assessed: gonion, mandibular front, maxillary front, zygomatic process, maxillary and mandibular canine and molar areas. RESULTS Statistically significant differences using the Mann-Whitney test were found in six of the eight evaluated areas when comparing the control to the study group. The maxillary skeletal areas did not show any difference between the groups. CONCLUSIONS Patients with Class II subdivision malocclusion show true skeletal and dental asymmetries when comparing right and left sides. The maxilla showed no significant skeletal asymmetry, but the maxillary teeth were positioned more mesially on the Class II side. The maxillary canine on the Class II side was also more bucally positioned. The mandible showed significant asymmetries with both skeletal and dental areas in the Class II side more distally and bucally positioned.
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Affiliation(s)
- Konstantinos Apostolopoulos
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fabio Antonio Piola Rizzante
- Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fernando Pugliese
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Xia K, Sun W, Yu L, Huang X, Zhao Z, Liu J. Treatment of the mandibular shift in an adult woman and the diagnostic value of joint space index: a case report. Eur J Med Res 2020; 25:50. [PMID: 33092645 PMCID: PMC7579934 DOI: 10.1186/s40001-020-00451-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/08/2020] [Indexed: 02/08/2023] Open
Abstract
Background Mandibular deviations are common clinical complaints. The orthodontic or orthognathic treatment of mandibular deviations is tricky because a comprehensive diagnosis, especially a functional one, is difficult to make. A inaccurate diagnosis may lead to a compromised and unstable treatment outcome. Case presentation This article describes the diagnosis and treatment of a woman with a mandibular deviation and facial skeletal asymmetry. By eliminating the disharmony of the arch form with elastics and bite turbos, her esthetic and functional outcomes improved. Cone-beam CT (CBCT) and Joint Space Index (JSI) analyses served as the diagnostic approaches and outcome evaluation methods before and after treatment. Conclusions A condyle position displacement could be an indication of functional deviation. JSI analysis is a quantitative and convenient choice to compare condyle relative positions.
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Affiliation(s)
- Kai Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Wentian Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Liyuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China. .,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.
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Jing D, Shen Y, Yang P, Zhao ZH. [Research progress on the relationship between centric relation and orthodontic treatment]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:527-532. [PMID: 31721502 DOI: 10.7518/hxkq.2019.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Centric relation (CR) is one of the core research contents in orthodontics, prosthodontics, and gnathology, acting as an important physiological factor in reconstructing the occlusion and adjusting the occlusal relationship. For over a century, CR is still a controversial subject in dentistry. CR has been redefined for several times, and recently, its application has been widened in orthodontics, including orthodontic diagnosis, clinical examination and analysis, and treatment goals. The purpose of this article is to review the definition of CR, its relationship with malocclusion, and the application of this relationship in orthodontic treatment.
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Affiliation(s)
- Dian Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yu Shen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Pu Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhi-He Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Akın M, Erdur EA, Öztürk O. Asymmetric dental arch treatment with Forsus fatigue appliances: Long-term results. Angle Orthod 2019; 89:688-696. [PMID: 30920873 DOI: 10.2319/092718-697.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the treatment efficacy and follow-up stability of the asymmetric Forsus appliance by evaluating longitudinal changes in dental arch asymmetry on digital dental models from 21 patients. MATERIALS AND METHODS Maxillary and mandibular reference lines were used for measurements of intra-arch asymmetry at pretreatment (T1), posttreatment (T2), and 4.2 years after treatment (T3). Maxillary and mandibular measurements were performed relative to the dental midline and anterior reference line on digital dental models. To determine the amount of asymmetry between the Class I and Class II sides of a given arch, all maxillary and mandibular parameters were measured on each side of the model separately. Repeated-measures analysis of variance/paired sample t-tests were performed to evaluate dental arch asymmetries at the P < .05 level. RESULTS The alveolar transverse dimensions of the posterior segment of both arches were increased during treatment (P < .05) and remained stable during the retention period. Class II subdivision malocclusion was caused by distal positioning of the mandibular canine, premolars, and first molar on the Class II side (P < .05). Asymmetry was resolved by treatment with asymmetric Forsus appliances. The resolved asymmetry remained stable over the long term. There were no significant differences between T2 and T3 (P > .05). CONCLUSIONS The asymmetric Forsus appliance can be used to treat dental arch asymmetry in patients with Class II subdivision malocclusions.
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10
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Surgical guide and CAD/CAM prebent titanium plate for sagittal split ramus osteotomy in the correction of mandibular prognathism. Br J Oral Maxillofac Surg 2018; 56:586-593. [PMID: 29970262 DOI: 10.1016/j.bjoms.2018.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 06/13/2018] [Indexed: 02/05/2023]
Abstract
This study was designed to introduce and evaluate the clinical use of a surgical guide and a CAD/CAM prebent titanium plate for sagittal split ramus osteotomy (SSRO) in the correction of mandibular prognathism. We studied 14 patients who had been diagnosed, and treated by bilateral SSRO with the guide, during the period July 2015-January 2016. Surface deviations of distal segments from simulation until the end of the operation were measured on a coloured map. Deviations of position and orientation of the condyle and proximal segment from before to after operation, and those from simulation until the end of the operation, were measured with a 3-dimensional vector. All patients were followed up for at least a year. The coloured map showed that the mean (SD) distances were 0.40 (0.25)mm between the simulated and postoperative distal segments. The 3-dimensional vector showed that the mean values of mediolateral, anteroposterior, and superior-inferior translations of the condyles were less than 1mm (p<0.02) from before the operation until the end, and from simulation to the end of the operation, and the mean value of pitching for proximal segments was less than 1° (p<0.02) from simulation to the end of the operation. At the one year follow-up, the occlusions were stable. Based on accurate diagnosis and simulation, this guide takes the distal segment precisely to its planned position, and the condyle and proximal segment are well-controlled. This is a useful tool, which is comparatively easy to make and operate.
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Huang M, Hu Y, Yu J, Sun J, Ming Y, Zheng L. Cone-beam computed tomographic evaluation of the temporomandibular joint and dental characteristics of patients with Class II subdivision malocclusion and asymmetry. Korean J Orthod 2017; 47:277-288. [PMID: 28861389 PMCID: PMC5548708 DOI: 10.4041/kjod.2017.47.5.277] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/09/2017] [Accepted: 03/30/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. METHODS Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. RESULTS The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. CONCLUSIONS Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.
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Affiliation(s)
- Mingna Huang
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yun Hu
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinfeng Yu
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jicheng Sun
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ye Ming
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Leilei Zheng
- The Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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12
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de Mattos JM, Palomo JM, de Oliveira Ruellas AC, Cheib PL, Eliliwi M, Souki BQ. Three-dimensional positional assessment of glenoid fossae and mandibular condyles in patients with Class II subdivision malocclusion. Angle Orthod 2017; 87:847-854. [PMID: 28862492 DOI: 10.2319/121216-890.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To test the null hypotheses that the positions of the glenoid fossae and mandibular condyles are identical on the Class I and Class II sides of patients with Class II subdivision malocclusion. MATERIALS AND METHODS Retrospective three-dimensional (3D) assessments of the positions of the glenoid fossae and mandibular condyles were made in patients with Class II malocclusion. Relative to a fiducial reference at the anterior cranial base, distances from the glenoid fossae and condyles were calculated in pretreatment cone beam computed tomographic scans of 82 patients: 41 with Class II and 41 with Class II subdivision malocclusions. The 3D distances from glenoid fossae to sella turcica in the X (right-left), Y (anterior-posterior), Z (inferior-superior) projections were calculated. RESULTS Patients with Class II malocclusion displayed a symmetric position of the glenoid fossae and condyles with no statistically significant differences between sides (P > .05), whereas patients with Class II subdivision showed asymmetry in the distance between the glenoid fossae and anterior cranial base or sella turcica (P < .05), with distally and laterally positioned glenoid fossae on the Class II side. (P < .05). Male patients had greater distances between glenoid fossae and anterior cranial fossae (P < .05). The condylar position relative to the glenoid fossae did not differ between the two malocclusion groups nor between males and females (P > .05). CONCLUSIONS The null hypotheses were rejected. Patients with Class II subdivision malocclusion displayed asymmetrically positioned right- and left-side glenoid fossae, with a distally and laterally positioned Class II side, although the condyles were symmetrically positioned within the glenoid fossae.
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Weaver CA, Miller SF, da Fontoura CSG, Wehby GL, Amendt BA, Holton NE, Allareddy V, Southard TE, Moreno Uribe LM. Candidate gene analyses of 3-dimensional dentoalveolar phenotypes in subjects with malocclusion. Am J Orthod Dentofacial Orthop 2017; 151:539-558. [PMID: 28257739 DOI: 10.1016/j.ajodo.2016.08.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 08/01/2016] [Accepted: 08/01/2016] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Genetic studies of malocclusion etiology have identified 4 deleterious mutations in genes DUSP6,ARHGAP21, FGF23, and ADAMTS1 in familial Class III cases. Although these variants may have large impacts on Class III phenotypic expression, their low frequency (<1%) makes them unlikely to explain most malocclusions. Thus, much of the genetic variation underlying the dentofacial phenotypic variation associated with malocclusion remains unknown. In this study, we evaluated associations between common genetic variations in craniofacial candidate genes and 3-dimensional dentoalveolar phenotypes in patients with malocclusion. METHODS Pretreatment dental casts or cone-beam computed tomographic images from 300 healthy subjects were digitized with 48 landmarks. The 3-dimensional coordinate data were submitted to a geometric morphometric approach along with principal component analysis to generate continuous phenotypes including symmetric and asymmetric components of dentoalveolar shape variation, fluctuating asymmetry, and size. The subjects were genotyped for 222 single-nucleotide polymorphisms in 82 genes/loci, and phenotpye-genotype associations were tested via multivariate linear regression. RESULTS Principal component analysis of symmetric variation identified 4 components that explained 68% of the total variance and depicted anteroposterior, vertical, and transverse dentoalveolar discrepancies. Suggestive associations (P < 0.05) were identified with PITX2, SNAI3, 11q22.2-q22.3, 4p16.1, ISL1, and FGF8. Principal component analysis for asymmetric variations identified 4 components that explained 51% of the total variations and captured left-to-right discrepancies resulting in midline deviations, unilateral crossbites, and ectopic eruptions. Suggestive associations were found with TBX1AJUBA, SNAI3SATB2, TP63, and 1p22.1. Fluctuating asymmetry was associated with BMP3 and LATS1. Associations for SATB2 and BMP3 with asymmetric variations remained significant after the Bonferroni correction (P <0.00022). Suggestive associations were found for centroid size, a proxy for dentoalveolar size variation with 4p16.1 and SNAI1. CONCLUSIONS Specific genetic pathways associated with 3-dimensional dentoalveolar phenotypic variation in malocclusions were identified.
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Affiliation(s)
| | - Steven F Miller
- Department of Anatomy, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Ill; Department of Dental Medicine, College of Dental Medicine-Illinois, Midwestern University, Downers Grove, Ill
| | - Clarissa S G da Fontoura
- The Iowa Institute for Oral and Craniofacial Research, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - George L Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Brad A Amendt
- Department of Anatomy and Cell Biology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Nathan E Holton
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Veeratrishul Allareddy
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Thomas E Southard
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Lina M Moreno Uribe
- The Iowa Institute for Oral and Craniofacial Research, College of Dentistry, University of Iowa, Iowa City, Iowa; Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, Iowa.
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Anderson WM, Marsh CM, Kessel NC, Dunn WJ. Studying the prevalence and etiology of Class II subdivision malocclusion using cone-beam computed tomography. J World Fed Orthod 2016. [DOI: 10.1016/j.ejwf.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Aras I, Pasaoglu A. Class II subdivision treatment with the Forsus Fatigue Resistant Device vs intermaxillary elastics. Angle Orthod 2016; 87:371-376. [PMID: 27762602 DOI: 10.2319/070216-518.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of comprehensive fixed appliance treatments implemented in combination with Forsus or intermaxillary elastics in Class II subdivision subjects. MATERIALS AND METHODS Twenty-eight Class II subdivision patients were allocated to two groups using matched randomization: Forsus group (mean age, 14.19 ± 1.02 years) and elastics group (mean age, 13.75 ± 1.16 years). Patients received fixed appliance therapy in combination with either Forsus or intermaxillary elastics. The study was conducted on lateral cephalograms and digital models acquired before orthodontic treatment and 10-12 weeks after the fixed appliances were removed. RESULTS The treatment phase comprising the use of Forsus (4.53 ± 0.91 months) was significantly shorter compared with elastics application (6.85 ± 1.08 months). This was also true for comparing duration of overall comprehensive treatment in both groups. Extrusion and palatal tipping of maxillary incisors and clockwise rotation of the occlusal plane were greater in the elastics group (P < .05). The mandibular incisors were proclined in both groups (P < .001), but no significant difference was observed between groups (P > .05). The mandibular incisors showed intrusion in the Forsus group and extrusion in the elastics group; the difference between groups was significant (P < .05). Overbite was decreased in both groups (P < .001) in similar amounts. Improvement in overjet, mandibular midline deviation, and correction of molar relationship on the Class II side were greater in the Forsus group (P < .05). CONCLUSION Forsus is more effective for correcting Class II subdivision malocclusion in a shorter treatment period with minimal patient compliance required.
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Pedreira FRDO, de Carli ML, Pedreira RDPG, Ramos PDS, Pedreira MR, Robazza CRC, Hanemann JAC. Association between dental anomalies and malocclusion in Brazilian orthodontic patients. J Oral Sci 2016; 58:75-81. [DOI: 10.2334/josnusd.58.75] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Fernanda R. de O. Pedreira
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas
- Marcelo Pedreira Orthodontic Institute
| | - Marina L. de Carli
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas
| | - Renato do P. G. Pedreira
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas
- Marcelo Pedreira Orthodontic Institute
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