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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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Zhao J, Xu Y, Wang J, Lu Z, Qi K. 3-dimensional analysis of hard- and soft-tissue symmetry in a Chinese population. BMC Oral Health 2023; 23:432. [PMID: 37386472 PMCID: PMC10308641 DOI: 10.1186/s12903-023-03163-z] [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: 01/04/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Facial symmetry severely affects appearance and function. Large numbers of patients seek orthodontic treatment to improve facial symmetry. However, the correlation between hard- and soft-tissue symmetry is still unclear. Our aim was to investigate the hard- and soft-tissue symmetry in subjects with different levels of menton deviation and sagittal skeletal classes with 3D digital analysis and to investigate the relationship between the entire and individual hard- and soft-tissues. METHODS A total of 270 adults (135 males and 135 females) consisting of 45 subjects of each sex in each sagittal skeletal classification group. All subjects were further classified into relative symmetry (RS), moderate asymmetry (MA) and severe asymmetry (SA) groups based on the degree of menton deviation from the mid-sagittal plane (MSP). The 3D images were segmented into anatomical structures and mirrored across the MSP after establishing a coordinate system. Original and mirrored images were registered by a best-fit algorithm, and the corresponding root mean square (RMS) values and colormap were obtained. The Mann‒Whitney U test and Spearman correlation were conducted for statistical analysis. RESULTS The RMS increased with greater deviations with regard to the deviation of the menton in most of anatomical structures. Asymmetry was represented in the same way regardless of sagittal skeletal pattern. The soft-tissue asymmetry had a significant correlation with dentition in the RS group (0.409), while in the SA group, it was related to the ramus (0.526) and corpus (0.417) in males and was related to the ramus in the MA (0.332) and SA (0.359) groups in females. CONCLUSIONS The mirroring method combining CBCT and 3dMD provides a new approach for symmetry analysis. Asymmetry might not be influenced by sagittal skeletal patterns. Soft-tissue asymmetry might be reduced by improving the dentition in individuals with RS group, while among those with MA or SA, whose menton deviation was larger than 2 mm, orthognathic treatment should be considered.
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Affiliation(s)
- Jiamin Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Yifei Xu
- Department of Oral Anatomy and Physiology and TMD, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Jinxiu Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Zhen Lu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China
| | - Kun Qi
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China.
- Department of Orthodontics, Stomatological Hospital of Xi'an Jiaotong University, 98 XiWu Road, 710004, Xi'an, Shaanxi, P.R. China.
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