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Köktürk B, Pamukçu H, Gözüaçık Ö. Evaluation of different machine learning algorithms for extraction decision in orthodontic treatment. Orthod Craniofac Res 2024. [PMID: 38764408 DOI: 10.1111/ocr.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION The extraction decision significantly affects the treatment process and outcome. Therefore, it is crucial to make this decision with a more objective and standardized method. The objectives of this study were (1) to identify the best-performing model among seven machine learning (ML) models, which will standardize the extraction decision and serve as a guide for inexperienced clinicians, and (2) to determine the important variables for the extraction decision. METHODS This study included 1000 patients who received orthodontic treatment with or without extraction (500 extraction and 500 non-extraction). The success criteria of the study were the decisions made by the four experienced orthodontists. Seven ML models were trained using 36 variables; including demographic information, cephalometric and model measurements. First, the extraction decision was performed, and then the extraction type was identified. Accuracy and area under the curve (AUC) of the receiver operating characteristics (ROC) curve were used to measure the success of ML models. RESULTS The Stacking Classifier model, which consists of Gradient Boosted Trees, Support Vector Machine, and Random Forest models, showed the highest performance in extraction decision with 91.2% AUC. The most important features determining extraction decision were maxillary and mandibular arch length discrepancy, Wits Appraisal, and ANS-Me length. Likewise, the Stacking Classifier showed the highest performance with 76.3% accuracy in extraction type decisions. The most important variables for the extraction type decision were mandibular arch length discrepancy, Class I molar relationship, cephalometric overbite, Wits Appraisal, and L1-NB distance. CONCLUSION The Stacking Classifier model exhibited the best performance for the extraction decision. While ML models showed a high performance in extraction decision, they could not able to achieve the same level of performance in extraction type decision.
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Affiliation(s)
- Begüm Köktürk
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Hande Pamukçu
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
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Geramy A, Ebrahimi S. Evaluation of different models of intrusive force application and temporary anchorage device (TAD) placement in total arch intrusion using clear aligners; a finite element analysis. BMC Oral Health 2023; 23:740. [PMID: 37817113 PMCID: PMC10566175 DOI: 10.1186/s12903-023-03465-2] [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: 07/14/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION Present study aims to evaluate different models of total arch intrusion using clear aligners in a finite element setup, which might be helpful in gummy smile patients who seek this treatment modality. METHODS Four patterns of intrusive forces were applied on each side of the upper arch aligner model: (1) Distal to the lateral incisors (facial - 80 g) and distal to the first molar (palatal - 150 g). (2) Distal to the lateral incisors (facial - 80 g) and distal to the first molars (facial - 80 g and palatal - 80 g). (3) Distal to the canines (facial - 80 g) and distal to the first molars (facial - 150 g). (4) Distal to the lateral incisors (facial - 80 g) and mesial to the first molars (facial - 150 g). Vertical and horizontal movements of the teeth were measured. RESULTS Extrusion movements were solely detected at buccal cusps of the first and second molars in the first model. Palatal movements of posterior teeth were detected in this model. Model II showed a homogeneous intrusion in anterior and posterior teeth and the amount of palatal movements of posterior teeth was reduced compared to model I. In contrast to Model IV, Model III had more intrusion in the posterior compared to anterior teeth. Facial movements of posterior teeth were detected in the third and fourth models. Incisor teeth showed facial movements among all of the models except for the lateral incisor in the third model. CONCLUSIONS Each model of force application, causes different outcomes and side effects which is beneficial in certain clinical situations.
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Affiliation(s)
- Allahyar Geramy
- Orthodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroush Ebrahimi
- Orthodontics Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Kang DO, Yu HS, Choi SH, Kim ST, Jung HD, Lee KJ. Stability of vertical dimension following total arch intrusion. BMC Oral Health 2023; 23:164. [PMID: 36949457 PMCID: PMC10031991 DOI: 10.1186/s12903-023-02842-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The purpose of this study is to evaluate stability of vertical dimension following total arch intrusion using miniscrews by measuring the change during treatment and relapse amount after more than one year of retention. METHODS Thirty patients (6 men, 24 women) were included in this study. Lateral cephalographs were taken with conventional radiography at the start of treatment (T0), after treatment (T1), and at least one year after treatment (T2). The evaluation was performed by measuring changes of selected parameters during treatment and the extent of relapse after more than one year. RESULTS During total arch intrusion treatment (T1-T0), anterior and posterior teeth intruded significantly. The mean vertical distance between the maxillary posterior teeth and palatal plane was reduced by 2.30 mm (P < 0.001). The mean vertical distance between the maxillary anterior teeth and palatal plane was reduced by 2.04 mm (P < 0.001). The anterior facial height was also reduced by 2.70 mm (P < 0.001). During retention period (T2-T1), the vertical distance between the maxillary anterior teeth and the palatal plane significantly increased by 0.92 mm (P < 0.001). The anterior facial height increased by 0.81 mm (P < 0.01). CONCLUSIONS Anterior facial height significantly decreases after treatment. During retention period, relapse of AFH and maxillary anterior teeth observed. There was no correlation between initial amount of AFH, mandibular plane angle, or SNPog and posttreatment AFH relapse. However, there was a significant correlation between the amount of intrusion of anterior and posterior teeth achieved by the treatment and the extent of relapse.
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Affiliation(s)
- Dong-Ok Kang
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Sung-Hwan Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Seong-Taek Kim
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Hwi-Dong Jung
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50‑1 Yonsei‑ro, Seodaemun‑gu, Seoul, 03722, Korea.
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Choi JY, Park JJ, Park KH, Park YG, Park JH. Torque and vertical control of maxillary incisors for an esthetic smile using TSADs implanted in various areas: Biomechanical considerations. Semin Orthod 2022. [DOI: 10.1053/j.sodo.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wang P, Chen J, Wang X, Bai D, Guo Y. Orthodontic correction of a skeletal Class II malocclusion with severe gummy smile by total intrusion of the maxillary dentition. Am J Orthod Dentofacial Orthop 2022; 162:777-792. [PMID: 35985965 DOI: 10.1016/j.ajodo.2021.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/01/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022]
Abstract
A 22-year-old woman visited the hospital complaining of lip protrusion, crowded teeth, and a gummy smile. The clinical examination showed a convex profile with a hyperdivergent mandible and a severe gummy smile in both anterior and posterior regions. The unstable mandible position was considered during treatment planning, and a targeted mechanic system was carefully designed. Temporary skeletal anchorage devices in the posterior dental region and a transpalatal arch were introduced as anchorage for the intrusion of the entire maxillary dentition and controlled retraction of the anterior teeth. Based on effective and simple mechanisms, we successfully eliminated the severe gummy smile and improved the facial aesthetics with the aid of conventional appliances. This approach provided an alternative option to orthognathic surgery or bulky invasive miniscrews for treatment of skeletal Class II malocclusion with severe gummy smile.
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Affiliation(s)
- Peiqi Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiajun Chen
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xinghai Wang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yongwen Guo
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Diseases, and Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Evangelista K, de Freitas Silva BS, Yamamoto-Silva FP, Valladares-Neto J, Silva MAG, Cevidanes LHS, de Luca Canto G, Massignan C. Accuracy of artificial intelligence for tooth extraction decision-making in orthodontics: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6893-6905. [PMID: 36269467 DOI: 10.1007/s00784-022-04742-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 10/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to analyze the accuracy of artificial intelligence (AI) for orthodontic tooth extraction decision-making. MATERIALS AND METHODS PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO, Computers & Applied Science, ACM Digital Library, Compendex, and gray literature (OpenGrey, ProQuest, and Google Scholar) were electronically searched. Three independent reviewers selected the studies and extracted and analyzed the data. Risk of bias, methodological quality, and certainty of evidence were assessed by QUADAS-2, checklist for AI research, and GRADE, respectively. RESULTS The search identified 1810 studies. After 2 phases of selection, six studies were included, showing an unclear risk of bias of patient selection. Two studies showed a high risk of bias in the index test, while two others presented an unclear risk of bias in the diagnostic test. Data were pooled in a random model and yielded an accuracy value of 0.87 (95% CI = 0.75-0.96) for all studies, 0.89 (95% CI = 0.70-1.00) for multilayer perceptron, and 0.88 (95% CI = 0.73-0.98) for back propagation models. Sensitivity, specificity, and area under the curve of the multilayer perceptron model yielded 0.84 (95% CI = 0.58-1.00), 0.89 (95% CI = 0.74-0.98), and 0.92 (95% CI = 0.72-1.00) scores, respectively. Sagittal discrepancy, upper crowding, and protrusion showed the highest ranks weighted in the models. CONCLUSIONS Orthodontic tooth extraction decision-making using AI presented promising accuracy but should be considered with caution due to the very low certainty of evidence. CLINICAL RELEVANCE AI models for tooth extraction decision in orthodontics cannot yet be considered a substitute for a final human decision.
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Affiliation(s)
- Karine Evangelista
- School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil. .,Division of Orthodontics, School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil.
| | - Brunno Santos de Freitas Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil
| | - José Valladares-Neto
- Division of Orthodontics, School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil
| | - Maria Alves Garcia Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Avenida Universitária esquina com 1a Avenida, Goiânia, S/N. Zip Code: 74605-220, Brazil
| | - Lucia Helena Soares Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI, Zip Code: 48109, USA
| | - Graziela de Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Health Sciences Center, Federal University of Santa Catarina, Rua Delfino Conti, 1240-Trindade, Florianópolis, Zip Code: 88040-535, Brazil
| | - Carla Massignan
- Department of Dentistry, University of Brasilia, UnB Estac. Medicina UnB-Asa Norte, Brasilia, Zip Code: 70297-400, Brazil
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Rizzi RI, Portes MIP, Ertty E, Meloti F, An TL, Cardoso MDA. Aesthetic perception of smile in long face pattern patients who underwent maxillary impaction with miniplates or orthognathic surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:498-504. [PMID: 35577305 DOI: 10.1016/j.jormas.2022.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The gummy smile is perceived in 10% of the population aged 20 to 30 years old, and it causes an aesthetic imbalance in the smile. This study investigated the existence of differences in the aesthetic perception of the smile after correcting the gummy smile using two different techniques: orthognathic surgery for maxillary impaction and miniplate-aided orthodontic impaction. METHODS Photographs of 16 Long Face Pattern female patients were evaluated by 56 oral and maxillofacial surgeons, 56 orthodontists, and 56 laypeople before and after the treatment with one of the two techniques. These photographs were standardized using the Photoshop program, randomly organized, and then presented to the evaluators via the Google Meeting® application in the PowerPoint® program. To evaluate the attractiveness of the smile, the Visual Analogue Scale (VAS) was used. To analyze the intra and inter-examiner concordances, Spearman's correlation and Kendall's concordance tests were used, respectively. For intergroup comparison, the Friedman test was used, with a 5% significance level. RESULTS For all three groups of evaluators, the post-treatment evaluation results were superior to the results before the treatment: surgeons and orthodontists assigned higher scores for surgical cases and laypeople for orthodontic cases. CONCLUSION From a clinical point of view, there was no difference between the results of both techniques with regard to the aesthetic perception of smiles. A gingival exposure ranging from zero to two millimeters was considered the most aesthetic for all evaluators.
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Affiliation(s)
- Ricardo Ideny Rizzi
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, 230-Apt 164, Cambuí, Campinas, São Paulo, SP 13024-490, Brazil
| | - Maila Izabela Pêsso Portes
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, 230-Apt 164, Cambuí, Campinas, São Paulo, SP 13024-490, Brazil.
| | - Ertty Ertty
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, 230-Apt 164, Cambuí, Campinas, São Paulo, SP 13024-490, Brazil
| | - Fernanda Meloti
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, 230-Apt 164, Cambuí, Campinas, São Paulo, SP 13024-490, Brazil
| | - Tien-Li An
- Department of Dentistry, School of Health Sciences, Brasilia, Brazil
| | - Mauricio de Almeida Cardoso
- Department of Orthodontics, Faculdade São Leopoldo Mandic, Instituto São Leopoldo Mandic, 230-Apt 164, Cambuí, Campinas, São Paulo, SP 13024-490, Brazil
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Abstract
Orthodontists play a vital role in the smile design of individuals. There are a variety of orthodontic goals and tooth movements that can be achieved to obtain the ideal smile that ultimately leads to the optimum esthetic outcomes. In this article, some methods and appliance systems to control and achieve the desired tooth movements are described and illustrated.
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Affiliation(s)
- Chung How Kau
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Suite 305, 1919 7th Avenue South, Birmingham AL 35294, USA.
| | - Terpsithea Christou
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Suite 305, 1919 7th Avenue South, Birmingham AL 35294, USA
| | - Shubam Sharma
- Department of Orthodontics, School of Dentistry, University of Alabama Birmingham, Suite 305, 1919 7th Avenue South, Birmingham AL 35294, USA
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Rajamanickam P, Babu H, Jain RK, Balasubramaniam A. Evaluation of Dentoalveolar and Soft Tissue Changes in Adult Class II Malocclusions Treated with Different Modalities. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/qi6dbkmcmy] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kim KJ, Park JH, Chang NY, Seo HY, Chae JM. A cone-beam computed tomography evaluation of posterior available space in both arches relative to various skeletal patterns. Am J Orthod Dentofacial Orthop 2022; 161:798-808. [DOI: 10.1016/j.ajodo.2021.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/01/2022]
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Kawamura J, Park JH, Kojima Y, Tamaya N, Kook YA, Kyung HM, Chae JM. Biomechanical analysis for total distalization of the maxillary dentition: A finite element study. Am J Orthod Dentofacial Orthop 2021; 160:259-265. [PMID: 33972141 DOI: 10.1016/j.ajodo.2020.04.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to identify the tooth movement patterns relative to various force angulations (FAs) when distalizing the total maxillary dentition. METHODS Long-term orthodontic movement of the maxillary dentition was simulated by accumulating the initial displacement of teeth produced by elastic deflection of the periodontal ligament using a finite element analysis. Distalization forces of 3 N were applied to the archwire between the maxillary canine and first premolar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane. RESULTS Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. At a force angulation of 30°, almost bodily distalization of the total maxillary dentition occurred, but incisors showed considerable lingual tipping because of the effect of clearance gap (0.003-in, 0.022 × 0.025-in bracket slot, 0.019 × 0.025-in archwire) and elastic deflection of the archwire. Medial displacement of the maxillary anterior teeth occurred because of lingual tipping during distalization. The occlusal plane rotated clockwise at all FAs because of extrusion of the maxillary incisors and intrusion of the maxillary second molars, and the amounts decreased as FA increased. CONCLUSIONS Tooth movement patterns during distalization of the total maxillary dentition were recognized. With an understanding of the mechanics, a proper treatment plan can be established.
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Affiliation(s)
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz, Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, South Korea
| | - Hee-Moon Kyung
- Department of Orthodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Jong-Moon Chae
- Department of Orthodontics, School of Dentistry, Wonkwang University, Wonkwang Dental Research Institute, Iksan, South Korea, Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, Ariz.
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Ihde S, Sipic O, Pałka L. A Single-Step Implant Treatment of a Patient Presenting with a High Smile Line (Gummy Smile) - Surgical, Prosthetic, and Financial Considerations of Full-Mouth Rehabilitation with One-Piece Implants Anchored in Cortical Bone - A Case Report. Ann Maxillofac Surg 2021; 10:512-517. [PMID: 33708607 PMCID: PMC7943993 DOI: 10.4103/ams.ams_43_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 11/17/2022] Open
Abstract
Dental implant treatment and immediate loading protocol in the front maxillae provides severe esthetical difficulties, for example in cases where the transition zone of the patients' teeth and the gums is visible during habitual movements of the upper lip or when the patient presents excessive gingival display. In this case report, it is shown in detail how to overcome the esthetic problems in a straightforward manner in such clinical situations. The article also discusses in which financial environments treatments on teeth are endlessly continued and under which conditions patients manage to get (and prefer) an early switch to implant borne teeth.
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Affiliation(s)
- Stefan Ihde
- International Implant Foundation, Department of Evidence and Research, Munich, Germany
| | - Olga Sipic
- International Implant Foundation, Department of Evidence and Research, Munich, Germany
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Protocols for orthodontic treatment of patients with temporomandibular joint disorders. Am J Orthod Dentofacial Orthop 2021; 159:373-388. [PMID: 33485717 DOI: 10.1016/j.ajodo.2020.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022]
Abstract
Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles. This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan. This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.
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Jerrold L, Chay C, Accornero M. The extraction of teeth: Part 1 diagnostic and treatment considerations. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jung MH. Total arch distalization with interproximal stripping in a patient with severe crowding. Korean J Orthod 2019; 49:194-201. [PMID: 31149610 PMCID: PMC6533184 DOI: 10.4041/kjod.2019.49.3.194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
When a patient shows severe crowding, premolar extraction should be considered to provide required available space for alignment. If the third molars have already erupted and demonstrate a poor prognosis, third molar extraction and distalization of the posterior dentition can be used instead of premolar extraction to obtain space. Interproximal stripping (IPS) may also be used to gain space in cases of crowding. This case report describes the treatment of a 25-year-old man with severe crowding and mild lip protrusion. Although the crowding in the lower arch was severe enough to require first premolar extraction, distalization of the entire lower dentition with orthodontic mini-implants, extraction of the lower third molars, and IPS could successfully resolve the crowding and lip protrusion.
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Affiliation(s)
- Min-Ho Jung
- Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
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Jung MH. Vertical control of a Class II deep bite malocclusion with the use of orthodontic mini-implants. Am J Orthod Dentofacial Orthop 2019; 155:264-275. [DOI: 10.1016/j.ajodo.2018.08.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 02/08/2023]
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Nguyen T, Baek ES, Hwang S, Kim KH, Chung CJ. Nonsurgical and nonprosthetic camouflage treatment of skeletal Class II open bite with bilaterally missing lower first molars. Angle Orthod 2018; 89:505-517. [PMID: 30124320 DOI: 10.2319/030718-189.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This report illustrates the successful nonsurgical and nonprosthetic camouflage treatment of a skeletal Class II open bite malocclusion combined with missing mandibular first molars bilaterally. In the mandible, the second and third molars were uprighted and protracted, substituting for the missing first molars. In the maxilla, anterior bodily retraction and full-arch intrusion were achieved following premolar and second molar extraction, which also induced autorotation of the mandible. The treatment outcome and prognosis were confirmed with three-dimensional superimposition techniques, along with long-term stability.
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