Lip-to-incisor Relationship and
Postorthodontic
Long-term Stability of Cover-
bite Treatment
www.indiandentalacademy.com
I...
Introduction
 COVER BITE
 (A) Pronounced retroclination
of at least the upper central and
coverage of the lower by the
u...
Characteristics
 Highly variable post-treatment stability
 Factors considered important in the prevention of
relapse inc...
Aim
 To investigate long-term stability of the therapeutic
correction of retroclined maxillary central incisors in
cover-...
MATERIALS AND METHODS
Study Group
 A group of 31 former patients
 Inclusion criteria were (1) pretreatment retro incline...
Odontometric Analysis
 Plaster casts T1, T2, T3, and T4.
 Odontometric method for determination
of maxillary central inc...
Cephalometric Determination
of Lip-line Parameters
Parameters describing the morphological
relationship between the maxill...
Clinical Follow-up Examination and
Evaluation of Treatment Records
 Dental impressions (odontometric analysis)
 Treatmen...
Statistical Analysis
 Change in incisor inclination (T4 - T2) was subjected
to multiple regression analysis by using SAS ...
RESULTS
Evaluation of Treatment Records
 Extractions in the upper jaw (n = 6)
 Retention type
 Breakages
 (T3 - T2) wa...
Model Cast Analysis and
Cephalometric Evaluation
www.indiandentalacademy.com
 Box plots:
 (A) Change in maxillary
central inclinations (relative
to occlusal plane) during
therapeutic (T2-T1) and
po...
Statistical Analyses of Maxillary Central
Incisor Inclination Relapse
 Correlation between
the dorsal lip line
level (hor...
 The combination of dorsal lip-line level
(DorsLipL(T2)) and lower lip level (LowLipL(T2))
explained 31% of maxillary cen...
 This means that the maxillary central incisor inclinational
relapse tendency was particularly high in cases of a high
li...
www.indiandentalacademy.com
DISCUSSION
 High average stability found in the present study for the
therapeutic correction of retroinclined maxillary c...
 Pressure magnitude and distance from the center of
resistance of the tooth are maximized along with relatively
proclined...
 Physiology roughly implies that the lower lip covers a
maximum of 3 mm of the maxillary central incisors.
www.indiandent...
CONCLUSIONS
 The relapse tendency of orthodontic correction of the
maxillary central incisor retroclination displayed gre...
 For maximum treatment stability, the elimination of
an excessive overlap of the upper incisors by the lower
lip should b...
For more details please visit
www.indiandentalacademy.com
www.indiandentalacademy.com
Upcoming SlideShare
Loading in …5
×

Lip to-incisor relationship and postorthodontic /certified fixed orthodontic courses by Indian dental academy

485 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

Published in: Health & Medicine, Business
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
485
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Lip to-incisor relationship and postorthodontic /certified fixed orthodontic courses by Indian dental academy

  1. 1. Lip-to-incisor Relationship and Postorthodontic Long-term Stability of Cover- bite Treatment www.indiandentalacademy.com INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  2. 2. Introduction  COVER BITE  (A) Pronounced retroclination of at least the upper central and coverage of the lower by the upper incisors as typical dental characteristics of cover-bite malocclusion.  (B) Intraoral situation in the same patient showing the upper incisors almost completely covered by the extremely high lower lip.  Prevalence in permanent dentition is 7% www.indiandentalacademy.com
  3. 3. Characteristics  Highly variable post-treatment stability  Factors considered important in the prevention of relapse include a physiological, post-therapeutic occlusion in the anterior dental segment;  Factors considered important in causation of relapse is increased resting lip pressure; and a high lip line. www.indiandentalacademy.com
  4. 4. Aim  To investigate long-term stability of the therapeutic correction of retroclined maxillary central incisors in cover-bite patients and to evaluate the significance of possible relapse- inducing factors. www.indiandentalacademy.com
  5. 5. MATERIALS AND METHODS Study Group  A group of 31 former patients  Inclusion criteria were (1) pretreatment retro inclined maxillary central incisors (<980 relative to the anterior cranial baseline), (2) pretreatment frontal overbite >/= 3 mm, (3) maxillary central incisors uprighted during orthodontic therapy, (4) the availability of a lateral cephalograms taken after completion of active mechanotherapy of sufficient quality to evaluate the post treatment lip-to-incisor relationship, and (5) completion of active mechanotherapy at least 3 years before a follow-up examination.  Mean age of the patients at the start of treatment was 10.6 years (range: 7.0–33.9 years).  Included both nonextraction (n = 25) and extraction (n= 6) cases. www.indiandentalacademy.com
  6. 6. Odontometric Analysis  Plaster casts T1, T2, T3, and T4.  Odontometric method for determination of maxillary central inclinations relative to the occlusal plane (defined as the tip of the cuspid and the most prominent cusp of the upper first molar).  (A) Removal of half of the maxillary central incisor crown in mesiodistal dimension.  (B) Drawing of the maxillary central incisor crown axis.  (C) Measurement of maxillary central incisor crown inclination. www.indiandentalacademy.com
  7. 7. Cephalometric Determination of Lip-line Parameters Parameters describing the morphological relationship between the maxillary central incisor and the lips on the lateral cephalograms: Ventral and dorsal lip line level (VentLipL, DorsLipL) measured as the vertical distance between the incisal edge (Is) and the most ventral and the most dorsal contact point of upper and lower lip (VentStm, DorsStm). The lower lip level (LowLipL) was determined as the vertical distance between the incisal edge and the most cranial contact point of maxillary central incisor and lower lip (LowLipCont). The constructed true horizontal plane (THP) served as reference line. Inter-incisal angle and The perpendicular distance from the maxillary central incisor incisal edge to the nasion-pogonion line. www.indiandentalacademy.com
  8. 8. Clinical Follow-up Examination and Evaluation of Treatment Records  Dental impressions (odontometric analysis)  Treatment records of the 31 patients were evaluated regarding Tooth extractions during therapy, Type of retention appliance, Period the retention appliance was worn (T3 T2), T4 – T2. www.indiandentalacademy.com
  9. 9. Statistical Analysis  Change in incisor inclination (T4 - T2) was subjected to multiple regression analysis by using SAS statistical software  UExIn  Re- ApIn  Pearson correlation coefficients were calculated for relevant interrelations between model parameters.  Reproducibility www.indiandentalacademy.com
  10. 10. RESULTS Evaluation of Treatment Records  Extractions in the upper jaw (n = 6)  Retention type  Breakages  (T3 - T2) was 1.3 years  (T4 - T2) was 9.0 years www.indiandentalacademy.com
  11. 11. Model Cast Analysis and Cephalometric Evaluation www.indiandentalacademy.com
  12. 12.  Box plots:  (A) Change in maxillary central inclinations (relative to occlusal plane) during therapeutic (T2-T1) and posttherapeutic (T4-T2) intervals, showing the 5th, 25th, 50th, 75th, and 95th percentiles.  (B) Change in overbite during therapeutic (T2-T1) and posttherapeutic (T4-T2) intervals. www.indiandentalacademy.com
  13. 13. Statistical Analyses of Maxillary Central Incisor Inclination Relapse  Correlation between the dorsal lip line level (horizontal axis) and the relapse of the therapeutical correction of the maxillary central incisor retroclination (n = 31). www.indiandentalacademy.com
  14. 14.  The combination of dorsal lip-line level (DorsLipL(T2)) and lower lip level (LowLipL(T2)) explained 31% of maxillary central incisor inclinational relapse variability (maxillary central incisor Incl(T4T2)). www.indiandentalacademy.com
  15. 15.  This means that the maxillary central incisor inclinational relapse tendency was particularly high in cases of a high lip-line level at the dorsal lip contact point and, simultaneously, a relatively small overlap of the maxillary central incisor by the lower lip in the area of their incisal edge.  Additional inclusion of the therapeutic inclinational change of the maxillary central incisors (maxillary central incisor Incl(T2T1)) in the regression model increased the proportion of relapse variability explained by the (three- parametric) model to 34% www.indiandentalacademy.com
  16. 16. www.indiandentalacademy.com
  17. 17. DISCUSSION  High average stability found in the present study for the therapeutic correction of retroinclined maxillary central incisors was in agreement with previous studies on treatment stability in Class II division 2 and cover- bite cases  The higher the lip line level and the greater the proclination of maxillary central incisors in the course of therapy, the greater the relapse tendency.  Relatively high percentage of relapse variability that could be explained by the combination of a high dorsal lip line level and simultaneously a small, incisally located area of direct overlap between the maxillary central incisors and the lower lip. www.indiandentalacademy.com
  18. 18.  Pressure magnitude and distance from the center of resistance of the tooth are maximized along with relatively proclined maxillary inicisors.  An interesting finding regarding the results of the previous study and the present study was that the proportion of relapse variability explained by the lip-line level variability alone was much higher in the present study  Elimination of a high posttherapeutic lip line level is certainly more readily considered as a therapeutic objective along with the simultaneous esthetic improvements in most cases. www.indiandentalacademy.com
  19. 19.  Physiology roughly implies that the lower lip covers a maximum of 3 mm of the maxillary central incisors. www.indiandentalacademy.com
  20. 20. CONCLUSIONS  The relapse tendency of orthodontic correction of the maxillary central incisor retroclination displayed great interindividual variability.  An increased tendency to relapse was especially found in patients with a high posttherapeutic (dorsal) lip- line level and simultaneously with maxillary central incisor and lower lip contact only in the incisal area of these teeth, as well as in patients with a marked therapeutically induced change in maxillary central incisor inclination. www.indiandentalacademy.com
  21. 21.  For maximum treatment stability, the elimination of an excessive overlap of the upper incisors by the lower lip should be regarded as one of the most important therapeutic objectives when treating this malocclusion. www.indiandentalacademy.com
  22. 22. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

×