1) Retention of anterior open bites is challenging as relapse can occur due to ongoing vertical growth, tongue posture issues, and resumption of habits like digit sucking.
2) Accurately diagnosing an open bite as dental or skeletal is important for determining the appropriate treatment approach and relapse prevention.
3) Long-term retention, often including fixed lingual retainers and Hawley retainers incorporating a tongue crib, is usually necessary to prevent open bite relapse.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
The treatment of skeletal malocclusion often needs repositioning of maxillary or mandibular arch.
Unlike the conventional means of resorting to orthognathic surgery, current technology enables predictable displacement of entire dental arch mainly based on the relationship between the center of resistance of entire dental arch and the location of the force vector.The clinical implication of the so-called “total arch movement” includes efficient tooth movement without round-tripping during treatment, compliance-free treatment and higher possibility of non-surgical and/or non-extraction treatment in non-growing subjects.The concept of simultaneous movement of the whole dental arch has already been in clinical use for more than a decade.
Sugawara et al. in 2004 introduced the use of miniplates for respective maxillary or mandibular molar distalization with out causing undesired movement of incisors.Jeon etal and Yamada etal propose the simultaneous incisal and molar movement using interradicular miniscrews placed between the 2nd premolar and the 1st molar
Eliminating the need for incisor retraction subsequent to the molar distalization
The document discusses using bite ramps or bite turbos in orthodontic treatment to correct deep overbites and curves of Spee. It provides instructions on how to make and place bite ramps using light cure material. Bite ramps are bonded to the palatal surfaces of maxillary central incisors. The ramps can be extended lingually if needed. Bite ramps are a useful orthodontic device to correct deep overbites and allow bonding of lower anterior brackets which may otherwise not be possible.
orthodonticTraction of impacted maxillary canine and Piggyback techniquemohammed alawdi
This document discusses impacted maxillary canines. It notes that canines are commonly impacted palatally, with females more often affected than males. Clinical signs of an impacted canine include delayed eruption of the permanent canine or prolonged retention of the deciduous canine. Impacted canines can be located using radiographs. Treatment involves either open or closed surgical exposure techniques followed by orthodontic forces to erupt the canine into alignment. Forces are typically applied using cantilever springs or the Kilroy spring. Case examples demonstrate successful treatment of palatally and buccally impacted canines using these approaches.
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.for more details please visit
www.indiandentalacademy.com
determinate vs indeterminate force systemKumar Adarsh
This document discusses force systems in orthodontics. It describes determinate and indeterminate force systems, with determinate systems providing better control of forces and moments. One-couple systems are created using a cantilever spring or auxiliary arch wire tied to a tooth at one end. Two-couple systems are created when an arch wire is tied into brackets on both ends. Common applications of one and two-couple systems include intrusion/extrusion arches and lingual arches. Segmented arch mechanics allow precise control but require more wire bending compared to continuous arch wires.
This document discusses various types of springs and loops used in orthodontics. It describes design factors that influence properties like stiffness, elastic limit, and moment-to-force ratio. Specific loops discussed include T-loops, tear drop loops, and Opus loops. Key points covered are how wire size, alloy, loop height/design, and position can be altered to achieve different force systems for controlled tooth movement. Maintaining an optimal moment-to-force ratio throughout treatment is important for controlled tipping, translation and root movement.
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
The treatment of skeletal malocclusion often needs repositioning of maxillary or mandibular arch.
Unlike the conventional means of resorting to orthognathic surgery, current technology enables predictable displacement of entire dental arch mainly based on the relationship between the center of resistance of entire dental arch and the location of the force vector.The clinical implication of the so-called “total arch movement” includes efficient tooth movement without round-tripping during treatment, compliance-free treatment and higher possibility of non-surgical and/or non-extraction treatment in non-growing subjects.The concept of simultaneous movement of the whole dental arch has already been in clinical use for more than a decade.
Sugawara et al. in 2004 introduced the use of miniplates for respective maxillary or mandibular molar distalization with out causing undesired movement of incisors.Jeon etal and Yamada etal propose the simultaneous incisal and molar movement using interradicular miniscrews placed between the 2nd premolar and the 1st molar
Eliminating the need for incisor retraction subsequent to the molar distalization
The document discusses using bite ramps or bite turbos in orthodontic treatment to correct deep overbites and curves of Spee. It provides instructions on how to make and place bite ramps using light cure material. Bite ramps are bonded to the palatal surfaces of maxillary central incisors. The ramps can be extended lingually if needed. Bite ramps are a useful orthodontic device to correct deep overbites and allow bonding of lower anterior brackets which may otherwise not be possible.
orthodonticTraction of impacted maxillary canine and Piggyback techniquemohammed alawdi
This document discusses impacted maxillary canines. It notes that canines are commonly impacted palatally, with females more often affected than males. Clinical signs of an impacted canine include delayed eruption of the permanent canine or prolonged retention of the deciduous canine. Impacted canines can be located using radiographs. Treatment involves either open or closed surgical exposure techniques followed by orthodontic forces to erupt the canine into alignment. Forces are typically applied using cantilever springs or the Kilroy spring. Case examples demonstrate successful treatment of palatally and buccally impacted canines using these approaches.
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.for more details please visit
www.indiandentalacademy.com
determinate vs indeterminate force systemKumar Adarsh
This document discusses force systems in orthodontics. It describes determinate and indeterminate force systems, with determinate systems providing better control of forces and moments. One-couple systems are created using a cantilever spring or auxiliary arch wire tied to a tooth at one end. Two-couple systems are created when an arch wire is tied into brackets on both ends. Common applications of one and two-couple systems include intrusion/extrusion arches and lingual arches. Segmented arch mechanics allow precise control but require more wire bending compared to continuous arch wires.
This document discusses various types of springs and loops used in orthodontics. It describes design factors that influence properties like stiffness, elastic limit, and moment-to-force ratio. Specific loops discussed include T-loops, tear drop loops, and Opus loops. Key points covered are how wire size, alloy, loop height/design, and position can be altered to achieve different force systems for controlled tooth movement. Maintaining an optimal moment-to-force ratio throughout treatment is important for controlled tipping, translation and root movement.
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.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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
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
00919248678078
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
This document provides an overview of pitchfork analysis for evaluating changes in cephalometric radiographs over time. It discusses landmarks used for superimposing tracings of the cranial base, maxilla, and mandible. For the cranial base, sella and nasion are commonly used. The maxilla can be superimposed along the palatal plane or contours of the zygomatic arches. For the mandible, the lower border, symphysis, or gonion-gnathion and gonion-menton planes are used. Pitchfork analysis expresses changes in molar and incisor relationships algebraically to quantify treatment effects.
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.for more details please visit
www.indiandentalacademy.com
Roth philosophy /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
This document discusses molar distalization, which is an alternative method for gaining space when treating orthodontic patients with space deficiencies. It provides the history of molar distalization, indications and contraindications for its use, different appliance options, and considerations for appliance selection. Molar distalization involves using orthodontic appliances to distalize or move the molars backwards in the dental arch in order to gain space.
This document discusses the three orders of tooth movement that can be achieved through bending orthodontic archwires: first, second, and third order bends. First order bends move teeth inwards/outwards and can be used for derotation. Second order bends tip teeth vertically and are used for anchorage. Third order bends torque individual teeth by twisting the wire. Special pliers can help perform specific bends, like step pliers for first order bends and rose pliers for third order torque bends. Proper bending technique is important to avoid wire fractures.
1) Mandibular molar protraction is challenging due to the high density of mandibular bone and inadequate anterior dental anchorage. Temporary anchorage devices (TADs) provide skeletal anchorage to protract molars.
2) Various TAD techniques are described for molar protraction, including using a lingual elastic tied from the molar to the archwire to prevent crossbite, and a "push-pull" technique placing a TAD in the edentulous space.
3) Molar protraction through atrophic alveolar ridges carries risks of periodontal complications, so techniques are described to minimize risks and protract molars at their center of resistance.
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.for more details please visit
www.indiandentalacademy.com
Orthodontic tooth movement during space closure can occur through two types of mechanics: segmental/sectional mechanics which do not involve friction, and sliding mechanics which do involve friction between the bracket and archwire. Friction plays a significant role in sliding mechanics. Several methods are used to apply force during space closure, including elastomeric modules, elastomeric chains, and closed coil springs made of materials like stainless steel and nickel titanium. These methods vary in terms of factors like force degradation over time and sensitivity to environmental factors like temperature. Maintaining an optimal force during retraction is important for controlled tooth movement.
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
K- Sir loop /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
This document discusses the management of low angle cases (skeletal deep bites). It covers the etiology, which can include hereditary factors and horizontal growth patterns. Clinical features include a short square face, upper teeth hidden behind the lips, and decreased interlabial distance. Diagnostic features include decreased facial angles and a horizontal growth pattern seen on cephalograms. Management options discussed include removable appliances, growth modification, magnets, fixed appliances, implants, lingual appliances, Invisalign, and surgery. Stability and retention are also addressed.
Molar uprighting /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
The document provides an overview of the Tip-edge bracket system created by Dr. Peter Kesling in 1986. It was designed to allow for differential tooth movement by removing corners from conventional edgewise brackets. This allows the crown to tip into place before final torque and positioning. The system uses light forces and a sequence of 3 stages to align, level and torque teeth into the desired positions. A variety of auxiliaries like sidewinders and power pins are used throughout treatment to control individual tooth movements. The Tip-edge bracket is intended to provide controlled three dimensional tooth positioning with light continuous forces.
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.for more details please visit
www.indiandentalacademy.com
This document discusses treatment planning for complete dentures. It describes a classification system developed by the American College of Prosthodontics for complete edentulism based on objective variables. The system defines four classes ranging from Class I (uncomplicated) to Class IV (most complex). Treatment is planned based on factors like residual ridge morphology, muscle attachments, jaw relationship, and systemic health. Modifiers to the treatment plan are considered for each variable, such as using cheek plumpers for loose muscle tone or relieving bony undercuts surgically. The goal is to match treatment options to patient needs in a logical sequence.
This document discusses the diagnosis and management of anterior open bite in mixed dentition. Anterior open bite is defined as no contact between maxillary and mandibular incisors. It has multifactorial etiology including habits like thumb sucking, tongue thrusting, and skeletal or dental factors. Diagnosis involves case history and cephalometric analysis to determine skeletal vs dental components. Treatment depends on severity and can range from simple habit control to appliance therapy using devices like bite blocks or headgear to guide growth, or complex orthodontic-surgical approaches. Early treatment from ages 7-8 aims to enhance development before permanent dentition and reduce high relapse risks.
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.for more details please visit
www.indiandentalacademy.com
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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
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
00919248678078
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
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.for more details please visit
www.indiandentalacademy.com
This document provides an overview of pitchfork analysis for evaluating changes in cephalometric radiographs over time. It discusses landmarks used for superimposing tracings of the cranial base, maxilla, and mandible. For the cranial base, sella and nasion are commonly used. The maxilla can be superimposed along the palatal plane or contours of the zygomatic arches. For the mandible, the lower border, symphysis, or gonion-gnathion and gonion-menton planes are used. Pitchfork analysis expresses changes in molar and incisor relationships algebraically to quantify treatment effects.
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.for more details please visit
www.indiandentalacademy.com
Roth philosophy /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
This document discusses molar distalization, which is an alternative method for gaining space when treating orthodontic patients with space deficiencies. It provides the history of molar distalization, indications and contraindications for its use, different appliance options, and considerations for appliance selection. Molar distalization involves using orthodontic appliances to distalize or move the molars backwards in the dental arch in order to gain space.
This document discusses the three orders of tooth movement that can be achieved through bending orthodontic archwires: first, second, and third order bends. First order bends move teeth inwards/outwards and can be used for derotation. Second order bends tip teeth vertically and are used for anchorage. Third order bends torque individual teeth by twisting the wire. Special pliers can help perform specific bends, like step pliers for first order bends and rose pliers for third order torque bends. Proper bending technique is important to avoid wire fractures.
1) Mandibular molar protraction is challenging due to the high density of mandibular bone and inadequate anterior dental anchorage. Temporary anchorage devices (TADs) provide skeletal anchorage to protract molars.
2) Various TAD techniques are described for molar protraction, including using a lingual elastic tied from the molar to the archwire to prevent crossbite, and a "push-pull" technique placing a TAD in the edentulous space.
3) Molar protraction through atrophic alveolar ridges carries risks of periodontal complications, so techniques are described to minimize risks and protract molars at their center of resistance.
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.for more details please visit
www.indiandentalacademy.com
Orthodontic tooth movement during space closure can occur through two types of mechanics: segmental/sectional mechanics which do not involve friction, and sliding mechanics which do involve friction between the bracket and archwire. Friction plays a significant role in sliding mechanics. Several methods are used to apply force during space closure, including elastomeric modules, elastomeric chains, and closed coil springs made of materials like stainless steel and nickel titanium. These methods vary in terms of factors like force degradation over time and sensitivity to environmental factors like temperature. Maintaining an optimal force during retraction is important for controlled tooth movement.
This document discusses various types of intrusion arches used in orthodontics to correct deep overbites. It begins by defining intrusion and describing the biomechanics and principles involved. It then covers 9 specific intrusion arch designs: 1) Rickett's Utility Arch 2) Tipback Springs 3) Burstone's Continuous Intrusion Arch 4) Burstone's Three Piece Intrusion Arch 5) K-SIR 6) Connecticut Intrusion Arch 7) PG Retraction Spring 8) Translation Arch 9) Lingual Arch for intruding lower incisors. For each type, it provides details on materials, design, and mechanics of intrusion.
K- Sir loop /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
This document discusses the management of low angle cases (skeletal deep bites). It covers the etiology, which can include hereditary factors and horizontal growth patterns. Clinical features include a short square face, upper teeth hidden behind the lips, and decreased interlabial distance. Diagnostic features include decreased facial angles and a horizontal growth pattern seen on cephalograms. Management options discussed include removable appliances, growth modification, magnets, fixed appliances, implants, lingual appliances, Invisalign, and surgery. Stability and retention are also addressed.
Molar uprighting /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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
The document provides an overview of the Tip-edge bracket system created by Dr. Peter Kesling in 1986. It was designed to allow for differential tooth movement by removing corners from conventional edgewise brackets. This allows the crown to tip into place before final torque and positioning. The system uses light forces and a sequence of 3 stages to align, level and torque teeth into the desired positions. A variety of auxiliaries like sidewinders and power pins are used throughout treatment to control individual tooth movements. The Tip-edge bracket is intended to provide controlled three dimensional tooth positioning with light continuous forces.
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.for more details please visit
www.indiandentalacademy.com
This document discusses treatment planning for complete dentures. It describes a classification system developed by the American College of Prosthodontics for complete edentulism based on objective variables. The system defines four classes ranging from Class I (uncomplicated) to Class IV (most complex). Treatment is planned based on factors like residual ridge morphology, muscle attachments, jaw relationship, and systemic health. Modifiers to the treatment plan are considered for each variable, such as using cheek plumpers for loose muscle tone or relieving bony undercuts surgically. The goal is to match treatment options to patient needs in a logical sequence.
This document discusses the diagnosis and management of anterior open bite in mixed dentition. Anterior open bite is defined as no contact between maxillary and mandibular incisors. It has multifactorial etiology including habits like thumb sucking, tongue thrusting, and skeletal or dental factors. Diagnosis involves case history and cephalometric analysis to determine skeletal vs dental components. Treatment depends on severity and can range from simple habit control to appliance therapy using devices like bite blocks or headgear to guide growth, or complex orthodontic-surgical approaches. Early treatment from ages 7-8 aims to enhance development before permanent dentition and reduce high relapse risks.
Rpd consideration in maxillofacial prostheticshamide norouzi
This document discusses considerations for removable partial dentures in patients with maxillofacial defects. It describes different types of maxillofacial defects including acquired, congenital, and developmental. For acquired defects, it discusses preoperative planning, interim prosthetics, potential complications, defect hygiene, and definitive care. It also describes different classifications of maxillary and mandibular defects and prosthetic options for each, including obturator, speech aid, palatal lift, and palatal augmentation prostheses. Framework designs and retention strategies are discussed for different types of mandibular resections.
1. A study compared long-term stability of adolescent versus adult surgery for treatment of mandibular deficiency, finding that beyond 1 year post-surgery, younger patients showed significantly greater changes in horizontal and vertical positions of mandibular landmarks and angles.
2. Early mandibular advancement surgery may be less stable long-term than performing the same surgery on older, growth-completed patients.
3. Younger patients undergoing two-jaw surgery experienced even greater long-term changes than those receiving isolated mandibular advancement.
Change in the Vertical Ralation in Class II Deformity with Skeletal Open Bite...Abu-Hussein Muhamad
This document summarizes the treatment of a 21-year-old female patient who presented with a Class II deformity, open bite, and long lower face. The treatment plan involved a combined orthodontic-surgical approach including:
1. Presurgical orthodontics to align the teeth and prepare for surgery.
2. Orthognathic surgery consisting of a LeFort I osteotomy to impact the maxilla 4mm dorsally and 2mm ventrally, and a sagittal split osteotomy to advance the mandible 6mm on the right and 2mm on the left with 4.5mm left shift.
3. Postsurgical orthodontics to settle the occlusion, followed by
Fabrication of functional complete dentures for edentulous patients who have undergone hemimandibulectomy is a very arduous and demanding endeavor.
The most challenging situation encountered during this procedure is the deviation of the mandible to the resected side. The deviation of the mandible to the resected side is directly proportional to the loss of tissues in the area hemi-mandibulectomy has been performed.
In cases with Cantor and Curtis classes II, III, IV, and V, guide flange prosthesis would be a treatment modality. For guide flange prosthesis to be effective, the sufficient number of posterior teeth that are periodontally sound should be present in the opposite arch.
In patients where reconstruction is not done after resection of the mandible, scar tissue formation occurs over a period of time that stiffens the tissues and worsens prosthetic rehabilitation, leading to compromised treatment planning.
Orthodontic treatment of deep bite part 1Maher Fouda
The document discusses the classification and treatment of deep bite. It defines deep bite as overbite greater than 3mm and classifies it as true deep bite caused by infraposition of posterior teeth or pseudo deep bite caused by supraocclusion of anterior teeth. Treatment involves intrusion of maxillary incisors, extrusion of premolars or molars, or a combination, and may include removable appliances, fixed appliances, headgear, or orthognathic surgery depending on the severity and skeletal vs. dental factors. Functional analysis is important to determine the correct treatment approach.
Change in the Vertical Relation in Class II Deformity with Skeletal Open Bite...Abu-Hussein Muhamad
This summarizes a document describing a case study of a patient with Class II deformity and skeletal open bite treated with orthodontics and orthognathic surgery. Key points:
- The 21-year-old female patient presented with missing lower front teeth, crowded upper teeth, and pain in the temporomandibular joints. Diagnosis found a long lower face and non-occlusion on one side.
- Treatment involved presurgical orthodontics to align the teeth, followed by double jaw surgery involving maxillary impaction and mandibular advancement and rotation.
- Post-surgical orthodontics were used to settle the occlusion, and a retainer was employed long-term due to
Full mouth fixed implant rehabilitation in a patientUE
This case report describes the full mouth rehabilitation of a 37-year old female patient who had lost most of her teeth due to generalized aggressive periodontitis. After extracting all remaining teeth, the patient received 12 dental implants, with 6 placed in each jaw. Fixed detachable prostheses were fabricated connecting all 12 implants. The patient was satisfied with the final result and remained stable at the 10 month follow up, though continuous maintenance care is critical for long term success given the risk of peri-implantitis in patients with periodontal disease.
Management of posttraumatic malocclusion caused by condylar process fractureDr. SHEETAL KAPSE
This study evaluated the treatment of 21 patients with post-traumatic malocclusions caused by condylar process fractures. For asymmetric malocclusions from unilateral fractures (n=15), patients underwent unilateral or bilateral mandibular ramus osteotomies. For anterior open bites from bilateral fractures (n=6), patients underwent either Le Fort I osteotomies (n=5) or bilateral ramus osteotomies (n=1). All patients had stable dental and skeletal results after 1+ years except one treated with bilateral ramus osteotomies. The authors conclude that osteotomies of the affected jaw are effective for treating post-traumatic malocclusions from condylar fractures.
1) A 12-year-old patient presented with mucosal trauma from a deep overbite.
2) Traumatic deep overbites can be classified based on their skeletal and dental characteristics.
3) Treatment aims to relieve pain, correct vertical and anteroposterior discrepancies, and ensure stability.
Treatment of gingival recession using coronally advanced flapShruti Maroo
This document describes a case study evaluating the efficacy of the coronally advanced flap technique for treating gingival recession. A 27-year old male patient presented with Miller's Class I gingival recession on teeth 22 and 23, along with sensitivity. The coronally advanced flap procedure was performed, involving incisions and elevation of a partial-thickness flap. One month and three months post-operatively, the patient showed uneventful healing and 100% root coverage, with reduction in sensitivity and no probing defects. The coronally advanced flap technique alone can successfully treat gingival recession when residual gingiva is thick and wide, resulting in good esthetic and functional outcomes.
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
This document describes a case study involving periodontally accelerated osteogenic orthodontics (PAOO) to accelerate orthodontic tooth movement. PAOO involves selective alveolar decortications and bone grafting to induce regional acceleratory phenomenon and reduce orthodontic treatment time. The case report describes performing corticotomy and bone grafting to close a 6.5mm space between teeth in a 27-year-old female patient, achieving the space closure in 4 months, which is significantly faster than conventional orthodontic treatment. PAOO provides benefits like reduced treatment time, increased bone volume, and improved post-treatment stability compared to traditional orthodontics.
Periodontally Accelerated Osteogenic Orthodontics: A Surgical Technique and C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Anterior openbite diagnosis and managment (oral surgery)dentalcare3
1. The document discusses the diagnosis and treatment of anterior open bite malocclusion. It defines anterior open bite and lists its causes such as skeletal, dental, soft tissue, and habits.
2. Treatment depends on the cause and age of the patient, and can include appliances, headgear, fixed appliances, extractions, and sometimes surgery. For growing patients, habit correction and arch expansion may work.
3. In skeletally mature patients, open bite can be corrected orthodontically by extruding incisors, intruding molars, and expanding the maxilla. Stability is a concern and compromise of facial aesthetics is possible.
4. Surgical options are discussed for cases involving
Partial or complete edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism in the maxillary arch and total edentulism in the mandibular arch. The main clinical findings were unopposed remaining teeth, over eruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with intentional root canal therapy of the remaining natural teeth. Series of provisional prostheses were applied to facilitate the transition to the final treatment.
Key-words: Edentulism, Vertical dimension, Provisional Restoration, Fixed and Removable prosthesis
This study evaluated 14 cases of autogenous maxillary canine transplantation in young patients. Impacted or partially erupted maxillary canines were extracted and immediately transplanted to prepared recipient sites. Two years later, 12 cases showed normal mobility and lamina dura formation on radiographs, indicating successful transplantation. Two cases showed inflammatory resorption, increased mobility, and widening of the periodontal space, indicating unsuccessful transplantation. Autotransplantation of impacted or partially erupted maxillary canines can be a viable alternative to other treatments like orthodontics or dental implants when patient selection criteria are met and proper surgical technique is followed.
COMPLETE DENTURE CONSTRUCTION
1- Diagnosis and Treatment Planning for Removable Prosthodontics
2- Preliminary Maxillary and mandibular impression procedures
3- Final Maxillary and mandibular impression procedures
4- Jaw Relation Registration
a. Introduction and the stomatognathic system
What 'occlusion' is and why it is important
b. Definitions.
c. Check denture foundation and Establishment of facial contour.
d. Establishment of the occlusal plane.
e. Importance of mounting the maxillary cast using Maxillary face-bow record and transfer.
f. Determination of vertical dimension of centric occluding relation.
g. Determination of centric and eccentric relations at the accepted vertical dimension.
5- Selection of Artificial Teeth
6- Prosthetic Problems and possible solutions in Setting –up of teeth for skeletal Class I, II and Class III arch relationship of completely edentulous patients.
7- Try-in of the wax trial complete denture.
8- Complete denture insertion (Delivery)
9- Occlusal corrections.
10- Managements of Post Insertion Problems and Complaints.
11- Single denture and Kelly's Syndrome
12- Denture Processing and Laboratory Errors.
13- Relining, rebasing and repair of removable dentures
The document discusses the features, prevalence, and early intervention of class II division 1 malocclusion involving maxillary excess. It describes the clinical and cephalometric characteristics of class II malocclusion and the use of cervical headgear with a Kloehn facebow to restrain maxillary growth and distalize the upper dentition during the mixed dentition stage to intercept the developing malocclusion. The headgear application is aimed at maintaining a class I molar and canine relationship through orthopedic modification of the maxilla.
selection of preformed archwires during the alignment stage of preadjusted or...Maher Fouda
This document discusses orthodontic archwire selection during the alignment stage of treatment with preadjusted appliances. It provides details on different types of archwires used for alignment including multi-strand stainless steel, conventional and superelastic nickel-titanium (NiTi), and heat-activated NiTi wires. Superelastic NiTi wires are preferred for alignment due to their low stiffness, high springback, and ability to deliver nearly constant light forces during tooth movement. The document discusses various archwire sequences used during alignment and leveling, noting that there is no set sequence but heat-activated NiTi can replace multiple stainless steel wires to reduce visits and discomfort.
The document discusses orthodontic initial alignment. It defines alignment as moving teeth into their correct positions in relation to the planned dental arch form. Initial alignment uses thin, flexible round archwires to move tooth crowns horizontally into better positions, as root positions are often closer to correct. It describes using progressively thicker archwires as alignment improves. Factors like bypassing severely displaced teeth, using reinforcement sleeves, and avoiding excessive forces are discussed to optimize initial tooth movement.
This document discusses various techniques for orthodontic tooth alignment and leveling. It begins by outlining the stages of the straight wire technique. It then provides details on objectives and techniques for the initial alignment and leveling stage, including:
- Aligning tooth brackets to allow progression to stiffer archwires
- Placing brackets slightly off-center to aid in correcting tooth rotations
- Techniques for aligning high or impacted canine teeth, such as auxiliary wires or springs
- Using archwire sleeves or bypass arches to protect crowded incisors from unwanted movement
- Achieving curve of spee flattening mostly through proclination of mandibular incisors
The document emphasizes using lighter arch
Moment-to-Force Ratios and Controlling RootNew Microsoft PowerPoint Presentat...Maher Fouda
1. Moment-to-force ratios describe the relationship between an applied orthodontic force and the counterbalancing moment, or rotational force, required to control tooth movement.
2. Altering the ratio of the moment of an applied force to the moment generated by a force couple at the bracket allows for different types of tooth movement, from simple tipping to controlled tipping to bodily movement.
3. Achieving the desired tooth movement depends on manipulating these moments such that their ratio results in the desired movement, whether that be tipping, controlled tipping, or translation without rotation.
The document discusses orthodontic bracket prescriptions, including:
1) Early edgewise brackets required wire bends to control tooth movement, while contemporary brackets have built-in prescriptions for in-out, tip, and torque adjustments.
2) Lawrence Andrews introduced the pre-adjusted edgewise appliance with customized brackets programmed for specific tooth control without wire bends.
3) Later prescriptions like Roth and MBT incorporated changes like more torque in upper incisors to compensate for bracket limitations, while individual adaptations are often needed for specific cases.
This document discusses orthodontic controlled space closure using fixed appliances. It describes a case where the maxillary and mandibular first premolars were extracted and all teeth were bonded with pre-adjusted edgewise brackets. Initial alignment took 4 months. Space closure involved retracting the anterior teeth with a continuous tear drop loop activated over months until the extraction space was closed after 9 months. It discusses principles and objectives of space closure, including maintaining the desired occlusal and aesthetic outcomes through controlled tooth movement.
1. Retention is required after active orthodontic tooth movement to allow tissues to remodel and support teeth in their new positions.
2. Several factors can cause relapse, including residual forces in the periodontium and gingiva as they remodel over 3-6 months, forces from muscles and occlusion, and ongoing facial growth.
3. The type of original malocclusion, treatment performed, and a patient's growth pattern inform the appropriate retention plan, which may include removable or fixed retainers worn long-term to stabilize results.
The document discusses bracket variations that can be used to optimize tooth positioning for different malocclusion types. Specifically, it describes how inverting the bracket on an upper lateral incisor that is palatally displaced can provide beneficial labial root torque to help align the crown and root. Inverting the bracket changes the torque prescription from +10 degrees to -10 degrees, facilitating labial movement of the root during treatment. Careful selection and positioning of brackets can simplify treatment of localized anomalies.
Andrew identified 6 keys to normal occlusion based on a study of non-orthodontic models. The 6 keys are:
1. Proper molar relationship between the upper first molar and lower second molar.
2. Positive crown angulation for all teeth.
3. Negative crown inclination for most teeth, except upper front teeth.
4. Teeth should be free from undesirable rotations.
5. Tight contact points between all teeth.
6. An occlusal plane that is relatively flat, rather than a deep or reverse curve of Spee.
When these 6 keys are present, it results in optimal intercuspation and occlusion. Deviations
MBT wire sequence during orthodontic alignment and levelingMaher Fouda
This document discusses different archwire sequences used during tooth leveling and aligning. It begins by describing a case where a non-extraction approach was used with .016 HANT wires for initial alignment. After 3 months, rectangular HANT wires were placed, followed by .019/.025 stainless steel wires after 6 months to help correct the occlusion. The document then provides historical background on archwires and discusses the introduction of nickel-titanium wires as substitutes for steel wires during initial alignment. Heat-activated nickel-titanium wires are described as being able to replace 3 traditional stainless steel wires. Recommendations are provided on when stainless steel wires are still preferable to heat-activated wires.
This document discusses arch form in orthodontic treatment. It notes that while custom archwires were traditionally used, preadjusted appliances assumed one arch form could fit all patients. However, some customization is still needed. The document examines stability of arch form changes after treatment and notes expansion, especially of lower intercanine width, often relapses. It recommends using tapered, square, and ovoid arch forms to balance efficiency and accuracy for individual patients.
Orthodontic alignment phase of pre-adjusted fixed appliance ...Maher Fouda
1. The document discusses the orthodontic alignment phase when using pre-adjusted fixed appliances. It begins by describing how the original edgewise appliance required wire bending to position each tooth, whereas pre-adjusted brackets incorporate each tooth's final position.
2. It then explains how pre-adjusted brackets achieve three-dimensional control of each tooth's position by varying bracket base thickness, slot angulation, and base contour. Various archwire sequences and techniques used during initial alignment are also described.
3. The summary concludes by noting that efficient initial alignment is important for simplifying future treatment and is typically achieved using light nickel-titanium or steel wires until adequate alignment is reached.
Hazards of swallowing orthodontic appliancesMaher Fouda
The document discusses the clinical examination process for orthodontic patients, including assessing risks of foreign body aspiration or ingestion. A thorough examination involves obtaining medical history, conducting extra-oral and intra-oral exams, and taking radiographs. It is important to evaluate predisposing factors that could increase risks, such as medications, medical conditions, or behaviors. Symptoms may vary depending on the location of any foreign objects in the airway, esophagus, or gastrointestinal tract. Proper patient positioning and emergency procedures should be followed to address any potential complications.
This document provides an overview of functional appliances used in orthodontic treatment. It begins with an introduction to functional appliances and their use in guiding natural forces to correct morphological abnormalities. It then covers classifications of functional appliances, how cephalometric analysis is used to assess patients, and descriptions of common appliances like the activator, bionator, and twin-block. The document discusses how functional appliances can correct Class II and III malocclusions by influencing facial growth. In under 3 sentences.
This document discusses deep bite, including its definition, types, etiology, diagnosis, factors, and treatment. A deep bite is defined as excessive vertical overlap of the upper and lower incisors. It can be true, caused by infraocclusion of posterior teeth, or pseudo, with normal posterior eruption. Causes include genetic, acquired, and muscular factors. Diagnosis involves clinical exams, casts, radiographs, and cephalograms. Treatment aims to correct the underlying occlusion and may involve bite planes, fixed appliances, or intrusion/extrusion of teeth to reduce the overbite. Bite ramps are an effective option to help correct a deep bite over time through posterior development.
1. Orthodontic tooth movement occurs through remodeling of the alveolar bone in response to prolonged mechanical forces on teeth. Bone resorbs on the pressure side and forms on the tension side of the periodontal ligament.
2. Physiologic tooth movements include eruption, drift, and minor movements during mastication. Eruption occurs through growth of the root and forces from the periodontal ligament.
3. When forces are within physiologic limits, tooth movement occurs through frontal resorption on the pressure side and bone formation on the tension side. Excessive forces cause hyalinization and undermining resorption.
This document discusses the classification, etiology, clinical features, and assessment of Class II malocclusions. It describes two main types of Class II malocclusions - Division 1 where the upper anteriors are proclined, and Division 2 where the upper anteriors are retroclined. Class II Division 1 is often due to a skeletal Class II pattern or habits that procline the upper incisors. Class II Division 2 can be associated with a mild skeletal Class II or reduced lower facial height. A thorough assessment of skeletal patterns, soft tissues, dental factors, growth potential, and likelihood of stability is needed to determine the appropriate treatment approach.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. What are retention
considerations in open bite
cases?
An open bite
malocclusion may be
dental or skeletal in
nature. A dental open
bite may be caused by
depression of the
incisors because of a
habit such as thumb- or
finger-sucking or poor
tongue posture.
3. A good cephalometric
value to differentiate
between a dental and
skeletal open bite is
incision-stomion;
dental open bites have
intruded maxillary
incisors whereas
skeletal open bites
have a normal incisor
position.
5. The open
bite must
be
accurately
diagnosed
and treated
if relapse is
to be
prevented.
Treatment and retention of relapsed anterior openbite with low tongue
posture and tongue-tie: A 10-year follow-up
[Korean J Orthod 2014;44(4):203-216]
6. The open
bite must
be
accuratel
y
diagnose
d and
treated if
relapse is
to be
prevented
Facial and intraoral
photographs of relapse after
3-year post-treatment
Treatment and retention of relapsed anterior openbite with low tongue
posture and tongue-tie: A 10-year follow-up
[Korean J Orthod 2014;44(4):203-216]
8. Controlling the
eruption of the
maxillary molars
with high-pull
headgears and a
transpalatal bar
with a midline
acrylic palatal
button 4 mm off of
the palate is useful
to control
extrusion
a Patient with Clark
Twinblock with flying
tubes to insert a
Headgear. b Patient
wearing Clark Twinblock
with high-pull headgear
9. Camouflage of a high-angle skeletal Class II
open-bite malocclusion in an adult after mini-
implant failure during treatment
American Journal of Orthodontics and
Dentofacial Orthopedics
March 2017 " Vol 151 " Issue 3
11. One reason is that
vertical
growth and eruption
of posterior teeth
may
continue until the late
teenage years or
early
twenties, with vertical
growth of the maxilla
being the last stage
of maturation.
12. Recurrence of
the open bite
malocclusion
is possible and
that’s why a
long retention
phase appears
to be very
important,
particularly in
following
instances :
Nonsurgical approach to Class I open-bite malocclusion with extrusion mechanics: A 3-
year retention case report
American Journal of Orthodontics and Dentofacial Orthopedics
April 2015 Vol 147 Issue 4
13. Nonsurgical approach to Class I open-bite malocclusion with extrusion mechanics: A 3-
year retention case report
American Journal of Orthodontics and Dentofacial Orthopedics
April 2015 Vol 147 Issue 4
Three-year retention facial
and intraoral photographs
A fixed retainer was
attached to the lingual
surface of the
mandibular anterior
teeth. Overlayed Hawley
retainers were fabricated
and delivered to secure
the stability of both
arches. A tongue crib
was incorporated in the
maxillary Hawley
retainer to prevent
relapse of the tongue-
thrust habit. Total
treatment time for this
patient was 24 months.
14. Appearance pre-op
(top row), post-q
(middle row) and 36
months post-op
(hottom row).
1-Macroglossia.
2-Dolichofacial
growth after
the completion
of the
treatment.
RELAPSE
FOLLOWING
SURGICAL
TREATMENT OF
ANTERIOR OPEN
BITE
British Journal of
Oral and
Maxillofacial
Surgery (1986) 24,
391-404
long retention phase
appears to be very
important in
15. (A) Example of a high angle
case with mandibular
retrusion and anterior open
bite treated demonstrating
relapse of the orthognathic
surgical correction of a severe
anterior open bite. (B) Extra
and intraoral photographs
before orthognathic surgical
treatment after orthognathic
surgical treatment (C) and 2
years after orthognathic
surgical treatment
16. Orthodontic treatment of severe anterior open bite and alveolar bone defect
complicated by an ankylosed maxillary central incisor: a case report
Lin et al. Head & Face Medicine 2014, 10:47
Stages in the
orthodontic
tooth
alignment. (A–
F) Orthodontic
traction and
alignment of
the tooth; (G) A
modified
Hawley retainer
bonded with
resin to the
central incisors
to provide
retention for
the tooth in the
dental arch.
Pre-treatment photographs showing a
severe anterior open bite from the left
maxillary canine to the right lateral
incisor. The maxillary left central incisor
was severely infra-occluded and the
right central incisor had a fractured
crown.
17. Orthodontic treatment of severe anterior open bite and alveolar bone defect
complicated by an ankylosed maxillary central incisor: a case report Lin et al. Head & Face Medicine 2014, 10:47
intraoral
photographs of
patient at 2-
year follow-up
Post-
treatment
intraoral
photographs
19. Relapse of AOB has been
attributed to:
Inappropriate
orthodontic tooth
movement, such as
extrusion of
incisors where their
eruption had not
been
previously impeded
,
Appearance
pre-op (top
row), post-
op (middle
row). and
36 months
post-op
(bottom
20. Relapse of AOB has been
attributed to:
Surgery that
has increased the
posterior face
height – as would
occur if the aob is
closed using a
mandibular
procedure only.
,
Appearance
pre-op (top
row). post-
op (middle
row) and 24
months
post-op
(bottom
row).
21. Surgical Orthodontic Treatment of Severe
Class Iii and Anterior Open Bite
World Journal of Oral and Maxillofacial
Surgery
2018 | Volume 1 | Issue 1 | Article 1004
Pre-surgical photographs.
Initial photographs.
22. Surgical Orthodontic
Treatment of Severe Class Iii
and Anterior Open Bite
World Journal of Oral and
Maxillofacial Surgery
2018 | Volume 1
| Issue 1 | Article
1004
The surgery
was performed
under general
anesthesia, with
nasal
intubation, and
the sagittal
surgical
technique for
the mandibular
setback with
counterclockwis
e rotation was
used.
photographs of 1 month after surgery.
23. Surgical Orthodontic
Treatment of Severe
Class Iii and Anterior
Open Bite
World Journal
of Oral and
Maxillofacial
Surgery
2018 | Volume 1 |
Issue 1 | Article
1004
Intermaxillary
elastics for
posterior and
anterior
intercuspation
were used,
such as post-
surgical
blockage, for
10 days. photographs of 1 month after surgery.
24. Surgical Orthodontic Treatment of Severe
Class Iii and Anterior Open Bite
World Journal of Oral and Maxillofacial
Surgery
2018 | Volume 1 | Issue 1 | Article 1004
After this time,
the elastics
continued to
be used at
night, for
maintenance
and
stabilization of
the occlusion
obtained after
surgery.
photographs of 1.5 years follow-up.
25. Relapse of open
bite can occur
because of
tongue size or
posture, digit-
sucking habits,
respiratory
problems,and
condylar
resorption.
Vertical relapse after orthodontic and orthognathic surgical
treatment in a patient with myotonic dystrophy
European Journal of Paediatric Dentistry vol. 20/1-2019
Intra-oral photographs before treatment.
Intra-oral photographs after active treatment.
13.5 years post-treatment: intra-oral photographs .
26. Anterior open bite
due to idiopathic
condylar resorption
during orthodontic
retention of a Class II
Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Pretreatment photographs and radiographs.
27. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Posttreatment photographs and radiographs
28. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Radiographic imaging (CBCT) of the patient's condylar
resorption. A, 10 months posttreatment;
29. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Radiographic imaging (CBCT) of the patient's condylar
resorption. A, 10 months posttreatment;
30. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Radiographic imaging (CBCT) of the patient's condylar
resorption. B, 15 months posttreatment.
31. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American
Journal of
Orthodontics
and
Dentofacial
Orthopedics
October
2019 Vol
156 Issue 4
Radiographic imaging (CBCT) of the patient's condylar
resorption. B, 15 months posttreatment.
32. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention
of a Class II Division 1
malocclusion
American Journal of
Orthodontics and
Dentofacial
Orthopedics
October 2019 Vol 156
Issue 4
Lateral cephalograms and panoramic radiographs showing the
progress of ICR with aggravated open bite, condylar shape change, and
shortening of the mandibular length. A, pretreatment;B, posttreatment;
33. Anterior open bite due
to idiopathic condylar
resorption during
orthodontic retention of
a Class II Division 1
malocclusion
American Journal of
Orthodontics and
Dentofacial
Orthopedics
October 2019
Vol 156 Issue 4
Lateral cephalograms and panoramic radiographs showing the progress of ICR with
aggravated open bite, condylar shape change, and shortening of the mandibular length. C,
10 months posttreatment; D, 15 months posttreatment.
34. Anterior open bite due to idiopathic condylar resorption during orthodontic retention of a
Class II Division 1 malocclusion
American Journal of Orthodontics and Dentofacial Orthopedics October 2019 Vol 156 Issue 4
Progress of anterior open bite over time shown in intraoral and profile photos. A, posttreatment (14.1
years old); B, 10 months posttreatment (14.11 years old); C, 15 months posttreatment (15.4 years old); D,
23 months posttreatment (16.0 years old).
35. Anterior open bite due to idiopathic condylar resorption during orthodontic retention of a
Class II Division 1 malocclusion
American Journal of Orthodontics and Dentofacial Orthopedics October 2019 Vol 156 Issue 4
. Phases of condylar degeneration from normal TMJ to destructive, repair, and finally stable stage. A, normal
TMJ; B, beginning of active/destructive phase; C, “cup” shaped defect in superior surface of condyle (B and C,
stages vulnerable to biomechanical force); D, beginning of repair stage; E, advanced repair phase; F, stable
stage.
36. Preoperative Occlusion. Demonstration of
Preoperativ
e Frontal
Repose.
Preoperative
Cephalometric
Radiograph
Preoperati
ve Frontal
Smile.
6-month Postoperative Occlusion
12-month Postoperative Occlusion
Stability and Relapse in Orthognathic Surgery Neeraj Panchal, DDS, MD, MA Christine Ellis, DDS, MSD Paul
Tiwana, DDS, MD, MS, FACS
Relapse Due
To Condylar
Resorption
One Year
After
Bilateral
Sagittal Split
Osteotomy
To Correct
Apertognat
hia and
Mandibular
Deficiency.
37. Tongue habits,
particularly
tongue–thrust
swallowing, are
often blamed
for relapse into
open bite, but
the evidence to
support this
contention is
not convincing
Patient with an anterior open
bite which was believed to be due to an
endogenous tongue thrust. Both upper and
lower incisors were proclined. The patient did
not have a digit-sucking habit.
38. Open-bile cases
present a great
challenge to the
orthodontist. It
is important lo
evaluate
tongue position
and
tongue habits
in the finishing
stages of
treatment.
40. Active habits (of
which thumb
sucking is the best
example) can
produce intrusive
forces on the
incisors, while
at the same time
leading to an
altered posture of
the jaw that
allows posterior
teeth to erupt.
The occlusal effects of a persistent
digit-sucking habit. Note the anterior open bite
and the unilateral posterior crossbite.
42. Relapse of AOB has been
attributed to:
Unfavourable
growth (a posterior
mandibular growth
rotation)
soft-tissue factors
such as an unfavourable
tongue posture
Resumption of a
digit-sucking habit;
,
43. - Bite elevation
after eruption
of the second
molars. - After
an active
intrusion of
molars or
extrusion of
the front.
44. Severe open bite due to traumatic condylar
fractures treated nonsurgically with implanted
miniscrew anchorage
female patient
was 36 years 0
months of age at
the first
examination. She
had chief
complaint of
chewing
difficulties
associated with the
anterior teeth.
45. Severe open bite due to traumatic condylar
fractures treated nonsurgically with implanted
miniscrew anchorage
She had injured her
head and face in a traffic
accident 6 months before
her
visit. Initially, her frontal
facial appearance
showed left
deviation of the
mandible, and her lateral
profile exhibited
posterior mandibular
positioning.
46. Severe open bite due to traumatic condylar
fractures treated nonsurgically with implanted
miniscrew anchorage
Tongue
thrusting was observed during
conversation. The dental
midline of her mandible was
deviated 2 mm to the left
relative to the facial midline.
Her molars showed occlusal
interferences, and her
anteroposterior relationship
was
Angle Class II, with an overjet
of 5.2 mm and an overbite
of 4.0 mm .
47. Severe open bite due to traumatic condylar
fractures treated nonsurgically with implanted
miniscrew anchorage
On the
pretreatment 3-
dimensional
computed
tomography
images,
we found that
both condyles
were deformed;
however,
the fracture lines
were not clear .
Pretreatment 3-dimensional computed tomography scans.
48. The results
of an examination with a 3-dimensional, 6 degree of
freedom jaw movement measurement apparatus (Gnathohexagraph
system, version 1.31; Ono Sokki, Kanagawa,
Japan) showed that the movements of the
bilateral condyles during lateral sliding movements
and anterior movements were irregular, with the incisal
path unstable. With an occlusal force recording system
(Dental Prescale and Occluzer; Fuji Film, Tokyo, Japan),
her maximum occlusal force was found to be relatively
weak (201 N). No impacted teeth were seen on the panoramic
radiograph . The cephalometric analysis
showed that she had a skeletal Class II anteroposterior
jaw relationship with an ANB angle of 8.3
54. The fallacy of tongue thrust and non-surgical
treatment of a severe anterior open bite
Journal of Dental Health Oral Disorders & Therapy
Volume 4 Issue 4 - 2016
The patient is a 33-year old
female dentist who presents with
a chief complaint of an open bite
and poor posterior occlusion. As a
12-year old child growing up in
Serbia, the patient accompanied
by her parents first presented to
the private family dentist for
evaluation and treatment. She
was diagnosed with a skeletal
open bite secondary to a “tongue
thrust problem” which her
dentist described as continuous
suckling.
55. She was given a series of removable
habit correcting appliances which
she used as instructed but tapered
herself off in about a year because
treatment was ineffective. Several
years passed before the patient
returned to a public dentist for
treatment at the age of 19 where she
was given removable
orthodontic/orthopedic appliances
followed by application of brackets
prior to surgical orthodontic
treatment.
56. Once again her anterior open bite
was attributed to tongue thrust.
Because of the uncertain outcome
and difficulty associated with the
surgical orthodontic procedure as
described by her dentist and
surgeon she decided not to pursue
treatment and brackets were
removed. Shortly thereafter she
started dental school where she
was seen by a professor in the
department of orthodontics.
57. She was told that
surgical orthodontics
was the only viable
treatment option but
was once again
cautioned of the
difficulty and uncertain
outcome of the
procedure. She once
again decided to forgo
surgery and all
orthodontic treatment
for several years.
58. Treatment took 15 months with
appointments scheduled
approximately on a monthly
basis. Brackets were initially
placed on
the four maxillary incisors for
patient comfort for one month. At
the second appointment brackets
were placed on all remaining
maxillary teeth including the
properly occluding second
molars.
59. This set up provided
appropriate force and
adequate torque for both
the maxillary first molars
and all premolar roots to
upright and aligns the
maxillary arch by
inducing alveolar bone
growth in order to
provide proper occlusion
with opposing
mandibular teeth.
60. At the third visit and three
months into treatment,
brackets were placed on
the mandibular teeth with
elastics to close the anterior
bite. The treating co-
author notes that treatment
time could have been
substantially less had the
patient diligently complied
with the use of elastics.
63. Most of the relapses
happen during the first
year of the retention.
Many studies showed
that extraction treatment
had greater stability than
a nonextraction
treatment. Still non-
extraction therapy
provided a reliable
stability of results.
65. If correction of severe
open bite is not started
in the mixed dentition,
it will most likely
require orthognathic
surgery in late
adolescence or
adulthood. The skeletal
open bite phenotype is
easily diagnosed in the
early mixed dentition.
67. Essix-type retainers
with full-thickness
plastic posterior
coverage are the
best retainers for
open bites because
they maintain
intrusive force on
the posterior teeth,
which in turn
maintains good
anterior bite depth.
68. Clear and Fixed
Retainer's Outcomes
After Orthodontic Ally
Treated Open Bite
Cases : Clinical Study
Medical Journal of
Babylon Vol. 13- No.
2: 271 - 276 , 2016
69. There are another
two
major approaches to
accomplishing this: a
maxillary retainer
with bite
blocks (or a
functional appliance)
to impede eruption,
or high-pull
headgear.
70. Retention has been
directed towards
intrusion, or at
least prevention of
eruption, of
maxillary posterior
teeth, using
headgear attached
to an upper
removable retainer.
A high-pull headgear
device attached to a
removable maxillary
retainer to control the
post-orthopedic phase
of growth and retain
the dentoalveolar
correction
The removable
retainer incorporates
headgear tubes
attached to the
Adam’s clasps on the
upper molars to
facilitate insertion of
the facebow
72. Although highpull
headgear can be quite
effective in a cooperative
patient, a removable
appliance with bite blocks
is a better choice for most
patients for two
reasons: it controls
eruption of both the upper
and lower molars, and
usually it is better
accepted because it is
easier to wear.
74. High-pull headgear to
the upper molars,
in conjunction with a
standard removable
retainer to maintain
tooth position, also can
be effective, but the
intraoral
appliance is better
tolerated and controls
eruption of lower
as well as upper
posterior teeth.
A high-pull
headgear device
attached to a
removable maxillary
retainer to control
the post-orthopedic
phase of growth and
retain the
dentoalveolar
correction.
he removable
retainer
incorporates head-
gear tubes attached
to the Adam’s
clasps on the upper
molars to facilitate
insertion of the
facebow.
76. Neither
the extent of the
pretreatment open
bite or mandibular
plane angle nor any
other single
parameter of
dentofacial
form was a reliable
predictor of post-
treatment stability.
Lopez- Gavito et al.
also reported that,
78. There is general
agreement among
orthodontists that
patients with AOBs
are challenging to
treat, and relapse is
common after
treatment with
orthodontics alone or
combined with
orthognathic surgery.
80. Thus, clinicians
should pay more
attention during
retention phase
and long-term
studies on post-
treatment changes
and stability
should be
encouraged.
82. The problem
of retaining
open bite
corrections is
the same
irrespective
of the
treatment
that closed
the open bite.
A new skeletal retention system for
retaining anterior open bites
APOS Trends in Orthodontics| March 2013 |Vol 3 | Issue 2
83. It is expected that
LeFort surgical
open bite closure
procedures will be
relatively stable,
and these
treatments
actually reduce
the space for the
tongue.
86. Conventional wraparound
retainer with a tongue grid
Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
It is recommended that patients
wear this retainer during the
night while sleeping. The retainer
consists of a conventional
removable appliance made with
a 0.9- mm stainless steel labial
bow placed at the middle third of
the crown and with a tongue grid
fixed on the acrylic portion to
discourage abnormal tongue
posture, which is hopefully
corrected by the muscle exercises
during the day.
87. modified retainer adapted
at the cementoenamel
junction of the anterior
teeth
Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Daytime wraparound retention
with modified contour
It is recommended that patients
wear this retainer during the
day. It has a 0.8-mm stainless
steel wire that
contours around the gingival
margin of the anterior teeth.
The aim is to reduce relapse
due to intrusion or protrusion
of the anterior teeth
88. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 1 — post-
treatment intra-oral
photographs (a)
frontal, (b) right side,
(c) left side, (d) upper
occlusal, (e) lower
occlusal, (f) daytime
wraparound
retention and (g)
night-time
wraparound
retention
89. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 1 — 2
years post-
retention
intra-oral
photographs
: (a) frontal,
(b) right side
and (c) left
side
90. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 2 — pre-
treatment
intra-oral
photographs:
(a) frontal,
(b) right side,
(c) left side,
(d) upper
occlusal and
(e) lower
91. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 2 — post-
treatment
intra-oral
photographs:
(a) frontal, (b)
right side, (c)
left side, (d)
upper occulsal,
(e) lower
occlusal, (f)
and (g)
daytime
retention
92. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 2 — 6-year post-retention intra-oral photographs:
(a) frontal, (b) right side and (c) left side
93. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 3 —
pre-
treatment
intra-oral
photographs:
(a) frontal,
(b) right side,
(c) left side,
(d) upper
occlusal and
(e) lower
occlusal
94. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
Case 3 — post-
treatment intra-
oral
photographs P:
(a) frontal, (b)
right side, (c)
left side, (d)
upper occlusal,
(e) lower
occlusal and (f)
daytime
wraparound
retention
95. Skeletal class III and anterior open bite treatment with
different retention protocols: a report of three cases
Journal of Orthodontics, Vol. 39, 2012, 212–223
0 Case 3 — 5 years post-retention intra-oral photographs:
(a) frontal, (b) right side and (c) left side
These three cases demonstrate adequate stability with this retention
protocol, which we believe is suitable for open bite patients treated
with incisor extrusion.
96. Drawings showing the differences between the action of the
two retainers — conventional (a) and modified (b)
97. American Journal of Orthodontics and Dentofacial Orthopedics July 2010
Stability of anterior open-bite
treatment with occlusal adjustment
The sample consisted of 17 patients (7 male, 10
female). All patients originally had an anterior
open-bite malocclusion, had undergone
orthodontic treatment with fixed appliances, had
anterior open-bite relapse after a mean
posttreatment period of 4.15 years (range, 1-6
years), and were retreated with the occlusal
adjustment procedure.
98. If the intra-arch alignment of
the teeth is acceptable, and
the position of her anterior
teeth in the face is
reasonable the first option
generally consider for an
anterior open bite is occlusal
equilibration; altering the
posterior occlusion by
reshaping the teeth,
effectively closing the
vertical dimension and
bringing the anterior teeth
into contact
OCCLUSION & WEAR
A Guide to Anterior Open Bites
By Frank Spear on February 18, 2018
Intraoral photographs before occlusal
adjustment show the anterior open bite.
Intraoral photographs after occlusal adjustment
show the corrected anterior open bite
99. The risk of equilibration is that
it may require excessive tooth
reduction, exposing dentin in
the process, and it may be
inadequate to achieve the
necessary closure to gain
anterior contact. For these
reasons, a trial equilibration is
typically performed on mounted
models to see if the desired
occlusion can be obtained with
just equilibration - and to
evaluate the amount of
alterations necessary to the
posterior teeth
OCCLUSION & WEAR
A Guide to Anterior Open Bites
By Frank Spear on February 18, 2018
100. American Journal of Orthodontics and
Dentofacial Orthopedics July 2010
Stability of anterior open-bite
treatment with occlusal adjustment
Intraoral photographs
taken before the occlusal
adjustment show the
anterior open bite
Intraoral photographs taken
after the occlusal
adjustment show correction
of the anterior open bite,
with a positive overbite.
Intraoral photographs taken in the
long term after the occlusal
adjustment show clinical stability
of the open-bite correction with
the occlusal adjustment. However,
a slight reduction in the overbite
is obvious.
101. American Journal of Orthodontics and
Dentofacial Orthopedics July 2010
Stability of anterior open-bite
treatment with occlusal adjustment
CONCLUSIONS 1. There was a statistically significant
relapse of anterior open bite in the whole sample;
growth seemed to have contributed to a significant
amount of the relapse. 2. The primary factor that
contributed to the relapse was the increase in
posterior molar height, consequent to
compensatory posterior tooth eruption. 3. There
was clinically significant stability in 66.7% of the
patients. 4. Dentinal sensitivity remained within the
normal range in the long term.
102. Relapse tendency
can be minimized if
a habit-breaking
appliance or a
tongue crib is used
for at least 6
months prior to any
incisor extrusion
mechanics.
104. In this way, some
patients
learn to modify their
tongue position or
activity, by holding
the tip of the tongue
in the roof of the
palate during
swallowing and other
activities.
105. However, in some cases,
a
tongue will reassert
itself, despite the best
efforts of the
patient and the
orthodontist. The
patient should be
informed
of this possibility before
treatment.
106. These cases will
often benefit from
the use of
positioners to
help bite closure. If
a conventional upper
retainer is to be
used, a small hole can
be placed in the
palatal surface of the
acrylic, for tongue
positioning.
107. In patients who do
not place some object
between the front
teeth, return of open
bite is almost always
the result of
elongation of the
posterior teeth,
particularly
the upper molars,
without any evidence
of intrusion of
incisors
Facial and intraoral
photographs of relapse
after 3-year post-
treatment
109. .
Four years after
removal of the
orthodontic
appliances,
this 17-year-old has
an anterior open
bite, 5 mm of
overjet with
an end-on molar
relationship, and
severe crowding of
the mandibular
incisors..
110. Relapse of this type is
associated with little or no
mandibular
growth and a downward
and backward mandibular
rotation as the
maxilla grows downward
and upper posterior teeth
erupt, as shown in
the cephalometric
superimposition from the
end of treatment to 4-year
recall.
111. .
The incisor
crowding is due
to uprighting
and lingual
repositioning
of the incisors
as the
mandibular
rotation thrusts
them into the
lower lip.
112. The question of
retainers is
difficult
because the
typical Hawley
type retainer
has little impact
on open bites.
Bluegrass Maxillary Hawley retainer
113. Improving Retention of Anterior Open-Bite Cases
To improve the retention of
an anterior open-bite case or
recover an open-bite relapse,
small composite bumps can
be bonded to the labial
surfaces of the incisors.
Before light-curing,the paste
is shaped into smooth round
balls using a brush saturated
with primer solution
114. Improving Retention of
Anterior Open-Bite Cases
The labial wire of a
Hawley-type retainer
is slightly activated
incisally and placed
against the gingival
edges of the
composite bumps.
115. Improving Retention of
Anterior Open-Bite Cases
For more positive
retention, the gingival
edges can be shaped
into horizontal steps
with a fluted bur .
These steps are not
required when using
positioners or clear
plastic retainers.
116. A removable retainer
can keep teeth from
tipping to the facial,
which, if occurring,
will reduce overbite.
Removable retainers
cannot prevent
actual translation of
the center of
resistance in an
intrusive direction.
117. A) and (B):
Retention plate with
anterior tongue crib
to avoid tongue
thrust in the anterior
teeth, anterior
tongue posture, and
a posterior bite
block to
restrict vertical
development of the
posterior teeth.
118. (C) and (D):
Retention
plate with
an orifice in
the region of
incisive
papillae to
condition
correct tongue
position.
121. After the positioner
use, a wraparound
retainer for the
upper arch is better
than a conventional
Hawley, as the
objective should be
to prevent wires
between the
occluding surfaces
123. The removal of
acrylic from the
incisor area of the
upper retainer is
recommended,
along with the
placement of a
small hole in the
anterior region as
a reminder for the
tongue.
Upper Hawley style
removable retainer.
removal of acrylic from the
incisor area
124. Results achieved with
extrusion arches have
been generally positive.
The preferred method to
control relapse toward
anterior
open bite is an
appliance with bite
blocks between
the posterior teeth that
creates several
millimeters of jaw
separation (an open bite
activator or bionator.
Severe anterior open bites (front teeth that do not touch)
125. In a patient with
the long-face
growth pattern,
either must be
continued as a
nighttime
retainer through
the late teens.
126. Excessive vertical
growth
and eruption of the
posterior teeth often
continue until late
in the teens or early
twenties, so
retention also must
continue
well beyond the
typical completion
of active treatment.
127. Cephalometric
superimpositions showing the
chin position as a result of
growth changes in a patient
between 7 and 14 years of
age. It was observed that the
chin moved downward and
forward till the age of 11
years; thereafter, it was
displaced downward and
backward as a result of less
condylar growth and more
vertical growth in the molar
area
128. A patient with a severe
open bite problem is
particularly
likely to benefit from
having conventional
maxillary and
mandibular retainers
for daytime wear and an
open bite
bionator as a nighttime
retainer from the
beginning of the
retention period.
129. The
etiology of
the
anterior
open bite
should be
determine
d
before
treatment.
Facial and intraoral
photographs of relapse after
3-year post-treatment
Treatment and retention of relapsed anterior
openbite with low tongue posture and
tongue-tie: A 10-year follow-up
130. Understanding Post-orthodontic Relapse and
Retention
by Eli Halabi, DMD the Journal: summer 2015
Feature
Article
Higher incidence
of relapse has
been noted
in cases when the
incisors are
extruded to close
an open bite
that is skeletal in
nature.
131. A more appropriate
approach for
such patients would
be orthognathic
surgery, or the use of
temporary
anchorage devices
(TADs) to intrude the
posterior
teeth so as to close
the anterior open
bite.
134. The postulated clinical
theory purports that
the thermoplastic
between the posterior
teeth causes a “bite-
block effect,” keeping
the posterior teeth
from extruding and
therefore preventing
open-bite relapse
135. Fabrication of the spur-implanted Essix Retainers
. Before the fabrication of Essix
plate on the upper cast, a small
amount of dental stone was
added near the incisive papilla
region in order to create space for
insertion and securing of the wire.
C type Essix plates (0.40) were
fabricated over the casts and
trimmed. A 0.9mm stainless steel
laboratory wire is bent in “U”
shape with a small helix at the
base for retention.
a) Upper cast. b) Bump on
the lingual side of incisors.
c) U shaped wire. d) Essix
plate for the upper cast. e)
Insertion of the wire. f)
Addition of self-curing
acrylic. g) Retainer after
polishing.
progress in orthodontics 1 1 (2010) 45–52
A new type of modified Essix Retainer for anterior
open bite retention
136. The wire is heated and inserted
to the space created on the
lingual side of incisors. The hot
wire easily punctures, and
when cooled, sticks to the Essix
plate. A small amount of self-
curing acrylic is applied to fill
the rest of the space in order to
keep the wire firmly in place.
The spurs are sharpened and
polished accordingly after the
curing of the acrylic (Fig. 9).
137. Retainers used after active phase of orthodontic
treatment. (a) Two
retainers with posterior bite blocks were constructed;
(b) Daytime retainer with an
orifice close to the incisive papillae and; (c)
Night-time retainer with a palatal crib
Wrap-around
retainers were
provided
for the maxillary
arch and a
0.028-inch
stainless-steel
arch wire segment
was bonded to the
mandibular
anterior teeth.
Nonsurgical treatment and
stability
of an adult with a severe anterior
open-bite malocclusion
2018 Journal of
Orthodontic Science
138. Retainers used after active phase of orthodontic
treatment. (a) Two
retainers with posterior bite blocks were constructed;
(b) Daytime retainer with an
orifice close to the incisive papillae and; (c)
Night-time retainer with a palatal crib
Two maxillary
appliances with
posterior
bite blocks to
retain the
posterior
intrusion were
constructed for
day and
night-time use
139. Retainers used after active phase of orthodontic
treatment. (a) Two
retainers with posterior bite blocks were constructed;
(b) Daytime retainer with an
orifice close to the incisive papillae and; (c)
Night-time retainer with a palatal crib
The daytime
retainer
incorporated
an orifice
close
to the incisive
papillae which
guided
correct
tongue
position
140. Retainers used after active phase of orthodontic
treatment. (a) Two
retainers with posterior bite blocks were constructed;
(b) Daytime retainer with an
orifice close to the incisive papillae and; (c)
Night-time retainer with a palatal crib
.The
night-time
retainer
contained
a palatal crib
to prevent
lingual
pressure on
the anterior
teeth .
141. A loop was
made in the
mandibular
retention wire to
allow
subsequent
restoration of the
left central
incisor
142. Relapse of the non-
extraction groups mainly
happened in the first
year after finishing
treatment. Many studies
showed that the post-
treatment phase of non-
extraction therapy was
longer in comparison to
extraction treatment,
therefore producing a
higher tendency for
relapse.
143. In some cases the wrap-around
retainer (in the maxilla) is used 24
h/day in the first 8 months, half a
day (at night) for an additional 3
months and every other night in the
last month of use. A lower retainer in
the six anterior teeth (3-3) are set for
undetermined ending time . The
patient is urged to maintain her
orofacial myofunctional therapy with
the speech therapist for additional
12 months.
Case report
144. Treatment and retention of relapsed anterior openbite with
low tongue posture and tongue-tie: A 10-year follow-up
pISSN 2234-7518 • eISSN 2005-372X
http://dx.doi.org/10.4041/kjod.2014.44.4.203
Design of the
tongue elevator:
The acrylic base
occupies the
entire mouth
floor except for
the region that
can disturb the
movement of the
lingual frenum.
145. Treatment and retention of relapsed anterior openbite with
low tongue posture and tongue-tie: A 10-year follow-up
pISSN 2234-7518 • eISSN 2005-372X
http://dx.doi.org/10.4041/kjod.2014.44.4.203
The occlusal rests
are placed on the
lingual occlusal
grooves of the
posterior teeth. In
a modified tongue
elevator , the
volume and height
of the resin part
are reduced for
tongue-tie.
146. If the open bite
is due to a
persistent low
tongue
posture,
a tongue elevator
is applied as an
active
retreatment
alternative, and
is used thereafter
as a retainer
147. A tongue
elevator is a
removable
appliance
comprising an
acrylic base,
occlusal rests,
and several
retentive
elements
148. The acrylic base
occupies the entire
sublingual space,
except for the lingual
frenum, and the
occlusal rests are
placed in the lingual
occlusal grooves of
the posterior teeth.
For retention, a labial
bow and other
retentive clasps can
be added.
149. The function of the
tongue elevator is to
keep the
tongue in a higher
than usual position,
which is accomplished
by the sheer volume
of the acrylic base. The
positional change
induced by the tongue
elevator brings about
three dentoalveolar
effects
150. First, the tongue tends to go
back to its original position
when elevated, which
generates a downward
force. This force is then
transmitted to the occlusal
rests of the appliance, which
results in intrusion of the
lower posterior teeth.
Second, when elevated, the
tongue occupies the space
under the palatal vault, and
contacts the upper dentition
151. In this position, the
tongue exerts an
outward force that
results in upper arch
expansion. Finally, the
pushing force exerted by
the elevated tongue can
be used in conjunction
with a transpalatal arch,
or upper removable
retainer with occlusal
rests, to intrude the
upper posterior teeth.
152. Thus, the anterior open-bite can
be corrected by inhibition of posterior alveolar growth
153. Journal of Orthodontic Science | 2018
Nonsurgical treatment and stability of an adult with a
severe anterior open-bite malocclusion
154. Wrap-around retainers
were provided for the
maxillary arch and a
0.028-inch stainless-steel
arch wire segment was
bonded to the mandibular
anterior teeth. Two
maxillary appliances with
posterior bite blocks to
retain the posterior
intrusion were constructed
for day and night-time use.
Retainers used after active phase of
orthodontic treatment. (a) Two retainers with
posterior bite blocks were constructed; (b)
Daytime retainer with an orifice close to the
incisive papillae and; (c) Night-time retainer
with a palatal crib
155. The daytime retainer
incorporated an orifice
close to the incisive
papillae which guided
correct tongue
position.The night-time
retainer contained a
palatal crib to prevent
lingual pressure on the
anterior Figure 4:
Miniscrews placed and
biomechanics employed
for molar intrusion teeth.
Retainers used after active phase of
orthodontic treatment. (a) Two retainers with
posterior bite blocks were constructed; (b)
Daytime retainer with an orifice close to the
incisive papillae and; (c) Night-time retainer
with a palatal crib
156. A loop was
made in the
mandibular
retention wire
to allow
subsequent
restoration of
the left central
incisor .