{"title":"Orthodontic retreatment with clear aligners of an adult patient with late development of anterior open bite","authors":"Mankiran Kaur, Vicente Telles, Rassal Syed Hussain, Jessica Kocan Itani, Eung-Kwon Pae, Monica Schneider","doi":"10.1016/j.xaor.2024.09.003","DOIUrl":"10.1016/j.xaor.2024.09.003","url":null,"abstract":"<div><div>Correcting an anterior open bite in an adult patient often presents a formidable challenge for orthodontists. This case report presents a 67-year-old woman who previously completed successful orthodontic treatment with maxillary first premolar extractions and developed an anterior open bite after approximately 40 years of retention. Her treatment consisted of a stabilization splint for 6 months, followed by orthodontic therapy with clear aligners. The treatment results demonstrated successful intrusion of mandibular second molars and minor relative extrusion of the incisors. Treatment was completed with ideal occlusal relationships with Class II molars in accordance with previous maxillary first premolar extractions, Class I canines, and acceptable overjet and overbite. The patient showed stable results at the 12-month follow-up, with a minor decrease in vertical overlap, and the patient reported improvement in her chewing abilities and satisfaction with her final occlusion and esthetics.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 6","pages":"Pages 499-508"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retreatment of an adult patient with skeletal Class II malocclusion, large overjet, and shallow overbite using orthodontic mini-implants and clear aligners","authors":"Hyeok Ji , Seung-Hak Baek","doi":"10.1016/j.xaor.2024.08.003","DOIUrl":"10.1016/j.xaor.2024.08.003","url":null,"abstract":"<div><div>This case report aimed to introduce the retreatment concept of adult patients with skeletal Class II malocclusion and large overjet using orthodontic mini-implants (OMI) and clear aligners. A 26-year-old woman had a history of fixed treatment with the extraction of her four first premolars and splint therapy because of temporomandibular disorder. She had a normally positioned maxilla (SNA, 82.1°), retrusive mandible (SNB, 74.0°), skeletal Class II malocclusion (ANB, 8.1°; overjet, 6.9 mm), and shallow overbite (0.4 mm). In stage 1 treatment, with the help of four OMIs installed at the palate and the buccal attached gingiva of the mandible, a series of 34 clear aligners were applied to obtain intrusion of the maxillary and mandibular posterior teeth and sequential distalization of the maxillary teeth, and mesialization of the mandibular teeth. Counterclockwise rotation of the mandible, distal movement of the maxillary dentition, and mesial movement of the mandibular dentition helped to obtain a Class I relationship. Stage 2 treatment was performed with 15 sets of aligners and OMIs for additional distalization of the maxillary teeth and intrusion of the maxillary and mandibular anterior teeth. Improvement of the retrusive mandible (SNB, 76.0°), Class I relationship, and normal overbite and overjet (3.1 mm; 2.7 mm) were obtained. The total treatment duration was 1 year and 5 months. Treatment outcomes were well maintained at 1-year retention. Combining clear aligners and OMIs might help clinicians obtain good treatment outcomes in retreatment of Class II malocclusion and excessive overjet. However, meticulous monitoring of the counterclockwise rotation of the mandible and the resulting change in overbite and overjet is necessary.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 6","pages":"Pages 469-482"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Miniplate-anchored Forsus fatigue-resistant device with a fail-safe attachment","authors":"Amrin Rizwana, Anshika Gandhi, Priyank Rai, Tulika Tripathi","doi":"10.1016/j.xaor.2024.08.001","DOIUrl":"10.1016/j.xaor.2024.08.001","url":null,"abstract":"<div><div>The Forsus fatigue resistance device (FRD) is a widely used appliance for correcting skeletal Class II malocclusion in late adolescence. However, it is associated with dentoalveolar side effects such as mandibular incisor protrusion, limiting its effectiveness. In this study, we introduced the bimaxillary anchored Forsus-FRD appliance system with a superior anchorage mechanism. The appliance design incorporates a fail-safe attachment system, offering the following advantages: fail-safe design, customizable dimensions, simple fabrication, cost-effectiveness, versatility in angulation, and a quick-release system. The bimaxillary anchored Forsus-FRD demonstrated skeletal Class II correction with greater skeletal and less dentoalveolar effects. The technique resulted in increased mandibular length, anterior mandibular positioning, and minimal posterior displacement of the maxillary region. Dental changes included retroclination of maxillary incisors and limited proclination of mandibular incisors. The molar relationship was corrected to Class I, primarily because of skeletal changes. Soft tissue analysis showed improved facial esthetics, with notable improvement in the position of the lower lip. The bimaxillary miniplate–anchored Forsus-FRD offers an effective treatment modality for patients in late adolescence, either because of noncompliance with removable functional appliances or those who consult the orthodontist at an older age. This technique not only minimizes the undesirable effects but also circumvents the need for orthognathic surgery by using residual growth.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 6","pages":"Pages 445-468"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yifan Zhang , Xiaoting Wang , Liting Jiang , Zhenyan Xie , Bing Fang , Niansong Ye
{"title":"Camouflage treatment of severe hyperdivergent Class Ⅲ malocclusion with clear aligners","authors":"Yifan Zhang , Xiaoting Wang , Liting Jiang , Zhenyan Xie , Bing Fang , Niansong Ye","doi":"10.1016/j.xaor.2024.09.006","DOIUrl":"10.1016/j.xaor.2024.09.006","url":null,"abstract":"<div><div>A 41-year-old female presented with chief complaints of anterior crossbite and mandibular protrusion, along with an anterior open bite. She declined orthognathic surgery and fixed appliances and opted for orthodontic treatment with clear aligners. After assessment and consultation, we addressed her esthetic concerns by extracting the mandibular right central incisor and distalized the mandibular molars with the help of temporary skeletal anchorage devices. The gingival black triangles, which resulted from excessive anterior retraction, were reduced by reshaping the proximal surfaces of the adjacent teeth using flowable composite resin restorations. After 41 months of active treatment, the crossbite and open bite were successfully corrected. The facial profile associated with mandibular protrusion was improved.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 6","pages":"Pages 509-520"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gye Hyeong Lee , Jae Hyun Park , Jung Joo Park , Kyungmin Clara Lee , Sang Mi Lee , Danal Moon
{"title":"Key considerations for efficient 3-dimensional data integration with a face scanner in the digital era: Product review of the hybrid face scanner","authors":"Gye Hyeong Lee , Jae Hyun Park , Jung Joo Park , Kyungmin Clara Lee , Sang Mi Lee , Danal Moon","doi":"10.1016/j.xaor.2024.06.004","DOIUrl":"10.1016/j.xaor.2024.06.004","url":null,"abstract":"<div><div>To achieve patient treatment goals for improved occlusion and facial appearance in 3 dimensions, precise analysis of the patient's soft tissue and occlusion in 3 dimensions is imperative. In this digital era of dentistry, the invention of electronic devices has allowed for the acquisition of 3-dimensional (3D) information about a patient's face and dentition. However, it has been difficult for clinicians to obtain accurate 3D soft-tissue images because of the technique sensitivity and the challenges in the superimposition of the 3D skeletal, dental, and soft-tissue information. This article will first introduce the distinguished roles, pros, and cons of different face scanners in dentistry and then describe the clinical situations in which each type of scanner is used most effectively. The RAYFace200 (Ray Co, Ltd, Seongnam, South Korea), a hybrid of two different scanner mechanisms, will be introduced as a collage of the strengths of the existing 3D scanners. Integrating stereophotogrammetry and structured light methods for the first time, this face scanner is considered an important piece of the puzzle in soft-tissue diagnosis and the fabrication of diagnostic tools and treatment devices with great accuracy and convenience for clinicians.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 5","pages":"Pages 351-359"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Protocol for facially guided digital orthodontic diagnosis and treatment planning","authors":"Rupert H.G. Kelley , Carlos Flores-Mir , Jorge Ayala Puente , Álvaro Ferrando Cascales , Itamar Michael Friedländer , Raúl Ferrando Cascales","doi":"10.1016/j.xaor.2024.06.003","DOIUrl":"10.1016/j.xaor.2024.06.003","url":null,"abstract":"<div><div>Using a digital workflow in orthodontics and interdisciplinary dentistry undoubtedly benefits both the patient and professional. This 9-step protocol guides orthodontists through an interdisciplinary treatment planning and execution. First, it establishes an exhaustive digital diagnosis and then formulates an interdisciplinary digital treatment plan with 3-dimensional (3D) goals. Finally, objective verification of the treatment results occurs through 3D superimposition. This 9-step protocol proposes a fully integrated workflow platform by providing a digital, 3D, clear planning protocol for the interdisciplinary team. It gives them a clear vision of successfully managing the patient from start to finish. It is versatile, logical, and methodical and can be applied to any clinical situation involving orthodontics.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 5","pages":"Pages 370-375"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sergio Luiz Mota-Júnior , Claudia Trindade Mattos , Diego Coelho Lorenzoni , Gil Guilherme Gasparello , Orlando Motohiro Tanaka
{"title":"Is the presence of severe external apical root resorption a contraindication to orthodontic retraction of maxillary incisors?","authors":"Sergio Luiz Mota-Júnior , Claudia Trindade Mattos , Diego Coelho Lorenzoni , Gil Guilherme Gasparello , Orlando Motohiro Tanaka","doi":"10.1016/j.xaor.2024.08.002","DOIUrl":"10.1016/j.xaor.2024.08.002","url":null,"abstract":"<div><div>This case report details the orthodontic retreatment of an adult patient with a maxillary dentoalveolar protrusion, a 6.0-mm overjet, severe mandibular crowding, and maxillary central incisors exhibiting a short root anomaly. The treatment involved the extraction of premolars, followed by retracting the anterior teeth to improve the patient's profile and smile esthetics and to achieve a balanced occlusion with adequate overbite and overjet. A β titanium-molybdenum alloy 0.019 × 0.025-in archwire with a teardrop loop with 0.5-mm activation was used to ensure lighter forces during the incisors’ retraction. Root resorption was monitored with periapical radiographs throughout the treatment. After four years of comprehensive treatment, satisfactory occlusion, an improved facial profile, and enhanced smile esthetics were achieved. Eight-year follow-up records demonstrate the stability of dental and facial outcomes and the absence of external apical root resorption progression posttreatment. The results confirm the feasibility of orthodontic treatment involving extensive movement of teeth with short root anomaly, provided that precautions such as the application of light forces and radiographic monitoring are maintained.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 5","pages":"Pages 416-425"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven D. Harrison , Reza Movahed , Ryan Semensohn
{"title":"Orthodontic and surgical management of Goldenhar's syndrome, including joint replacement, orthognathic surgery, and polyetheretherketone implants, using virtual surgical planning","authors":"Steven D. Harrison , Reza Movahed , Ryan Semensohn","doi":"10.1016/j.xaor.2024.07.002","DOIUrl":"10.1016/j.xaor.2024.07.002","url":null,"abstract":"<div><div>Goldenhar syndrome is a rare syndrome with multiple facial characteristics. These include incomplete development of the ear, nose, soft palate, mandible, maxilla, zygoma, and ocular abnormalities as well. Treatment of these patients requires a multidisciplinary approach involving the orthodontist, craniofacial surgeon, and potentially other specialists. This paper presents a case of Goldenhar's, with detailed treatment objectives which required comprehensive orthodontic care, virtual surgical planning, orthognathic surgery, multipiece maxillary procedure including approximately 14 mm down graft on the affected, right side with an iliac crest bone graft, bilateral temporomandibular joint replacement with advancement of the mandible, polyetheretherketone facial implant for pogonion, on the lower border of the right side of the mandible and right malar area. The treatment outcome reflects a significant improvement in occlusal function, range of movement, and improved facial esthetics, although there is still a 1-2 mm cant of the occlusal plane.</div></div>","PeriodicalId":72140,"journal":{"name":"AJO-DO clinical companion","volume":"4 5","pages":"Pages 360-369"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}