Benedito Viana Freitas

Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique

A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery.

Tratamento ortodôntico do sorriso gengival utilizando-se mini-implantes (Parte I): tratamento do crescimento vertical do complexo dentoalveolar anterossuperior

Orthodontic mini-implants have revolutionized orthodontic anchorage and biomechanics by making anchorage perfectly stable. In this Part I, ‘gummy smile’ was defined and classified according to the etiologies. Among them, dentoalveolar type, a good indication of mini-implant treatment, was divided into three categories: (1) Cases with vertical growth of upper anterior dentoalveolar complex (Cases 1, 2, and 3), (2) Cases with protrusion of anterior dentoalveolar complex (Cases 4, and 5), and (3) Cases with protrusion of upper anterior dentoalveolar complex and extrusion of upper posterior teeth (Cases 6, and 7). Three cases with excessive vertical growth of the upper anterior dentoalveolar complex were presented. They were characterized with extruded and retroclined upper incisors, deep overbite, and gummy smile. The aim of this paper is to show that mini-implants are useful in the anterior area to intrude incisors and correct the gummy smile. An upper anterior mini-implant (1.6 x 6.0 mm) and a NiTi closed coil spring were used to intrude and procline the retroclined extruded incisors. Mini-implants can be used successfully as orthodontic anchorage to intrude anterior teeth. Abstract

Tooth loss and craniofacial factors associated with changes in mandibular condylar morphology

Abstract Objective: To investigate the association between tooth loss and craniofacial factors with changes in mandibular condylar morphology. Methods: A total of 123 patients participated in this cross-sectional study. The mandibular condylar morphology was evaluated using digital panoramic radiography. The exposure variables included gender, age group, molar relationship, facial growth pattern, facial asymmetry, dental midline, posterior crossbite, presence of fixed dental prosthesis, and tooth loss. Results: Unilateral and bilateral mandibular condyle structural alterations were found in 20.3% and 28.5% of the sample, respectively. After the adjustment analysis, posterior crossbite (adjusted OR = 3.34, 95% CI = 1.23–9.06) and tooth loss (adjusted OR = 4.08, 95% CI = 1.72–9.64) were associated with the outcome. The tooth type associated with mandibular condyle structural alterations were premolars and upper molars. Conclusion: The findings suggest that posterior crossbite and tooth loss are associated with mandibular condyle structural alterations.

Nonsurgical correction of a severe anterior open bite with mandibular molar intrusion using mini-implants and the multiloop edgewise archwire technique

&NA; This article reports the case of a 24‐year‐old man with a large anterior open bite, mild mandibular crowding, increased overjet, no passive lip sealing, and Angle Class I malocclusion. The treatment results were achieved by mandibular molar intrusion using 1.8 × 8.5‐mm mini‐implants (C‐implants) inserted between the mandibular first and second molars bilaterally. A 2.5‐mm molar intrusion and open‐bite closure occurred within 8 months. The multiloop edgewise archwire technique helped to intrude the posterior teeth. Total treatment time was 20 months. Fifty months postretention records are also presented. The patient achieved a suitable occlusion and satisfactory facial esthetics at the end of treatment and at the 50‐month retention check.