Psychosocial implications of malocclusion: a 15-year follow-up study in 30-year-old Danes

Long-term psychosocial effects of malocclusion should be studied longitudinally from childhood to adulthood in orthodontically untreated populations. In 1965-66, the occurrence of morphologic traits of malocclusion was recorded in 977 Danish adolescents who had no access to organized orthodontic care. In a follow-up study 15 years later, a questionnaire was mailed to the subjects; this contained general questions about body image and specific inquiries concerning self-perception and social implications of dental appearance. The response rate was 86%. Ten percent had received orthodontic treatment. In the remaining individuals, only one entry among thirteen items of body image--the teeth--was rated significantly less satisfactory by subjects with malocclusion at adolescence than by subjects without malocclusion at adolescence. The lowest ratings were observed in subjects with extreme maxillary overjet, extreme deep bite, and crowding. Highly significant differences were found between the two groups (subjects with and without malocclusion) in recalling adolescent awareness of malocclusion, dissatisfaction with the appearance of the teeth, and unfavorable appearance of the teeth compared with those of peers. Schoolmates' teasing occurred seven times more often in the presence of malocclusion. Differences were less marked in the perceptions of the same individuals in adulthood. However, in both adolescence and adulthood unfavorable perceptions of the teeth were expressed significantly more often by subjects with extreme maxillary overjet, extreme deep bite, and crowding. No association was found between malocclusion and present occupational status. It was concluded that certain malocclusions, especially conspicuous occlusal and space anomalies, may adversely affect body image and self-concept, not only at adolescence but also in adulthood.     

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??Objective??To analyze and evaluate the clinical effect of customized bracket-less appliance for class I malocclusion by 3Shape 3D digital simulation technology. Methods??Seventy-two patients with Angle Class ?? malocclusion were enrolled??of whom 35 were crowding and 37 were scattered interstitial. Customized bracket-less appliance was used in orthodontic treatment??3Shape three-dimensional digital simulation was used for analysis and evaluation of the treatment effect. Results??Seventy-two patients achieved satisfactory clinical results. For crowding patients??the patient's anterior ratio??maxillary length??mandibular length??left incisor coverage??and right incisor coverage were significantly improved after treatment. For scattered patients??the total tooth ratio??anterior ratio??maxillary length??mandibular length??left incisor coverage??right incisor coverage??maxillary canine width??and mandibular canine width were significantly improved after treatment. Conclusion??Customized brackets-less appliance can effectively correct the malocclusion in Angle Class ??crowding patients and interstitial patients.     

定制式无托槽矫治器个性化矫治安氏Ⅰ类错的临床效果研究

目的　对定制式无托槽矫治器矫治安氏I类错牙合的临床效果进行3Shape三维分析和评价。方法  　选取2014—2016年于首都医科大学附属北京安贞医院口腔科就诊的安氏Ⅰ类错牙合患者72例,其中拥挤型35例,散在间隙型37例。应用定制式无托槽矫治器正畸,通过3Shape三维数字化模拟技术对两种类型患者的治疗效果进行分析和评价。结果　72例安氏Ⅰ类错牙合患者均取得了良好的治疗效果。对于拥挤型患者,通过治疗能显著改善患者的前牙比、上颌长度、下颌长度、左切牙覆盖、右切牙覆盖。对于散在间隙型患者,通过治疗能显著改善患者的全牙比、前牙比、上颌长度、下颌长度、左切牙覆盖、右切牙覆盖、上颌尖牙宽度和下颌尖牙宽度。结论　定制式无托槽矫治器可有效矫治安氏Ⅰ类拥挤型患者和散在间隙型患者的错牙合畸形。     

Talon cusp associated with other dental anomalies: a case report

Talon cusp is an uncommon dental anomaly referring to an accessory cusp projecting from the cingulum area, or cemento-enamel junction of maxillary or mandibular anterior teeth, in both the primary and permanent dentition. This paper reports a rare case of talon cusp affecting the mandibular right central incisor and maxillary right lateral incisor, together with other dental abnormalities, viz. an inverted impacted migrating mandibular right second premolar; complete agenesis of the maxillary and mandibular third molars, the maxillary right second permanent molar, and the mandibular left permanent central incisor; severe crowding; deep bite; hypoplastic teeth; bilateral reverse cross-bite in the premolar region; and a retrognathic mandible. The presence of this number of dental anomalies in a single patient is rare.     

Lower premolar extraction/removable plastic Herbst treatment for mandibular retrognathia

The patient was a 12-year-old girl with a Class I malocclusion characterized by maxillary arch width constriction, dental crowding, and mandibular retrognathia. Treatment goals related to the chief compliant were anterior mandibular repositioning, maxillary arch expansion, and dental alignment. Because the preexisting overjet was minimal and prevented adequate anterior repositioning of the mandible, lower first premolar extraction was recommended to increase the overjet and allow greater anterior repositioning. Treatment was divided into four stages: (1) extraction of mandibular first premolar teeth, alignment, space closure, and an increase in the overjet, (2) anterior mandibular repositioning with a removable plastic Herbst appliance, (3) arch alignment and detailing of the occlusion with full fixed appliances and a tooth positioner, and (4) retainers. At the end of treatment, the patient had an acceptable dental alignment with a Class III molar relationship and an improvement in facial appearance.     

应用Time自锁托槽与传统托槽矫治牙列拥挤的临床比较研究

目的　比较使用Time自锁托槽与传统直丝托槽矫治上颌轻中度拥挤前后的牙弓宽度和上前牙凸度变化的差异。方法　选择46例轻中度拥挤的骨性Ⅰ类患者（女26例,男20例,13～16岁）,治疗组23例,采用Time自锁托槽矫治技术,对照组23例,采用传统直丝托槽结扎矫治技术。分别测量矫治前后牙弓宽度和上前牙唇倾度,比较2种方法所致的牙弓宽度和上前牙凸度的变化,并进行统计学分析。结果　2组患者的前磨牙宽度和上前牙凸度在矫治后均增大,其改变量比较,差异有统计学意义(P＜0.05);2组患者的尖牙宽度和磨牙宽度在矫治后也增大,但其改变量比较,差异无统计学意义(P＞0.05)。结论　自锁托槽在矫治牙列拥挤过程中较传统结扎托槽有更好的后牙弓扩展作用,但也会导致前牙的唇倾,故临床上可选择面型良好的轻中度拥挤患者进行非拔牙矫治。     

牙列拥挤患者与正常[牙合]人的Bohon指数分析

目的探讨牙列拥挤患者与正常[牙合]人Bohon指数的差异，为临床诊疗提供参考。方法分别选取正常[牙合]人91名和安氏Ⅰ类中重度牙列拥挤患者80名作为实验对象，年龄16～26岁，平均年龄21岁，运用昆明医学院正畸科开发的牙[牙合]模型系统测量两组Bolton指数的各项指标，将测量结果导入SPSS，将各项指标进行成组t检验。结果正常骀人与牙列拥挤患者的Bolton指数均无显著性的性别差异；牙列拥挤组的6个上前牙牙冠宽度总和、6个下前牙牙冠宽度总和、上颌12个牙牙冠宽度总和和下颌12个牙牙冠宽度总和均大于正常[牙合]组，都存在高度显著性差异，而两组的Bolton前牙比和全牙比并无显著性差异。结论本研究结果提示安氏I类牙列拥挤患者Bolton指数与正常[牙合]人无明显差异，但对牙列拥挤患者应关注牙量过大的情况。     

Relationship between mandibular anterior crowding and lateral dentofacial morphology in the early mixed dentition

Mandibular anterior crowding is identified as the discrepancy between mesiodistal tooth widths of four permanent incisors and available space in the alveolar process. However, incisor crowding is not merely a tooth-arch size discrepancy. Many variables such as direction of mandibular growth, early loss of deciduous molars, the oral and perioral musculature and incisor and molar inclination can be associated with crowding. Only few studies evaluated the relationship between mandibular anterior crowding and cephalometric measurements in the early mixed dentition. It was the aim of this study to search for dentofacial factors that might be associated with mandibular crowding in the early mixed dentition. Lateral cephalograms and dental casts of 60 children (33 girls, 27 boys) were evaluated. It was determined that patients with crowding had smaller lower incisor to NB angles, maxillary skeletal lengths, mandibular skeletal length, and mandibular dental measurements. They also had greater interincisal angles, overjet, overbite, and Wits appraisal measurements. Significant inverse correlations were found between crowding and SNB, lower incisor to NB angle, anterior cranial length, mandibular length, maxillary length, mandibular dental measurement and direct correlations between crowding and interincisal angle, overjet, overbite, and FMIA. According to these results, we conclude that crowding of the mandibular incisors is not only a tooth-arch size discrepancy. Dentofacial characteristics also contribute to this misalignment.     

Class III malocclusion with missing maxillary central incisor and facial asymmetry treated with orthodontics and intraoral vertical ramus osteotomy

A 28-year-old female with a Class III malocclusion and facial asymmetry was treated with orthodontics combined with intraoral vertical ramus osteotomy (IVRO). She had severe skeletal Class III (Wits: -9.7 mm). She was missing her maxillary left central incisor and had a fixed three-unit bridge on her maxillary anterior teeth. The patient presented a concave profile with a protrusive mandible. Her dental and mandibular midline was shifted 3 mm toward the left. After presurgical orthodontic treatment, IVRO was performed. The total active treatment time was 16 months including surgery. Both occlusion and facial appearance were significantly improved by the surgical-orthodontic treatment. Posttreatment records after 2 years showed excellent results with good, stable occlusion, facial balance and harmony, and long-term stability.     

A case report of adult skeletal mesio-occlusion

The patient was a 22-year-old female with a class III malocclusion characterized by maxillary constriction, dental crowding and mandibular protrusion. The treatment goals which were related to the chief complaints included correction of negative overjet, negative overbite, and dental alignment. Since the pre-existing crowding created some severe problems and prevented adequate posterior repositioning of the mandible and anterior teeth, extraction of the four first premolars were recommended to correct the overjet. This treatment resulted in greater posterior repositioning. The treatment was divided into three stages: 1) extraction of first premolar teeth, alignment, space closure and an increase in the overjet and overbite, 2) arch alignment and detailing of the occlusion with a full fixed appliance, and 3) retainers. At the end of the treatment, the patient had an acceptable dental alignment with a class I molar relationship and an improvement in facial appearance.     

Six mandibular permanent incisors: report of a case

This article involves dental management of a girl with bilateral supplemental mandibular permanent incisors. If not removed promptly, these supernumerary teeth will lead to crowding and malocclusion; as a result, early diagnosis is important. Dentists who treat children should be aware of this condition when unusual crowding and displacement is seen in the mandibular incisor region.     

下切牙先天缺失与牙颌畸形关系的分析研究

目的：探讨下恒切牙先天缺失情况及其与牙颌畸形的关系以及下尖牙近远中径的变化。方法：从962名门诊正畸病人中选取下颌恒切牙缺失的病例27名，并测量下前牙牙冠的近远中径。结果：下颌恒切牙先天缺失96％是中切牙，92％伴有前牙深覆He，下尖牙无显著性增大。结论：下颌中切牙先天缺失与前牙深覆He的形成有密切关系，下尖牙无代偿性增大。     

Dental crowding in primary dentition and its relationship to arch and crown dimensions among preschool children of Davangere

The purpose of the present study was to evaluate dental crowding in the deciduous dentition and its relationship to the crown and the arch dimensions among preschool children of Davangere. Stratified randomized selection of one hundred, 3-4 year old healthy children with all primary teeth erupted was done and divided into two groups. One group had children with anterior crowding in both the arches while the other had spacing. Alginate impressions of the upper and lower arches were made and the study casts were obtained. The tooth and arch dimensions were determined. Mesiodistal dimensions of all the teeth were significantly larger in the crowded arch group. However, the buccolingual dimensions of the maxillary right central incisor, mandibular lateral incisors and the maxillary molars and the crown shape ratio of maxillary lateral incisors, mandibular canines and mandibular right second molar was statistically different. No significant correlation was found between the arch width and the presence of crowding of deciduous dentition. The arch depth of the spaced dentition was greater when compared to the crowded ones. The arch perimeter of the crowded arches was significantly less than the spaced arches.     

Supplemental mandibular central incisor

Most of the supernumerary teeth are located in anterior maxillary region with their presence giving rise to a variety of clinical problems. Occurrence of supernumerary supplemental mandibular central incisor is a rare phenomenon. This case report describes a rare case of supernumerary supplemental mandibular central incisor which had erupted labially causig mild crowding in the anterior midline region.     

Congenitally missing maxillary lateral incisor treated with atypical extraction pattern

The congenital absence of one or more maxillary lateral incisors poses a challenge to effective treatment planning for general dentists and dental specialists. An evaluation of anterior smile esthetics must include both static and dynamic evaluations of frontal and profile views to optimize both dental and facial appearance. This article presents a case with canine substitution treatment to replace a missing maxillary lateral incisor combined with the extraction of two mandibular lateral incisors and a small maxillary lateral incisor Both the patient's occlusion and facial appearance were significantly improved after orthodontic treatment.     

Mini-implants for en masse intrusion of maxillary anterior teeth in a severe Class II division 2 malocclusion

This case report describes the treatment of a 16-year-old post pubertal male patient with a severe Class II division 2 malocclusion and 100% deep bite. In the first phase of treatment, a 'Jones-Jig' molar distalization appliance was used to distalize the maxillary molars by more than 6 mm, to achieve a Class I molar relation. In the second phase of treatment, mini-implants were inserted between the roots of the maxillary lateral incisor and canine to intrude all the maxillary anterior teeth en masse in a single step. Four millimetres of intrusion was achieved. The implants remained stable throughout treatment. In the mandibular arch the incisors were proclined to alleviate the severe crowding. Good overjet and overbite was achieved and has been maintained one year after completion of active orthodontic treatment.     

Multidisciplinary solution for an avulsed upper central incisor: case report

Abstract – This case report refers to an 18‐year‐old female who suffered from dental trauma when she was 7 years old caused by a bicycle accident. Her maxillary right central incisor was avulsed, and the left one was extrusively luxated. The left central incisor was correctly repositioned and immobilized with a semi‐rigid splint. The right one could not be found. She presented with class II malocclusion and severe negative arch‐length discrepancies in both arches. The treatment objectives were the following: recover smile esthetics by replacing the maxillary right central incisor, correct the class II relationship, and optimally reduce mandibular and maxillary crowding. Extractions of the maxillary left lateral incisor and the lower right first bicuspid were performed; thus, the maxillary right lateral incisor would function as a maxillary right central incisor, the canines would function as lateral incisors, and the first bicuspids would function as canines. This allowed for the malocclusion to be corrected while simultaneously reestablishing the smile esthetics, without the use of an osseointegrated implant. A good occlusion with coincident upper and lower midlines was achieved. After orthodontic therapy, the patient underwent periodontal surgery to improve her gingival margins. Subsequent teeth bleaching was performed, and the patient received six porcelain veneers. A combination of orthodontic space closure and prosthetic rehabilitation may be the best treatment option after severe traumatic tooth loss.     

Effects of early treatment of maxillary incisor crowding by using two bands and four brackets (2×4) mechanotherapy

The purpose of the present study was to investigate effects of early treatment of maxillary incisor crowding on anteroposterior skeletal and dental changes. Treatment group comprised 17 patients with maxillary incisor crowding treated with the two bands and four brackets (2×4) mechanotherapy, and with an initial mean age of 8 years and 10 months. Control group consisted of 17 patients with the same type of malocclusion as the treatment group and with an initial mean age of 8 years and 7 months. Lateral cephalograms in the treatment group were obtained at three time periods: T1, at the start of the 2×4 mechanotherapy; T2, at the end of the 2×4 mechanotherapy; T3, at the end of posttreatment observation. In the control group, lateral cephalograms were obtained at two time periods: T1, at the start of observation; T3, at the end of observation. Ten linear and 10 angular measurements were made for each cephalogram and the cephalometric data obtained were analysed statistically.The significantly large retroclination of the mandibular incisors was found at T1 in both groups compared with Japanese norms, resulting in the obtuseness of the interincisal angle. The resolution of maxillary incisor crowding during T1–T2 produced the retrusive movement of maxillary central incisor tips and the retroclination of mandibular incisors. There were no statistically significant differences for the T1–T3 changes in any linear and angular measurements between both groups. The mandibular incisors were, however, inclined labially during T1–T3 in the treatment group, which were, on the contrary, inclined lingually in the control group. These results suggested that the resolution of maxillary incisor crowding mostly produce the anteroposterior dental effects, and that its effect on the correction of the retroclination of mandibular incisors which was observed at the start of the 2×4 mechanotherapy was not so significant.     

下颌切牙先天缺失女性患儿的牙颌面形态分析

目的研究下颌切牙先天缺失女性患儿的牙颌面形态特征,探讨下颌切牙先天缺失对其颌面部生长发育的影响。方法选取47例12～15岁的下颌切牙先天缺失女性患儿(实验组)进行X线头影测量分析,与21例不缺牙的个别正常同龄女性儿童(对照组)比较。结果缺失一颗下前牙与两颗下前牙者,X线头影测量无显著差异;将两者合并,与对照组比较,缺牙组UI-NA(mm)、IMPA显著减小,ANB、NA-PA、MP-SN、N-ME、ANS-ME、下颌长显著增加。结论下颌切牙先天缺失可以引起女性患儿Ⅱ类错,上前牙舌侧移位、下前牙舌倾,下颌骨的顺时针旋转,全面高、下面高以及下颌骨长度增加。