Orthodontics and Orthodontology Commons^™

Non-Surgical Correction Of Craniofacial Microsomia With Occlusal Plane Canting, Tzu-Pin Su, Huei-Mei Tsai, Chia-Yi Pan, Yuen-Yung Tsang, Yu-Ling Cheng

Taiwanese Journal of Orthodontics

An adult woman suffered moderate complications of cranio-facial microsomia (CFM) with different severity on both sides of the face. This anomaly leads to short ramal height, condylar pathology, chin deviation and facial asymmetry. The malformed dental arch, open bite and severe canting of the occlusal plane were the reasons for the patient to request the therapy. Orthodontic treatment was performed with pre-adjusted edgewise system assisted by temporal anchorage devices (TADs). These modalities were executed through leveling of the occlusal plane. The improvement was noticed for both better oral function and esthetics.

Vertical Maxillary Excess Complicated With Mutilated Dentition Treated By An Interdisciplinary Approach, Shao-Ching Su, Huei-Mei Tsai, Ming-Jeaun Su, Yi-Min Liu

Taiwanese Journal of Orthodontics

Vertical skeletal dysplasia can lead to excessive lower facial height and maxillary teeth elongation with gum exposure. Patients usually have long face, steep mandibular plane angle, usually with mandibular retrognathism. The clinical manifestations include narrow nose, narrow upper dental arch, excessive incisal display, a significant backward and downward rotated mandible as well as vertical maxillary excess (VME). Traditional classifications which mainly based on sagittal jaw relation is inadequate in describing the vertical skeletal discrepancy. The patient also suffered from multiple missing posterior teeth, that requires an interdisciplinary dental care. The main treatment objectives are to normalize overjet and overbite, improve …

Surgery First And Atypical Extraction For A Skeletal Class Iii With Severe Anterior Open Bite And Severe Crowding— Three-Year Stability, Sutthinee Ruschasetkul, Thatchawee Borikanphanitphaisan, Yi-Chin Wang

Taiwanese Journal of Orthodontics

This case report features a successful combined surgical-orthodontic treatment of a patient with skeletal Class III malocclusion with severe anterior open bite and severe mandibular crowding. Clinical examination revealed concave profile with long-face deformity caused by retrognathic maxilla and excessive vertical growth of mandible, maxillary crowding despite absence of maxillary first premolars, mandibular incisor retroclination, deep curve of Spee, and blocked-out mandibular canines. The treatment involved surgery-first approach with extraction of lower right first premolar and atypical extraction of lower left canine due to its poor periodontal support. Harmonized facial profile, pleasing smile, good occlusal interdigitation as well as skeletal …

Clinical Effectiveness Of Using Clear Aligners In Orthodontic Treatment, Chih-Ling Lin, Yi-Chin Wang, Yuh-Jia Hsieh, Yun-Fang Chen, Yu-Chih Wang

Taiwanese Journal of Orthodontics

Purpose: To assess the clinical treatment effectiveness of clear aligners in orthodontic tooth movements.

Methods: The database of Cochrane Central Register of Controlled Trials, Embase, PubMed, Web of Science, and Scopus were searched from Jan 2015 to Jan 2020. The National Institute for Health and Clinical Excellence assessment tool was used for the methodological quality of included studies.

Results: The literature review yielded 166 articles after removal of duplicates, and an additional 2 articles were included from hand search of the bibliographies of included articles and relevant reviews. Fifteen studies were included in the systematic review. One study was randomized …

Effect Of Angular Insertion Of Orthodontic Miniscrews On Primary Stability, Prajak Jariyapongpaiboon, Jirawan Chartpitak

Taiwanese Journal of Orthodontics

Purpose: Infrazygomatic crest (IZC) miniscrews have useful clinical applications. They are applied with angular insertion to the bone surface. However, appropriate angles for the maximum stability of the miniscrew have not yet been well documented. This study aimed to compare the primary stability of different angles of orthodontic miniscrew insertion by analyzing maximum insertion torque (MIT) and pull out strength (PS).

Materials and methods: Sixty miniscrew implants were divided into 3 groups which underwent different angular insertion, with 20 samples in each group. Three pairs of bearing devices were constructed with an angulation of 30, 40 or 50 degrees. An …

Orthodontic Treatment Combined With Autotransplantation In Adults, I-Ting Chiang, Yi-Horng Chen, Rebecca Chen, Chien-Cheng Chen

Taiwanese Journal of Orthodontics

A 28-year-old female with mild skeletal Class II and dental Class I malocclusion had chief complaint of teeth crowding and poor esthetics. The patient presented with a convex facial profile, long face with a steep mandibular angle, bimaxillary dentoalveolar protrusion with 9 mm overjet, and dental crowding. She had severe caries on the maxillary right first and second molars, and the mandibular left second molar. The mandibular left first and second premolars had ill-fitting porcelain-fused-to-metal crowns. The maxillary right third molar and the mandibular left third molar were impacted. The orthodontic treatment included autotransplantation of the maxillary left first premolar …

Molar Protraction Through Downward Extension Of Maxillary Sinus In Patient With Central Diastema Caused By Small Lateral Incisors, Hsien-Fang Hung, Ming-Chu Huang, Ming-Jeaun Su

Taiwanese Journal of Orthodontics

A 32-year-old male patient presented with upper central diastema resulting from upper bilateral smallsized lateral incisors. The patient also had a deep bite of dental origin. A relatively simple mechanotherapy with pre-adjusted edgewise appliances was applied. A favorable and stable result of the ideal overbite and overjet after the correction of central diastema. Besides the above primary complaints, the prolonged retained roots of upper left first molar caused difficulty for proper space closure since the maxillary sinus wall was downward extended. The lower sinus floor may impede the orthodontic movement, but was very likely to be overlooked. The upper left …

Camouflage Orthodontic Treatment On Skeletal Class Ii Malocclusion With Idiopathic Condylar Resorption, Hsin-Yi Lo, Liang-Ru Chen, Kwong-Wa Li, Ming-Lun Hong

Taiwanese Journal of Orthodontics

Idiopathic condylar resorption (ICR), also known as idiopathic condylysis or condylar atrophy, and progressive condylar resorption (PCR), is a poorly understood progressive disease that affects the temporomandibular joint (TMJ) with multifactorial factors leading to severe mandibular retrognathism and anterior open bite. It is difficult to distinguish the exact causes for each individual. Different diagnostic methods and different treatment options can be chosen for different phases. In this report, we present a camouflage treatment with temporary anchorage devices (TADs) for a skeletal Class II open bite with ICR. The goal of improving facial profile and reconstructing of occlusion was achieved. Comprehensive …

Treatment Options For Obstructive Sleep Apnea, Shao-Chih Hsieh, Szu-Ting Chou, Yu-Chuan Tseng

Taiwanese Journal of Orthodontics

Obstructive sleep apnea (OSA) is sleep-disordered breathing caused by the collapse of the upper airway. Because anatomical abnormalities of the narrow upper airway are undoubtedly the most critical cause of OSA, the available treatment methods for OSA mostly focus on these anatomical problems. The collapse of the respiratory tract is associated with different levels of upper airway obstruction. The obstruction of the airway can be divided into three parts: the nasal cavity, retropalatal region, and retrolingual region. This article summarizes some common OSA treatment methods, their underlying theories, and their effect on the upper airway.

Effects Of Different Occlusion Setups With A Surgery-First Approach And Simulated Presurgical Orthodontics On The Mandibular Position In Skeletal Class Iii Malocclusion, Gloria Shih-Wen Fan, Yu-Chih Wang, Chiung Shing Huang, Ellen Wen-Ching Ko

Taiwanese Journal of Orthodontics

Purpose: The purposes of this study were to compare the occlusion designs implemented for the surgery-first approach (SFA) and the resultant mandibular movements by different orthodontists, as well as to investigate whether presurgical dental alignment is associated with mandibular positioning.
Methods: This prospective study included 15 patients with skeletal Class III malocclusion who underwent orthognathic surgery through the SFA. Three orthodontists designed an occlusion setup for each case, which were assigned as SFA groups. The same group of patients, who received simulated presurgical orthodontics (SPO) through a virtual setup, composed the control group. The postoperative dental relationship and resultant mandibular …

Nonsurgical Correction Of Skeletal Class Iii Malocclusion With Evident Profile Change In An Adult Patient With Functional Shift And Low Mandibular Plane Angle, Ting-Yu Kuo, Chun-Liang Kuo

Taiwanese Journal of Orthodontics

This article reports the successfully utilize the range of functional shift to treat a 16-year-old female with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a protrusive mandible, anterior crossbite, low mandibular plane angle and facial asymmetry.

To achieve optimal correction of facial profile and occlusion, orthognathic surgery would be the first treatment option. However, this patient and her family declined the surgical option for higher cost. As a consequence, we use lower anterior bite turbo to disocclude posterior teeth for the posterior teeth extrusion. Class III elastics were applied for the correction …

Non-Surgical Treatment For A Patient With Condyle Head Resorption And Unstable Occlusion, Tsung-Jui Hsieh, Tzu-Ying Wu

Taiwanese Journal of Orthodontics

This case report presents multiple TADs application technique on managing difficult dental and skeletal malocclusion. This 36-year-old female who was diagnosed as rheumatoid arthritis and had been under medication control for 6 years. In addition, she was diagnosed as condyle erosion with bilateral crepitus sound during jaw movement. The characters of occlusion including Class II malocclusion with increased overjet (6 mm), multiple posterior teeth missing and super-erupted teeth 17 and 26, and unstable occlusion. During phase I, patient was referred for occlusal splint treatment, and we followed the progression of condylar condition. At phase II, surgical intervention was suggested but …

Non-Surgical And Non-Extraction Orthodontic Treatment Of An Excess Reverse Bite With Anterior Open Bite, Jung-Chi Hsu, I-Hua Liu, Chun-Liang Kuo, Chun-Hsiu Yang, Yu-Ling Tsai, Chung-Li Wang

Taiwanese Journal of Orthodontics

This 13-year-old female had a severe Angle’s Class III malocclusion with an excessive negative overjet 7 mm, anterior open bite 2 mm, a prognathic chin and a concave lateral profile. But this patient and her parents refused orthognathic surgery. Finally, she was treated with a non-surgical and non-extraction approach. The treatment plan consisted of total distalization of mandibular dentition with bilateral temporary anchorage device (TAD) and maxillary incisor extrusion with vertical elastics. The active treatment period was 34 months. Normal overbite, overjet, and acceptable profile were achieved.

Applications Of Artificial Intelligence In Orthodontics, Hsien-Ching Hung, Yi-Chin Wang, Yu-Chih Wang

Taiwanese Journal of Orthodontics

Artificial intelligence (AI) technology is a tool for finding insights in different kind of information in medical field. The purpose of this article was giving a brief introduction to applications of AI in orthodontic treatment. The reviewed literatures were further categorized into (1) extraction or non-extraction therapy in orthodontic treatment, (2) orthognathic surgery, (3) segmentation and landmark identification, (4) growth prediction, (5) cleft related studies, and (6) TMD classification.

Surgical Methods To Accelerate Tooth Movement, Miao-Jing Chen, Shih-Chieh Chen, Jung-Hsuan Cheng, Yu-Chuan Tseng Dds, Mds, Phd

Taiwanese Journal of Orthodontics

Comprehensive orthodontic treatment usually takes 1–3 years to finish the details. The treatment duration depends on the complexity of treatment. Longer treatment times may increase the risk of root resorption, oral hygiene–related problems such as white spot lesion or dental caries, and periodontal destruction. Several methods, such as surgical-assisted procedures, drugs, and physical/mechanical stimulation methods, may accelerate tooth movement and shortened whole treatment time. This article reviews various surgical-assisted procedures and how the surgical method that can effectively shorten the treatment time. The advantages and disadvantages of various technique were also assessed.

Treatment Efficacy Of Invisalign: Literature Review Update, Meng-Huan Tsai, Stephanie Shih-Hsuan Chen, Yi-Jane Chen, Jane Chung-Chen Yao

Taiwanese Journal of Orthodontics

Purpose: Inconsistency between computer prediction and actual tooth movement in Invisalign treatment always limits clinical judgment. The objective of this review was to update the evidence on the treatment efficacy of the Invisalign appliance.
Material and Methods: Medical databases were screened for relevant peer-reviewed articles from 2000 to 2018 for the use of Invisalign as a treatment intervention. All human studies other than case reports and case series were included.
Results: A total of 25 articles (4 RCTs, 6 prospective cohort studies, 15 retrospective cohort studies) were included. Treatment outcomes have been improving over the past 17 years. Invisalign treatment …

Combined Multi-Segmental Surgical-Orthodontic Treatment In Skeletal Class Iii With Facial Asymmetry And Gummy Smile: Two-Year Stability, Rouh-Hwai Wang, Hui-Ling Chen

Taiwanese Journal of Orthodontics

This is a case of skeletal class III malocclusion with facial asymmetry, gummy smile, and maxillary canting, treated with bimaxillary surgery and orthodontic treatment. The two-jaw surgery was performed including a 3-pieces LeFort I segmental osteotomy, anterior segment impaction with clockwise rotation, and bilateral sagittal split osteotomies with genioplasty. Through the 2-year-4-month treatment procedure, the skeletal and occlusal relationship turned to be normal with esthetically pleasing smile and profile. Furthermore, in the two-year follow-up, we found the treatment results were quite stable no matter in skeletal or dental aspects.

The Effects Of Low Intensity Light Emitted Diode On Human Periodontal Ligament Cell And Mouse Cementoblast Cell Line, Yu-Ting Wu, Yun-Ting Huang, Chun-Yu Chen, Chien-Wei Chao, Chia Tze Kao

Taiwanese Journal of Orthodontics

Objectives: The prevention of external root resorption caused by orthodontic tooth movement was endeavored by many researches. The photobiomodulation with low level dose light emitted diode (LED) is reported. The purpose of this study was to investigate the LED effects on the OCCM-30 and PDL cells proliferation. Materials and Methods: The cementoblast cell line (OCCM-30) and periodontal ligament (PDL) cells were cultured in the FX-5000 Compression System with the 0.255 kPA compression model for one hour; the experimental groups were treated with 860 nm low LED for 20 and 60 minutes. The control group did not receive the LED treatment. …

Diagnosis And Management Of Impacted Maxillary Canines, Yu-Cheng Hsu, Chia-Tze Kao, Chih-Chen Chou, Wen-Ken Tai, Po-Yu Yang

Taiwanese Journal of Orthodontics

Maxillary canines play an important role in facial esthetics, since the canine eminence can support the alar and the upper lip. Impacted maxillary canines is a common problem which requires multidisciplinary diagnosis and treatment in dental clinic. The aim of this review is to integrate the studies that include clinical diagnosis and guidelines for management of canine impaction.

Accuracy Of Different Sequencing In Bimaxillary Orthognathic Surgery: A Systematic Review And Meta-Analysis, Thatchawee Borikanphanitphaisan, Ellen Wen-Ching Ko

Taiwanese Journal of Orthodontics

Introduction: Compared to the classic maxilla-first sequence in bimaxillary orthognathic surgery, inverted mandible-sequence has been encouraged for potentially higher accuracy. However, evidence regarding this topic is lacking. Methods: A systematic review of the literature on different sequencing of bimaxillary surgery was conducted, gathering from following databases: Cochrane, Pubmed, Scopus, Medline (Ovid), Web of Science, ScienceDirect. Articles mentioning “sequencing”, “mandible-first”, “orthognathic surgery” of at least case-report level of evidence were included without restriction. Relevant articles were included for quality assessment and extracted data for indications of mandible-first sequence from all studies. Meta-analysis of surgical accuracy at upper central incisors in horizontal …

Use The Lip Bumper Appliance To Control The Lower Lip Biting Habit, Chun-Yu Chen, Chia-Tze Kao, Yu-Tin Wu, Chih-Chen Chou, Jui-Hsien Yang

Taiwanese Journal of Orthodontics

This is a 9 years old boy in mixed dentition stage, with Angle Class I malocclusion, anterior teeth crowding and proclined upper incisors. He was diagnosed with lower lip biting habit. The treatment plan was delivered with two stages treatment, stage 1 was to correct the lip biting habit by using the lip bumper. After four-month observation and lip training, the habit was corrected and the irregularity of lower dentition was decreased. Continued with stage 2 treatment, patient had upper and lower 2x4 fixed appliances to align and level the anterior teeth. The result showed the previous proclined upper incisors …

Orthodontic Correction Of Bimaxillary Protrusion With Mini-Screws In Class Ii Hyperdivergent Patient, Shih-Ying Lin, Kai-Wen Yu, Tai-Ting Lai, Chung-Ji Liu, Li-Fang Hsu

Taiwanese Journal of Orthodontics

To achieve a harmonious profile with pleasant smile arc in Class II hyperdivergent adult cases has been a clinical challenge. Adequate retraction and intrusion of maxillary dentition as well as vertical control are the key factors to improve the smiling appearance and the facial profile. A 19-year-old female initially presented with lip protrusion, convex profile, retrusive chin, and a Class II malocclusion. The cephalometric analysis showed a Class II skeletal pattern (ANB = 9°) with high mandibular plane angle (SN-MP = 38°). The treatment plan included extraction of four first premolars for anterior teeth retraction as well as installation of …

A Comparison Of Two Tad Techniques (Miniscrews Versus Miniplates) For Treating Class Iii Malocclusion And The Associated Skeletal And Dental Effects, James Chen, Jesus I. Patino, Jenny Zwei-Chieng Chang, Chung-Chenjane Jane Yao, Ib Leth Nielsen

Taiwanese Journal of Orthodontics

The aim of this study was to compare two different techniques for distalizing the mandibular dentition in patients with Class III malocclusion using either miniscrews or miniplates. We evaluated the skeletal and dento-alveolar changes associated with each method. The study also aimed at identifying cephalometric characteristics in the subjects associated with the most predictable, successful outcome of treatment. Patients and Methods: Our sample consisted of 20 adult subjects (10 females and 10 males) that met the inclusion criteria. We examined pre and post treatment headfilms and analyzed the dental and skeletal changes using a computer program that provided the data …

Unusual Skeletal Growth Of An Adult Patient With Acromegaly: A 12 Year Follow-Up After Orthognathic Surgery, Szu-Ching Lee, Shou-Hsin Kuang, Yu-Shu Yen, Shen-Chieh Lina, Tzu-Ying Wu

Taiwanese Journal of Orthodontics

Acromegaly is an uncommon endocrinological disorder, which is rarely seen in patients presenting for orthodontic treatment. Herein, we report a patient who underwent orthognathic surgery and was diagnosed with acromegaly during the retention phase. During disease progression and treatment, gradual changes in the mandible and facial soft tissue were detected. General information and management of acromegaly are reviewed, and the role of orthodontists in the treatment of patients with acromegaly is discussed.

Management Of A Patient With Euryprosopic Face And Upper Central Diastema, Chung-Teng Chang, Yi-Min Liu, Yuen-Yung Tsang, Huei-Mei Tsai

Taiwanese Journal of Orthodontics

An adult female has upper central diastema complicated with a complete deep bite and spacing in lower dentition. The broad face and ovoid shaped dental arch form require special attention as an intrinsic transverse dimensional skeletal malocclusion. The treatment modality therefore should be totally different from other deep bite cases with crowding or tapered dental arch. The space retention after active treatment is of prime important. Root divergence of upper incisors and bodily protraction movement of lower posterior teeth were the main concerns during treatment. Fixed lingual retainer and long term follow up are essential for stable outcome.

Validating The 3d And 2d Mandibular Plane To The Frankfort Plane For Craniofacial Measurement, Jason Jyun-Chen Kuo, Ellen Wen-Ching Ko

Taiwanese Journal of Orthodontics

Purpose: This study evaluated whether the three-dimensional (3D) plane-to-plane mandibular plane angle measurement method could be applied in clinical analysis in a manner similar to the application of conventional two-dimensional (2D) cephalometric measurement, regardless of whether patients had symmetrical planes. Patients and methods: This retrospective study selected 30 patients who had undergone both lateral cephalometric radiography and cone beam computed tomography (CBCT). The 2D measurement was manually traced from the lateral cephalometric radiographs for the Frankfort horizontal plane line and mandibular plane line (2D FMA). The 3D reconstructions for each patient in the CBCT were evaluated using 3D software and …

Class Ii Deep Bite Malocclusion Corrected By Two-Stage Approach, Meng-Yun Tsai, Wei-Ting Tseng, Li-Fang Hsu, Kelvin Wen-Chung Chang, Jenny Zwei-Chieng Chang, Eddie Hsiang-Hua Lai

Taiwanese Journal of Orthodontics

In Class II deep-bite malocclusions with growth potential, we could combine orthodontic treatment with orthopedic methods to achieve stable occlusion. The case was a 12-year-old male presented with Class II malocclusion, deep-bite, and low mandibular plane angle. In the stage I treatment, headgear was used to restrict the growth of maxilla. Bilateral Class III molar relationship was gained. After re-evaluation, stage II treatment was started from full mouth banding and bonding, with emphasis on leveling lower curve of Spee and intruding lower anterior teeth by placing reverse curve of Spee in the archwire and intrusive arch to solve the deep …

Long-Term Observation Of Orthodontic Management And Facial Growth On A Patient With Familial Cleidocranial Dysplasia, Chung-Yi Ho, Ellen Wen-Ching Ko, Cheng-Hui Lin

Taiwanese Journal of Orthodontics

The orthodontic management of patients with cleidocranial dysplasia (CCD) is challenging, which takes a long treatment duration and observation to follow the progress. The completion of treatment is usually not finished until growth completion. This case describes the long-term stage treatment of a 22-year-old female presented with familial CCD. The first stage orthodontic treatment was separated into two phases including surgical exposure of the anterior and posterior teeth, respectively. Extraction of the delayed exfoliated deciduous incisors and supernumerary teeth to clear the eruption path of the submerged permanent anterior teeth was started at her age of 8. The impacted anterior …

Correction Of Skeletal Class Iii Malocclusion With Four Missing Premolars By Surgery-First Approach, Yi-Bo Huang, Chia-Yi Pan, Yu-Ling Cheng, Shih-Wei Pan

Taiwanese Journal of Orthodontics

A 21-year-old female with severe concave profile and prominent chin came for surgical-orthodontic consultation. The patient had missing of four premolars which became intricate with extremely lingual inclined incisors and over-developed mandible. The surgery first approach (SFA) was adopted to correct the skeletal factors at the early stage. The pre-adjusted orthodontic bracket system was applied to normalize the torque of the teeth afterward. The capacities of anterior root-torquing auxiliary wire (ART) and multiple-loop edgewise archwire (MEAW) will be discussed, accordingly. The progress records showed remarkable improvement of profile and occlusion. The change of upper incisor show was also discussed. The …

Orthodontic Correction Of Transposed Maxillary Canine And First Premolar In Mixed Dentition, Lan-Tien Lin, Yi-Min Liu, Yuen-Yung Tsang

Taiwanese Journal of Orthodontics

Transposition is rare and occurred commonly on maxillary canine and premolar. To extract or not to extract, to correct or not to correct the dental transposition teeth, it’s a tough decision. A 12-year-old boy was referred for orthodontic correction because of bad alignment at upper dentition. His dental age was in late mixed dentition. Both upper deciduous canines were still retained. Left canine was buccally blocked-out, and first premolar was in palatal crossbite with the lower premolars. Panoramic film showed impacted upper right canine and transposed left canine and first premolar. The treatment duration took 3.5 years. The upper left …