Orthodontics and Orthodontology Commons^™

Noninvasive Orthodontic Treatment For Class Ii Division 2 Adult Patient With 100% Deep Bite By Continuous Wire Mechanism, Yu-Hui Huang, Chun-Liang Kuo, I-Hua Liu, Chun-Hsiu Yang, Chung-Li Wang

Taiwanese Journal of Orthodontics

A characteristic of Class II Division 2 malocclusion is severe deep overbite and lingual inclination of the incisors. Deep overbite can be corrected by intrusion of anterior teeth, extrusion of posterior teeth, or a combination of both. Intrusion of the incisors should be the preferred treatment in nongrowing patients with anterior deep bites.

The patient is a 21-year-old female who had a skeletal Class II, hypodivergent facial pattern, Class II division 2 malocclusion, crowding dentition and traumatic 100% deep overbite. We extracted the two upper first premolars to relieve crowding, and the mandibular crowding was resolved by aligning the lower …

Treatment Of A Class Ii Hyperdivergent Case With Progressive Condylar Resorption, In-Ru Lin, Meng-Yen Chen, Tung-Yiu Wong, Chen-Jung Chang

Taiwanese Journal of Orthodontics

Condylar resorption can be challenging to orthodontist when encountered during treatment. The clinical characteristics and cephalometric findings of a patient who experienced postoperative skeletal relapse caused by progressive condylar resorption (CR) are presented in this case report. The predisposing factors and treatment protocols of condylar resorption are also discussed. A 17-year-old female patient came to our hospital with chief complaint of no contact of anterior teeth. Cephalometric analysis shows that she is a patient with skeletal Class II hyper-divergent pattern caused by mandibular retrognathism. Flattened left condylar head was found on panoramic film suggesting possible condylar erosion in the past. …

Asymmetric Orthodontic Space Closure Of Unilateral Congenitally Missing Second Premolars, Weerayuth Vejwarakul, Yu-Chih Wang, Yuh-Jia Hsieh

Taiwanese Journal of Orthodontics

This case report presents successful orthodontic management of unilateral retained deciduous second molars and congenitally missing second premolars using an additional anchorage in conjunction with the segmented arch approach. A 21-year-old female patient presented as skeletal Class I malocclusion, mild crowding, straight facial profile, and orthodivergent facial pattern. The treatment plan was established to extract deciduous teeth and close the extraction space by molar protraction. A Nance appliance and lingual holding arch were used as an additional anchorage to maintain the facial profile and dental midline, with pure molar protraction performed using a segmented arch and sliding mechanics. After 1 …

Orthodontic Correction Of Insufficient Posterior Overjet With Microimplant-Assisted Rapid Palatal Expansion, Po-Yi Chen, Tai-Ting Lai, Kai-Wen Yu, Huey-Yuan Wang, Shih-Ying Lin

Taiwanese Journal of Orthodontics

Transverse maxillary deficiency is often characterized by insufficient posterior overjet or posterior cross bite and anterior crowding. However, arch expansion in adult patients has been considered to be problematic owing to its possible periodontal side effects, such as gingival recession and bone dehiscence. On the other hand, nonsurgical maxillary expansion of the palatal bone in young adults has been demonstrated to correct transverse maxillary deficiency. This report describes the case of an 18-year-old patient with mild transverse maxillary deficiency accompanied by crowding who underwent microimplant-assisted rapid palatal expansion (MARPE). Using microimplant-assisted rapid palatal expansion allowed relief of crowding and correction …

Comparing Outcomes And Stability After Single- And Two-Piece Lefort I Osteotomies In Patients With Cleft Lip And Palate, Chanin Jittithaworn, Chun-Shin Chang, Chiung Shing Huang, Cheng-Hui Lin, Ellen Wen-Ching Ko

Taiwanese Journal of Orthodontics

Purpose: LeFort I osteotomy is used to correct and improve the maxillary hypoplasia in secondary cleft deformities. However, surgical complex and challenge would be the risk factor of postsurgical instability. This study compared surgical and postsurgical changes in maxillary and mandibular movements and stability in patients with cleft lip and palate (CLP) who underwent single- or two-piece LeFort I osteotomies.

Materials and Methods: Forty-five patients with CLP were included, of whom 30 and 15 received single- and two-piece LeFort I osteotomies, respectively. Cone-beam computed tomography was administered at three time points (T0: presurgery; T1: <1-month postsurgery; and T2: ≥1-year postsurgery) to evaluate surgical (T1–T0) and postsurgical (T2–T1) changes in maxillary and mandibular movement and stability. The overall movement, arch width, and relapse rate were measured and compared between the groups. Potential factors influencing skeletal stability were surgical change, segmental maxilla, cleft types, age, sex, and prior alveolar bone graft placement were analyzed.

Results: There revealed a significant difference …

Is The Anb Norm In Tao Board Examination Appropriate? Meta-Analysis Of Taiwanese Cephalometric Norms, Ya-Lan Chan, Johnson Hsin-Chung Cheng, Pei-Hsuan Chen, Daniel De-Shing Chen

Taiwanese Journal of Orthodontics

Purpose: According to clinical experience, the ANB angle (A point, nasion, B point) norm value of Taiwan Association of Orthodontists (TAO) board examination seems to be larger than the Taiwanese population. Therefore, this study aimed to integrate studies of Taiwanese cephalometric norms by a meta-analysis.

Patients and Methods: Studies were searched from electronic database of PubMed, National Digital Library of Theses and Dissertations in Taiwan, and physical libraries. Ten measurement values were collected. According to age and gender, all samples were divided into three groups. A meta-analysis of the mean and standard deviation values in all groups was performed.

Results: …

Segmental Maxillomandibular Rotational Advancement (Smmra) In The Treatment Of Adult Patients With Severe Obstructive Sleep Apnea, Hsien-Ching Hung, Ya-Ying Teng, Yuh-Jia Hsieh, Yi-Chin Wang, Yu-Chih Wang

Taiwanese Journal of Orthodontics

Obstructive sleep apnea (OSA) occurs as an increased collapsibility of the upper airway during sleep, which threatens health and quality of life. Asian men with greater severity of OSA presents less obese and are connected with craniofacial abnormalities. Although the traditional maxillomandibular advancement (MMA) had the comparable effectiveness to the continuous positive airway pressure therapy, the midfacial esthetics might be compromised in Asian individuals. The modified MMA procedure was proposed to balance the esthetic demands and improvement of OSA symptoms. The case report showed a 25-year-old man presented with a diagnosis of severe OSA. The pretreatment Apnea Hypopnea Index (AHI) …

Protraction Of Maxillary Single Side Teeth For Substitution Of Missing Canine And 1st Molar, Wan-Jung Tsai, Szu-Ching Lee, Tzu-Ying Wu

Taiwanese Journal of Orthodontics

This case report presents a 24-year-old female with Class III skeletal pattern, anterior cross-bite, retroclined upper incisors with missing teeth (23, 26, 46). Upper dental midline was shifted to left for 3.5 mm due to early missing of tooth 23. Maxillary sinus pneumatization was noted at both sides.

Our treatment goal was to correct upper dental midline and anterior crossbite. On the other hand, the patient requested to close all of the extraction space and solve the problem of poor prognostic tooth 36. Therefore, we extracted tooth 14 for crowding relief and midline correction. Interdental screw was used to protract …

Surgical Alteration Of Occlusal Plane Angulation Followed By Orthodontic Application Of Tads And Yin-Yang Arch Wire In Hypodivergent Prognathic Malocclusion, Chih-Hsun Hou, Yi-Min Liu, Chia-Yi Pan, Huei-Mei Tsai

Taiwanese Journal of Orthodontics

Surgical clockwise pitch rotation of the maxillo-mandibular complex could change the occlusal plane angulation and thereby open the bite. This procedure also increases the mandibular plane angle by forcing the lower face to turn backward and downward; it is the key to correct both skeletal and dental Class III malocclusions.

This case report presents a skeletal deformaty which primarily resulted from excessive transverse growth and reduced vertical growth in the midface and upper dentition. The counterclockwise growth rotation and excessive forward growth mandible aggravated the sagittal jaw bone discrepancy. The dental effect included canted maxillary occlusal plane and severe attrition …

Indication And Timing Of Mucogingival Soft Tissue Augmentation Associated With Orthodontic Treatment, Shun-Jen Yu, Yi-Hao Lee, Aaron Yu-Jen Wu

Taiwanese Journal of Orthodontics

Gingiva recession is defined as an apical shift of the gingival margin caused by different conditions/pathologies. It is associated with clinical attachment loss. Several studies showed prevalence of gingiva recession in orthodontic patients. Some predisposing factors should be taken carefully considering the effect of the treatment modality. No consensus agreement was identified about the timing of the soft tissue augmentation intervention for orthodontic patients with the risk of gingival recession. However, several critical factors can guide the decision making to obtain the most preferred treatment option.

This article reviews the factors regarding the correlation of gingival margin alteration and orthodontic …

Perception Of And Attitudes On Malocclusion: A Literature Review, Gannaran Narangerel, Hsin-Chung Cheng, Bolormaa Sainbayar, Ganjargal Ganburged

Taiwanese Journal of Orthodontics

Purpose: This study aimed to review published evidence on the perception of and attitude on malocclusion and to examine existing assessment tools and influencing factors.

Methods: PubMed, Cochrane Library, and Scopus databases, as well as electronic archives of the European Journal of Orthodontics, American Journal of Orthodontics and Dentofacial Orthopedics, and Angle Orthodontist, were searched to collect articles that compared perception differences between dental professionals and laypeople. Articles that investigated perceptions of dental professionals were excluded.

Results: The literature search identified 94 articles. A total of 31 suitable studies from 1970 to 2019 were finally considered in the review. …

Could Cephalometric Landmarks Serve As Boundaries Of Maxillary Molar Distalization? A Comparison Between Two- And Three-Dimensional Assessments, Jhong-An Ye, Chi-Yu Tsai, Yi-Hao Lee, Yu-Jen Chang, Shiu-Shiung Lin, Jui-Pin Lai, Te-Ju Wu

Taiwanese Journal of Orthodontics

Purpose: This study aimed at measuring the differences between the two-dimensional (2D) and three-dimensional (3D) radiographic boundaries for molar distalization, and their correlations for the amount of maxillary molar distalization.

Patients and Methods: A total of 250 consecutive adult patients were retrospectively reviewed. All the enrolled patients possessed Angle Class III malocclusion with moderate maxillary crowding and suitable for camouflage treatment. The spatial differences between the 2D and 3D radiographic boundaries were compared and measured. The correlation among the range of the distalization boundary and studied clinical variables were assessed by Pearson correlation and the linear regression to determine the …

The Non-Surgical Treatment Of Class Ii Jaw Relation With Anterior Open Bite, Jyun-Long Wang, Yu-Chuan Tseng

Taiwanese Journal of Orthodontics

This 19-year-old female presents anterior open bite with skeletal Class II jaw relation. The treatment modality was non-surgical treatment with 4-bicuspid extraction and molar intrusion by full-mouth fixed edgewise appliances and temporary anchorage devices. A favorable result of ideal overbite/overjet and improvement of profile change were achieved. The patient was satisfied with the improvement of function and esthetics after treatment.

Hemimandibular Hyperplasia Treated By Orthognathic Surgery And Condylectomy In A Young Woman, Shin Pey Peng, Wen-Ching Ellen Ko, Cheng-Hui Lin, Chung-Yi Ho

Taiwanese Journal of Orthodontics

Hemimandibular hyperplasia is a developmental asymmetry characterized by 3-dimensional enlargement in one half of the mandible. The malformation results in facial asymmetry, associated with tilted occlusal plane and a deviated chin to the contralateral side. These cause esthetic and progressive functional problems and need to be corrected without recurrence.

This report describes a 27-year-old woman presented with skeletal Class III malocclusion, occlusal plane cant and facial asymmetry. Radiographic films showed hyperplasia of half mandible and condyle on the left side. The condylar hyperactivity over left mandibular condyle was also confirmed by 99m-Tc bone scan. In order to correct her skeletal …

Unilateral Premolar Crossbite And Atypical Extraction Case Treated With Clear Aligner, Ting-Fen Chang, Tzu-Ying Wu

Taiwanese Journal of Orthodontics

A unilateral buccal crossbites can be observed in adult patients with skeletal asymmetry and crowded dentition. This case report describes the orthodontic treatment with clear aligners for a 57-year-old female with chin deviation, lower dentition crowding and a unilateral complete buccal crossbite in right premolars. Mandibular single incisor extraction was planned to relieve crowding and the crossbite was resolved by intrusion of upper premolar and uprighting of lower premolar with clear aligners in combined with inter-arch elastic. The entire treatment was completed within 20 months and the treatment result showed good vertical control. This case report demonstrates that clear aligners …

Surgery First Approach For Correcting A Skeletal Class Ii Malocclusion With Impinging Deep Bite, Yu-Ting Chiou, Tzu-Hang Hsu, Sang Heng Kok, Chung-Chen Jane Yao

Taiwanese Journal of Orthodontics

This case report illustrates a surgery-first treatment for surgical correction of Class II malocclusion. A 54- year-old female, presenting a chief complaint of deep bite and gum biting, came to seek for treatment. She had skeletal Class II and dental Class II malocclusion with 11 mm excessive overjet. Intraoral examination revealed large mandibular curve of Spee. Treatment was performed with a surgery-first approach, moving the dentition towards edge-to-edge bite, followed by extruding mandibular posterior teeth and normalizing the overjet and overbite. Finally, good interdigitation was achieved, as well as the improvement of masticatory function. The patient was satisfied with the …

Reliability Of Panoramic Radiography In Assessing Gonial Angle Compared To Lateral Cephalogram In Patients With Class I Malocclusion, Ravi Ranjan Kumar Rajak, Rabindra Man Shrestha, Sushmit Koju

Taiwanese Journal of Orthodontics

Purpose: To investigate whether panoramic radiograph can be used as an alternative to lateral cephalogram for measuring the gonial angle in skeletal Class I patients. Patients and Methods: Panoramic radiograph and lateral cephalogram were collected from the pretreatment records of 100 patients of the age 16-30 years from the Department of Orthodontics. Radiographs were manually traced and the gonial angle was measured. Paired t-test was used to find the difference in mean gonial angle between the panoramic radiograph and lateral cephalogram. A simple regression analysis was performed to find the relationship between the gonial angles in two different …

Class Ii, Division 2 Malocclusion: What The Clinician Should Know About Treatment Of This Malocclusion (Part Ii), Ib Leth Nielsen

Taiwanese Journal of Orthodontics

Treatment of Class II, Div. 2 malocclusion can be a challenging undertaking for the orthodontists. The facial growth pattern and in particular the mandibular growth pattern can greatly influence the outcome of treatment and the long-term stability. In this article we will discuss factors determining the best time for treatment, the choice of treatment mechanics and the indications for extraction versus non-extraction. Criteria for treatment with two upper bicuspid extraction will be discussed and we provide 8 rules to consider for a successful outcome of treatment. Factors influencing long-term stability will be discussed and a protocol to improve stability will …

Strategies For Treatment Of Bilateral Impacted High Canine–Lateral Incisor Transposition: A Stepwise Approach, Yun-Yun Wu, Fu-Hui Tsai, Jui-Hsien Yang

Taiwanese Journal of Orthodontics

To achieve a satisfactory outcome for transposed impacted teeth, the esthetic assessment and functional rehabilitation should be considered from both the orthodontic and periodontic perspective. In this case, a stepwise approach was used for both surgical uncovering and orthodontic treatment to manage the soft and hard tissue of transposed high canine. The case involved a girl aged 11 years and 7 months with bilateral high impacted canine–lateral incisor transposition. The impacted canines were first uncovered with the closed eruption technique and then moved horizontally to a normal sequence in the arch. Apically repositioned flap surgery was then performed, and the …

Management Of Unilateral Maxillary Canine Impaction, Maureen Antolis, Krisnawati E. Tarman

Taiwanese Journal of Orthodontics

Maxillary canine is an essential part of teeth for smile esthetic and function. Orthodontic treatment for patient with impacted maxillary canine is considered to be more complex and require good biomechanical control during traction. This case report describes an orthodontic treatment of a 17-year old female patient with unilateral maxillary canine impaction on the left side. Orthodontic traction was used to guide the canine into normal occlusion. The orthodontic treatment had been completed within 19 months and successfully obtained favourable esthetic and stable occlusion.

Compare Two Methods Of Dental Arch Length Measurements On Digital Dental Models, Ying-Chen Chen, Carol Yi-Hsuan Chen, Ellen Wen-Ching Ko

Taiwanese Journal of Orthodontics

Purpose: Accurate space discrepancy evaluation is important in treatment planning. Straight-line segments and brass wire method are the most common methods in arch length assessment. However, using segments causes underestimation, while more reliable brass wire method shows lower reproducibility. The aim of our study is (1) to compare the difference between conventional segmental distance method (SD) and a new method, ideal arch form (IA), and (2) to assess the reproducibility and reliability of two methods by means of digital models. Materials and methods: Thirty sets of digital dental models presented full permanent dentition and Angle’s Class III malocclusion were included. …

Evaluation Of Patients’ Experiences After Microimplant-Assisted Rapid Palatal Expansion (Marpe) Treatment, Huei-Rou Tsai, Kwok-Hing Ho, Chih-Wei Wang, Kai-Long Wang, Shun-Chu Hsieh, Heng-Ming Chang

Taiwanese Journal of Orthodontics

Purpose: Various microimplant- assisted rapid palatal expansion (MARPE) appliances were developed in these years. By applying this procedure, maxillary transverse deficiencies can be corrected in adults with limited dental tipping. However, some undesirable effects could happen during treatment. In this study, we aimed to record the incidence of any adverse effect or complication. Pain score was also measured during treatment. Patients and Methods: Twenty-nine patients (22.8 ± 8.6 years old) with 13 males and 16 females were enrolled. Clinical photographs, radiographs and cone-beam computed tomography were taken before insertion of MARPE and after expansion. Interview was conducted by one orthodontist …

Etiology, Development, Diagnosis And Considerations In Treatment Of The Class Ii, Division 2 Malocclusion: What The Clinician Should Know About This Malocclusion (Part I), Ib Leth Nielsen

Taiwanese Journal of Orthodontics

The Class II Division 2 malocclusion has puzzled a great many orthodontists over the years. How does it develop and how does it get its characteristic appearance? What are the etiological factors that lead to the typical arrangement of the front teeth? How should we treat it? These are just a few of the many questions that still need answers. In this article we will discuss the etiology and development of this malocclusion and in Part II provide some guidelines for timing and correction of the Class II, Div. 2 malocclusion that are applicable to most cases. We shall also …

Class Ii Malocclusion And Traumatized Incisors In Adolescent With Twin Block And Fixed Appliance, Ying Hsu, Yu-Chuan Tseng, Shih-Chieh Chen

Taiwanese Journal of Orthodontics

This case report presents the outcome of atypical extraction and effect of Twin Block appliance on a growing adolescent. A 12-year-old boy who had complained about protrusive upper lips after being involved in a traffic accident. Tooth 11 was replanted at a local dental clinic, while tooth 21 was lost. In extra-oral examination, this patient had convex profile, obtuse nasolabial angle, and receded chin position. In intra-oral examination, bilateral Class II molar and canine relation were shown, the overjet was 11 mm between tooth 11 and 41; 7 mm between tooth 22 and 31; the overbite was 6 mm. Cephalometric …

Obstructive Sleep Apnea Treated With Maxillomandibular Advancement Surgery By Computer-Assisted Simulation, Bing-Luen Yang, Yu-Feng Chen, Szu-Ting Chou, Yu-Chuan Tseng

Taiwanese Journal of Orthodontics

This 23-year-old female patient was diagnosed as a severe type of obstructive sleep apnea (OSA), skeletal Class II jaw relation with mandibular deficiency, hyper divergent facial pattern, dental Class II malocclusion, midline deviation and occlusal plane canting. By the assistance of virtual surgical simulation and maxillomandibular advancement (MMA) approaching, patient was satisfied the improvement of functional and esthetic changes after the 18-months treatment.

Interdisciplinary Approach Of Pediatric Obstructive Sleep Apnea With Congenitally Missing Second Premolars, Shih-Hsuan Lin, Yu-Feng Chen, Yu-Chuan Tseng

Taiwanese Journal of Orthodontics

This report is a case of 11-year-old young boy who was diagnosed with pediatric obstructive sleep apnea (OSA) by sleep surgeon and was referred for further evaluation of co-therapy with intervention of orthodontic appliances. This patient is a growing case of skeletal class II jaw relation, hypodivergent facial pattern, large overjet and anterior deep overbite with congenitally missing premolars. The treatment contained two folds. In the first stage, functional appliance was designed to help with the skeletal jaw discrepancy. By doing so, the expansion over upper airway was also expected. In the second stage, fixed edgewise appliances were bonded for …

Comparison Of Shear Bond Strengths And Fiction Forces Among Various Self-Ligating Ceramic Brackets, Chia-Lin Wu, Chen-Jung Chang, Tzer-Min Lee, Jen-Bang Lo, Jia-Kuang Liu

Taiwanese Journal of Orthodontics

Purpose: Ceramic self-ligating brackets were developed recently, however, only few comparative studies had been reported about their bond strengths and friction. The aim of the study was to compare shear bond strengths and friction forces of various self-ligating ceramic brackets. Materials and methods: The present study is divided into two parts. In shear bond strength test, bovine teeth were used as a substitute for human teeth. Five groups of brackets (three ceramic self-ligating brackets including ClippyC, GeniusCrystal, DamonClear2, ClarityAdvanced (conventional ceramic bracket), Damon3MX (metal self-ligating bracket), were used and debonded with 12 brackets in each group. The shear bond strengths …