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Case Series: Strategic implants and bone morphogenic changes: Survival and clinical success in long-term |
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B Gangadhar, Anbu Ila, Randhir Kumar, Beautlin Ruban, Kurian Punnoose, Shilpa Dandekeri, J Suresh Babu, C Swarnalatha, Abhishek S Nayyar J Orthodont Sci 2023, 12:24 (18 March 2023) DOI:10.4103/jos.jos_43_22
Dental implants are one of the established treatment protocols to replace/restore lost tooth/teeth structures. Ihde and Ihde redefined concept of strategic implantology based on immediate loading. The aim of present case series was to evaluate efficacy of strategic implants regarding primary stability, quality of bone, survival, and clinical success in long-term. The present case series included a total of 26 patients aged 40 to 70 years restored with strategic implants after an immediate loading protocol. On follow-up visits, clinical assessment of implant stability was done by absence of implant mobility and absence of pain and dysesthesia while radiographically, immediate postoperative crestal bone level was compared with that observed on follow-up visits. Also, integration of apical and/or crestal threads of implants were assessed radiographically for any signs of radiolucency along with healing of sockets and crestal bone levels in relation to abutment margins.
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Case Report: Management of ankyloglossia by functional frenuloplasty using diode laser |
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Deepthi Cherian, Raed Saeed, K Anusha, Bimal Rag, Tim Peter J Orthodont Sci 2023, 12:23 (18 March 2023) DOI:10.4103/jos.jos_20_22
Ankyloglossia or tongue-tie is a condition present since birth that results in restricted movement of the tongue due to the attachment of the lingual frenulum. The condition affects breastfeeding, speaking, swallowing, occlusion, and proper tongue posture. Tongue ties vary in degree of severity from mild cases of mucus membrane bands to complete tongue ties where the tongue adheres to the floor of the mouth. Treatment options such as speech therapy, frenotomy,frenectomyhave all been suggested in the literature. Surgical correction often causes, bleeding,chances of infection, swelling, and relapse.A systemically healthy 23-year-old male patient who experienced difficulty in speech since childhood was referred for treatment to the dental clinic in September 2020. He was diagnosed with Kotlows class III tongue tie and angles class 3 malocclusion. Orthodontic correction and Functional frenuloplasty using a diode laser was carried out.In conjunction with it,orofacial myofunctional therapy was advised. Follow-up: The surgical procedure was uneventful. The patient was reviewed post-operatively at regular intervals every 3 months to check for relapse. This paper elaborates on the newer modes of diagnosis, orofacial myofunctional therapy, and lingual frenuloplasty with diode laser. This technique will help to overcome all the challenges of conventional tongue-tie treatments providing long-term excellent results.
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Case Report: Orthodontic management of anterior disc displacement without reduction  |
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Fahad F Alsulaimani, Wafa A Alswajy J Orthodont Sci 2022, 11:30 (4 May 2022) DOI:10.4103/jos.jos_24_22
This article presents a novel idea for managing patients with anterior disc displacement without reduction that often develops in susceptible patients during routine orthodontic treatment. The patient was a 24-year-old male who presented with class I right molar and canine relationship and class III left molar and canine relationship on a class I skeletal base, complaining of bimaxillary crowding. The case was treated with fixed orthodontic appliance with maxillary expansion and unilateral mandibular extraction to eliminate the mandibular crowding. Due to a life crisis, the patient developed anterior disc displacement on the right joint. A maxillary occlusal splint was fabricated to reduce the symptoms and attempt to recapture the disc; however, this attempt failed. An attempt was then made to recapture the disc using occlusal pivots and elastics. The disc was eventually recaptured, and the patient resumed normal jaw function and mouth opening. This case report aims to demonstrate a new way to achieve stable occlusion in a patient who sustained disc displacement.
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Case Report: Successful 2 phase treatment of growing skeletal Class III malocclusion based upon cephalometric prognostic factor: A case report  |
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Tabassum Qureshi, Prabhat K Chaudhari J Orthodont Sci 2022, 11:29 (4 May 2022) DOI:10.4103/jos.jos_160_21
Early treatment of Class III malocclusion provides an improvement in facial appearance and corrects the reverse bite. Orthopedic protraction of maxilla is considered best approach in growing Class III patients with maxillary deficiency. Present case report describes the management of a growing 10-year-old boy with skeletal Class III malocclusion using facemask therapy (Phase 1) followed by fixed orthodontic treatment (Phase 2) based upon cephalometric prognostic findings of growth treatment response vector (GTRV). With the successful orthopedic phase of maxillary protraction with facemask therapy for 7 months of period, a significant improvement in profile had been achieved along with the correction in reverse overjet. This was followed by retention with chin cup therapy for a period of 20 months. After a period of 20 months retention, a fixed orthodontic treatment was started with the objective to achieve stable functional occlusion. After 11 months of treatment with fixed appliance therapy a stable functional occlusion was achieved. The patient was placed on Hawleys retainer in maxillary arch and bonded fixed spiral wire (FSW) retainer in mandibular arch. Successful management of growing Class III patient was done using facemask and fixed orthodontic therapy based upon cephalometric prognostic findings of growth treatment response vector (GTRV).
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Case Report: Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders  |
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Akihiko Iwasa, Shinya Horiuchi, Nao Kinouchi, Takashi Izawa, Masahiro Hiasa, Nobuhiko Kawai, Akihiro Yasue, Ali H Hassan, Eiji Tanaka J Orthodont Sci 2017, 6:152 (5 October 2017) DOI:10.4103/jos.JOS_63_17 PMID:29119097
The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of −2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite.
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Case Report: Severe skeletal Class II Division 1 malocclusion in postpubertal girl treated using Forsus with miniplate anchorage  |
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Harshal Ashok Patil, Veerendra V Kerudi, BM Rudagi, Jitendra S Sharan, Pawankumar Dnyandeo Tekale J Orthodont Sci 2017, 6:147 (5 October 2017) DOI:10.4103/jos.JOS_59_17 PMID:29119096
This case report outlines the treatment of a 17-year-old female with Class II Division 1 malocclusion with mandibular retrusion, deep bite, and convex facial profile. The Forsus fatigue resistance device with miniplate was used for this patient and it was very affecting tool in correcting both skeletal and dental parameters. The total active treatment time was 19 months. This method can serve as an alternate choice of treatment, especially those who refuse orthognathic surgery. Hence, Forsus with miniplate might be useful in both growing and postpubertal patients.
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Case Report: Orthodontic treatment for a patient with multiple sclerosis  |
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Manal A Bakathir J Orthodont Sci 2017, 6:110 (29 June 2017) DOI:10.4103/jos.JOS_2_17 PMID:28717636
Multiple sclerosis (MS) is a chronic, autoimmune inflammatory disorder of the central nervous system (CNS) that affects myelinated axons, destroying the myelin and damaging axons to varying degrees. The course of MS is highly varied and unpredictable. Metals used during orthodontic treatment can negatively affect imaging techniques used to diagnose and monitor the progression of MS, while medications used to treat MS can negatively affect orthodontic tooth movement. The present case report highlights some of the challenges encountered during orthodontic treatment of a patient with MS and how to overcome them. The patient was a 20-year-old woman with complaints of diastema and spacing in the upper arch. Although closing the spaces was challenging due to some of the MS medications, she was treated successfully, without complications, within 20 months using closing loops.
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Case Report: The fabrication of a customized occlusal splint based on the merging of dynamic jaw tracking records, cone beam computed tomography, and CAD-CAM digital impression  |
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Katerina Aslanidou, Chung How Kau, Christos Vlachos, Tayem Abou Saleh J Orthodont Sci 2017, 6:104 (29 June 2017) DOI:10.4103/jos.JOS_61_16 PMID:28717635OBJECTIVES: The aim of this case report was to present the procedure of fabricating a customized occlusal splint, through a revolutionary software that combines cone beam computed tomography (CBCT) with jaw motion tracking (JMT) data and superimposes a digital impression.
MATERIALS AND METHODS: The case report was conducted on a 46-year-old female patient diagnosed with the temporomandibular disorder. A CBCT scan and an optical impression were obtained. The range of the patient's mandibular movements was captured with a JMT device. The data were combined in the SICAT software (SICAT, Sirona, Bonn, Germany).
RESULTS: The software enabled the visualization of patient-specific mandibular movements and provided a real dynamic anatomical evaluation of the condylar position in the glenoid fossa. After the assessment of the range of movements during opening, protrusion, and lateral movements all the data were sent to SICAT and a customized occlusal splint was manufactured.
CONCLUSIONS: The SICAT software provides a three-dimensional real-dynamic simulation of mandibular movements relative to the patient-specific anatomy of the jaw; thus, it opens new possibilities and potentials for the management of temporomandibular disorders. |
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Case Report: Molar distalization with 2K appliance: one-year follow-up  |
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Tulika Tripathi, Priyank Rai, Navneet Singh J Orthodont Sci 2017, 6:97 (29 June 2017) DOI:10.4103/jos.JOS_143_16 PMID:28717634Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angle's Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space. |
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Case Report: Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder  |
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Silvia Naomi Mitsui, Akihiro Yasue, Shingo Kuroda, Eiji Tanaka J Orthodont Sci 2016, 5:104 (12 July 2016) DOI:10.4103/2278-0203.186168 PMID:27556023This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. |
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Case Report: Mandibular incisor extraction treatment in Angle's Class I malocclusion with peg-shaped maxillary lateral incisors  |
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Ankit H Shah, Darshit H Shah J Orthodont Sci 2016, 5:100 (12 July 2016) DOI:10.4103/2278-0203.186167 PMID:27556022Accurate diagnosis and treatment planning are essential for obtaining ideal treatment result in cases involving mandibular incisor extraction. This case report describes a 15-year-old female with balanced soft-tissue profile, peg-shaped maxillary lateral incisors, and moderate mandibular anterior crowding treated with a mandibular incisor extraction. Ideal overbite and overjet were achieved. "Black triangle" formation was avoided due to the bodily movement of mandibular incisors and the use of uprighting springs for ideal axial inclination of mandibular incisors. A mandibular incisor extraction can be an effective treatment option in carefully selected clinical situations. |
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Case Report: Surgery-first orthognathic approach case series: Salient features and guidelines  |
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Narayan H Gandedkar, Chai Kiat Chng, Winston Tan J Orthodont Sci 2016, 5:35 (16 February 2016) DOI:10.4103/2278-0203.176657 PMID:26998476Conventional orthognathic surgery treatment involves a prolonged period of orthodontic treatment (pre- and post-surgery), making the total treatment period of 3-4 years too exhaustive. Surgery-first orthognathic approach (SFOA) sees orthognathic surgery being carried out first, followed by orthodontic treatment to align the teeth and occlusion. Following orthognathic surgery, a period of rapid metabolic activity within tissues ensues is known as the regional acceleratory phenomenon (RAP). By performing surgery first, RAP can be harnessed to facilitate efficient orthodontic treatment. This phenomenon is believed to be a key factor in the notable reduction in treatment duration using SFOA. This article presents two cases treated with SFOA with emphasis on "case selection, treatment strategy, merits, and limitations" of SFOA. Further, salient features comparison of "conventional orthognathic surgery" and "SFOA" with an overview of author's SFOA treatment protocol is enumerated. |
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Case Report: Simplified treatment mechanics with a miniscrew for a case of canine impaction  |
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Zuhair Bakhsh J Orthodont Sci 2016, 5:30 (16 February 2016) DOI:10.4103/2278-0203.176656 PMID:26998475With the introduction of miniscrews into the orthodontic field, the efficiency and effectiveness of treating complex cases have significantly improved. Biomechanical considerations, especially relating to anchorage control have become less of a concern and side effects, as a consequence, have become minimal. This article reports on a canine impaction case in which an orthodontic miniscrew has been used to effectively and efficiently pull the canine, thereby reducing anchorage unit side effects and simplifying treatment mechanics. |
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