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Objective: The aim of this study was to compare the craniomaxillofacial changes when using high-pull J-hook headgear (HPJH) and mini-implants (MIs) as maxillary anchorage in adolescents. Study Design: 40 female adolescents with dentoalvolar protrusion were divided into 2 groups; the HPJH group (n=20) and the MI group (n=20). Lateral cephalograms taken before treatment (T0) and after anterior tooth retraction (T1) were superimposed on the stable structures and then craniomaxillofacial changes were evaluated. Results: The cranial base angle, SNB, and facial angle decreased in the HPJH group but increased in the MI group. ANB decreased more in the MI group than in the HPJH group. Mandibular plane angle increased in the HPJH group but decreased in the MI group. Facial height index increased in the MI group while it showed no change in the HPJH group. Mandibular true rotation occurred clockwise in the HPJH group and counterclockwise in the MI group. Maxillary central incisors were intruded and retracted more in the MI group than in the HPJH group. Maxillary first molars were extruded in the HPJH group and were intruded in the MI group. Maxillary first molars were protracted more in the HPJH group than in the MI group. Mandibular central incisors were retracted more in the HPJH group than the MI group. Mandibular first molars were extruded more in the MI group than in the HPJH group. Conclusion: More favorable craniomaxillofacial changes occurred in the MI group than in the HPJH group.

Currently, the treatment protocol for cleft palate at several centers around the world involves primary lip repair around 3-4 months of age, using presurgical nasoalveolar molding, which is done soon after birth. Unfortunately, in cases where treatment is delayed, the potential for repositioning the nasoalveolar apparatus is severely limited. The purpose of this paper is to illustrate a novel use of an expansion screw appliance to aid in the faster and more efficient active molding of the premaxillary and lateral maxillary segments in infants for whom the start of PNAM therapy is delayed, without the side effects commonly seen with pin-retained active molding appliances.

Technology has transformed almost every aspect of our lives. Smartphones enable patients to request, receive, and transmit information irrespective of the time and place. The global pandemic has forced healthcare providers to employ technology to aid in ‘flattening the curve. The Novel Coronavirus, which is responsible for COVID-19, is transmitted primarily through person-to-person contact but may also be spread through aerosol generating procedures, so many clinics have severely limited interpersonal interactions. The purpose of this article is to provide helpful information for those orthodontists considering some form of remote practice. Various HIPAA-compliant telecommunication or teledentistry systems that can be used for orthodontic treatment are introduced and discussed. Detailed information about each platform that can potentially be used for orthodontics is provided in Figure 1. The authors do not endorse any of the products listed and the included software is not all inclusive but instead is a glimpse into the options available.

A 9-year-old female was referred by her general dentist for an evaluation of an impacted maxillary left central incisor. Her maxillary left primary incisors showed crossbites and her right central incisor showed an edge-to-edge bite which caused gingival recession on the mandibular right central incisor. After treatment, the impacted maxillary central incisor erupted successfully. An optimal overbite and overjet were also achieved, and her gingival recession was improved.

Treatment of horizontally and deeply impacted mandibular molars is challenging for both orthodontists and oral surgeons because of the limited access and anchorage control. We report on two patients who had horizontally and mesially impacted mandibular second molars (MM2s). Both patients were treated by a surgical orthodontic approach, and the crowns of the impacted teeth were brought into the arches by closed forced eruption. Mesially impacted MM2s were uprighted with orthodontic microimplants, inserted in the retromolar area, and then moved into their ideal position. The first patient was in an active growing stage, while the second patient was beyond the active growing stage. Therefore posterior available space (PAS) should be analyzed before treatment of impacted MM2s to prevent periodontal problems after uprighting of impacted teeth. If PAS is not enough for uprighting impacted MM2s, alternative treatment should be considered based on the stage of growth.

Objective: This study was designed to assess the morphological and histological alterations of the condyle of rats undergoing forward mandibular repositioning via functional appliance. Materials and Methods: Functional appliances were mounted onto the upper jaws of rats. Morphological analysis was conducted on micro-CT images of sacrificed animals. Histological changes in condyle were examined by immunohistochemistry using proliferating cell nuclear antigen (PCNA), matrix metalloproteases (MMPs), vascular endothelial growth factor (VEGF), tissue inhibitors of matrix metalloproteinases (TIMP-1), interleukin 1b (IL-1β), Aggrecan and Type II collagen. Osteoclast activity was identified by tartrate-resistant acid phosphatase (TRAP) staining. Results: Morphological analysis confirmed the forward positioning of the condyles of rats by the appliance, but the position gradually returned to normal on days 14 after treatment. An increase in PCNA positive cells was observed in the posterior region of the condyles on days 7, whereas PCNA positive cells decreased in the anterior region. Aggrecan and Type II collagen localization increased in the posterior region throughout the entire period, but decreased in the anterior region on days 14. In both regions, IL-1β and VEGF localization was significantly increased for 14 days while MMPs localization was evident throughout the entire period. The TRAP positive cells were significantly elevated on days 3 and 7. Conclusions: These results suggest that the functional appliance therapy induces significant morphological and histological changes in the anterior and posterior regions of the condyle and subsequently causes adaptive cellular functions such as chondrocyte differentiation and cartilage matrix formation.

Silver-Russell syndrome (SRS) is a very rare genetic disorder characterized by intrauterine growth retardation, short stature, and typical craniofacial abnormalities including micrognathia. While growth hormone (GH) therapy in children with SRS significantly improves somatic growth, functional orthopedic treatment can also be effective in adolescents with mandibular deficiency. We report the effects of Phase 1 functional orthopedic treatment of a twin-block appliance in conjunction with GH administration in a 9-year-old boy with GH deficiency and SRS, and the result of the subsequent Phase 2 orthodontic treatment.

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

During the mixed dentition stage, adolescents experience rapid dental and skeletal development. Unfortunately, many of them do not visit the orthodontist early enough and miss out on the opportunity to take advantage of preventive and interceptive orthodontic treatment. This article describes the management of regaining leeway space and correcting anterior crossbite using a modified maxillary molar distalizing appliance.

Objective: To evaluate the palatal soft tissue thickness among placement sites of temporary anchorage devices (TADs) in late mixed, early permanent and permanent dentition. Materials and Method: The sample consisted of three groups; 42 late mixed dentition (mean age = 11.0 years), 41 early permanent dentition (mean age = 13.8 years), and 38 permanent dentition (mean age = 23.1 years). Soft tissue thickness was measured intraorally with an ultrasonic device using a grid of 27, 4x4 mm2 squares to delineate the measurement points. Repeated measures analysis of variance was performed to analyze the data. Results: There was a significant difference in soft tissue thickness among dentition groups with the permanent dentition group showing the highest values (P < 0.001). In each group, the thickness significantly increased from median to lateral and from anterior to posterior sites. Furthermore, the thickness showed a significant difference according to the arch form and gender (P < 0.05). However, there were no significant differences according to irregularity index and Angle classification. Conclusions: The soft tissue thickness of the palate increases from the late mixed to permanent dentition. These findings may be helpful for clinicians to enhance their successful application of TADs in the palate.

There have been many attempts to correlate dental development with skeletal growth. The relationship is generally considered to be moderate at best. However, there is evidence that hand-wrist radiographic interpretation of remaining growth can be augmented by taking into account the developing dentition. In addition, the practicality of evaluating routine dental radiographs and avoiding additional radiation is advantageous. To this point, no system has been described to match apical development by Demirjian’s stages and compare it to skeletal development and remaining growth. This study reviewed articles pertinent to the relationship between developing teeth and skeletal maturity and remaining growth, and a system is proposed to give practitioners an additional assessment for growth and development.

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.

Autotransplantation can provide patients with all the benefits of a natural tooth, but is seldom considered as a treatment option, in large part because of a lack of knowledge about periodontal tissue or the anatomy of teeth. The authors conducted a literature search using the PubMed database. They searched for key words including "autotransplantation," "clinical indications," "sequence and treatment procedures," "healing factors and prognosis" and "treatment options". Autotransplantation demonstrates as a viable treatment alternative,especially in growing adolescents. It provides a biological and economical treatment option for tooth replacement.

Management of space problems is an important factor in the mixed dentition. The Clear Aligner can carry out minor tooth movement with no brackets bonded to the teeth. In addition, it can provide tooth movement for the following: crowding resolution, space closure, arch expansion or constriction, space maintenance or regaining, intrusion or extrusion, guidance of the eruption, and other interceptive orthodontic treatment.