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Introduction: The soft tissue aspect in orthodontics treatment has gained attention in the last few years. The soft tissue profile is said to reflect the underlying skeletal profile, which causes a convex profile in patients with class II skeletal malocclusion. This research was aimed to determine the changes in the soft tissue facial profile of class II skeletal malocclusion patients with retrognathic mandible after twin block treatment. Methods: The type of research used in this study was retrospective descriptive research with paired t-test. The population was children aged 10-13 years old with class II skeletal malocclusion that were treated with twin block appliance in the Faculty of Dentistry Universitas Padjadjaran, Indonesia. The results of soft tissue changes before and after twin block treatment were compared. Results: There was an insignificant increase in soft tissue profile angle and Holdaway’s soft tissue angle after twin block treatment (p > 0.05). Whereas, Holdaway’s H-angle was decreasing and Merrifield’s Z-angle was increasing after twin block treatment, with statistically significant difference (p < 0.05). Conclusion: There was a decrease of H-angle, indicates a reduction in facial convexity and improvement of the facial profile after twin block treatment, but no difference in soft tissue profile angle and Holdaway’s soft tissue angle after twin block treatment. Keywords: Facial soft tissue profile, class II skeletal malocclusion, retrognathic mandible, twin block appliance

Aim: The aim of this study was to assess the association between lip print pattern and different types of skeletal malocclusion. Materials and Methods: A sample of 60 individuals (18–30 years old) with skeletal Class I, Class II Division 1, Class II Division 2, and Class III malocclusion as confirmed by Angle between point A and point B. angle were taken for the study and were named as Groups I, II, III, and IV, respectively. Lip print was recorded by lipstick-paper method and was classified according to Tsuchihashi classification as Type I, Type I', Type II, Type III, Type IV, Type V. Results: It was seen that partial vertical groove (PVG) lip pattern was most prevalent for all the groups. In skeletal Class I, PVG lip pattern was most prevalent, whereas in skeletal Class II Division 1, intersecting groove, in skeletal Class II Division 2, PVG, and in skeletal Class III, complete vertical groove were prevalent. The difference between the four malocclusion groups of each type of lip print was significant except for Type II. Conclusion: Lip print will help in sorting out participants in more reliable manner in cases of mass disaster or criminal investigations. Furthermore, they help in predicting type of malocclusion beforehand for the successful execution of preventive and interceptive orthodontic procedures.

The aim of this study was to highlight the current dilemma of gonial angle measurement on orthopantomograms and lateral cephalograms of adults with different skeletal malocclusion types. The sample consisted of 50 Class I, 50 Class II and 50 Class III (25 males and 25 females for each group) orthopantomograms and cephalograms obtained from previously treated orthodontic patients. For each malocclusion group, the angle between Tweeds mandibular plane and the tangent from the line running along the gonion to the distal point of the condyle was measured on the right and left sides on orthopantomograms and the superimposed images of the mandible on cephalograms. Paired t-test demonstrated no significant difference between the values of gonial angles determined by cephalograms and orthopantomograms in Cl I patients. Pearson correlation also showed a high correlation between gonial angle values measured on the two diagnostic tools in Cl I patients. In Cl II and Cl III patients, statistical analysis showed a significant difference between the gonial angles defined by cephalograms and orthopantomograms. Orthopantomograms can be used for determining gonial angle as accurately as cephalograms in Cl I patients. Hovewer, orthopantomograms are not appropriate tools for measuring the gonial angle in Cl II and Cl III patients. [Med-Science 2019; 8(1.000): 93-6]

A young lady presented to Department of Orthodontics with a chief complain of gap between upper and lower front teeth. On analysis she had Class I dental and skeletal malocclusion with proclined and forwardly placed incisors, and open bite. The treatment was carried out with extraction of all four first premolars and retraction was done with the help of mini-implant screws. Successful correction of open bite was achieved with “drawbridge effect”. DOI: http://dx.doi.org/10.3126/ojn.v3i1.9286 Orthodontic Journal of Nepal, Vol.3, No.1, 2013: 69-72

The goal of this work was to conduct a survey of oral health-related quality of life (OHRQoL) among skeletal malocclusion patients who had undergone orthodontic treatment combined with orthognathic surgery. The study included 28 patients who had undergone orthodontic therapy combined with orthognathic surgery (surgical repositioning osteotomy) to treat skeletal malocclusion. OHRQoL was assessed based on a 14-item German version of the Oral Health Impact Profile (OHIP-G14) and an additional questionnaire developed by the authors to evaluate aspects of quality of life specific to skeletal malocclusion patients. The mean OHIP-G14 score demonstrates that the malocclusion patients have a lower OHRQoL than the general population. The information collected via our skeletal malocclusion questionnaire correlates with the patients’ perceived esthetic and functional outcomes of treatment as well as their psychological state and social interactions. Satisfaction with treatment outcomes and improved social interactions correlated with high OHRQoL scores. High OHRQoL scores significantly correlated with enhanced well-being and the intensification of social contacts. Our skeletal malocclusion questionnaire provides useful additional information on specific aspects of skeletal malocclusion patients, mapping in a detailed fashion aspects of function, esthetics, psychological condition, and social interactions. OHIP-G14 scores correlated negatively with OHRQoL.

In growing children it is frequently found that dental maturation is strongly influenced by the growth rate of maxilla or mandible. If there is evidence to prove this, it might be utilized as a criterion in the early diagnosis of skeletal malocclusion, even before the object`s real skeletal features are yet revealed. The purpose of this study was to find out if the difference of dental maturation in over-grown mandible in children with skeletal Class III has any relationship with some skeletal features of mandible. 50 patients in Hellman dental age IIIA with normal occlusion and Class III malocclusion of mandibular over-growth type respectively were selected as study objects. The age estimation was performed on maxillary and mandibular teeth, eruption rate of the 2nd molars of each group have been measured on panoramic radiography, and the differences in dental age of the upper and lower jaw were analyzed under Demirijian`s method. The results were as follows: The difference of dental age of maxillary and mandibular teeth between the two groups was 0.66 and 1.20 years respectively, with a higher difference in the experimental group (p 0.05).

Amac : Bu calismanin amaci; farkli sagittal iskeletsel iliskiye sahip bireylerde, frontal sinus morfolojisini postero-anterior sefalometrik radyograflar kullanarak arastirilmasidir. Gerec ve Yontem : 75 bireyden olusan calisma cenelerin sagittal iskeletsel iliskisine gore 3 gruba ayrilmistir (Sinif I bireyler; ortalama yas: 15,14±1,40 yil, Sinif II bireyler; ortalama yas: 15,21±1,77 yil, Sinif III bireyler; ortalama yas: 15,16±1,57 yil). Frontal sinusun sag ve sol maksimum yuksekligi ve genisligi, maksiller genislik, nazal genislik, kranial genislik ve antegonial genislik parametreleri 75 postero-anterior sefalometrik radyograf uzerinde olculmustur. Veriler bagimsiz t, Mann Whitney U, tek yonlu varyans analizi ve Kruskal-Wallis testleri kullanilarak analiz edilmistir. Bulgular : Sag frontal sinus yuksekligi, sol frontal sinus yuksekligi ve genisligi gruplar arasinda istatistiksel olarak anlamli farklilik gostermistir ( P

OZET Amac: Bu calismanin amaci sagital yonde iskeletsel malokluzyona sahip olan ve olmayan hastalarin kemik yasini karsilastirmak ve kizlar ve erkekler arasindaki farkliligi kiyaslamaktir. Bireyler ve Yontem: Orneklem buyuklugu klinigimize basvurmus 120 hastadan olusmaktaydi (Ortalama yas 12,00±1,10). Kemik yasi her bir cinsiyet ve iskeletsel sinif icin Greulich ve Pyle standartlari atlasi kullanilarak konvansiyonel el bilek rontgeninden hesaplandi. Her iki cinsiyet icin iskeletsel siniflar arasindaki karsilastirma tek yonlu ANOVA ile yapildi. Gruplar arasindaki bireysel farkliliklari belirlemek amaciyla tukey post hoc testi kullanildi. Her bir gruptaki bireylerin kemik yasi ve kronolojik yasi arasindaki ortalama farklar paired t-testi ile test edildi. Bulgular: Sinif I, Sinif II ve Sinif III malokluzyonlu kizlar icin ortalama kemik yasi ortalama kronolojik yastan sirasiyla 0,43, 0,22, ve 0,61 yil ileriydi (P=0,051, P=0,228, ve P=0,003). Sinif I, Sinif II ve Sinif III malokluzyonlu erkekler icin kemik yas...

The correction of skeletal Class III malocclusion with severe mandibular prognathism in an adult individual requires surgical and Othodontic combination therapy. The inter disciplinary approach is the treatment of choice in most of the skeletal malocclusions. A case report of an adult individual with Class III malocclusion, having mandibular excess in sagittal and vertical plane and treated with orthodontics,, bilateral sagittal split osteotomy and Le - Forte I osteotomy for the correction of skeletal, dental and soft tissue discrepancies is herewith presented. The surgical-orthodontic combination therapy has resulted in near-normal skeletal, dental and soft tissue relationship, with marked improvement in the facial esthetics in turn, has helped the patient to improve the self-confidence level.

Amelogenesis imperfecta (AI) is a set of hereditary defects representing the development and clinical appearance of enamel without the presence of whole body symptoms. An esthetic and functional approach must be aspired for these patients to improve the life quality. There was various type of AI and they can be cause of defects on multiple teeth and skeletal malocclusion. Teeth extraction, endodontic treatment of remaining teeth before post and core restorations, esthetic and functional crown lengthening, fixed dental prostheses are include the rehabilitation. This article represents, a patient referred to our clinic suffering from AI who overcame the esthetical and functional problems by receiving multidisciplinary team rehabilitation and must be monitored at periodically for ensuring long-term success to the restorations, Amelogenesis imperfecta (AI) kalıtımsal bozuklukların gelişimini temsil eden ve klinik olarak mine varlığının tamamlanamadığı bir vücut semptomları dizisidir. Bu hastaların yaşam kalitesini arttırmak için estetik ve fonksiyonel bir yaklaşım düşünülmelidir. Çeşitli AI tipleri vardır; bunlar birden çok diş ve iskeletsel maloklüzyon bozukluğuna neden olabilirler. Uygulanacak rehabilitasyon dişlerin çekimini, kalan dişlerin post–core restorasyonlar öncesi endodontik tedavilerini, estetik ve fonksiyon amaçlı kron boyu uzatma işlemini ve sabit diş protezlerini içerir. Bu makalede kliniğimize sevk edilen AI’lı bir hastanın estetik ve fonksiyonel problemlerinin multidispliner tedaviler ile nasıl giderildiği anlatılmaktadır. Restorasyonların uzun dönem başarısı için periyodik kontrollerin yapılması gerekmektedir.

The use of functional jaw orthopedics, at the correct time during growth, can ultimately result in malocclusion patients achieving a broad beautiful smile, an excellent functional occlusion, a full face with a beautiful jaw line and lateral profile. Following is a case report of a young growing individual with mandibular retrognathia. Treatment was planned in two stages with the use of twin block during the first phase for correction of skeletal malocclusion and forward positioning of the mandible, followed by the second phase of fixed pre-adjusted edgewise orthodontic appliance for camouflaging the remaining skeletal discrepancy and achieving a stable harmonious occlusion.

Objective: to study the prevalence of skeletal malocclusion (SMO) cases in the orthodontic and maxillofacial surgery unit of King Khalid university health center / Aseer central Hospital (KKUHC) in the southern Aseer region of Saudi Arabia (SSA) where no previous epidemiological data took place. Materials and methods: A retrospective chart review of all the cases visiting the orthodontic / maxillofacial surgery unit at KKUHC from September 2010 to August 2012 was reviewed. All the pertinent data were extracted and tabulated for investigation while incomplete records were eliminated. Results: A total of 364 completed charts were included in the study and all the pertinent data were extracted and tabulated. It was found that 42% of the cases had skeletal malocclusion (SMO) while 58% had dental maocclusion only. Class 3 SMO represented the majority of the cases scoring 49% of the records. The female to male ratio was 1:3.2, which is significantly lower than other recorded studies. Conclusion: SMO deformity was found to be a common presentation in the SSA health care center where class 3 comprised the majority unlike other areas in the country.

Introduction: The hyoid bone and its relation with the pharyngeal space in health and disease has been an intriguing subject for years. Aim: This study attempts to evaluate the hyoid bone position and to ascertain any correlations with pharyngeal airway space in skeletal class I, II, and III malocclusions. Materials and Methods: McNamara′s airway analysis was carried out to assess the upper and lower airway widths and Hyoid triangle analysis by Bibby and Preston was carried out to determine the position of the hyoid bone. Conclusion: A positive correlation was found between the lower airway and horizontal distance from the hyoid bone to the retrognathion in class I skeletal pattern with average growth pattern.

Objective The aim of this study was to combine the huge amount of information of low dose Cone Beam CT with a cephalometric simplified protocol thanks to the latest informatics aids. Lateral cephalograms are two-dimensional (2-D) radiographs that are used to represent three-dimensional (3-D) structures. Cephalograms have inherent limitations as a result of distortion, super imposition and differential magnification of the craniofacial complex. This may lead to errors of identification and reduced measurement accuracy. The advantages of CBCT over conventional CT include low radiation exposure, imaging quality improvement, potentially better access, high spatial resolution and lower cost. Materials and methods This study assessed cephalometric 2D and 3D measurements and the analysis of CBCT cephalograms of the volume and centroid of the maxilla and mandible, in 10 clinical cases. Results With a few exceptions the linear and angular cephalometric measurements obtained from CBCT and from conventional cephalograms did not differ statistically (p > 0.01). There was a correlation between the variation in the skeletal malocclusion and growth direction of the jaws, and the variation in the spatial position (x, y, z) of the centroids and their volumes (p Conclusions The 3D cephalometric analysis is easier to interpret than 2D cephalometric analysis. In contrast to those made on projective radiographies, the angular and linear measurements detected on 3D become real, moreover the fewest points to select and the automatic measurements made by the computer drastically reduced human error, for a much more reliable reproducible and repeatable diagnosis.

Background: Skin is the largest human organ, which performs a dynamic role in life. The ectodermal layers of the skin found on the palm with intricate lines are stable throughout life and have grabbed scientific attention. Any disturbances during their formation might possibly have the likelihood of a person developing malocclusion. Aims and Objectives: The aims of this study were to evaluate and compare the dermatoglyphic pattern with various skeletal malocclusions. Materials and Methods: The study was carried out on 40 outpatients reported with an age group of 18–20 years divided into four groups as follows: Group: I – 10 (Class I occlusion), Group: II – 10 (skeletal Class I malocclusion), Group: III – 10 (skeletal Class II malocclusion), and Group: IV – 10 (skeletal Class III malocclusion). The fingerprints were recorded using scanner exclusively designed for diagnostic purpose of the study. The collected data were analyzed using SPSS statistics software Version 23.0 to find which groups had significant differences. Results and Conclusion: Increased frequency of arch pattern was present in participants with Class I malocclusion, and loop patterns were observed in those with Class I occlusion and Class III malocclusion and whorl patterns in Class II malocclusion with P < 0.05. Dermatoglyphic pattern remains constant throughout life and it can be used as a noninvasive aid in determining the development of malocclusion at a very early age.

Aim: The present study was aimed to investigate the variation of soft palate morphology and Need's ratio in various sagittal skeletal malocclusions. Materials and Methods: The study was conducted on 300 individuals (aged 15–25 years) who presented to the department of orthodontics for orthodontic treatment. The participants were divided into skeletal Class I, II, and III based on ANB angle on the lateral cephalogram. The soft palate morphology was examined and individuals were grouped into six types. The Need's ratio was calculated for all the participants by division of pharyngeal depth by soft palate length. The results were then subjected to statistical analysis to find the association between morphological variants of soft palate and skeletal malocclusions. Results: The most common type of soft palate was leaf shaped and the least common was S shaped. Leaf-shaped soft palate was the most common in males and rat tail-shaped soft palate was common in females. Individuals with skeletal Class I malocclusion were most frequently found to have leaf-shaped soft palate, skeletal Class II malocclusion had rat tail type, and skeletal Class III had leaf shape and crooked shape in equal proportions. Need's ratio was maximum in skeletal Class III and minimum in Class II malocclusions. Conclusions: There was a significant correlation between the variants of soft palate and the types of skeletal malocclusion in North Indian individuals. The knowledge of morphological variants of soft palate helps the clinician in etiological study of obstructive sleep apnea syndrome, snoring, and other conditions.

one another. Malocclusion is a common occurrence in dogs but the only time when it is of clinical significance is when the malocclusion results in discomfort or pain. This discomfort may result from tooth-on-tooth contact or more importantly when there is soft tissue trauma caused by a tooth or teeth. Malocclusions can result from either a jaw length discrepancy (skeletal malocclusion) or from a malpositioned tooth or teeth (dental malocclusion). Mandibular brachygnathism is an example of a skeletal malocclusion, resulting from a relatively shorter lower jaw. Skeletal malocclusions are always considered to be an inheritable condition.

Malocclusion occurs where the relationship between maxillary and mandibular dentition is abnormal. This may be due to the individual position of teeth within the jaw or the relationship between maxilla and mandible. There are thus two main types of malocclusion: 1. Skeletal malocclusion due to jaw size and shape relationships 2. Dental malocclusion due to the position or morphology of individual teeth.

The relationship between cranial base flexion and facial prognathism has been of interest to orthodontists, orthognathic maxillofacial surgeons, and plastic surgeons. This study aimed to identify the cranial base flexion of adults with anteroposterior skeletal disharmony. Because the sample was representing a mixed racial population, the authors performed an investigation to confirm an association with other researches performed in different parts of the world. The results revealed an increase in the cranial base flexion in cases diagnosed as class II skeletal pattern and reduction in the group with class III skeletal pattern. These findings suggested that the characteristics of the Brazilian cases did not differ from some other studies despite various influences of different ethnicities in that population.

OBJETIVO: a finalidade deste trabalho é avaliar os resultados de tratamento de pacientes com desarmonias esqueléticas Classe III e discrepâncias transversas, tratados com a técnica de expansão maxilar assistida cirurgicamente, associada à mecânica de tração reversa. METODOLOGIA: Foram avaliados 10 pacientes portadores de Classe III esquelética e discrepância transversal, submetidos à expansão maxilar assistida cirurgicamente e ao uso de máscara facial. A avaliação das alterações ortodônticas e ortopédicas foram realizadas por meio dos exames clínico e radiográfico. CONCLUSÃO: os resultados clínicos e radiográficos demonstraram eficiência nestes procedimentos, evitando nova cirurgia de maxila, diminuindo a morbidade do tratamento e o seu custo. AIM: The purpose of this article is to evaluate the correction of anteroposterior and transverse maxillary deficiency in adult patients with the use of facial mask and surgically assisted RME (SARME). METHODS: Reverse traction of the maxilla was applied to 10 subjects through a facial mask after a SARME. All individuals presented a Class III skeletal malocclusion. Cephalometric tracings were used to access the amount of anterior maxillary displacement during treatment. RESULTS AND CONCLUSION: The association of these procedures promoted transverse correction and anterior displacement of the maxilla. This approach avoided a two step correction - one for SARME and other for maxillary advancement, reducing morbidity and costs of treatment.

Objective: To compare soft tissue changes in Class I borderline cases treated with extraction and nonextraction modalities. Methods: A parent sample of 150 patients with Class I dental and skeletal malocclusion (89 patients treated with premolar extraction and 61 patients without extraction) was randomly selected and subjected to discriminant analysis which identified the borderline sample of 44 patients (22 extraction and 22 nonextraction patients). Pretreatment and post-treatment cephalograms of the borderline subsample were analyzed using 22 soft tissue parameters. Results: Upper and lower lips were more retracted and thickness of the upper lip increased more in the borderline extraction cases (p < 0.01). The nasolabial angle became more obtuse and the interlabial gap was reduced in the borderline extraction cases (p < 0.01). Lower lip, interlabial gap and nasolabial angle showed no changes in the borderline nonextraction cases. Conclusion: The soft tissue parameters which can be used as guideline in decision making to choose either extraction or nonextraction in Class I borderline cases are upper and lower lip protrusion in relation to the E-plane and Sn-Pg' line, lower lip protrusion in relation to the true vertical line (TVL), upper lip thickness, nasolabial angle and interlabial gap. RESUMO Objetivo: comparar as alterações sofridas nos tecidos moles em casos limítrofes de Classe I tratados com extrações e sem extrações. Métodos: uma amostra inicial de 150 pacientes com má oclusão esquelética e dentária de Classe I (89 pacientes tratados com extrações de pré-molares e 61 pacientes tratados sem extrações) foi aleatoriamente selecionada e submetida a uma análise discriminante, a qual permitiu selecionar uma amostra de 44 pacientes limítrofes (22 tratados com extrações e 22 tratados sem extrações). Telerradiografias obtidas antes e depois do tratamento dessa subamostra de pacientes limítrofes foram analisadas, utilizando-se 22 grandezas em tecidos moles. Resultados: nos casos limítrofes tratados com extrações, houve maior retração dos lábios superior e inferior e um maior aumento na espessura do lábio superior (p < 0,01); bem como o ângulo nasolabial tornou-se mais obtuso e o espaço interlabial sofreu redução (p < 0,01). Já nos casos limítrofes tratados sem extrações, o lábio inferior, o espaço interlabial e o ângulo nasolabial não apresentaram alterações significativas. Conclusão: as grandezas em tecidos moles que podem ajudar na tomada de decisão entre o tratamento com e sem extrações nos casos limítrofes de Classe I são: protrusão dos lábios superior e inferior em relação ao plano E e em relação à linha Sn-Pg', protrusão do lábio inferior em relação à linha vertical verdadeira (LVV), a espessura do lábio superior, o ângulo nasolabial e o espaço interlabial.

Objective: No study has investigated the relationship between maxillary sinus findings and skeletal malocclusion based on cone-beam computed tomography (CBCT). The objectives of this study were to determine the relationship between the frequency of sinus findings and patients' skeletal malocclusion classification. Materials and Method: A total of 105 CBCT scans were examined and divided into 3 groups according to skeletal classification. Two experienced observers reviewed the CBCT images and recorded all maxillary sinus findings. The patients' skeletal malocclusion, the thickness of the Schneiderian membrane, and the pathologic sinus findings were evaluated. Results: The sinus findings were classified into 4 groups: 0 = no finding, 1 = mucosal thickening, 2 = partial opacification with liquid accumulation, and 3 = total opacification. The statistical analysis showed that there was no correlation between the skeletal malocclusion and pathological sinus findings. However, there were significant dif...

This study evaluated associations between craniofacial candidate genes and skeletal variation in patients with malocclusion. Lateral cephalometric radiographs of 269 untreated adults with skeletal classes I, II, and III malocclusion were digitized with 14 landmarks. Two-dimensional coordinates were analyzed using Procrustes fit and principal component (PC) analysis to generate continuous malocclusion phenotypes. Skeletal class classifications (I, II, or III) were used as a categorical phenotype. Individuals were genotyped for 198 single-nucleotide polymorphisms (SNPs) in 71 craniofacial genes and loci. Phenotype-genotype associations were tested via multivariate linear regression for continuous phenotypes and multinomial logistic regression for skeletal malocclusion class. PC analysis resulted in 4 principal components (PCs) explaining 69% of the total skeletal facial variation. PC1 explained 32.7% of the variation and depicted vertical discrepancies ranging from skeletal deep to open bites. PC1 was associated with a SNP near PAX5 ( P = 0.01). PC2 explained 21.7% and captured horizontal maxillomandibular discrepancies. PC2 was associated with SNPs upstream of SNAI3 ( P = 0.0002) and MYO1H ( P = 0.006). PC3 explained 8.2% and captured variation in ramus height, body length, and anterior cranial base orientation. PC3 was associated with TWIST1 ( P = 0.000076). Finally, PC4 explained 6.6% and detected variation in condylar inclination as well as symphysis projection. PC4 was associated with PAX7 ( P = 0.007). Furthermore, skeletal class II risk increased relative to class I with the minor alleles of SNPs in FGFR2 (odds ratio [OR] = 2.1, P = 0.004) and declined with SNPs in EDN1 (OR = 0.5, P = 0.007). Conversely, skeletal class III risk increased versus class I with SNPs in FGFR2 (OR 2.2, P = 0.005) and COL1A1 (OR = 2.1, P = 0.008) and declined with SNPs in TBX5 (OR = 0.5, P = 0.014). PAX5, SNAI3, MYO1H, TWIST1, and PAX7 are associated with craniofacial skeletal variation among patients with malocclusion, while FGFR2, EDN1, TBX5, and COL1A1 are associated with type of skeletal malocclusion.

Objective: To assess skeletal and dentoalveolar effects of fixed functional appliances, alone or in combination with multibracket appliances (comprehensive treatment), on Class II malocclusion in pubertal and postpubertal patients. Materials and Methods: Literature survey was conducted using the Medline, SCOPUS, LILACS, and SciELO databases and The Cochrane Library, and through a manual search. The studies retrieved had to have a matched untreated control group. No restrictions were set regarding the type of fixed appliance, treatment length, or to the cephalometric analysis used. Data extraction was mostly predefined at the protocol stage by two authors. Supplementary mandibular elongation was used for the meta-analysis. Results: Twelve articles qualified for the final analysis of which eight articles were on pubertal patients and four were on postpubertal patients. Overall supplementary total mandibular elongations as mean (95% confidence interval) were 1.95 mm (1.47 to 2.44) and 2.22 mm (1.63 to 2.82) among pubertal patients and −1.73 mm (−2.60 to −0.86) and 0.44 mm (−0.78 to 1.66) among postpubertal patients, for the functional and comprehensive treatments, respectively. For pubertal subjects, maxillary growth restraint was also reported. Nevertheless, skeletal effects alone would not account for the whole Class II correction even in pubertal subjects with dentoalveolar effects always present. Conclusions: Fixed functional treatment is effective in treating Class II malocclusion with skeletal effects when performed during the pubertal growth phase, very few data are available on postpubertal patients.

Objective: This study was carried out to ascertain if the position of the hyoid bone demonstrates sexual dimorphism. Materials and Methods: This was a retrospective cross-sectional study conducted using patient records from the institution. Institutional Ethical Committee approval was obtained prior to the study. A total of 60 subjects were divided into three groups and studied. Hyoid triangle analysis by Bibby and Preston was carried out to determine the position of the hyoid bone. All radiographs were traced by a single operator and they were retraced to check for measurement error. Results: Student's t -tests and Mann-Whitney U-test were used to find out whether any sexual dimorphism exists. The horizontal distance from the hyoid bone to the retrognathion was found to be significantly larger in males than in females. The hyoid bone is positioned at a lower level in class I and II in males than in females. Also, it was observed that the hyoid angle was significantly greater in males than in females in class II group. Conclusion: Sexual dimorphism was observed in the sample studied.

This case report was submitted to the American Board of Orthodontics as part of the board-certification process. The summary of treatment and records are reprinted here much as they were submitted to the board.

The success or the failure of the orthodontic treatment accomplished in patients in the growth phase has been justified many times by the standard and the variability that this growth can present. Understanding these current changes of the growth and separating them from the changes imposed by the orthodontic treatment is the objective of this work. The superimposition cefalometric method developed by Ricketts will be used and applied to a patient with skeletal malocclusion Class II, first division, treated at the age of 9 years old and accompanied until the age of 18 years old. The mechanics used for the correction of the Class II was considered ideal since the obtained results were satisfactory, from the static point of view as well as the functional one. Besides, it was observed that a clockwise rotation of the jaw didn't take place in spite of the use of a Quad - helix, Elastic of Class II and Cervical headgear. Another important discovery was the great growth of the jaw that occurred between the beginning (T1) and the end of the treatment (T2) of 12mm or 3,5mm/year.

The objective of this study was to answer the following questions: Are profiles of Class I patients perceived as more attractive than profiles of Class II or Class III patients in Germany today? How pronounced must a skeletal malocclusion be to be perceived as less attractive? Are there differences in perception between dentists and laypersons? For the present study we examined seven patients with skeletal Class I, orthognathic maxillae and mandibles, and straight average faces (ideal biometric face as defined by A. M. Schwarz). Using the Onyx Ceph™ software, their profile lines were modified to reflect three different Class II profile variants and three different Class III profile variants. The 49 profiles thus obtained were assigned to two groups. Group 1 comprised the seven straight average faces and the first part of the retrognathic and prognathic profile variants. Group 2 comprised the same seven straight average faces and the remaining retrognathic and prognathic profile variants. Both groups of faces were scored by 130 laypersons and 126 dentists. Both groups of observers perceived the seven straight average faces similarly both in the first and second (subsequent) scoring rounds. The straight average face was perceived as most attractive by laypersons (mean, 5.48; 95% confidence interval (CI:) 5.33–5.60) and dentists (mean, 5.44; 95% CI, 5.28–5.50) alike, followed by the mildest variant of the retrognathic face (laypersons, mean, 4.85; 95% CI, 4.68–5.01; dentists, mean, 4.98; 95% CI, 4.81–5.10). Dentists differentiated more clearly by degree of skeletal malocclusion than did laypersons. Both groups alike perceived the extreme variant of the prognathic and retrognathic profile lines as the least attractive. Grouping the subjects by gender yielded only minor differences in perception. The straight average face is perceived as most attractive by representative German populations today. Dentists make clearer gradual distinctions in their perceptions than do laypersons.

Skeletal malocclusion affects dental and facial tissues. A complicating factor for diagnosis and treatment of skeletal class III malocclusion is its multifactorial etiology. Genetics play an important role in determining the facial morphology of an individual. Prediction of a skeletal class III based on morphology can play an important step in orthodontic diagnosis and treatment planning. This case report further supports the significant role of genetics in skeletal class III malocclusion. As seen in our case the skeletal class III if left untreated does not detiorate but rather shows a decrease in ANB ie anterioposterior discrepancy. Hence the need for treatment should be analysed thoroughly in skeletal class III patients.

AIM: To review the component, working ,advantage, disadvantage and treatment effects of Forsus appliance OBJECTIVES: To give a complete guide on component, working ,advantage, disadvantage and treatment effects of Forsus appliance. BACKGROUND: Forsus appliance are often used for the correction of Class II skeletal malocclusion who are at their growth. Forsus appliance is the most widely used rigid fixed functional appliance . It is used along with conventional fixed appliance and which cannot be removed by the patient, thus eliminating the need for patient compliance. REASON : A review on Forsus appliance will create awareness to the orthodontist about advantages, disadvantages and treatment effects of Forsus appliance

Background: The orofacial musculature plays a pivotal role in maintaining a balance in positioning of the teeth and any imbalance which occurs in this , results in malocclusion. Lingual frenum is a soft tissue structure which tethers the ventral surface of the tongue to the floor of the mouth. Objective: This study was performed to analyze the lingual frenal lengths in skeletal class I, class II and Class III malocclusion and to correlate relationship between both. Materials and Methods: This study comprised of 30 subjects, with 10 in each group and an impression was made with the maximum mouth opening position and the tip of tongue touching the incisive papilla. The length of the lingual frenum was then measured from the casts. The maximum mouth opening position was also determined by measuring the interincisal distance with the maximum mouth opening position. Statistical analysis was done to analyze the relationship between both. Results: The lingual frenum was found to be longest in class III malocclusion, with a statistical significant value of p

The likelihood of birth defects in orofacial tissues is high due to the structural and developmental complexity of the face and the susceptibility to intrinsic and extrinsic perturbations. Skeletal malocclusion is caused by the distortion of the proper mandibular and/or maxillary growth during fetal development. Patients with skeletal malocclusion may suffer from dental deformities, bruxism, teeth crowding, trismus, mastication difficulties, breathing obstruction and digestion disturbance if the problem is left untreated. In this review, we focused on skeletal malocclusion that affects 27.9% of the US population with different severity levels. We summarized the prevalence of class I, II and III of malocclusion in different ethnic groups and discussed the most frequent medical disorders associated with skeletal malocclusion. Dental anomalies that lead to malocclusion such as tooth agenesis, crowding, missing teeth and abnormal tooth size are not addressed in this review. We propose a modified version of malocclusion classification for research purposes to exhibit a clear distinction between skeletal vs. dental malocclusion in comparison to Angle’s classification. In addition, we performed a cross-sectional analysis on orthodontic (malocclusion) data through the BigMouth Dental Data Repository to calculate potential association between malocclusion with other medical conditions. In conclusion, this review emphasizes the need to identify genetic and environmental factors that cause or contribute risk to skeletal malocclusion and the possible association with other medical conditions to improve assessment, prognosis and therapeutic approaches. Keyword: Skeletal malocclusion; Micrognathia; Retrognathia; Prognathia; Late-onset diseases

Objectives: This study aimed at clarifying the morphological interactions among the cranial base, face, and mandible, to improve the assessment and treatment of skeletal malocclusions involving the mandible. Design Untreated adult subjects (n = 187) were grouped according to standard cephalometric criteria of vertical and sagittal relationships. Geometric morphometrics were used to test the null hypothesis that integration patterns between the mandible and its associated basicranial and upper midfacial counterparts would be similar among various vertical and sagittal facial patterns. Results: The null hypothesis was rejected for vertical groups, because the dolicho- and brachyfacial subjects showed significantly different integration patterns, but was accepted for sagittal groups, which showed identical covariation patterns. The morphological integration between the cranium-face and mandible were similarly high in the three skeletal classes, which explained the similarly large covariance between the two structures (57.80% in Class II to 60% in Class III). Conclusions: Dolicho- and brachi-facial subjects showed specific and different cranium-face and associated mandible configurations. The cranium-face configuration may have an important influence (∼60%) on the generation of sagittal (anteroposterior) skeletal malocclusions. The remaining morphological component of the skeletal malocclusion (∼40%) would be independent of this particular integration (PLS1) between the cranium-face and mandible. © 2013 Elsevier Ltd., This research was founded by the Spanish Ministry of Economy and Competitiveness (Projects CGL2012-36682 and CGL2012-37279).

Patients affected by severe maxillary atrophy and skeletal malocclusion have been widely treated by simultaneous orthognathic surgical procedures, interpositional bone insertion and immediate or delayed implant placement. Although several authors have described that the "quad" technique using 4 zygomatic fixtures as an effective way to fully rehabilitate the severe atrophic maxilla, there are still no experiences relative to the use of zygomatic fixtures associated to maxillary osteotomies in case of large skeletal discrepancy. The aim of this study is to report a 1-step surgical rehabilitation of severe atrophic maxilla by means of Le Fort I osteotomy for maxillary forward repositioning and simultaneous insertion of 4 zygomatic implants with immediate prosthetic loading.

For patients whose orthodontic problems are so severe that neither growth modification nor camouflage offers a solution, surgery to realign the jaws or reposition dentoalveolar segments is the only possible treatment. Surgery is not a substitute for orthodontics in these patients. Instead, it must be properly coordinated with orthodontics and other dental treatments to achieve good overall results. Dramatic progress in recent years has made it possible for combined surgical orthodontic treatment to be carried out successfully for patients with a severe dentofacial problem of any type. This case report provides an overview of the current treatment methodology in managing a combination of asymmetrical mandibular prognathism and vertical maxillary excess.

Introduction: In orthodontics, apart from essential diagnostic aids, there are so many soft tissue analyses in which lips are major part of concern. However, lip prints have never been used in orthodontics as diagnostic aid or forensic tool. Therefore, this study was designed to explore the possible association of lip prints with skeletal malocclusion. Materials and Methods: A sample of 114 subjects in the age group of 18-30 years, from North Indian adult population were selected on the basis of skeletal class I, class II and class III malocclusion, each comprising of 38 subjects with equal number of males and females. Lip prints of all the individuals were recorded and digital soft copies of lateral cephalograms were taken. Lip prints were compared between different skeletal malocclusions. Results: It was found that branched lip pattern was most common in North Indian adult population with no sexual dimorphism. The Z-test for proportion showed that the prevalence of vertical lip pattern was significantly higher in subjects having skeletal class III malocclusion. Conclusion: A definite co-relation of vertical lip patterns with skeletal class III malocclusion was revealed.

The diagnosis and treatment of temporomandibular disorders (TMD) remain controversial despite considerable research and publication in this area. The relationship of these problems to dental and skeletal malocclusion is equally debatable. Recent studies suggest that although malocclusion may have a role, it is a small one. Accordingly, treatment of TMD with occlusion-altering therapy, such as orthodontics and orthognathic surgery, should be limited to specific situations. This report discusses the management of patients with coexisting TMD and skeletal malocclusion. Current concepts in clinical and radiographic diagnosis are discussed, as well as an overview of noninvasive therapy. A case report is used to illustrate an approach to diagnosis and treatment planning in an individual with active TMD and a skeletal malocclusion requiring orthognathic surgery for correction.

Objective: To examine the relationship between third-molar agenesis and different skeletal malocclusion patterns. Materials and Methods: Pretreatment records of 1046 orthodontic patients (aged 13–17 years; mean age, 14.07 ± 1.27) were used. Third-molar agenesis was calculated with respect to genders, number of missing teeth, jaws, and skeletal malocclusion patterns. The Pearson chi-square test was performed to determine potential differences. Results: Among the 1046 subjects, 237 subjects were diagnosed with third-molar agenesis (22.7%) with no statistical gender difference (P > .05). It was more common in the maxilla than in the mandible or in both jaws (P < .01). The prevalence of patients with a third-molar agenesis was the most commonly found type (P < .001). The prevalence of third-molar agenesis in those with a Class III malocclusion was significantly higher than in those with Class I or Class II (P < .05). However, there was similar prevalence among the hyper-divergent (24.5%), normal (23.8%), and hypo-divergent (19.2%) groups (P > .05). Conclusion: These results suggest that agenesis of the third molar does not depend on vertical patterns of the skeletal malocclusions, but does depend on sagittal skeletal malocclusions in this orthodontic patient population.