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Objective: This case report presents a female adult patient who exhibits poor oral hygiene, a mutilated dentition with multiple missing teeth, and skeletal asymmetry. Clinical Considerations: Interdisciplinary treatment was necessary to maintain oral hygiene, treat caries, extract residual roots, and upright a horizontally impacted third molar using a miniplate. Additionally, orthodontic mini‐implants were utilized as anchorage to improve sagittal relationship and space closing. Space management was completed with orthodontic treatment, followed by restoration of the multiple missing teeth with dental implants. Conclusion: Consequently, an esthetic smile and functional occlusion were achieved by interdisciplinary treatment using orthodontic skeletal anchorage devices and dental implants. Clinical Significance: Missing mandibular first molar spaces were closed with retraction of the anterior teeth and protraction of the mandibular second molars using orthodontic mini‐implants. The mandibular right third molar, which should have erupted, was protracted with the second molar, while the horizontally impacted mandibular left third molar was uprighted using a miniplate and was protracted with an orthodontic mini‐implant. The missing maxillary lateral incisors were replaced with the maxillary canines, and the maxillary canines were replaced with the maxillary first premolars. The missing maxillary right second premolar and first molar and left first and second molars were successfully restored with dental implants. [ABSTRACT FROM AUTHOR]

A 23-year-old female patient with moderate crowding and a bilateral molar scissor-bite was successfully treated without tooth extraction. Extra-alveolar skeletal anchorage, involving a three-dimensional key plate in the maxilla and two miniscrews in the buccal shelf of the mandible, were used for distalisation, buccolingual uprighting, and the intrusion of molars by fixed orthodontic appliances. Cone-beam computed tomography was used to identify available posterior space for the distalisation and buccolingual correction of the molars in scissor-bite. The total treatment time was 24 months. Post-treatment results showed good occlusal relationships and smile aesthetics. Twelve-month post-treatment records demonstrated no significant relapse and a favourable facial balance.

Objective: This finite element analysis (FEA) aimed to assess the stress distribution in the mandible and fixation system with various directions of the intermaxillary fixation (IMF) using mini‐implants (MIs) and elastics following mandibular advancement with a bilateral sagittal split ramus osteotomy (BSSRO). Materials and Methods: A total of nine mandibular advancement models were set according to the position of the MIs (1.6 mm in diameter, 8 mm in length) and direction of the IMF elastics (1/4 inch, 5 oz). Major and minor principal stresses in the cortical and cancellous bones, von Mises stresses in the fixation system (miniplate and monocortical screws), and bending angles of the miniplate were analysed. Results: Compressive and tensile stress distributions in the mandible and von Mises stress distributions in the fixation system were greater in models with a Class III IMF elastic direction and a higher IMF elastic force than in models with a Class II IMF elastic direction and a lower IMF elastic force. The bending angle of the miniplate was negligible. Conclusions: Stress distributions in the bone and fixation system varied depending on the direction, amount of force, and position of IMF elastics and MIs. Conclusively, IMF elastics in the Class II direction with minimal load in the area close to the osteotomy site should be recommended. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this prospective study was to examine the efficacy of posterior interradicular and infrazygomatic crest mini‐implants for en‐masse anterior retraction. Methods: The 22 patients were divided into two groups. In group 1 (IZC n = 11), mini‐implants were placed in the infrazygomatic crests and in group 2 (IR, n = 11), mini‐implants were placed in the molar‐premolar interradicular sites. Soft tissue, skeletal, and dental treatment effects between two groups were compared using lateral cephalometric measurements. Results: The average angle between the cranial base and A point was 1.01 degrees (P =.004), and the linear distance between the upper incisor and A point was 2.67 to 5.2 millimetres (P =.00). In IZC group the maxillary incisor to the palatal plane moved upward by a mean of −5.20 mm (P =.059), whereas in IR group the incisor movement changed by −2.67 mm (P =.068). There was no significant difference between groups IZC and IR while comparing overall treatment changes on upper incisor position change, angle, and overjet. Conclusions: Mini‐implants placed in between the molar and premolar as well as the infrazygomatic crest can withstand the deepening of the bite during retraction. Mini‐implants in IZC are capable of causing intrusion of the anterior teeth and preventing intrusion of the molars, thereby providing absolute anchoring in all planes. Placement of the mini‐implants in the infrazygomatic crest resulted in more linear retraction. [ABSTRACT FROM AUTHOR]

Objective: This case report demonstrates an interdisciplinary approach to treat a 26‐year‐old male patient with hyperdivergent Class II skeletal pattern, maxillary transverse deficiency, slight anterior open bite, and multiple hopeless teeth with root rests. Clinical Considerations: An interdisciplinary treatment was required for oral hygiene improvement, caries treatment, extraction of residual roots and hopeless teeth, maxillary expansion using microimplant‐assisted rapid palatal expansion, improvement of skeletal and dental relationship using orthodontic microimplants, and prosthetic restorations with the aid of dental implants. Conclusion: Consequently, esthetic and functional occlusal rehabilitation was achieved. Clinical Significance: Hyperdivergent Class II facial and skeletal patterns with multiple missing teeth can be effectively treated using orthodontic skeletal anchorage. In young adults, the transverse discrepancy can be resolved using MARPE, which is also useful for improving the sagittal and vertical relationships. In the case of multiple missing teeth, orthodontic treatment can provide the proper space to facilitate dental implants to achieve optimal esthetics and function. [ABSTRACT FROM AUTHOR]

Objective: The aim of this retrospective study was to evaluate the bone density (BD) at the mandibular symphysis according to horizontal and vertical patterns using cone-beam computed tomography (CBCT).Setting and Sampling: Three hundred nineteen untreated adults with a mean age of 24 years.Materials and Methods: CBCT images were converted into the lateral cephalometric images, and tracings were performed for categorizing the patients based on skeletal features. Cortical BDs at B point, pogonion (Pog), genion (Ge) and menton (Me), and cancellous BDs of the mandibular symphysis were measured using CBCT images. Statistical analyses were performed to evaluate the effects of horizontal and vertical skeletal patterns on BDs.Results: Females exhibited higher BD than males at the Me, Pog, Ge (P < .001). Hyperdivergent skeletal pattern showed significantly higher cortical BD than normovergent and hypodivergent skeletal patterns at Me (P < .001). Normovergent skeletal pattern showed significantly higher cortical BD than hypodivergent skeletal patterns at Me (P = .001). Class II skeletal pattern showed significantly higher cortical BD than Class I and III skeletal patterns at Me (P < .001) and Ge (P < .05). Class I skeletal pattern showed significantly higher mean cortical BD than Class III skeletal pattern at B point (P = .025). Cancellous BD was higher in Class III and hypodivergent skeletal patterns than others but showed no statistical significance.Conclusions: Significant differences were identified across various skeletal patterns. Several mandibular symphyseal landmarks showed statistically significant differences in BD at Me, B point and Ge, with Me having the most statistically significant findings. [ABSTRACT FROM AUTHOR]