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Purpose: To demonstrate the effect of an orofacial myofunctional therapy intervention by an interdisciplinary team composed of a registered dental hygienist who is also a certified orofacial myologist (COM ® ), a general dentist, and an orthodontist on the elimination of oral habits and changes in dental malocclusion., Method: This case study describes a 7-year-old female who underwent an individualized myofunctional therapy program and was given supervised education on a series of exercises targeting the muscles of mastication and facial expression over 5 months. Correct oral rest postures of the tongue and the lips were also established through therapy., Results: The intervention enabled the client to eliminate multiple oral habits, which corrected oral rest postures of the lips and tongue. This correction consequently improved the client's malocclusion and further prepared the client for future orthodontic treatment., Conclusion: Myofunctional therapy facilitated the elimination of unfavourable oral habits that led to malocclusion. Eliminating oral habits better prepared the client for orthodontic treatment and retention. Use of an interdisciplinary team facilitates optimal client care., Competing Interests: The authors have declared no conflicts of interest., (Copyright © 2023 CDHA | ACHD.)

Thumb sucking and tongue thrusting habits are mostly counteracted and rehabilitated using a tongue crib. Most patients find the conventional crib difficult (due to its position and length) in the initial days of treatment and become uncooperative. Hence, few modifications are made to the traditional design of the tongue crib for easy adjustment of the crib height and angulation, which provides comfort to the patient.

Introduction: After being discarded from hospitals due to its lack of scientific evidence, medical hypnosis is once more in the spotlight thanks to neuroscience and medical imaging, which have proven its specificity. Medical hypnosis is currently enjoying real enthusiasm, and now the doors are opening not only to medical and surgical units but also to our orthodontic clinics., Materials and Methods: This article defines hypnosis and its different levels of application and the required techniques. It also explores all the different fields in which it can be used in orthodontic treatment., Discussion: Hypnosis can be applied from the very first contact with the patient and can be useful and therapeutic at every step of the process. It is useful to think of it in our discipline as a treatment in its own right contributing to heal parafunctions and tongue disorders more efficiently., (© EDP Sciences, SFODF, 2019.)

Tongue thrust, which is an oral reflex associated with sucking behaviour, may cause problems in swallowing, speech, oro-facial development and also drooling. We aimed to examine the effect of Functional Chewing Training (FuCT) on tongue thrust and drooling in children with cerebral palsy. The study included 32 children with a mean age of 58·25 ± 9·58 months who had tongue thrust. Children were divided into two groups: the FuCT group and control group receiving classical oral motor exercises. Each group received training for 12 weeks. Oral motor assessment was performed. Chewing performance level was determined with the Karaduman Chewing Performance Scale. Tongue thrust severity was evaluated with the Tongue Thrust Rating Scale. The Drooling Severity and Frequency Scale was used to evaluate drooling severity and frequency. The evaluations were performed before and after treatment. Groups were well matched in age, gender and oral motor assessment. No significant difference was found between groups in terms of pre-treatment chewing function, tongue thrust severity, drooling severity and frequency (P > 0·05). The FuCT group showed improvement in chewing performance (P = 0·001), tongue thrust severity (P = 0·046) and drooling severity (P = 0·002), but no improvement was found in terms of drooling frequency (P = 0·082) after treatment. There was no improvement in chewing performance, tongue thrust, drooling severity and frequency in the control group. A significant difference was found between groups in favour of FuCT group in tongue thrust severity (P = 0·043). This study showed that the FuCT is an effective approach on the severity of tongue thrust and drooling in children with CP., (© 2017 John Wiley & Sons Ltd.)

Since publication of the studies by the functionalist school (Ricketts, Linder-Aronson, Gola...), the role of function, and ventilation in particular, appears to be taken more widely into account. The close interconnection of ventilation / growth / lingual function and malocclusion is now evident to all. However, although an ENT diagnosis of a ventilation defect and its etiology is now standard practice, treatment of the condition is not always sufficient to ensure a functional environment conducive to orthodontic stability, even when rehabilitation is prescribed. In some instances, certain highly-invasive surgical treatments can even exacerbate the initial situation., (© EDP Sciences, SFODF, 2016.)

An anterior open bite is one of the most difficult occlusal abnormalities to treat. Quite often this aberration entails dental component and/or skeletal component. The skeletal open bite will require intrusion of the posterior sextants with the assistance of bite blocks, temporary anchorage devices, high pull headgear, and as a last resort - orthognathic surgery. The orthodontic treatment should be augmented with the orofacial myofunctional therapy. In this article, the author describes 3 different variations of treatment of the dental anterior open bite, first on acrylic models, and then on the actual patients. Consideration should be given to patients with a 'short upper lip," and in this case, surgical correction should be entertained.

This case report describes the interdisciplinary management of an adult patient with advanced periodontal disease. Treatment involved orthodontic and periodontal management. Good esthetic results and dental relationships were achieved by the treatment.

When confronted with difficult-to-eradicate dysfunctions and parafunctions, speech therapy most often proves a reliable ally to control the functional environment of the dental arches. However, a number of factors ranging from psychological issues to anatomical ENT obstructions, from genetic anomalies to iatrogenic procedures, account for the occasional mixed results achieved using this approach. In addition, our own treatment results can also be jeopardized or even obliterated by a recalcitrant tongue or one which has been inadequately provided for. The author will analyze the different factors involved through a series of clinical cases in order to outline her thinking regarding this organ, which can be either a driving force behind our treatments or a force for destruction., (© EDP Sciences, SFODF, 2016.)

An open-bite malocclusion with a tongue-thrust habit is a challenging type of malocclusion to correct. A 12-year-old girl came for orthodontic treatment with a severe anterior open bite, extruded posterior segments, a tongue-thrust habit, and lip incompetency. Her parents refused surgical treatment, so a nonextraction treatment plan was developed that used palatal temporary skeletal anchorage devices for vertical control and mandibular tongue spurs to reeducate the tongue. Interproximal reduction was also used to address the moderate to severe mandibular crowding. An abnormal Class I occlusion was achieved with proper overbite and overjet, along with a pleasing smile and gingival display., (Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Deleterious oral habits, such as non-nutritive sucking or tongue thrusting, if not intercepted at an early stage can cause complex malocclusions. This manuscript describes a clinical case report of a successful interception of a severe anterior dental open bite caused by thumb sucking and tongue thrusting habits. The case involved a six-year-old female patient treated with the use of palatal spurs and maxillary removable crib followed by monitoring the development of dental occlusion. At the end of the interceptive phase acceptable results were achieved, showing the efficacy of the treatment undertaken as well the importance of an early intervention to remove harmful oral habits.

Patients presenting reduced periodontium represent a major concern for orthodontists. The purpose of this article is to present the clinical case of an adult patient who presented sequel of periodontal disease (diastemas) compromising her dental aesthetics. She was subjected to an orthodontic treatment with the application of light forces distant from the teeth with reduced periodontium. A periodontal support therapy was successfully implemented. The final stage of the treatment indicated satisfactory occlusal and periodontal characteristics.

Objectives: This study aimed to assess behavioural and occlusal outcomes of non-orthodontic intervention (NOI) in a sample of children, 4-12 years of age, in Australia, in order to establish clinical relevance., Materials and Methods: Data from 91 patient records of 4- to 12-year-old children reporting a habit of digit sucking, from two clinics in north-eastern Australia, were de-identified and used. Each patient had been examined at two visits, separated by an interval of 4 months, using standard clinical procedures., Results: Of the 77 children who received a 4-month NOI, 69 (89.6%) had ceased their digit sucking habit by the end of the NOI period [χ2=67.0, degrees of freedom (d.f.)=1, P<0.001]. Of the 72 subjects who had front teeth, the number with anterior open bite decreased from 37 (51.4%) to 12 (16.7%) upon completion of NOI (χ2=21.3, d.f.=1, P<0.001). Among the 32 patients with a measurable overjet, the mean overjet was found to decrease from 4.2±2.4 mm to 3.1±1.9 mm after implementation of NOI (t=5.8, d.f.=31, P<0.001). Children who received NOI were more likely to quit the digit sucking habit in the 4-month period (P<0.001, OR=51.8, 95% CI: 9.8-273.9) and were more likely to appear without anterior open bite at a 4-month recall (P<0.001, OR=30.0, 95% CI: 5.9-151.6)., Conclusions: This study demonstrated clinical relevance of NOI on the cessation of a digit sucking habit, closure of anterior open bite and reduction of overjet. Further investigations are indicated., (© 2015 FDI World Dental Federation.)

Unilateral Brodie bite, called also Scissor bite, is a form of transversal malocclusion that often leads to minor facial asymmetry. The prevalence of this form of malocclusion is rare, especially met in mixed denture. We report a case of 11-year-old girl who presents unilateral scissor bite related to oral habits, with a skeletal class II. Modified activation by contraction of a bi-helix appliance was used to treat the unilateral scissor bite occlusion, before approaching the correction of the sagittal relationship.

Several studies have demonstrated the beneficial role of functional tongue therapy in stabilizing treatments for dental malocclusion and treating sleep-disordered breathing (SDB). The aim of this retrospective study was to evaluate the effect on the upper airways of the Tongue Right Positioner device (TRP) used for the correction of atypical swallowing. We analyzed lateral headfilms of 94 orthodontic patients aged between 11 and 17, before the start of treatment and after establishment of mature swallowing, treated with the TRP (TRP group) or by reeducation exercises (control group). In the TRP group, the establishment of mature swallowing occurs twice as fast as in the control group. This led to thinning of the floor of the mouth (-8.38%, P<0.001) linked to anteroposterior enlargement of the pharynx (+10.48%, P<0.01), both probably due to an increase in genioglossal and styloglossal muscle tone and correction of cranio-cervical posture (+2.52%, P<0.01). These results are not dependent on the type of orthodontic treatment. They suggest that the TRP could be used in the treatment of SDB., (Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Anterior open bite is one of the most challenging malocclusions for orthodontic treatment. The high incidence of relapse is a major concern. Therefore, accurate initial examination, diagnosis, treatment plan, and consideration of habitual risk factors are crucial for a successful outcome without unwanted sequelae. Excellent patient compliance for retainer wear is also a critical factor. This case report shows the 3-year stability of a nonsurgical and nonextraction orthodontic treatment of a 5-mm anterior open-bite malocclusion in a 12-year-old girl with extrusion mechanics and habit modification. After 2 years of orthodontic treatment, excellent outcomes were achieved. With an appropriate retention protocol, the long-term stability of the treatment was favorable., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

This article describes efficient techniques for distalization of maxillary and mandibular molars with the assistance of Temporary Anchorage Devices (TADs). There are numerous occasions where the distalization of molars is required in lieu of the odontectomy of bicuspids. In the past, extra-oral force has been used, (i.e. Cervical or Combination Head Gear, or intra-oral force, i.e. Posterior Sagittal Appliance, Modified Greenfield Appliance, Williams DMJ 20001, CD Distalizer, Magill Sagittal, Pendulum Appliance, etc.). All the intra-oral appliances have a common denominator the orthodontic clinician has to deal with, the undesirable expression of the Third Law of Newton. The utilization of TADs allows us to circumvent this shortcoming, establishing an absolute anchorage, and thus completely negate the expression of the Third Law of Newton.

This case report demonstrates the treatment effects of palatal crib combined with the myofunctional therapy in a child with anterior open bite (AOB) due to thumb sucking and habitual anterior and low tongue position. The patient, an 11-year-old boy, had an anterior open bite and flared and spaced upper and lower incisors. Palatal cribs in conjunction with myofunctional therapy were used to discourage sucking habit and to adapt normal tongue position. Successful correction of the AOB with adequate overjet and overbite were achieved with total treatment time of 7 months. The importance of myofunctional therapy in adopting normal tongue position and in maintaining the stability of open bite correction is emphasized.

Background: The purpose of this single blind, prospective, parallel randomized trial study was to compare the effects of face mask and fixed tongue appliance in treatment of Class III malocclusion with maxillary deficiency in growing patients., Methods: 88 patients with maxillary deficiency were selected. 60 fulfilled the study requirements. The patients were randomly assigned to 2 groups by computer generated tables. One group was treated with removable face mask and the other group was treated by fixed tongue appliance. 4 of the patients dropped out of study leaving a final number of 56 patients. Thus, the face mask group included 30 patients (13 males, 17 females) with the mean age of 8.5 (SD 1.4) years and the fixed tongue appliance group included 26 patients (13 males, 13 females) with the mean age of 8.9 (SD 1.7) years. The patients Lateral cephalograms obtained at the beginning and end of the study were analyzed., Results: Paired t-tests showed that SNA increased by 1.3° (SD 1.1°) in face mask group (P<0.001) and it increased by 1.8° (SD 0.9°) in fixed tongue appliance group (P<0.001). T-test showed that there were no statistically significant differences between the two groups except for SNB. IMPA decreased significantly in both groups., Conclusions: Both treatment modalities were successful in moving the maxilla forward and improving the profile of the patients; however, the bulky size of face masks might reduce patients' compliance and make them less favorite choice of treatment.

Multiple idiopathic external root resorption is a rare pathological condition usually detected as an incidental radiographic finding. External root resorption of permanent teeth is a multifactorial process related to several local and systemic factors. If an etiological factor cannot be identified for root resorption, the term "idiopathic" is applied. This report presents a case of multiple idiopathic apical root resorption. The condition was found in a young female patient seeking orthodontic treatment due to malocclusion. This kind of resorption starts apically and progresses coronally, causing a gradual shortening and rounding of the remaining root. Patients with this condition are not the ideal candidates for orthodontic treatment; however, the aim of this report is to describe an unusual case of idiopathic root resorption involving the entire dentition, and to present the orthodontic treatment of this patient. It describes the progress and completion of orthodontic therapy with satisfactory end results.

As most of the etiologic factors of malocclusion are of genetic origin and thus cannot be prevented, environmental causative factors have become the focus for correction. Early interception of oral habits may be an important step in order to prevent occlusal disturbances in children. The identification of an abnormal habit and the assessment of its potential immediate and long-term effects on the dentition and potentially on the craniofacial complex should be made at an early stage. This paper focuses on the most common oral habits influencing dentofacial growth in childhood and management of these habits in the developing dentition.

This article describes the technique and advantages of vertical dimension-primary molar buildups (VD-PMB's). These primary molar buildups help correct the vertical dimension on overclosed children from 3 to 12 years old. The advantages of these VD-PMB's are enormous, with very little or no disadvantages when placed correctly. This is a very important procedure for the orthodontist because opening the bite on these children has many beneficial results. It changes the resting tongue position, changes the slope of the anterior border of the glenoid fossa from steep to normal on Class 2 div 2 patients, corrects overclosure and otitus media with effusion (ear infections). It is important for the orthodontist since it is very simple and an easy way to correct overclosure on class 2 patients, which is often not done in the correction of overclosed patients.

Introduction: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite., Methods: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead., Results: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period.

The origins of Orofacial Myofunctional Therapy began in the early 1960's by orthodontists who recognized the importance of functional nasal breathing, proper swallowing, and more ideal oral rest postures. Re-patterning these functions through myofunctional therapy assisted with better orthodontic outcomes and improved stability. Experts in orofacial myology have concluded that improper oral rest postures and tongue thrusting may be the result of hypertrophy of the lymphatic tissues in the upper airway. Orthodontists are aware of the deleterious effects these habits have on the developing face and dentition. Sleep disordered breathing is a major health concern that affects people from infancy into adulthood. Physicians who treat sleep disorders are now referring patients for orofacial myofunctional therapy. Researchers have concluded that removal of tonsils and adenoids, along with expansion orthodontics, may not fully resolve the upper airway issues that continue to plague patients' health. Sleep researchers report that the presence of mouth breathing, along with hypotonia of the orofacial muscular complex, has been a persistent problem in the treatment of sleep disordered breathing. Orofacial myofunctional disorders (OMDs) coexist in a large population of people with sleep disordered breathing and sleep apnea. Advances in 3D Cone Beam Computed Tomography (CBCT) imaging offer the dental and medical communities the opportunity to identify, assess, and treat patients with abnormal growth patterns. These undesirable changes in oral structures can involve the upper airway, as well as functional breathing, chewing and swallowing. Leading researchers have advocated a multidisciplinary team approach. Sleep physicians, otolaryngologists, dentists, myofunctional therapists, and other healthcare professionals are working together to achieve these goals. The authors have compiled research articles that support incorporating the necessary education on sleep disordered breathing for healthcare professionals seeking education in orofacial myology.

The LCR Appliance if fabricated and used properly, has many advantages over the Herbst and Twin Block appliances in solving tongue thrust, mandibular deficiency and repositioning with proper mandibular advancement and mandibular growth results. The regular Chateau appliance was named in 1904 after Dr. Chateau in Franc. It was originally used in Europe but was an uncomfortable removable appliance with wires used in the mandibular anterior lingual area to reposition the mandible.

In addition to sucking habits, a range of other habits have been associated with short- and long-term dental and orthodontic problems. These habits include tongue thrusting and atypical swallowing, lip sucking, oral self-mutilation, mouth breathing, and bruxism. Although the association between form and function continues to be controversial, if habits are of sufficient duration they may lead to dental malocclusion and impede successful management. Oral self-injury and bruxism can lead to significant problems, such as soft tissue trauma and infection. Accurate history taking and examination are essential steps in formulating a diagnosis and management plan. Although a range of treatment options are often available, clear guidelines for treatment are difficult to develop due to a lack of high quality clinical trials. Optimal management is likely to be dictated by patient and severity variability. The purpose of this paper is to review and discuss the management of tongue thrust and atypical swallowing, lip sucking, oral self-mutilation, mouth breathing and bruxism.

Orthodontic treatment alone, or combined with maxillo-facial surgery, can benefit from a kinesthetic therapy approach. This method of functional management, set in place as soon as the orthodontic diagnosis is made, will allow for a comprehensive therapeutic approach to patients, marked by a dialogue, between the different players involved in treatment, orthodontists and maxillofacial surgeons who intelligently work in concert., (© EDP Sciences, SFODF, 2014.)

An 8-year-old Chinese girl sought treatment for a severe skeletal Class III malocclusion and open-bite skeletal pattern. Traditionally, patients with a skeletal Class III malocclusion are treated after they have stopped growing, and then they are treated with a combined orthodontic and orthognathic surgery approach. But the risks and expenses of this treatment plan are not acceptable to all patients. This young patient was treated with facemask therapy, a maxillary expansion device, and a molar occlusal splint for maxillary developmental stimulation with control of vertical jaw growth. After the completion of orthopedic therapy, 2 × 4 technology was used to adjust molar positions. A bonded tongue crib was used in the early permanent dentition to help the patient break her bad tongue habits. Straight-wire appliances were used for 16 months to adjust the occlusal relationship. This achieved significant improvement in anterior tooth relationships and facial profile esthetics. At the 2-year posttreatment follow-up, the results were satisfactory. The success of the sagittal relationship correction between the maxilla and the mandible for a skeletal Class III malocclusion depends on the coordination of transverse and vertical relationships combined with the growth potential of each patient., (Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Aim: Atypical swallowing is a myofunctional problem consisting of an altered tongue position during the act of swallowing. High incidence in population, multifactorial etiology and the recurring connection with the presence of malocclusions made it a topic of strong interest and discussion in science. The purpose of this review is to illustrate the current orientation on the topic of atypical swallowing, trying in particular to answer two questions: 1) what kind of connection is there between atypical swallowing and malocclusion; 2) what kind of therapy should be used to solve it., Methods: This review was conducted on the Medline database [www.ncbi.nim.nih.gov/pubmed] searching for the keywords "atypical swallowing" and "tongue thrust". We examined all the documents from the year 1990 onwards, excluding the ones about syndromic cases of the central motor system., Results: The causal relation between the two problems seems to be biunique: some authors affirm that this oral habit starts as a compensation mechanism for a preexisting malocclusion (especially in case of open-bite); other texts show that it has a tendency to exacerbate cases of malocclusion; it is also proven that a non-physiological tongue thrust can negatively influence the progress of an ongoing orthodontic therapy. Thereby, the best therapeutic approach seems to be a multidisciplinary one: beside orthodontics, which is necessary to correct the malocclusion, it is essential to set up a myofunctional rehabilitation procedure to correct the oral habit, therefore granting long time permanent results. There is also proof of a substantial difference between the results obtained from early (deciduous or primary mixed dentition) or later treatments., Conclusion: The biunique causal relation between atypical swallowing and malocclusion suggests a multidisciplinary therapeutic approach, orthodontic and myofunctional, to temporarily solve both problems. An early diagnosis and a prompt intervention have a significantly positive influence on the therapy outcome.

Unilateral posterior crossbites have been reported to be one of the most prevalent malocclusions of the primary dentition in Caucasian children. Facial asymmetry due to lateral mandibular displacement in unilateral posterior crossbite, if not treated in the primary dentition period, may lead to an undesirable growth modification which results in facial asymmetry of skeletal origin. Irregular tongue function and posture have also been diagnosed as important etiological factors. Early orthodontic treatment seems to be profitable and desirable to create conditions for normal dental, functional and skeletal development of the orofacial region. Treatment success after correction of unilateral posterior crossbite in the primary dentition is highly questionable, as it is very difficult to objectively assess correction of facial asymmetry and irregular tongue function and posture in small, growing children. Although facial photography is an important diagnostic tool in orthodontics, its main disadvantage is that it represents a three dimensional subject in two dimensions. Tongue posture and function during clinical examination are difficult to assess and is therefore unreliable. Contemporary 3D diagnostics in unilateral posterior crossbite enables uninvasive, valid and objective assessment of facial morphology, palatal volume, tongue function and posture. It can, therefore, become in the future an important part of morphological and functional diagnostics in orthodontics and dentofacial orthopedics before, during and after orthodontic treatment., (© EDP Sciences, SFODF, 2014.)

The aim of this study is to report five cases of children treated with an interceptive technique utilizing ALF (Advanced Light Force) functional orthodontic appliances in anterior and/or posterior cross bites in primary and early mixed dentition.

Many methods have been used to correct abnormal tongue habits. A mechanical device such as tongue spurs or cribs offers help till they are in the mouth, but the habit often returns when the device is removed. Patients with tongue thrusting habits complain to their clinician, of reopening of spaces, proclination of anteriors and contraction of arch, though the clinician successfully treated the case.

Orofacial myologists are frequently called upon to address retained oral habit concerns. During this process, current I.A.O.M. recommended treatment includes addressing tongue, lip, and jaw rest posture concerns. Following digit sucking remediation, we may also be called upon to address these rest posture issues, and tongue thrust more aggressively together. In this process, facial growth and development and jaw structure may coincidentally improve as a result of 'nature taking its course' by addressing both swallow AND rest posture. In a select subset of clients, dramatic improvements may occur if the timing is right. This article discusses one such case that appears to have yielded a significant improvement in oral postures influencing improved facial and oral growth and development.

Aim: A longitudinal casecontrol study, designed to analyse the isolated effect of attached palatal spurs in patients displaying a dentoalveolar anterior open bite, is presented., Methods: Thirty-one patients (mean age of 13.3 years +/- 3.17 years) underwent a standardised treatment protocol with fixed anterior spurs for 8.3 months. Lateral cephalograms and plaster casts were analysed before (T1) and after spur therapy (T2). The data were tested using paired t-tests with a significance level of p < 0.05., Results: The cephalometric analysis showed significant elongation of the height of the maxillary (mean +1.22 mm) and the mandibular (mean +1.39 mm) alveolar processes, as well as uprighting of the lower anterior teeth. The plaster cast analysis showed an increase in maxillary intermolar width (mean +0.98 mm) and a decrease in intercanine distance (mean -0.96 mm). The mandibular anterior width and dental arch length reduced. Overall, spur therapy resulted in a significant increase in overjet and overbite., Conclusion: The use of spurs produced a resolution of the open bite in all patients. Therefore, spurs could be considered an effective mechanism for the management of anterior open bite in selected adolescent patients.

Introduction: In nongrowing patients with skeletal Class II malocclusion, premolar extraction or maxillary distalization can be used as camouflage treatment. Zygomatic anchorage enables distalization in uncooperative or noncompliant patients. We describe 1 such procedure in a 24-year-old woman., Methods: We used novel improved superelastic nickel-titanium archwires combined with nickel-titanium open-coil springs to provide a constant and continuous low force to the dentition., Results: We were able to successfully eliminate the protrusive profile and correct the Class II molar relationship using this system of zygomatic anchorage. The posterior occlusal relationships were improved to achieve Class I canine and molar relationships on both sides, and ideal overbite and overjet relationships were established. Facial esthetics was improved with decreased protrusion of the upper and lower lips., Conclusions: The method used here is a promising alternative to traditional distalization techniques and might offer an effective and simple means of distalizing maxillary molars in uncooperative patients., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

An 8-mm anterior and posterior open bite caused by a tongue rest posture habit was closed in a 25-year-old man by means of mandibular soldered tongue spurs and without orthognathic surgery. All maxillary and mandibular first molars were extracted, and the spaces were closed. Inappropriate retention protocol allowed for relapse in a 6-month period. A new 1-year orthodontic retreatment was conducted; after an appropriate retention protocol, the outcomes of treatment were significantly improved., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

The treatment of anterior open bite often requires the use of skeletal anchorage to prevent excessive eruption of the posterior teeth and consequent downward rotation of the mandible. However, this procedure might not always be accomplished. This article reports the successful treatment of an anterior open bite and a posterior crossbite in a young boy, combining traditional techniques and involving high-pull maxillary traction to help growth to correct the skeletal Class II malocclusion without skeletal anchorage. The vertical dentoalveolar contribution of maxillary growth was also favorable to close the bite, whereas cross-elastics corrected the axial inclination of the mandibular posterior teeth, eliminating the inverted posterior crossbite. The open bite was completely closed with edgewise appliances, which also achieved normal overjet, intercuspation, and incisor exposure on smiling. Traditional mechanics for the treatment of open bite and crossbite remain a useful alternative when patients do not accept skeletal anchorage., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Aim: The aim of this study is to report three cases that needed myofunctional and orthodontic treatment and the good results achieved after the therapy. Orthodontic treatment alone, in presence of bad habits, is not enough to solve the orthodontic issues, so it needs to be combined with myofunctional treatment.