RESUMO
OBJECTIVES: A skeletal anterior open-bite is a challenging malocclusion for the orthodontist due to the difficulty and instability of correction. Treatment options for the adult patient include extractions, anterior extrusion with intermaxillary elastics, posterior intrusion using skeletal anchorage, occlusal adjustment, and orthognathic surgery. Patient compliance plays a key role in posttreatment stability. The present case report demonstrates the orthodontic treatment of an adult patient who presented with a complex open-bite malocclusion. MATERIALS AND METHODS: Treatment involved the placement of four miniscrews to assist intrusion of maxillary molars by applying posterior vertical maxillary elastics and extrusion of the anterior segments using anterior vertical interarch elastics. RESULTS: Ideal intercuspation was successfully achieved and good stability was maintained during 3 years following treatment. CONCLUSION: The intrusion of the maxillary molars with miniscrews is an interesting option in selected cases of skeletal anterior open bite. The retention protocol should be specific in these cases.
RESUMO
OBJECTIVES: This retrospective study aimed to evaluate the dentoalveolar, skeletal, and soft tissue effects obtained with bone-anchored pendulum appliance in patients with Class II malocclusion. MATERIALS AND METHODS: A total of 18 patients (4 male, 14 female) at a mean pretreatment age of 14.0 years (+1.08) were enrolled in this study. All patients were treated with the bone-anchored pendulum appliance for an average duration of 4.8 months. Only the active distalization period was evaluated with predistalization and postdistalization lateral cephalograms. Skeletal, dentoalveolar, and soft tissue variables were obtained. Based on these variables, the treatment effects were evaluated with dependent t-test. RESULTS: Correction of Class II molar relationship resulted from distal movement of 3.45 mm and tipping of 11.24° of the first maxillary molars. The premolars were distalized accompanying the molars. CONCLUSIONS: The bone-anchored pendulum appliance proved to be an effective method for distalization of maxillary molars in cases that require maximum anchorage, avoiding reciprocal mesial movement of premolars and incisors.
RESUMO
O objetivo deste estudo foi avaliar as alterações dentáriasdecorrentes do emprego do distalizador pêndulo modificado associadoà ancoragem esquelética, Com este propósito, foram avaliados modelosde gesso de 13 pacientes, sendo dez do gênero feminino e trêsdo masculino, com média de idade de 14 anos e seis meses. Todosos pacientes selecionados foram tratados com o aparelho pêndulomodificado, com molas removíveis, associado à ancoragem esqueléticapor meio de parafusos palatinos. As alterações dentárias foramavaliadas aplicando-se o teste t pareado, em nível de significância de5%. Os resultados evidenciaram alterações sagitais significantes dedistalização para os molares, pré-molares e caninos. Observou-se adistalização, respectivamente, para os lados direito e esquerdo dosseguintes elementos dentários: segundos molares de 7,73 mm e5,96 mm; primeiros molares de 9,22 mm e 7,37 mm; segundos prémolaresde 4,93 mm e 3,57 mm; primeiros pré-molares de 2,7 mm e1,87 mm; caninos de 1,45 mm e 0,93 mm. Os incisivos superiores nãosofreram alteração sagital significante. No sentido transversal, houve aexpansão significante de 1,73 mm e 3,8 mm para os segundos molaresdireito e esquerdo. Concluiu-se Que o aparelho pêndulo associado aosparafusos palatinos mostrou-se um método eficaz para a distalização demolares superiores, em casos Quenecessitam de máxima ancoragem.
The objective of this study was to evaluate the dentalalterations resulting from the usage of modified pendulum distilizerappliance associated with skeletal anchorage. With this purpose, itwas analyzed plaster models of 13 patients, ten females and threemales, with an average age of 14 years and six months. Each selectedpatient was treated by using the modified pendulum appliance withremovable springs associated with the skeletal anchorage by meansof palatal screws. The dental alterations were analyzed by applyingthe T paired test, in a significance levei of 5%. The results showedsignificant saggital alterations of distalization for molars, premolars andcanines. The distalization was observed, respectively, for the right andleft sides ofthe following teeth: second molars of 7,73 mm and 5,96mm; first molars of 9,22 mm and 7,37 mm; second premolars of 4, 93mm and 3,57 mm; first premolars of 2,7 mm and 1,87 mm; canines of1,45 mm and 0,93 mm. The upper incisors suffered no significantsaggital alteration. In the transverse direction, there was a significantexpansion of 1,73 mm and 3,8 mm for the right and left second molars.It can be concluded that the pendulum appliance associated with palatalscrews is an efficient method for the distalization of upper molars whenmaximum anchorage is needed.