Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders

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Abstract

The treatment of severe skeletal anterior open bite is extremely difficult in adults, and orthognathic surgery is generally selected for its treatment. We report the case of an 18-year-old adult patient with skeletal anterior open bite and temporomandibular disorders who was successfully treated using temporary anchorage devices. She had an open bite of −2.0 mm and an increased facial height. Miniplates were implanted in both the maxilla and mandible, and molar intrusion resulted in counterclockwise rotation of the mandible over a period of 12 months. After active treatment, her upper and lower first molars were intruded by approximately 2 mm and her overbite became +2.5 mm. Her retrognathic profile improved with counterclockwise rotation of the mandible. Orthodontic treatment aided with skeletal anchorage is beneficial for intrusion of bimaxillary molars in patients with anterior open bite.

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Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development.

B Thilander, Jose L B Pena, C Mayorga … (2002)

A sample of 4724 children (2353 girls and 2371 boys) (5-17 years old) were grouped not only by chronological age but also by stage of dental development (deciduous, early mixed, late mixed, and permanent dentition). The registrations included functional occlusion (anterior and lateral sliding, interferences), dental wear, mandibular mobility (maximal opening, deflection), and temporomandibular joint and muscular pain recorded by palpation. Headache was the only symptom of temporomandibular dysfunction (TMD) reported by the children. The results showed that one or more clinical signs were recorded in 25% of the subjects, most of them being mild in character. The prevalences increased during the developmental stages. Girls were in general more affected than boys. Significant associations were found between different signs, and TMD was associated with posterior crossbite, anterior open bite, Angle Class III malocclusion, and extreme maxillary overjet.

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Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort.

Teruko Takano-Yamamoto, Toru Deguchi, Shingo Kuroda … (2006)

In this study, we evaluated the clinical usefulness of miniscrews as orthodontic anchorage. We examined their success rates, analyzed factors associated with their stability, and evaluated patients' postoperative pain and discomfort with a retrospective questionnaire. Seventy-five patients, 116 titanium screws of 2 types, and 38 miniplates were retrospectively examined. Each patient was given a questionnaire that included a visual analog scale to indicate discomfort after implantation. The success rate for each type of implant was greater than 80%. The analysis of 79 miniscrews with a 1.3-mm diameter showed no significant correlations between success rate and these variables: age, sex, mandibular plane angle, anteroposterior jaw-base relationship, control of periodontitis, temporomandibular disorder symptoms, loading, and screw length. Most patients receiving titanium screws or miniplates with mucoperiosteal-flap surgery reported pain, but half of the patients receiving miniscrews without flap surgery did not report feeling pain at any time after placement. In addition, patients with miniscrews reported minimal discomfort due to swelling, speech difficulty, and difficulty in chewing. Miniscrews placed without flap surgery have high success rates with less pain and discomfort after surgery than miniscrews placed with flap surgery or miniplates placed with either procedure.

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A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage.

Shih-Jung Cheng, I-Yun Tseng, Jang-Jaer Lee … (2015)

The aim of this prospective clinical study was to assess the risk factors associated with failure of mini-implants used for orthodontic anchorage. A total of 140 mini-implants in 44 patients, including 48 miniplates and 92 freestanding miniscrews, were examined in the study. A variety of orthodontic loads were applied. The majority of implants were placed in the posterior maxilla (104/140), and the next most common location was the posterior mandible (34/140). A cumulative survival rate of 89% (125/140) was found by Kaplan-Meier analysis. There was no significant difference in the survival rate between miniplates and freestanding miniscrews, but miniplates were used in more hazardous situations. The Cox proportional-hazards regression model identified anatomic location and peri-implant soft tissue character as 2 independent prognostic indicators. The estimated relative risk of implant failure in the posterior mandible was 1.101 (95% confidence interval, 0.942 to 1.301; P = .046). The risk ratio of failure for implants surrounded by nonkeratinized mucosa was 1.117 (95% confidence interval, 0.899 to 1.405; P = .026). The results confirmed the effectiveness of orthodontic mini-implants, but in certain situations adjustment of the treatment plan or modifications in the technique of implant placement may lead to improved success rates.

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Author and article information

Journal

Journal ID (nlm-ta): J Orthod Sci

Journal ID (iso-abbrev): J Orthod Sci

Journal ID (publisher-id): JOS

Title: Journal of Orthodontic Science

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2278-1897

ISSN (Electronic): 2278-0203

Publication date (Print): Oct-Dec 2017

Volume: 6

Issue: 4

Pages: 152-158

Affiliations

[1] Department of Orthodontics and Dentofacial Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

[1 ] Department of Biomaterials and Bioengineering, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

[2 ] Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia

Author notes

Address for correspondence: Dr. Eiji Tanaka, 3-18-15 Kuramoto, Tokushima 770-8504, Japan. E-mail: etanaka@ 123456tokushima-u.ac.jp

Article

Publisher ID: JOS-6-152

DOI: 10.4103/jos.JOS_63_17

PMC ID: 5655966

PubMed ID: 29119097

SO-VID: 2405dbf7-2083-46e2-b002-24a8fc9d59bc

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Skeletal anchorage for intrusion of bimaxillary molars in a patient with skeletal open bite and temporomandibular disorders

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Most cited references 30

Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development.

Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort.

A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage.

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