• Title/Summary/Keyword: Maxillary protraction

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Maxillary protraction using skeletal anchorage and intermaxillary elastics in Skeletal Class III patients

  • Esenlik, Elcin;Aglarci, Cahide;Albayrak, Gayem Eroglu;Findik, Yavuz
    • The korean journal of orthodontics
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    • v.45 no.2
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    • pp.95-101
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    • 2015
  • The aim of this case report is to describe the treatment of a patient with skeletal Class III malocclusion with maxillary retrognathia using skeletal anchorage devices and intermaxillary elastics. Miniplates were inserted between the mandibular lateral incisor and canine teeth on both sides in a male patient aged 14 years 5 months. Self-drilling mini-implants (1.6 mm diameter, 10 mm length) were installed between the maxillary second premolar and molar teeth, and Class III elastics were used between the miniplates and miniscrews. On treatment completion, an increase in the projection of the maxilla relative to the cranial base (2.7 mm) and significant improvement of the facial profile were observed. Slight maxillary counterclockwise ($1^{\circ}$) and mandibular clockwise ($3.3^{\circ}$) rotations were also observed. Maxillary protraction with skeletal anchorage and intermaxillary elastics was effective in correcting a case of Skeletal Class III malocclusion without dentoalveolar side effects.

Comprehensive Orthodontic Treatment in a Middle-Aged Patient with Missing Maxillary Left First Premolar: A Case Report

  • Kwon, Sun-Mi;Baik, Hyoung-Seon;Choi, Sung-Hwan
    • Journal of Korean Dental Science
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    • v.11 no.1
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    • pp.32-41
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    • 2018
  • As the adult population continues to increase, orthodontic treatment for adult patients is becoming more common. This case report describes comprehensive orthodontic treatment of a middle-aged patient with closure of the extraction space without prosthetic restoration. A 55-year-old woman with her maxillary left first premolar extracted because of a periodontal problem, wanted to close the space with orthodontic treatment. Since she had generalized crowding and mild skeletal discrepancy, we planned comprehensive orthodontic treatment, including closure of the extraction space by protraction of the left maxillary molars using miniscrews and aesthetic alignment of anterior teeth. The total treatment period was 28 months. As a result of these treatments, the extraction space was successfully closed, good tooth alignment and satisfactory occlusion were achieved.

A cephalometric study on the velopharyngeal changes after maxillary protraction (상악골 전방견인치료후 구개범인두 변화에 대한 단기간의 측모두부방사선 계측학적 연구)

  • Lee, Nam-Ki;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.161-169
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    • 2006
  • The purpose of this study was to investigate cephalometrically the short term static velopharyngeal changes in 25 patients (10 boys and 15 girls, aged from 5 years 9 months to 12 years 10 months in the beginning of treatment) with skeletal Class III malocclusions who underwent nonsurgical maxillary protraction therapy with a facemask. The linear, angular and ratio measurements were made on lateral cephalograms. Only the change in hard palatal plane angle was negatively correlated with the change in maxillary depth or N-perp to A (p<0.01). The change in velar angle showed a statistically significant increase (p<0.001). This change was influenced more by the soft palatal plane angle than by the hard palatal plane angle (p<0.001). The changes in soft tissue nasopharyngeal depth and hard tissue nasopharyngeal depth showed statistically significant increases (p<0.001). Correlations between the changes in soft tissue (or hard tissue) nasopharyngeal depth and the change in soft palatal plane angle were significant (p<0.05). The increase in hard palate length was statistically significant (p<0.001). The change in hard palate length was negatively correlated with the change in soft tissue nasopharyngeal depth (p<0.05). The change in need ratio S (C) showed a statistically significant increase (p<0.001). But this difference was within the normal range reported by previous studies. These findings indicate that the velopharyngeal competence was maintained even if the anatomical condition of the static velopharyngeal area were changed after maxillary protraction.

Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate

  • Kim, Jung-Eun;Yim, Sunjin;Choi, Jin-Young;Kim, Sukwha;Kim, Su-Jung;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.4
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    • pp.238-248
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    • 2020
  • Objective: To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP). Methods: The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed. Results: Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNS-VRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNS-adenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS. Conclusions: FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

New Approach for Midface Hypoplasia in Cleft Lip and Palate Patients (구순구개열자의 중안면 열성장 개선을 위한 새로운 접근)

  • Kim, Young-Oh;Choi, Yoon-Kyung;Jung, In-Kyo;Kim, Yong-Deok;Son, Woo-Sung
    • Korean Journal of Cleft Lip And Palate
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    • v.16 no.1
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    • pp.1-8
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    • 2013
  • Purpose : To introduce a more effective and efficient protocol for protraction of maxillary complex in CLP patient and demonstrate it by case presentation. Methods : Miniplates are placed on zygomatic buttress and anterior part of mandible, at the time of secondary alveolar bone graft. During the night time, the orthopedic force is applied by wearing elastics from maxillary miniplates to facemask (500 g per side). During the day time, the intermaxillary elastics connecting maxillary miniplates to mandibular miniplates are applied (200 g per side). During the orthopedic treatment, dental alignment is possible. Results and conclusion : By the new protocol, the intermaxillary relation and occlusion are improved due to the stable intraoral anchorage and better cooperation of patients.

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Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique

  • Freitas, Benedito;Freitas, Heloiza;dos Santos, Pedro Cesar F.;Janson, Guilherme
    • The korean journal of orthodontics
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    • v.44 no.5
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    • pp.268-277
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    • 2014
  • A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery.

EFFECTS OF MAXILLARY PROTRACTION ON THE DISPLACEMENT OF THE MAXILLA (상악골 전방 견인이 상악골체의 변위에 미치는 영향)

  • Ko, Jeong-Seok;Kim, Jong-Chul
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.543-555
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    • 1995
  • In the orthopedic therapy, the biomechanical analysis of the appliance is necessary to get a desirable orthopedic effect. The purpose of this study was to investigate the desirable direction and application position of the protraction force. The protraction force of 500g was applied to the first premolar or to the first molar. The direction of force application was paralell or $20^{\circ}$ downward to the occlusal plane respectively. The stress distribution and the displacement within the maxilla was analyzed by a 3-dimensional finite element method. The findings obtained were as follows 1. Protraction forces caused a counterclockwise rotation of the maxilla. 2. The degree of maxillary rotation was less when the force was applied $20^{\circ}$ downward direction to the occlusal plane than when applied to the parallel direction. 3. The degree of rotation of maxilla was greater when the parallel force was applied to the 1st premolar than when applied to the first molar, whereas it was greater when force is applied $20^{\circ}$ downward than at the first premolar. In conclusion, the $20^{\circ}$ downward protraction from the first premolar induced the least counterclockwise rotation of the maxilla and was thought as the desirable direction and application position of the protraction force.

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A STUDY ON THE SKELETAL CHANGES IN MAXILLARY PROTRACTION OF THE SKELETAL GLASS III MALOCCLUSION PATIENTS (골격성 III급 부정교합 환자에서 상악골 전방 견인시 일어나는 골격 변화 양상에 관한 연구)

  • Lee, Young-Ji;Cha, Kyung-Suk;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.28 no.4 s.69
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    • pp.533-546
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    • 1998
  • A Skeletal Class III malocclusion may be the result of a large mandible, a small maxilla or combination of the two. Protraction devices for the maxilla are used to promote the growth of a deficient maxilla by applying extraoral force to actively growing patients. This study has been performed to determine whether there are significant differences in skeletal and dental changes between FH/Pal 1 and FH/Pal 2 group, SNA 1 and SNA 2 group, SNB 1 and SNB 2 group, and LFH 1 and LFH 2 group after RME and facial mask therapy. The results of this study can be summarized and concluded as follows ; 1. In all patients after maxillary protraction, the maxilla and maxillary dentitions moved forward, and the mandible rotated backward and downward. In most of them, palatal plane is tends to have an upward inclination. 2. The FH/Pal group 1, having an upward inclination of the palatal plane as a result of Facial mast showed statistically significant maxillary forward movement compared to the FH/Pal group 2. 3. The SNA group 1 showed significantly less mandibular backward movement and there was a tendency for the palatal plane to upward inclination compared to SNA group 2. 4. The SNB group 1 showed significantly less maxillary forward movement, but the vertical dimension, especially the lower facial height increased by mandibular downward rotation compared to SNB group 2. 5. LFH group 1, which had large saddle angle and posterior positioned mandible in the pre-treatment stage, showed maxillary protraction effect without significant increase in lower facial height compared to LFH group 2.

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