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30 November 2024, Volume 27 Issue 6 Previous Issue   

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The Application of Customized Fixed Lingual Orthodontics in the Treatment of an Adult with Skeletal Class I Malocclusion and Bimaxillary Protrusion: A Case Report Dian Jing, Ningjuan Ouyang, Bing Fang 2024, 27(6):  445-456.  DOI: 10.12337/zgkqjxjyzz.2024.06.001 Abstract ( 27 )   PDF (7226KB) ( 12 )   Objective: We presented a case of customized fixed lingual orthodontic treatment combined with corticotomy for a 41-year-old female patient with skeletal Class I bimaxillary protrusion, aiming to achieve safe and effective dentoalveolar remodeling and facial profile improvement. Diagnosis and Treatment: After thorough analysis, diagnosis, and informed consent, a treatment plan involving orthodontic extraction of teeth $\begin{array}{l|l}4 & 4 \\\hline 4 & 4\end{array}$ was performed. A customized fixed lingual orthodontic system was used, incorporating a transverse palatal arch and temporary anchorage device. Following alignment and leveling of the dental arches, corticotomy of the upper and lower alveolar bones was performed to retract the anterior teeth, followed by fine adjustments. Results: After 29 months of treatment, the patient’s profile was significantly improved, molar relationships were neutral, and the anterior teeth exhibited normal overbite and overjet. Conclusions: Digital customized fixed lingual orthodontic treatment is suitable for cases of skeletal Class I bimaxillary protrusion malocclusion. By leveraging the advantages of anchorage control and incorporating corticotomy, the treatment achieved an optimal balance of aesthetics and health in orthodontic outcomes.. References | Related Articles | Metrics

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Combined Orthodontic-orthognathic Management of A Patient with Skeletal Class III Malocclusion and Mandibular Lateral Deformity Using Clear Aligners: A Case Report Tingting Zhao, Xuewen Yang, Fang Hua, Hong He 2024, 27(6):  457-467.  DOI: 10.12337/zgkqjxjyzz.2024.06.002 Abstract ( 22 )   PDF (14141KB) ( 15 )   Objective: An adult case of skeletal ClassⅢ with mandibular deviation was treated by invisible orthodontic combined with orthognathic surgery. Diagnosis and Treatment: The patient received combined invisible orthodontic and orthognathic treatment after a clear diagnosis and the patient’s informed consent. In the preoperative orthodontic stage, $\begin{array}{l|l}65 & 58 \\ \hline 6 & 8 \end{array}$ extraction was performed. The extraction space was used for decompensation of maxillary anterior teeth, and using$\left. \frac{87}{87} \right|$ to replace$\left. \frac{76}{76} \right|$. The orthognathic operation was performed with maxillary LefortⅠosteotomy and bilateral mandibular sagittal split osteotomy. After operation, orthodontics further adjusted for the anterior deep overbite, mandibular midline deviation and posterior occlusion. Results: At the end of treatment, the patient’s profile was straight, the facial deviation was corrected, overbite and overjet were normal, the teeth were arranged neatly, the bilateral canine and molar were both neutral, and the upper and lower midline was aligned with the midline of the face. Conclusions: Clear aligner combined with orthognathic surgery can effectively treat the patients with skeletal Class Ⅲ with mandibular deviation. References | Related Articles | Metrics

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Invisible Aligner Treatment for Pathological Displacement Causing Occlusal Trauma in Severe Chronic Periodontitis: A Case Report Zilu Zhu, Liujing Chen, Chenyang Xing, Yibing Zhao, Jie Shi, Ruili Yang 2024, 27(6):  468-478.  DOI: 10.12337/zgkqjxjyzz.2024.06.003 Abstract ( 13 )   PDF (12584KB) ( 6 )   Objective: To evaluate the clinical effectiveness of using invisible aligners to remove occlusal trauma caused by pathological displacement in severe chronic periodontitis. Diagnosis and Treatment: A 53-year-old male patient presented with severe chronic periodontitis, scattered spaces among the upper and lower anterior teeth, deep overbite and overjet, molar neutral occlusion, and canine mesial occlusion. The anterior teeth exhibited a 2mm reverse overjet, significant spacing between the upper and lower central incisors, and the midline could not be recorded. The lower anterior teeth showed gradeⅢmobility. Periodontal treatment was performed to control inflammation, and orthodontic treatment with invisible aligners was used to eliminate occlusal trauma. Results: After combined orthodontic-periodontal treatment, occlusal trauma was eliminated, stable occlusion was established, the patient’s profile was improved, and the patient was satisfied with the treatment outcome. Conclusions: Invisible aligners, with their advantages of grouped anchorage and staged movement, facilitate the elimination of occlusal trauma. References | Related Articles | Metrics

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Sagittal-guidance Twin-block Appliance in Atypical Growth Modification Therapy: A Case Report Zixin Yan, Ye Cao, Bin Yan, Luwei Liu 2024, 27(6):  479-493.  DOI: 10.12337/zgkqjxjyzz.2024.06.004 Abstract ( 14 )   PDF (10177KB) ( 1 )   Objectives: This case reported the use of sagittal-guidance Twin-block appliance (SGTB) in the treatment of a patient with growth modification therapy. Diagnosis and Treatment: Following an accurate diagnosis and the patient’s informed consent, we protruded the mandible forward, expanded the upper arch and slightly aligned and retracted the maxillary front teeth using an adhesive SGTB. The brackets were bonded to finish fixed orthodontic treatment after the SGTB was removed. Results: The overall treatment time was 22 months. Mandibular growth in conjunction with dental movement and alveolar bone remodeling contributed to the favorable skeletal and dental relationships and soft tissue profile, with no relapse after three and a half years of follow-up. Conclusions: Adhesive SGTB is appropriate for patients reaching the end of maxillofacial growth peak. Growth modification therapy may also be tried on patients who have passed the peak of growth if it is expected to be beneficial to them. References | Related Articles | Metrics

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Orthodontic Treatment of Skeletal Class III Malocclusion with Lateral Deviation in an Adolescent: A Case Report Shengmei Zhou, Bing Wang 2024, 27(6):  494-503.  DOI: 10.12337/zgkqjxjyzz.2024.06.005 Abstract ( 18 )   PDF (8493KB) ( 5 )   Objective: This case report described the orthodontic camouflage treatment of a severe skeletal Class III malocclusion with asymmetry in a teenager using miniscrew assisted maxillary skeletal expander (MSE) and maxillary protraction with a facemask, along with micro-implant assisted mandibular full-arch distalization. Diagnosis and Treatment: The patient refused combined orthodontic-orthognathic treatment, leading to the decision to proceed with orthodontic camouflage treatment. The MSE was utilized to address the transverse deficiency of the maxilla, correct buccal tilting of the posterior teeth, and establish posterior occlusal coverage. Facemask protraction was used to promote maxillary development, meanwhile leading to posterior and downward rotation of the mandible. Micro-implant anchorage was employed to distalize the mandibular dentition, correct the crossbite and midline, and establish proper occlusion. Results: Post-treatment, the patient achieved Class I canine and molar relationships, with the upper and lower midlines nearly coinciding. The root parallelism was good, and both the patient and their family were satisfied with the treatment outcome. Conclusions: By strictly adhering to the indications of camouflage treatment, it is possible to correct maxillary transverse and sagittal deficiencies through arch expansion and forward traction, while retracting the mandibular dentition to resolve the crossbite, thereby establishing a neutral molar relationship. This approach improves both function and aesthetics for the patient, with confirmed clinical effectiveness. References | Related Articles | Metrics

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Orthodontic Extraction Treatment for Hyperdivergent Angle ClassⅢOpen-bite Malocclusion: A Case Report Zeqing Zhao, Yuxing Bai, Xianju Xie, Li Zhang 2024, 27(6):  504-515.  DOI: 10.12337/zgkqjxjyzz.2024.06.006 Abstract ( 13 )   PDF (9787KB) ( 2 )   Objective: This case reports the orthodontic treatment of hyperdivergent Angle classⅢ open-bite malocclusion. Diagnosis and Treatment: The patient received orthodontic treatment using straight wire fixed appliance after a clear diagnosis and the patient’s informed consent. Upper second premolars and lower first premolars were extracted. Impacted upper third molars were used to instead extracted upper second molars. Upper and lower teeth were aligned and leveled. Extraction spaces were used to retract anterior teeth. Open bite was closed. And the molar relationship was adjusted. Then vertical traction was applied to upper third molars. Results: After orthodontic treatment, the patient’s profile was optimized. The open bite was closed. The relationship of molars turned to be neutral. The crowding of anterior teeth was relieved. The long-term observation showed that the overbite and overjet were well maintained. Conclusions: Extracting premolars and using upper third molars to instead upper second molars can effectively help close the wide-range open bite and keep overbite and overjet stable. However, long-period retaining was still needed. References | Related Articles | Metrics

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Clear Aligner Achieving Efficient Root Torquing of Anterior Teeth and Molar Mesialization: A Case Report Qingming Tang, Lin Pan, Jiwei Sun, Shiqiang Gong 2024, 27(6):  516-525.  DOI: 10.12337/zgkqjxjyzz.2024.06.007 Abstract ( 32 )   PDF (14005KB) ( 27 )   Objective: This case reported the clear aligner therapy (CAT) of a patient with severe dental crowding, introverted deep overbite of the anterior teeth, and premolar impaction. Diagnosis and Treatment: A 28-year-old female patient, after being fully informed the treatment protocol and obtaining the patient’s informed consent, three first premolars and one lower first molar were extracted and the extraction space was used to relieve the crowding of the dentition, control the lingual movement of the root of the upper incisor, depress the lower anterior tooth to open the anterior tooth occlusion, and move the left molar mesially. Later stage of the first treatment, the segmented arch technology was used flexibly to right the $\left. {\overline {\, 5 \,}}\! \right| $ and align the left lower posterior teeth at the appropriate time. Finally, additional clear aligners were used to fine-tune the occlusion. Results: The orthodontic treatment course lasted for 29 months (54+34, a total of 88 sets of aligners). After treatment, the upper and lower dentitions were aligned, the overbite and overjet of anterior teeth were normal, with ClassⅠ relationship for right molars and ClassⅡrelationship for left molars. Conclusions: The precise design of the anterior tooth root control movement in the CAT plan and the flexible use of the advantages of the segmental arch, and the timely adjustment of the orthodontic technology, therefore improved the effectiveness of CAT. References | Related Articles | Metrics

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A Case of Extraction for Crowded Teeth with Protrusion Treated by Clear Aligners Yifan Fu, Longfei Wen, Siying Liu 2024, 27(6):  526-539.  DOI: 10.12337/zgkqjxjyzz.2024.06.008 Abstract ( 10 )   PDF (13134KB) ( 2 )   Objective: This case report presents a standardized treatment of a skeletal Class I malocclusion with crowded and protrusion using clear aligners. Diagnosis and Treatment: Following comprehensive diagnosis, difficulty assessment, treatment planning, and obtaining informed consent from the patient, extraction orthodontic treatment was performed using clear aligners. Key technical points included preparing posterior teeth for anchorage prior to space closure, employing a stepwise movement approach during space closure for canine distalization and incisor root control. Overcorrection was designed to counteract the “roller coaster” effect as much as possible. Results: The entire treatment involved one restart and a total of 73 steps. The patient’s facial profile improved significantly, occlusal relationships were satisfactory, no related complications were observed, and the patient expressed satisfaction with the treatment outcome. Conclusions: In extraction cases treated with clear aligners, it is essential to conduct anchorage design, vertical control, torque control, and overcorrection planning based on thorough diagnosis in order to minimize the risk of complications. References | Related Articles | Metrics

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Treatment of Malocclusion with Severe Periodontitis by Invisible Appliance without Brackets: A Case Report Lingling Ji, Di Miao, Qin Zhou, Tian Qian, Fei Wang, Rui Zou, Yucheng Guo 2024, 27(6):  540-556.  DOI: 10.12337/zgkqjxjyzz.2024.06.009 Abstract ( 16 )   PDF (8687KB) ( 5 )   Objective: To evaluate the clinical effect of a patient with malocclusion, accompanied by chronic severe periodontitis, who was treated with an invisible appliance without brackets. Diagnosis and Treatment: The patient had chronic severe periodontitis complicated by pathologic anterior displaced incisors, deep bite, and deep overjet. After a clear diagnosis and informed consent, the patient underwent a complete periodontal treatment, and was treated with orthodontic treatment by invisible appliance without brackets. Post-treatment lingual fixed retention wires and clear retainers were maintained. Regular periodontal maintenance was performed during the orthodontic treatment. Results: After the patient’s combined periodontal-orthodontic treatment, the deep bite and deep overjet reached a normal level, a good cusp-molar relationship was established, and the occlusal force line was improved. The periodontal condition did not undergo significant aggravation during orthodontic treatment. The results of orthodontic treatment were stable at 2-year follow-up. Conclusions: Bracketless invisible orthodontic appliances have certain therapeutic effect on secondary malocclusion in severe periodontitis. References | Related Articles | Metrics