Akizuki K, Fujita K, Kobayashi H, Tsuchida Y, Shimo T. Two middle-aged cases of deep overbite without molar support treated by orthognathic surgery.
Int J Surg Case Rep 2019;
63:135-142. [PMID:
31585324 PMCID:
PMC6796729 DOI:
10.1016/j.ijscr.2019.09.027]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 09/06/2019] [Accepted: 09/13/2019] [Indexed: 11/05/2022] Open
Abstract
A deep overbite is defined as a vertical overlap of the upper and lower incisors.
Problems related to deep overbite can include soft tissue trauma.
It is difficult to recover functions with ordinary prosthetic therapy alone in patients with severe deep overbite with dentofacial deformities.
Comprehensive surgical orthodontic treatment is indicated for such patients.
Introduction
Patients with severe overbite in middle age often undergo prosthetic treatment without a diagnosis of dentofacial deformity, but soft tissue trauma can occur in such patients due to the lack of inter-occlusal space. Comprehensive surgical orthodontic treatment and prosthetic treatment are indicated to correct the overbite and soft tissue injury for such patients.
Presentation of case
We report the cases of two middle-aged patients with dentofacial deformity and severe overbite without molar support. In both cases, prosthetic treatment had been performed for many years without any improvement of the occlusion. Case 1: A 47-year-old Japanese man had a maxillary incisor protrusion and reduced lower anterior facial height profile with the left mandibular molars lost due to periodontal disease. After preoperative orthodontic treatment and occlusal elevation in the molar teeth using an implant prosthesis, a sagittal split ramus osteotomy (SSRO) was performed. Case 2: A 57-year-old Japanese woman had mandibular retrognathia with maxilla and mandibular-arch length discrepancy. The left mandibular molars needed to be extracted due to periodontal disease. After preoperative orthodontic treatment and reconstruction of the molar occlusion using an implant prosthesis, three-segment Le Fort I osteotomy and SSRO were performed.
Discussion
Malocclusion with dentofacial deformity is a risk factor for severe deep overbite or other occlusion collapse.
Conclusion
In middle-aged patients with deep overbite with missing molar teeth, we should consider both prosthodontic treatment and comprehensive dental therapy, including orthognathic surgery.
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