[Etiological aspects of anterior open bite]

Management of a severe skeletal open bite case using temporary anchorage devices and multiloop edgewise arch wire technique

The primary cause of complex AOB malocclusion is typically a combination of dental, skeletal, functional, and habitual factors. Open bite correction is a challenging treatment due to its complexity and the requirement for long-term stability, therefore, multidisciplinary treatment is often the best option for achieving stable esthetic outcomes.

Investigating the Relationship between the Dimensions and Morphology of Sella Turcica with the Long-Face Growth Pattern and the Vertical Growth Pattern

Introduction

The sella turcica is one of the important landmarks of lateral cephalometry, which is used in orthodontics for the diagnosis, treatment plan, and evaluation of skeletal development and maturity. The purpose of the present study is to investigate the relationship between the dimensions and morphology of sella turcica with the long-face growth pattern and people with an open bite. This study also examines the relationship between sella turcica bridging (STB) and the vertical growth pattern.

Methods

As many as 153 radiographs were analyzed using the Romexis software, considering the basal, gonial, and FMA angles to determine the vertical growth pattern of the face. The basal angle was also used to check for an open bite. Of these patients, 80 had a long vertical face growth pattern, and 73 had a normal face growth pattern. The four landmarks of tuberculum sellae, dorsum sellae, sellae floor, and posterior clinoid were determined on the cephalograms to measure the length, depth, and anteroposterior diameter of the sella turcica.

Results

In this study, it was found that the chance of developing a long face in people with partial and complete bridging is 8.37 and 1.92, respectively. An increase in the length of the sella turcica for one unit decreases the chance of a long face, and as the depth of the sella turcica increases, the chance of a long face increases.

Conclusions

STB is frequently seen in people with long faces. However, this finding should be considered in relation to other diagnostic parameters. The shorter the length and higher the depth of sella turcica, the higher the chance of developing a long face.

Nonsurgical Orthodontic Treatment of a Severe Open Bite Case Using Miniscrews with Modified Multiloop Edgewise Arch Wire Technique

Skeletal open bite is one of the most challenging malocclusions to treat and maintain due to the difficulty and instability of correction. Although a combination of orthodontic treatment and orthognathic surgery may be the ideal approach in most cases, the complications, risks, and costs of surgery have sparked an interest in alternative treatment options that use temporary anchorage devices to achieve orthognathic-like effects. Adult patients can be treated without the need for special compliance using temporary anchorage devices such as miniscrews. This case report demonstrates a goal-oriented strategy for nonsurgical treatment of a complex skeletal open bite malocclusion in an adult patient using miniscrews and a modified multiloop edgewise arch wire (MEAW) technique, with the results evaluated clinically and cephalometrically.

Challenges in the Dental Management of Rett Syndrome under General Anesthesia: A Rare Disease

Rett syndrome is a neurodevelopmental genetic X-linked disorder. It is predominantly found in females with a prevalence rate of 1 : 9000. Rett syndrome patients are usually healthy the first months of their lives. The syndrome goes into a deceleration phase where motor, behavioral, and cognitive skills are impaired. Regarding their oral health, bruxism is one of the common oral manifestations found among Rett syndrome patients. We present a case of an 8-year-old patient with Rett syndrome who presented to the dental clinic for oral rehabilitation. The patient was evaluated and treated under general anesthesia with multiple extractions, restorations, and crown installments. Oral rehabilitation of Rett syndrome is important for those patients, and proper evaluation and treatment are the most efficient when performed under general anesthesia.

Three-dimensional analysis of condylar changes in surgical correction for open bite patients with skeletal class II and class III malocclusions

The aim of this study was to quantify three-dimensional condylar displacements as a result of two-jaw surgery for open bite correction in patients with skeletal class II and class III malocclusion. Pre-surgical (T1) and post-surgical (T2) cone beam computed tomography scans were taken for 16 patients with skeletal class II (mean age 22.3±9.47years) and 14 patients with skeletal class III (mean age 25.6±6.27years). T2 scans were registered to T1 scans at the cranial base. Translational and rotational condylar changes were calculated by x,y,z coordinates of corresponding landmarks. The directions and amounts of condylar displacement were assessed by intra- and inter-class Mann-Whitney U-test or t-test. Class II patients presented significantly greater amounts of lateral (P=0.002) and inferior (P=0.038) translation than class III patients. The magnitudes of condylar translational displacements were small for both groups. Skeletal class III patients had predominantly medial (P=0.024) and superior (P=0.047) condylar translation. Skeletal class II patients presented greater condylar counterclockwise pitch (P=0.007) than class III patients. Two-jaw surgery for the correction of open bite led to different directions and amounts of condylar rotational displacement in patients with skeletal class II compared to class III malocclusion, with greater rotational than translational displacements.

Oral health in a group of patients with Rett syndrome in the regions of Valencia and Murcia (Spain): a case-control study

Objectives: Rett syndrome (RS) is a rare disease with oral manifestations that have not been described in detail or in a standardized manner in the literature. The present study describes the oral health of the population with RS in two Spanish regions, following the protocol of the World Health Organization for conducting common oral health surveys. Study Design: A prospective, observational case-control study was carried out, involving a group of patients with RS (n1=41) and a mean age of 13.37±3.19 years, and an age- and gender-matched control group without RS (n0=82). The data referred to oral health and habits were recorded by means of a questionnaire and oral examination was used to document caries indicators (prevalence of caries, df(t), df(s), DMF(T), DMF(S) and indices referred to dental loss, morbidity, restoration), the Community Periodontal Index (CPI), and the most characteristic oral manifestations. Results: The most frequent oral habit in the patients with RS was diurnal bruxism, followed by stereotyped tongue movements and oral breathing. The caries scores were lower in the RS population than in the control group, but patients with RS showed greater periodontal alterations and a greater prevalence of drooling, dental wear, high-arched palate and anterior open bite. Conclusions: The population with RS exhibits characteristic and early oral habits and alterations, and periodontal problems that are more notorious than caries disease, so that our efforts should focus on the diagnosis and early correction of the parafunctional habits, promoting restorative treatment, and providing instructions on correct oral hygiene.

Key words:Rett syndrome, oral habits, bruxism, caries.