|
1
|
Inchingolo AD, Patano A, Coloccia G, Ceci S, Inchingolo AM, Marinelli G, Malcangi G, Di Pede C, Garibaldi M, Ciocia AM, Mancini A, Palmieri G, Rapone B, Piras F, Cardarelli F, Nucci L, Bordea IR, Scarano A, Lorusso F, Giovanniello D, Costa S, Tartaglia GM, Di Venere D, Dipalma G, Inchingolo F. Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report. Medicina (Kaunas) 2022; 58:medicina58050603. [PMID: 35630020 PMCID: PMC9147027 DOI: 10.3390/medicina58050603] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/06/2023]
Abstract
The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient's needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.
Collapse
Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Chiara Di Pede
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Mariagrazia Garibaldi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Filippo Cardarelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio 6, 80138 Naples, Italy;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (I.R.B.); (F.L.); Tel.: +40-744-919-319 (I.R.B.); +39-328-213-2586 or +39-087-1355-4100 (F.L.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (I.R.B.); (F.L.); Tel.: +40-744-919-319 (I.R.B.); +39-328-213-2586 or +39-087-1355-4100 (F.L.)
| | - Delia Giovanniello
- Department of Thoracic Surgery, Hospital “San Camillo Forlanini”, 00152 Rome, Italy;
| | - Stefania Costa
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, 98125 Messina, Italy;
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy;
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.P.); (G.C.); (S.C.); (A.M.I.); (G.M.); (G.M.); (C.D.P.); (M.G.); (A.M.C.); (A.M.); (G.P.); (B.R.); (F.P.); (F.C.); (D.D.V.); (G.D.); (F.I.)
| |
Collapse
|
|
2
|
Alzabibi BA, Burhan AS, Hajeer MY, Nawaya FR. Short-term effects of the orthodontic removable traction appliance in the treatment of skeletal Class III malocclusion: A randomized controlled trial. Dent Med Probl 2021; 58:163-172. [PMID: 34048643 DOI: 10.17219/dmp/126304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/06/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The orthodontic removable traction appliance (ORTA) was introduced as an intraoral removable appliance to treat Class III patients, but the pure treatment effects of ORTA have not been established yet. OBJECTIVES The aim of the study was to evaluate the skeletal, dental and soft tissue changes following the use of ORTA in treating Class III growing patients, and to compare these changes with those observed in an untreated control group (UCG). MATERIAL AND METHODS Forty-two patients with Class III malocclusion (mean age: 9.04 ±0.84 years) were randomly allocated to either the intervention group (ORTA) or UCG with a 1:1 allocation ratio. The patients in the ORTA group were treated until a positive overjet was achieved, whereas those in UCG were observed for an average of 6 months. Lateral cephalograms were obtained before (T1) and at the end of the treatment or observation period (T2). Twenty-six variables were used to evaluate treatment changes. The paired and independent t tests were used to detect significant differences within and between the groups, respectively. RESULTS Forty-two patients who met the inclusion criteria were included primarily. Two patients in UCG dropped out of the study. Therefore, 40 patients were included in the statistical analyses (ORTA: 21; UCG: 19). The orthodontic removable traction appliance was able to correct Class III malocclusion in a mean treatment time of 4.34 ±2.02 months. The maxilla moved forward by a mean of 1.31°, which was significantly greater than in the case of UCG (i.e., a mean difference of 1.02°). The mandible moved significantly backward in the ORTA group (the mean change in SNB: -1.85°) and significantly forward in UCG (the mean change in SNB: 0.97°), leaving the overall sagittal skeletal change significantly greater in the ORTA group as compared to UCG (the mean change in ANB: 3.81°) (p < 0.001). CONCLUSIONS In the short term, ORTA seemed to be an effective intraoral removable appliance in the treatment of growing Class III patients.
Collapse
Affiliation(s)
| | | | | | - Fehmieh Rafik Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| |
Collapse
|
|
3
|
Nota A, Caruso S, Ehsani S, Ferrazzano GF, Gatto R, Tecco S. Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles. Medicina (Kaunas) 2021; 57:178. [PMID: 33669677 DOI: 10.3390/medicina57020178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/31/2021] [Accepted: 02/16/2021] [Indexed: 01/13/2023]
Abstract
Background and objectives: The aim of this study is to evaluate mandibular elevator muscles activity and pain on palpation in the early stages of orthodontic treatment with clear aligners using surface electromyography (sEMG). Materials and methods: Surface electromyography (sEMG) activity and pain level on muscle palpation of masseter and anterior temporalis muscles were recorded in a sample of 16 adult subjects (aged 18–32 years; mean 22.5 +/− 3.5 SD) undergoing orthodontic treatment with clear aligners before the treatment (T0), after 1 month of treatment (two clear aligners) (T1), and after 3 months of treatment (T2) (six clear aligners). A chi-square test for nominal data, a Friedman test, and a Wilcoxon-signed rank test as post hoc analysis were applied. Results: No statistically significant differences in muscular pain were observed. At T1, the sEMG activity of masseter muscles at mandibular rest position showed a statistically significant reduction, but after 3 months (T2), the data appeared similar to T0 (p = 0.03 and p = 0.02). Conclusions: During the treatment with clear aligners, subjects could experience an initial reduction in the masseter basal activity after 1 month of treatment. This effect tends to decrease to baseline levels after 3 months of therapy.
Collapse
|
|
4
|
Caruso S, Darvizeh A, Zema S, Gatto R, Nota A. Management of a Facilitated Aesthetic Orthodontic Treatment with Clear Aligners and Minimally Invasive Corticotomy. Dent J (Basel) 2020; 8:dj8010019. [PMID: 32075255 PMCID: PMC7148540 DOI: 10.3390/dj8010019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/03/2020] [Accepted: 02/12/2020] [Indexed: 02/06/2023] Open
Abstract
Accelerating orthodontic tooth movement has become a topical issue and the corticotomy seems to be the only effective and safe technique reported in the literature. Simultaneously, aesthetic orthodontic treatment with removable clear aligners has become commonly requested. The aim of this paper is to illustrate the management of facilitated aesthetic orthodontic treatment, a combined approach including piezocision corticotomy and clear aligners for orthodontic treatment. Orthodontic planning for traditional clear aligners should be modified to take advantage of the corticotomy technique in order to facilitate the most difficult orthodontic movements needed to achieve treatment completion, where each aligner will be used for four days rather than 15 days for a total time of four months. A corticotomy with a modified minimally invasive flapless piezocision technique should be performed in both jaws at the same time, before the time window of the orthodontic treatment, where the most difficult orthodontic movements are planned. Treatment planning where difficult orthodontic movements, such as anterior open-bite closure and extraction space closure, are easily managed with clear aligners and are presented as examples of facilitated aesthetic orthodontic treatment application. The combination between aesthetic treatment with clear aligners and modified piezocision corticotomy, if carefully planned, seems to represent a synergy that achieves the current goals of orthodontic treatment. The primary objectives of this combination should be facilitating difficult orthodontic movements and reducing treatment duration.
Collapse
Affiliation(s)
- Silvia Caruso
- MeSVA, University of L’Aquila, 67100 L’Aquila AQ, Italy; (S.C.); (S.Z.); (R.G.)
| | | | - Stefano Zema
- MeSVA, University of L’Aquila, 67100 L’Aquila AQ, Italy; (S.C.); (S.Z.); (R.G.)
| | - Roberto Gatto
- MeSVA, University of L’Aquila, 67100 L’Aquila AQ, Italy; (S.C.); (S.Z.); (R.G.)
| | - Alessandro Nota
- MeSVA, University of L’Aquila, 67100 L’Aquila AQ, Italy; (S.C.); (S.Z.); (R.G.)
- Dental School, Vita-Salute San Raffaele University and IRCCS San Raffaele, 20132 Milan, Italy
- Correspondence:
| |
Collapse
|
|
5
|
Pliska BT, Nam H, Chen H, Lowe AA, Almeida FR. Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment. J Clin Sleep Med 2014; 10:1285-91. [PMID: 25325593 DOI: 10.5664/jcsm.4278] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 07/21/2014] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To evaluate the magnitude and progression of dental changes associated with long-term mandibular advancement splint (MAS) treatment of obstructive sleep apnea (OSA). METHODS Retrospective study of adults treated for primary snoring or mild to severe OSA with MAS for a minimum of 8 years. The series of dental casts of patients were analyzed with a digital caliper for changes in overbite, overjet, dental arch crowding and width, and inter-arch relationships. The progression of these changes over time was determined and initial patient and dental characteristics were evaluated as predictors of the observed dental side effects of treatment. RESULTS A total of 77 patients (average age at start of treatment: 47.5 ± 10.2 years, 62 males) were included in this study. The average treatment length was 11.1 ± 2.8 years. Over the total treatment interval evaluated there was a significant (p < 0.001) reduction in the overbite (2.3 ± 1.6 mm), overjet (1.9 ± 1.9 mm), and mandibular crowding (1.3 ± 1.8 mm). A corresponding significant (p < 0.001) increase of mandibular intercanine (0.7 ± 1.5 mm) and intermolar (1.1 ± 1.4 mm) width as well as incidence of anterior crossbite and posterior open bite was observed. Overbite and mandibular intermolar distance were observed to decrease less with time, while overjet, mandibular intercanine distance, and lower arch crowding all decreased continuously at a constant rate. CONCLUSIONS After an average observation period of over 11 years, clinically significant changes in occlusion were observed and were progressive in nature. Rather than reaching a discernible end-point, the dental side effects of MAS therapy continue with ongoing MAS use. COMMENTARY A commentary on this article appears in this issue on page 1293.
Collapse
Affiliation(s)
- Benjamin T Pliska
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Hyejin Nam
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Hui Chen
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Alan A Lowe
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Fernanda R Almeida
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|