Three-dimensional changes in the upper airway and craniomaxillofacial morphology of patients with Angle Class III malocclusion treated with a Frankel III appliance

Background Angle Class III malocclusion, characterized by a concave profile, can cause serious harm to children’s physical and mental health. The Frankel III appliance is an effective treatment for Angle Class III malocclusion in mixed denition. We explored three-dimensional changes in the upper airway and craniomaxillofacial morphology, after one year of Frankel III appliance treatment, in children with Angle Class III malocclusion. Methods We included 20 children (9 males), aged 8–10 years, with Angle Class III malocclusion from the Orthodontics Department of our hospital. Each child was treated with a Frankel III appliance for one year. Cone beam computed tomography was performed before and after treatment to evaluate three-dimensional changes in the upper airway and craniomaxillofacial morphology. Results After one year of treatment, in the upper airway, we observed significant increases in the nasopharynx volume and height (P < 0.05); the velopharyngeal volume, height, and average cross-sectional area (P < 0.05); the glossopharynx volume and minimum cross-sectional area (P < 0.05); and the laryngopharynx height (P < 0.05). Accordingly, the total upper airway volume, height, and average cross sectional area increased significantly (P < 0.05). An examination of craniomaxillofacial morphology showed significant increases in some bone tissues (P < 0.05) and dental measurements, and a significant reduction in the inclination of the mandibular central incisor (P < 0.05). Conclusion Children with Angle class III malocclusion treated with a Frankel III appliance showed no upper airway narrowing, even after repositioning the mandible posteriorly. Moreover, treatment promoted forward maxilla development and increased its width, in both the dental arch and alveolar bone, which provided a more harmonious craniofacial morphology.

Aesthetic and functional advantages of early orthodontic treatment in a child with Asperger's Syndrome: case report

Angle Class III malocclusion results in aesthetic and functional concerns, thus it is essential that this malocclusion is treated as early as possible, so that dentocraniofacial development occurs properly. A 7-year-old male patient with Asperger's syndrome had a Class III subdivision right malocclusion, anterior and posterior crossbite. To gain the patient's trust and collaboration, we used the behavioral management technique tell-show-do, in addition to the behavioral analysis method. Orthodontic treatment started using the Hyrax palatal expander, but the patient was not able to adapt to it. Correction of the crossbite was achieved using a removable expander with digital springs, which was better accepted by the patient and provided aesthetic and functional improvement.

A CBCT Evaluation of Midpalatal Bone Density in Various Skeletal Patterns

The purpose of this study was to evaluate midpalatal bone density (BD) by using cone-beam computed tomography (CBCT) according to gender, age, and vertical and horizontal skeletal patterns. CBCT images from 126 subjects (64 females and 62 males) were reoriented and analyzed in order to attain BD values at the midpalatal suture. Four age groups were used for classification (adolescence, 10 ≤ early < 14 years, 14 ≤ middle ≤ 17 years, and 17 < late ≤ 21 years; adult > 21 years). Vertical skeletal pattern categories were differentiated by the Frankfort horizontal line to mandibular plane angle (hypodivergent < 22°, 22° ≤ normovergent ≤ 28°, and 28° < hyperdivergent). Horizontal skeletal pattern differentiation was defined by ANB angle (Class III < 0°, 0° ≤ Class I ≤ 4°, and 4° < Class II). Females showed significantly higher BD than males (p < 0.001). As age increased, BD increased significantly (p < 0.001). There were no significant differences between vertical skeletal patterns. Class II showed significantly less BD than Class III (p < 0.05). With this information, clinicians can better understand BD trends of the midpalatal suture and, thus, better understand our patient’s anatomy and potential hurdles in successful treatment.

Three-dimensional changes in the upper airway and craniomaxillofacial morphology of patients with Angle Class III malocclusion treated with a Frankel III appliance

Background Angle Class III malocclusion, characterized by a concave profile, can cause serious harm to children’s physical and mental health. The Frankel III appliance is an effective treatment for Angle Class III malocclusion in mixed denition. We explored three-dimensional changes in the upper airway and craniomaxillofacial morphology, after one year of Frankel III appliance treatment, in children with Angle Class III malocclusion. Methods We included 20 children (9 males), aged 8-10 years, with Angle Class III malocclusion from the Orthodontics Department of our hospital. Each child was treated with a Frankel III appliance for one year. Cone beam computed tomography was performed before and after treatment to evaluate three-dimensional changes in the upper airway and craniomaxillofacial morphology. Results After one year of treatment, in the upper airway, we observed significant increases in the nasopharynx volume and height (P<0.05); the velopharyngeal volume, height, and average cross-sectional area (P<0.05); the glossopharynx volume and minimum cross-sectional area (P<0.05); and the laryngopharynx height (P<0.05). Accordingly, the total upper airway volume, height, and average cross sectional area increased significantly (P<0.05). An examination of craniomaxillofacial morphology showed significant increases in some bone tissues (P<0.05) and dental measurements, and a significant reduction in the inclination of the mandibular central incisor (P<0.05). Conclusion Children with Angle class III malocclusion treated with a Frankel III appliance showed no upper airway narrowing, even after repositioning the mandible posteriorly. Moreover, treatment promoted forward maxilla development and increased its width, in both the dental arch and alveolar bone, which provided a more harmonious craniofacial morphology.

THE PREVALENCE OF SECONDARY DENTO-MAXILLAIRE DEFORMITIES ASSOCIATED WITH UNCOMPENSATED DENTITION DEFECTS IN CHILD POPULATION

The aim is to determine the prevalence of dentition defects and secondary dento-maxillaire deformities in different periods of formation of the dento-maxillary system among the child population of Kyiv and the need for their therapeutic and prophylactic prosthetics, assess the level of prosthodontics care provided to them. Materials and methods. To determine the prevalence of dento-maxillary anomalies, dentition defects, and secondary dento-maxillary deformities, we examined 2276 children and adolescents aged 4 to 17 years in educational institutions in Kyiv for the 2017-2018 period. Results of the research. The prevalence of dento-maxillary anomalies among child population is 65.2%. Angle class I holds first place with 45,8% (among the anomalies of individual teeth), Angle class II comes second with 15,2%, the third place is occupied by Angle class III with 4,2%. Secondary dento-maxillary deformities caused by the early loss of both permanent and especially temporary teeth have become more common among the child population. The main reason for their occurrence is timely uncompensated dentition defects, which was confirmed by mass examinations of children aged 4 to 17 years in schools and kindergartens. Dentition defects of various sizes and localization were observed in 359 out of 2276 children, which is 15.8% of the total number of those examined. Tooth loss is most often caused by caries, its complications, and trauma, a little less often – by retention and anodontia. Secondary dento-maxillary deformities (dento-maxillary lengthening of teeth that have lost their antagonists; the inclination of the teeth towards the defect with displacement) were found in 278 children, which amounted to 12.2% of the total number of examined children, and 77.4% of the detected dentition defects (359 children). The obtained data indicate deterioration in the organization and implementation of oral cavity sanitation among the child population, which requires immediate measures to implement programs aimed at early identification and prevention of severe morphological and functional disorders of the dentition. Conclusions. The results of the obtained findings show a high prevalence of dento-maxillary anomalies among the child population – 65.2% (1484 people), and only 34.8% (792 people) had no orthodontic pathology. Dentition defects were diagnosed in 359 people, which is 15.8% of the total number of the examined children. Secondary dento-maxillary deformities were diagnosed in 278 people of the total number of the examined children (2276 people), that is 12.2% of the total number of the diagnosed dentition defects (359 cases) – 77.4%. Most often, secondary deformities occur between 6 and 11 years of age, that is, in the mixed dentition period of occlusion. The main reason for their occurrence was the inefficient prosthesis of dentition defects or its absence. Dentition defects are caused by premature removal of temporary teeth due to complications of caries, trauma, retention, and congenital absence of teeth.