JDO Vol. 73
Editorial
Chris H. Chang
Creating a More Effective Way of Learning
It has been a driving motivation and commitment of mine for the past 30-odd years to diversify the way that I, and consequently others, learn orthodontics. I have been seeking different methods that allow us to explore and truly learn all facets of orthodontics effectively. Especially for those who are just getting started, lowering the prerequisite criteria so that they can not only grasp and learn but also enjoy and appreciate the beauty of the knowledge in this field is, and always has been, the utmost goal for me.
From this year on, every article published in JDO will come with a supplementary 3-minute English video clip that incorporates audio and visual elaboration of the key points. This allows a more personal and animate presentation of the case reports that literally jumps off the pages, hopefully helping readers with diverse learning habits to review and fully comprehend the main ideas more easily…
Skeletal Class I Malocclusion with Severe Crowding and Anterior Crossbite Treated with 4 First Premolar Extractions
Tsung Hsiu Yang, Yin Hein Duan, Chris H. Chang, W. Eugene Roberts
History: y: A 19yr-6mo-old female presented with chief complaints of severe crowding and an anterior crossbite.
Diagnosis: The skeletal Class I malocclusion (SNA, 83.5˚; SNB, 85˚; ANB, -1.5˚) was associated with severe crowding (> 7 mm) and an anterior crossbite. The Discrepancy Index was 12.
Treatment: Bilateral maxillary and mandibular first premolars were removed to gain space for relieving the crowding and retracting the anterior segment to correct the anterior crossbite. A Damon® system appliance with passive self-ligating brackets was applied to correct the dental malocclusion after extracting four premolars.
Results: Improved dentofacial esthetics and occlusal function were achieved after treatment. The Cast-Radiograph Evaluation score was 24, and the Pink and White esthetic score was 2.
Conclusions: This case report demonstrates the use of passive self-ligating appliances and open coil springs to resolve an anterior crossbite and severe crowding. Furthermore, the application of Class II elastics during the closure of extraction spaces corrected the proclination of the upper anterior teeth. (J Digital Orthod 2024;73:4-18)
Key words: Skeletal Class I, proclined anterior teeth, anterior crossbite, passive self-ligating brackets, Class II elastics, first premolar extraction
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Pseudo-Class III Malocclusion in an Adolescent Treated with Mandibular Bone Screws and Bite Opening to Enhance Late Maxillary Growth
Alex Lin, Chris H. Chang, W. Eugene Roberts
History: A 12-year-old female presented with a chief complaint (CC) of anterior crossbite.
Diagnosis: Skeletal Class III (SNA, 77.5˚; SNB, 82˚; ANB, -4.5˚) relationship in centric occlusion (CO) was associated with midface deficiency, crossbite of the entire dentition except the molars, and lingually inclined lower incisors (L1 to MP, 75.5˚). The Discrepancy Index (DI) was 28.
Treatment: Bone screws were placed in the mandibular buccal shelves to retract the mandibular arch. To enhance adolescent maxillary growth, the bite was opened at the start of treatment with posterior bite turbos, and Class III elastics were applied. Left posterior crossbite was corrected with cross elastics. Lower arch retraction was limited by soft tissue impingement in the retromolar area.
Outcomes: After 25 months of active treatment, a near-ideal profile and occlusal alignment was achieved. The Cast-Radiograph Evaluation (CRE) was 19. Pink and White esthetic score was 0. There were two discrepancies from ideal: crossbite of the upper left second molar, and excessive lingual inclination of lower incisors (66.5˚).
Conclusions: This case report demonstrated the use of OrthoBoneScrew® (OBS) to resolve skeletal Class III malocclusion in a growing adolescent. Class III elastics in addition to bite opening for removal of incisal constraint resulted in enhanced anterior growth expression of the maxilla. A single phase of treatment in the early permanent dentition efficiently resolved a difficult skeletal Class III malocclusion. (J Digital Orthod 2024;73:26-44; reprinted from J Digital Orthod 2021;61:4-22)
Key words: Pseudo-Class III, anterior crossbite, late maxillary growth, passive self ligating brackets, mandibular buccal shelf, bone screws
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