Myofunctional Treatment of Anterior Crossbite in a Growing Patient (Case Report)

Authors: Pellegrino M., Cuzzocrea M.L., Rao W., Pellegrino G.and Paduano S.

Joural: Hindawi (Volume 2020)

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Abstract

The purpose of this case report is to add another means of treatment for the anterior cross-bite malocclusion in early mixed dentition. The selected functional device is an eruption guidance appliance (EGA). The analysed patient had a functional anterior cross-bite, a mandibular protrusion tendency, and a normo-divergent growth pattern. The early treatment was suggested to correct the malocclusion and avoid unfavourable occlusal conditions that could end in a class III malocclusion growth pattern. After 18 months of treatment, with night-time use, the malocclusion was completely resolved. This therapy strategy allowed the correction of the sagittal jaws’ relationship and maximum control of the vertical dimension. After 2 years of follow-up, the results were preserved. The peculiarity of this kind of intra-oral orthodontic tools is the use of the erupting forces rather than the active forces. This early treatment of anterior cross-bites with EGA may be considered an effective treatment approach for achieving good functional and aesthetic results.

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Early Treatment of Anterior Cross-bite with Eruption Guidance Appliance: a Case Report

Authors: Pellegrino M., Caruso S., Cantile T., Pellegrino G., Ferrazzano G.F.

Joural: Int J. Environ. Res. Public Health (2020)

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Abstract

The purpose of this investigation was to show how to manage an anterior cross-bite in early mixed dentition with an eruption guidance appliance (EGA). The analysed clinical case reported an anterior cross-bite, a bimaxillary retrusion tendency, and a horizontal growth pattern. The anterior cross-bite was an unfavourable occlusal condition that could lead to a class III malocclusion growth pattern. An early treatment approach was suggested to reach a correct sagittal jaw relationship. Hence, the selected approach acted on the dento-alveolar sector, aiming to have effects on the posterior vertical dimension and to improve the sagittal jaw’s relation. An EGA was selected to treat the patient in early mixed dentition. After 7 months of therapy with night-time use, the dental malocclusion was completely resolved. The patient continued to be treated with the same device, used as active retention. With the EGA treatment, the erupting forces, rather than the active forces, were used to resolve the dental malocclusion. This approach allowed a low compliance requirement and had a minimum psychosocial and psychological impact on the patient. The early treatment was essential to give a functional occlusion and a good balance of the soft perioral tissues and muscles.

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Removable orthodontic appliances and alterations in oral microbiota: a perspective longitudinal study

Authors: Pellegrino M., Pellegrino G.S., Fioretti L., Pellegrino G.

Conference: 15th Congress of the European Academy of Paediatric Dentistry (EAPD) (July3–4, 2020)

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Abstract

AIM: The present study was performed to evaluate whether the use of silicone made removable orthodontic devices alter the oral microbiota, the oral health indexes and the salivary pH.
‍METHODS: To pursue this aim, 52 patients were selected (age: 6-12y). The case group (n=26) was treated with LM Activator™ devices; the control group (n=26) involved patients who did not require orthodontic treatment. No differences in distribution of gender were observed between the groups. Two salivary swabs were taken from each individual to evaluate the oral microbiota: the first during the appliance delivery (T0), the second 15 days after the beginning of therapy (T1). The 7 bacterial species, mostly associated with caries and periodontal problems, were selected and analyzed with the real-time polymerase chain reaction. Salivary pH and the following oral health indices were monitored for all patients at both time points (T0 and T1): Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Bleeding On Probing (BOP), White Spot Lesions (WSL) and Decayed Missing Filled Teeth (DMFT).
‍RESULTS: The bacterial load and the oral health indices showed no statistically significant changes between T0 and T1 (p>0.05). Furthermore, the salivary pH average values did not show significative variations during the first 15 days of orthodontic treatment (p>0.05). Student's t-test and Mann-Whitney U test were performed for statistical analysis.
‍CONCLUSION: The analysed silicone-made appliance has minimal influences on oral microbiota and this is supported by oral health indices and salivary pH values. All these features make the silicone made device highly biocompatible.

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The management of hyperdivergent Class II growth with Eruption Guidance Appliance:
a case report

Authors: Pellegrino G., Pellegrino G.S., Fioretti L., Pellegrino M.

Conference: 15th Congress of the European Academy of Paediatric Dentistry (EAPD) (July3–4, 2020)

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Abstract

INTRODUCTION: The treatment of Classes II at an early age always requires a careful evaluation. The ideal treatment of this type of malocclusions is during the pubertal peak. Furthermore, an hyperdivergent growth pattern in Classes II can conduct to a good occlusion with aligned teeth, but a poor aesthetic. Though, it is necessary to avoid treatment in an advanced stage to correct the excess of growth in vertical dimension.
BACKGROUND: The use of Eruption Guidance Appliances (EGA) is suitable to treat hyperdivergent Class II cases, during the pubertal peak growth.
CASE REPORT: The considered patient started the therapy at 7.2 years, during the terminal phase of early mixed dentition. He presented a Dental Class II on the left side, an edge to edge relation on the right side, an Overjet of 6mm and an Overbite of 2mm. The midline was deviated to the left (3mm). According with the cephalometric analysis, the following values were measured: ANB 7.1° and SN-GoGn 36.4°. A perioral muscle tension was observed. The therapy was carried out using only EGA (LM-Activator) with an increased posterior thickness. A sequence of 3 LM-Activator with progressive size and only night-time use was adopted. The therapy ended after 3 years.
FOLLOW-UP: After 1.5 years of follow-up, a further skeletal improvement (ANB: 4°, SN-GoGn: 33.5°), the absence of muscle tension and a better occlusion were observed.
CONCLUSION: The use of EGA in hyperdivergent class II treatment allows a normalization of muscular function and a dentoalveolar growth control, preventing the worsening of a long-face structure and improving aesthetics.

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Properties and potentialities of silicone in orthodontic applications: an in vitro study

Authors: Pellegrino G.S., Pellegrino M., Fioretti L., Pellegrino G.

Conference: 15th Congress of the European Academy of Paediatric Dentistry (EAPD) (July3–4, 2020)

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Abstract

AIM: The present study aims to show the clinical potential of silicone in functional orthodontic applications, analysing the capability to retain its performance over time.
METHODS: First a quasi-static compression test was performed to mechanically characterize the material (Silasto 50). Then, a mechanical fatigue test was conducted to assess the application performance. Each test was performed on 3 cubic specimens (~10mm x 10mm x 10mm) (n=6) with the loading machine Instron E3000 with a 3KN loading cell. The fatigue test simulated a constant cyclic loading (300N-500N) on a surface of 1.9cm2 (molar surface), for a maximum applied stress of 2.6MPa. The loading frequency of the force was 3Hz over 30h, to simulate the use of an orthodontic Eruption Guidance Appliance (EGA) (10h/day) during 1 year.
RESULTS: The silicone subject to simple compression test has an initial Young modulus of 8(±2) MPa for the applied load. It was impossible to find the Yield point, as it went over the limit of the loading cell. The fatigue test revealed that the reduction in stress within the first 6-7 weeks of use is of ~9%, after 6 months of ~13% and after 12 months of ~15%.
CONCLUSION: Hence, the stability over time and the elastic deformation properties make silicone an ideal material to realize Eruption Guidance Appliances.

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Publications

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Case Reports

Myofunctional Treatment of Anterior Crossbite in a Growing Patient (Case Report)

Early Treatment of Anterior Cross-bite with Eruption Guidance Appliance: a Case Report

Removable orthodontic appliances and alterations in oral microbiota: a perspective longitudinal study

The management of hyperdivergent Class II growth with Eruption Guidance Appliance: a case report

Properties and potentialities of silicone in orthodontic applications: an in vitro study

What is your vision on the future of your practice ?

Supported by

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Get in touch

The management of hyperdivergent Class II growth with Eruption Guidance Appliance:
a case report