International Journal of Orthodontics

Published by the International Association for Orthodontics

www.iaortho.org

Target thousands of general dentists, pediatric dentists, and

other dentists who provide orthodontic care to patients in

the publication this targeted audience

relies on most – International Journal

of Orthodontics

2021

Med

ia P

lann

er

Published Quarterly by the

International Association f

or Orthodontics

International Journal of

OrthodonticsIn this Issue:

Invisible Cost Effective Me

chanics for

Anterior Space Closure

A New Method for Section

al T-loop

Attachment for Incisor Retra

ction

A Pilot Study on the Dento

alveolar

and Skeletal Effects of Two F

unctional

Appliances in Class II, Divisi

on 1 Growing

Children

Psycho-Neurological Statu

s in Children with

Malocclusions and Muscle P

ressure Habits

Rare Complications in Ort

hodontics

Orthodontic Treatment of

an Adult Class III

Malocclusion with Severe Tr

ansverse Dental

Compensation by Remaining

of Buccal

Crossbite

Facilitating Direct Bonding

for Lingual

Retainers

Multidisciplinary Rehabilit

ation in a Case

of Congenital Aglossia with

Situs Inversus

Totalis

Modified Transpalatal Arch

(m-TPA) for

Vertical Control and Anchor

age

Molar Intrusion in Open-b

ite Adults Using

Zygomatic Miniplates

Functional and Esthetic Tr

eatment of

Lateral Incisor Agenesis with

Mini-Implant

in a Young Patient

The Overbite Complexity: H

ow The Vertical

Position, Tooth-Size Ratios

And Other

Factors Affect Occlusion and

Overbites

Extreme Dental Compensa

tion in an Adult

Skeletal Class III Malocclusi

on: 3-Year

Follow-up of a Successfully C

ompromised

Treatment

VOLUME 26 | NUMBER 2

| SUMMER 2015

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ho.org

My Future as a Practitione

r

Published Quarterly by theInternational Association for Orthodontics

International Journal ofOrthodonticsIn this Issue:

Fixed Functional Therapy with an Anterior Bite Plane

Penta – V Helix: Modified Quad Helix for Correction of Bilateral Dentoalveolar Cross Bite

Customized Orthodontics: The Insignia System

Dento-Skeletal Effects of the Pendulum Hygienic Distalizer

Collaborative Management of a Young Patient with Generalized Aggressive Periodontitis

The Development And Benefits Of Vertical Dimension Primary Molar Buildup Crowns Camouflage Treatment of Class II Div 1

Malocclusion Complicated by Missing Lateral Incisor

Preventive Orthodontic Management of Tooth Transposition

Correction of Severe Class II Skeletal Discrepancy with Fixed Twin Block and High Pull Headgear

Effects of Twin-Block and Faramand-II Appliances on Soft Tissue Profile in the Treatment of Class II Division 1 Malocclusion

Redefining Treatment of Gummy Smile with Botox

Orthognathic Surgery: The Definitive Answer?

VOLUME 25 | NUMBER 4 | WINTER 2014

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Published Quarterly by the

International Association f

or Orthodontics

International Journal of

OrthodonticsIn this Issue:

Bonded Intrusior Arch - A

Simple Approach

Molar Distalization with th

e Assistance of

Temporary Anchorage Devic

es

Closure of Large Midline D

iastema by a “HIV

Spring”

Anterior Open Bite–Simplifi

ed Non Surgical

Technique to Correct in Adu

lts

Miniscrew Supported Burst

one Intrusion

Arch

Distalization Ccontrolled W

ith the Use of Lip-

bumper and Mini-screw as A

nchorage

The Short-term Effects of F

ace Mask and

Fixed Tongue Appliance on

Maxillary

Deficiency in Growing Patien

ts – A

Randomized Clinical Trial

A Simple Technique for Bo

nding Lingual

Retainer

An Alternative Approach t

o Debonding

Lingual Brackets

Upper Airway Obstruction

and Resultant

Growth Factors Influencing

Malocclusions

Biomechanical Considerati

ons in Mandibular

Incisor Extraction Cases

Agenesis of Maxillary Seco

nd Premolar -

Diagnosis and Clinical Mana

gement

Ergonomic & Efficiency Adv

antages of

Myofunctional Orthodontic

s

VOLUME 26 | NUMBER 1

| SPRING 2015

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ho.org

Pseudoscience in Orthodo

ntics

Published Quarterly by theInternational Association for Orthodontics

International Journal ofOrthodonticsIn this Issue:

The Eschler Arch in the correction of the Class III Donald H. Enlow: The Integrative Single Double Life of a Hard Tissue Naturalist Photo-editing in orthodontics: How much is too

much? Impaction of Maxillary Central Incisors: Surgical

and Orthodontic Treatment Non-compliance Appliances for Upper Molar Distalization: An Overview Multidisciplinary Management of a Patient with

Unusual Hypodontia Riding Pontic - Aesthetic Journey Aesthetic Goal Diagnosis and Management of Multiple Supernumerary Teeth Involving Both Jaws Effect of Oral Appliance for Snoring and

Obstructive Sleep Apnea Lingual Orthodontics: The Future? An Investigation into Orthodontic Clinical Record Taking

Quick and Easy Placement of Coil Spring Bracket Placement According to Malocclusion Synergistic Approach with Twin Block and Fixed Appliance Therapy in Class II Div 2 Malocclusion

VOLUME 26 | NUMBER 3 | FALL 2015

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The International Journal of Orthodontics is the flagship peer-reviewed clinical journal published quarterly by the

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90% have been practicing dentistry for 10+ years with 48% of those practicing for 25+ years.

65% have been practicing orthodontics for 10+ years with 24% of those practicing 25+ years.

IJO’s digital journal is a valued resource.Every quarter, readers turn to IJO, for authoritative information on the latest treatments and research plus opinion pieces, practice tips and office management tips as well as information on the latest products and services that can help them do their job better.

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International Association for Orthodontics750 North Lincoln Memorial Drive, #422 Milwaukee, WI, USA 53202

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41

IJO VOL. 24

NO. 2 SUMM

ER 2013

Management of Pseu

do Class III Malocclus

ion- Synergistic

Approach with Fixed

and Functional Appl

iance

By Amit Kumar, BDS, MDS; P

radeep Tandon, BDS, MDS,

FWFO; Gyan P. Singh, BDS, M

DS, FWFO

Abstract: Class III mal

occlusion has been divided i

nto two subtypes: skeletal an

d pseudo-Class III. A pseudo

Class III malocclusion

should be treated as early as

possible to reduce the functi

onal shift of the mandible an

d increase maxillary arch le

ngth. A case of pseudo-Class

III malocclusion was presen

ted here. A 11-year-old boy

came with an anterior cross

bite, the treatment was don

e with Fixed appliance (Roth

prescription) and Reverse Tw

in block therapy. This case d

emonstrated that an anterio

r cross bite was corrected aft

er 10 months of treatment.

Keywords: Pseudo-Class III

malocclusion, Reverse Twin

block, early treatment.

F E A T U R E

This article has been

peer reviewed

ntroduction

Pseudo Class III malocclu

sion is defined as a

functional forward displac

ement of the mandible

as a result of retroclined m

axillary incisors.1-4 About

5% of Chinese population

is affected by Class III

malocclusion, and more th

an half of these cases are P

seudo class

III.5

A cross bite associated

with a displacement is a fu

nctional

indication for orthodontic

treatment. Early treatmen

t of

pseudo Class III malocclu

sion has a number of adva

ntages: it

facilitates the eruption of

canines and premolar into

Angle’s

Class I occlusion,3 it elim

inates traumatic occlusion

to the

incisors6 (which may l

ead to dehiscence and gin

gival recession),

providing a normal enviro

nment for growth of the m

axilla and

it improves the child self-

estem.7-13 Variations in

diagnostic

criteria between pseudo–C

lass III and skeletal Class II

I patients

can have important clinica

l implications for the timi

ng and

mode of treatment. Pseud

o Class III patients typical

ly have

deficient midfacial length

and maxillary arch length,

upper lip

retrusion, excessive maxillo

-mandibular anterior disp

lacement,

retroclined maxillary inciso

rs and normal vertical dev

elopment.3

Combination therapy desc

ribes the combined use of

functional

and fixed techniques in th

e management of malocclu

sion. In

many respects the best of b

oth worlds, where orthope

dic and

orthodontic techniques ar

e combined to achieve cor

rection of

the skeletal discrepancy an

d detailing of the occlusion

.14

Case Presentation

The patient was an 11

-year-old boy, brought to

our hospital

by his mother to seek trea

tment for his “wrongly po

sitioned

front tooth.” His medical

and dental history was no

n-

contributory.

Diagnosis: On extra-o

ral examination, his face w

as

symmetrical with a slightl

y concave lateral profile (F

igure

1a, b, & c). Intra-orally he

presented with a Class III

incisor

relationship and Angle’s C

lass I permanent first mola

r

relationship, the upper an

terior segment was slightly

retroclined,

whereas the lower anterior

segment was well aligned

and a

Figure1a, 1b, 1

c: Pre-treatme

nt extra-oral p

hotographs.

Figure 2a, 2b,

2c, 2d, 2e: Pr

e treatment in

tra-oral

photographs.

Figure 3: Patie

nt is able to br

ing his mandi

ble into edge

to

edge relation

ship.

60

IJO VOL. 24 NO. 2 SUMMER 2013

Organizers). It is paramount to apply the translational force at the Center of Resistance of the second molar (at the furcation), in order to maintain the roots upright and prevent undesirable mesial moment (tipping).2, 3 All the teeth from the ipsilateral second bicuspid to contralateral cuspid are laced back (under-tied) with 010 SS ligature tie, thus creating a solid unmovable block. There is also a 45º off-center bend (gable bend), distally to the second bicuspid, in order to enhance the anterior anchorage.2, 3 In order to circumvent the undesirable mesio-palatal (rotation) and buccal moments (flaring) on the crown of the second molar, lingual intra- power chain or power thread is placed from the second molar cleat to the arch wire between the cuspid and bicuspid.3 The Maximum Anchorage case is a difficult one, nevertheless it can be successful by judicious placement of; TAD, Power Arm, off-center bend, and buccal and lingual intra. Medium Anchorage (Figure 2 a, b): After careful evaluation of the occlusion, it was determined that the patient’s cuspid and molar relationship on the left side is ½ (4.0 mm) Class II. Therefore, the cuspid and bicuspids should move distally about 4.0 mm to solid Class I and the second molar should move mesially 7.0 mm. This is referred to as a partial reciprocal closure.

The bracketing, arch wires and leveling are the same as at the Maximum Anchorage case, however, there is no need for TAD or soldered Power Arm on the molar band. There is a lace back (under-tie) from the contralateral to ipsilateral cuspid in order to prevent drifting of the anterior teeth. There are two 45º off-center bends (gable bends); one distally to second bicuspid and the second one between the two bicuspids.2, 3, 4, 5 These two off center bends prevent mesial and distal moments and help to maintain the roots parallel during translation. There are also two buccal intra- from the molar hook to the brackets of the first and second bicuspid.2 In order to circumvent the undesirable mesio-palatal (rotation) and buccal (flaring) moments on the second molar, lingual intra- power chain or power thread is placed from the second molar cleat to the lingual button of the second bicuspid and later to the lingual button of the first bicuspid.2, 3 The Medium Anchorage case is not as difficult as the previous one, nevertheless it can be successful by the judicious placement of off-center bends, and buccal and lingual intra.

Figure 2, a, b.

A

B

Figure 3, a, b, c.

A

B

C

A

BFigure 4 a, b.

Figure 5, a, b.

A

B

Case Study Alicia S, age: 16.10 (Figure 3 a, b, c). Maxillary left first molar was diagnosed with irreversible pulpitis with a large four surface amalgam restoration as a result of severe hypoplasia of the enamel. The Periapical radiogram revealed large restoration, good periodontal support, and an ectopically erupting third molar. After discussing all the available alternatives of treatment, the patient/parent decided on an odontectomy and an orthodontic space closure.Alicia’s

medical history was noncontributory, without any periodontal or caries considerations, and with good dental

hygiene. Examination of her occlusion revealed Class I skeletal pattern, Class I dental on the right, and ½ (4.0 mm) Class II on the left. Therefore, Alicia was a Medium Anchorage case for the purpose of an

orthodontic closure. Shortly after the odontectomy, SS orthodontic band was cemented on the maxillary second molar (.022 slot) and brackets (MAESTRO, Ortho organizers)

were bonded on the ipsilateral bicuspids (Figure 4 a, b). A .010 SS ligature tie lace back (under-tie) was placed from the gingival hook of the maxillary second molar to the bracket on the second bicuspid. The reciprocal movement is initiated by virtue of elasticity of the

.010 SS ligature wire. Only after the

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