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DDS2
1Assistant
Professor, Department of
Orthodontics, Graduate School of
Dental Medicine, Hokkaido University, Sapporo, Japan.
2Graduate Student, Department of
Orthodontics, Graduate School of
Dental Medicine, Hokkaido University, Sapporo, Japan.
3Professor and Chair, Department of
Orthodontics, Graduate School of
Dental Medicine, Hokkaido University, Sapporo, Japan.
CORRESPONDENCE
Dr Takashi S. Kajii
Department of Orthodontics
Division of Oral Functional Science
Graduate School of Dental Medicine
Hokkaido University
Kita 13 Nishi 7 Kita-ku
Sapporo 060-8586 Japan
Fax: 81-11-706-4917
Email: kajii@den.hokudai.ac.jp
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Fig 1
Pretreatment (top, 9 years 7 months of age) and midtreatment (bottom, 14 years 7 months of age).
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c
Fig 2 (a) Pretreatment without functional anterior position of the mandible, (b) pretreatment (9 years 7 months), and
(c) midtreatment (14 years 7 months).
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Treatment plan
Phase 1 of treatment consisted of labial
inclination of the maxillary central and
right lateral incisors using a lingual arch
appliance to eliminate the anterior crossbite, as well as a posterior bite plate on
the mandibular arch to eliminate any
interference between the incisors. Secondary autogenous cancellous bone graft
of the alveolar ridge was then planed
before eruption of the maxillary left lateral incisor using bone harvested from
the iliac crest.
Phase 2 consisted of nonextraction,
tooth alignment, and achievement of an
ideal occlusion using a fixed appliance,
followed by retention.
Treatment progress
At 9 years 7 months of age, a lingual arch
appliance and posterior bite plate were
placed in the maxillary and mandibular
dental arches, respectively; the posterior
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Fig 4
Kajii et al
Orthodontic correction.
Table 1
Cephalometric measurements
SNA (degrees)
SNB (degrees)
ANB (degrees)
FMIA (mm)
IMPA (mm)
FMA (mm)
FH to occlusal (degrees)
U1-SN (degrees)
Interincisal angle (degrees)
Pretreatment
9 y 7 mo
Interim
14 y 7 mo
Posttreatment
18 y 4 mo
2 y after debond
20 y 8 mo
80.0
77.2
2.8
57.8
89.9
32.3
14.2
84.7
146.9
81.0
77.5
3.5
57.6
88.7
33.7
9.6
104.9
126.2
81.0
77.8
3.1
54.6
92.1
33.3
10.2
107.9
120.5
81.0
77.9
3.1
53.1
93.6
33.3
11.0
104.7
122.4
RESULTS
Results show that treatment based on
pretreatment planning was successful.
The facial profile of the patient was
improved (Fig 5), solid intercuspation of
DISCUSSION
The intercuspation between the teeth
was satisfactory. The molar relationship
was Class I, and overjet and overbite
were ideal, with an improved arch form
and alignment. Both the maxillary and
mandibular dental midlines were nearly
aligned with the facial midline. In this
case, results would have been less satisfactory if the patient had presented with
a palatal cleft in addition to the alveolar
cleft.
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Fig 5
Posttreatment (top row, 18 years 4 months of age) and 2 years posttreatment (bottom row, 20 years 8 months of age).
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b
Fig 6
(a) Posttreatment (18 years 4 months of age) and (b) 2 years after posttreatment (20 years 8 months of age).
ACKNOWLEDGMENTS
The authors would like to thank Associate Prof
Yoshiaki Sato (Depar tment of Or thodontics,
Hokkaido University), Dr Kunihiro Kawashima (plastic surgery, Sapporo City Hospital), and Dr Hiroharu
Igawa for their contributions to this report.
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b
Fig 7 (a) Posttreatment (18 years 4
months of age) and (b) 2 years posttreatment (20 years 8 months of age)
radiographs.
Fig 8 Periapical radiographs. From left: pretreatment, just before bone graft (12
years of age), 3 months after grafting, midtreatment, posttreatment, and 2 years
posttreatment.
Pretreatment
Interim
Posttreatment
2 y after debond
Fig 9
Cephalometric superimposition.
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