Approaches to Correction of Class III Skeletal Malocclusion

Approaches to Correction of Class III Skeletal Malocclusion Combined Orthodontic and Surgical Approach in the Correction of Class III Skeletal Malocclusion Dr. Abdulaziz AlShahrani Astrac While growth modification and camouflage orthodontic treatment offers a limited solution in treating some skeletal Class III malocclusion depending on the age of the patient , Underlying skeletal severity, alignment of the teeth and the vertical facial proportions, a combination of surgical and Orthodontic therapy is the treatment of choice in all severe skeletal Class III malocclusion. In this case report I present a combination of surgical-orthodontic therapy for an adult female patient with skeletal class III malocclusion which resulted in good skeletal, dental and soft tissue relationship, with marked improvement in function and facial esthetics. Keywords: Class III malocclusion, Orthognathic Surgery, surgical orthodontics Introduction Class III malocclusion is considered to be one of the most difficult and complex orthodontic problems to treat. The prevalence of class III malocclusion has been reported to be as low as 3-5% in the Caucasian population, but is higher in the Chinese and Japanese population (4-13%) (Often associated with maxillary retrusion) [i] , [ii] , [iii] . The etiology of class III is complex and multifactorial. However, there is usually a strong genetic contribution. Genetic factor is one of the etiological factors where one third of children with severe Class III had a parent with the same problem and one-sixth had an affected sibling [iv] . Racial tendency may play a role as the blacks have shown higher incidence than white’s [v] .Environmental factors appear to play an adaptiverole in the etiology of Class III malocclusion [vi] .Class III malocclusion can be associated with other factors such as cleft palate [vii] . Individuals with class III malocclusion show combinations of skeletal and dentoalveolar components. Class III malocclusion may occur as a result of protrusive mandible, retrusive maxi lla, combination of both [viii] . While the most commonly found Class III malocclusion (30%) showed a combination of mandibular protrusion and maxillary retrusion, Maxillary retrusion alone was found in 19.5% of the sample and Mandibular protrusion alone was found in 19.1% of the sample [ix] .These complex nature of class III requirea careful planning, amultidisciplinary approach and patient cooperation [x] . Case Report A 17-year-old caucasian girl presented for orthodontic treatment because of referral from her dentist with primary complaint of un-esthetic facial and dental appearance. She has a hyper-divergent Class III skeletal and dental relationship. This is characterized by retrognathic maxilla, retroclined lower anterior teeth, with maximum active opening of 47mm with 5mm negative overjet and lateral excursions of 7 mm to both right and left sides. The patient has an ovoid, relatively asymmetrical face with chin slightly deviated to the left. The lip line at rest displayed a pproximately 2 mm of upper incisor. At full animation there was 7mm of upper incisal display and 2 mm of lower incisal edge. She has a slightly concave profile, and competent lips[Figure1]. Pretreatment extra oral photos Intraorally, the oral mucosa was healthy. There were no periodontal pockets present. The gingival tissues were inflamed especially around the prosthetic crowns. There was no bleeding tendency except sometimes with brushing. Free gingival margins were near to the CEJ and attached gingiva was of normal width throughout the mouth. The frenal attachments in both arches were normal. The tongue was normal in size, function and appearance. Teeth # 26, 36 and 46 have been crowned. There was a lingual arch placed one year ago to maintain lower incisors position.

How to find a good job Essay Example | Topics and Well Written Essays - 500 words

How to find a good job - Essay Example I believe that following a few easy rules will help everyone to become successful in their search for a proper job. To begin with, let’s find out what a â€Å"good† job means. For most people the best position is the one with the highest salary. But do not be confused by this global delusion. A real â€Å"good† job should be a combination of 3 most important factors: money, pleasure and time consumption. To be more persuasive I would like to illustrate you some examples. Imagine that you have successfully found a well-paid job, but it just does not suit your preferences. If a person does not like what he or she is doing, than he or she will not be dedicated to the job, they will not fulfill it properly and, in the end, they might get fired. Now think about another situation. You were lucky to find a well-paid job that you really enjoy doing. But the problem is that it takes all your spare time and you do not have any opportunity simply to have a rest. After first few weeks of such intense work you will be tired and exhausted and will think about leaving such a job. Furthermore, a â€Å"good† job should imply career growth. We are all mature people and everyone should think about future prospects when choosing a job. All the pains and dedication at work must be rewarded somehow, and the best way to do this is promotion. So, a proper job is also the one that ensures encouragement and stimulation in a form of career growth. Now, as we have figured out what a â€Å"good† job is, it is time to hunt for it. You should be aware that we all live in a world of extreme competition. Job market is pretty severe and we do not have a choice, except for adjusting to its tough conditions. Even if you are a good and skilled professional, an employer will not come and knock at your door one day with an offer of a wonderful job position. You will have to search for it yourself, attend dozens of job

Macroeconomics Essay Example | Topics and Well Written Essays - 1750 words - 2

Macroeconomics - Essay Example Checkable deposits in banks reduced in the period, but checkable deposits in thrift institutions increased. Hence, there was an increase in overall M1 level between the periods of one year from Nov 2010 to Nov 2011. In terms of M2, only M1 and saving deposits showed an increased. There was a fall in retail funds and small denomination of time deposits. But the increase in M1 and saving deposits was higher than the decrease in other components and hence M2 showed an increase over a period of one year from November 2010 to November 2011. a) There won’t be any change to M1 since both the currency in circulation and checking account are part of M1. Hence shifting money from one head to another won’t have any impact on the total size of M1 and it will remain unchanged. b) There won’t be any change to M1 since the money is simply being transferred from one head of the M1 to another. Since M1 is part of M2 and there isn’t any change to M1, therefore M1 and M2 both will remain unchanged. c) There won’t be any change to M2. Since the money has been transferred to M1 base, but since M1 is part of M2, there won’t be any change to M2. However, M1 will rise by the amount of purchases since the money has been converted from saving account to money and notes in circulation. d) When Fed buys Treasury bills from the banks its liabilities and assets accounts both are being reduced. Since Treasury Bills represents the money that the Fed owes to commercial banks, therefore the reduction in Treasury Bills or purchase of Treasury Bills by the Fed is going to reduce the bank’s liability. At the same time, the Fed will have to pay cash to commercials banks as a settlement for purchase of Treasury Bills and therefore there will be a reduction in Fed’s assets as well. Therefore both the assets and liabilities sides of the balance sheet will get affected