Journal of Oral Hygiene & Health
Open Access

Dental Malocclusion; Genetic Predisposition; Developmental Abnormalities; Environmental Factors; Hereditary Factors

Introduction

Dental malocclusion refers to a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. Malocclusion can range from mild to severe and may be associated with various factors, including genetic predisposition, developmental abnormalities, and habits such as thumb-sucking or mouth breathing. While mild malocclusions may not require intervention, more severe cases can impact oral function, aesthetics, and overall oral health. Treatment of severe malocclusion often involves a combination of orthodontic and surgical approaches to achieve optimal outcomes [1].

Genetic predisposition:

Dental malocclusion can have a hereditary component, with certain traits being passed down through generations. Genetic factors influence jaw size and shape, tooth size and shape, as well as the overall alignment of the teeth. Individuals with a family history of malocclusion are more likely to develop similar dental issues (Table 1).

Table 1: The treatment outcomes and results achieved for the case of dental malocclusion, highlighting the improvements in dental alignment, occlusion, functional aspects, aesthetic appearance, patient satisfaction, and follow-up observations.

Developmental abnormalities:

During the growth and development of the jaws and teeth, abnormalities may occur, leading to malocclusion. These abnormalities can affect the size, shape, and alignment of the teeth and jaws [2,3]. Examples include anomalies in dental eruption patterns, asymmetrical growth of the jaws, and anomalies in tooth size and shape.

Environmental factors (e.g., Habits like Thumb-sucking):

Environmental factors can also contribute to the development of malocclusion. Habits such as thumb-sucking, pacifier use, prolonged bottle-feeding, and tongue thrusting can exert pressure on the developing teeth and jaws, leading to misalignment. Persistent habits can interfere with normal dental development, causing anterior open bite, crossbite, or other malocclusion types [4]. Understanding these factors is crucial for assessing the etiology of malocclusion in individual patients and devising appropriate treatment plans tailored to their specific needs. By addressing both genetic predisposition and environmental influences, dental professionals can effectively manage malocclusion and promote optimal oral health outcomes [5].

Case presentation:

A 16-year-old male presented to the orthodontic clinic with complaints of crowded teeth, difficulty chewing, and dissatisfaction with his smile aesthetics. Clinical examination revealed severe malocclusion characterized by Class II skeletal relationship, anterior open bite, and crowding of both dental arches. Panoramic radiograph and cephalometric analysis confirmed skeletal discrepancies and dental abnormalities. The patient had a history of thumb-sucking during childhood, contributing to the development of malocclusion [6].

Treatment plan:

The treatment plan involved a multidisciplinary approach, combining orthodontic treatment with surgical correction of skeletal discrepancies. Orthodontic treatment aimed to align and level the dental arches, correct crowding, and close the anterior open bite. Fixed orthodontic appliances were used to gradually reposition the teeth over a period of 24 months. Pre-surgical orthodontic preparation included dental decompensation to optimize dental arch alignment and achieve stable occlusion.

Surgical intervention:

After completion of pre-surgical orthodontics, the patient underwent orthognathic surgery to correct skeletal discrepancies. Bilateral sagittal split osteotomy (BSSO) was performed to reposition the mandible, while Le Fort I osteotomy was used to reposition the maxilla [7]. The surgical procedures were carefully planned to achieve proper alignment of the jaws, improve facial aesthetics, and establish stable occlusion. Post-surgical orthodontic adjustments were made to fine-tune the occlusion and optimize dental aesthetics.

Outcome:

Following completion of orthodontic treatment and orthognathic surgery, the patient achieved significant improvement in dental occlusion, facial symmetry, and smile aesthetics. The Class II skeletal relationship was corrected, and anterior open bite was successfully closed. The patient reported improved chewing function, speech clarity, and overall satisfaction with his smile. Follow-up evaluations revealed stable occlusion, improved oral hygiene, and reduced risk of temporomandibular joint dysfunction [8].

Result and Discussion

Result

After completion of the multidisciplinary treatment approach, the patient demonstrated significant improvements in both functional and aesthetic outcomes. Orthodontic treatment successfully aligned and leveled the dental arches, addressing crowding and closing the anterior open bite. The use of fixed orthodontic appliances facilitated gradual repositioning of the teeth over a period of 24 months, resulting in improved occlusion and dental aesthetics. Pre-surgical orthodontic preparation, including dental decompensation, optimized dental arch alignment and facilitated stable occlusion [9]. Following orthognathic surgery, which included bilateral sagittal split osteotomy (BSSO) and Le Fort I osteotomy, the patient achieved correction of the Class II skeletal relationship and closure of the anterior open bite. These surgical interventions were meticulously planned to achieve proper alignment of the jaws, restore facial harmony, and establish stable occlusion. Postsurgical orthodontic adjustments further fine-tuned the occlusion and optimized dental aesthetics. As a result of the comprehensive treatment approach, the patient reported improved chewing function, speech clarity, and overall satisfaction with their smile. Follow-up evaluations revealed stable occlusion, improved oral hygiene, and a reduced risk of temporomandibular joint dysfunction. The successful outcome of this case underscores the importance of interdisciplinary collaboration and comprehensive treatment planning in managing complex malocclusion cases to achieve optimal functional and aesthetic results while enhancing overall oral health and quality of life.

Discussion:

The successful management of severe dental malocclusion requires a collaborative approach involving orthodontists, oral surgeons, and other dental specialists. Orthodontic treatment aims to align the dental arches and correct dental abnormalities, while surgical intervention addresses underlying skeletal discrepancies. Orthognathic surgery plays a crucial role in correcting severe malocclusion, restoring facial harmony, and improving oral function. Close coordination between the orthodontic and surgical teams is essential to ensure optimal treatment outcomes and long-term stability [10].

Conclusion

This case report highlights the successful correction of severe dental malocclusion through a combination of orthodontic and surgical interventions. The interdisciplinary approach involving orthodontists and oral surgeons facilitated comprehensive treatment planning and optimal outcomes for the patient. Correction of malocclusion not only improved dental aesthetics but also reduced the risk of tooth decay and relieved excessive pressure on the temporomandibular joint. This case underscores the importance of early diagnosis and timely intervention in managing complex malocclusion cases to enhance oral health and overall quality of life.

Acknowledgment

None

Conflict of Interest

None

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