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Considerations before orthodontic camouflage treatment in skeletal class III malocclusion Budhiawan, Marcella; Anggani, Haru Setyo
Padjadjaran Journal of Dentistry Vol 20, No 1 (2008): March
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Skeletal Class III malocclusions are caused by maxillary deficiency, mandibular protrusion, or a combination of the two. This patient, in this case, may have a sunken in face, strong chin appearance. Most persons with Class III malocclusions, which is a dentofacial deformity, show combinations of skeletal and dentoalveolar components. Orthodontic therapy is usually aimed at compensating for the underlying mild-moderate skeletal Class III discrepancy and patients with severe skeletal Class III discrepancies require a combination of orthodontic treatment and orthognathic surgery to correct the underlying skeletal pattern. By considering many factors, the orthodontic treatment can be done on mild to severe skeletal Class III. These factors are facial profile, dental relationship and skeletal pattern. Those factors should be considered a starting point in making a treatment decision. They give the limitation of orthodontic treatment in terms of whether the occlusion could be corrected, or whether the deformity could be camouflage.

Patients knowledge about side effects of orthodontic treatment Amalia, Mia; Anggani, Haru Setyo; Ismaniati, Nia Ayu
Padjadjaran Journal of Dentistry Vol 23, No 2 (2011): July
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Disharmonious of dental arrangement can possibly create problems for the patient, such as the masticatory function, esthetical, psychosocial, and also the increased risk of trauma and periodontal disease. These are reasons for a patient to seek orthodontic treatment. The aim of this study was to know the patientâs knowledge about the side effects possibility that they receive during orthodontic treatment. The side effects include pain experience during orthodontic treatment, the possibility of soft tissue damage, email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders, and relapse. A cross-sectional study was conducted in patients who registered at Orthodontic Department, Faculty of Dentistry, Universitas Indonesia on March-June 2009. The participants of this study were 100 patients, consist of 86 women and 14 men respectively. Twenty-seven questions about the side-effects of orthodontic treatment were used to obtain the patientâs knowledge and the result was categorized into 3 groups, good, average and poor. The result of the study showed that patientâs knowledge about the side effect of pain experience during orthodontic treatment was average and the patientâs knowledge about the possibility of soft tissue damage due to orthodontic treatment was good. However, the patientâs knowledge about the possibility of email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders and relapse due to orthodontic treatment was low.

Efek pemakaian bisphosphonate pada pergerakan gigi ortodonti Dini Anggraini; Haru Setyo Anggani
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 2, No 1 (2016)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Pergerakan gigi penjangkaran yang tidak diinginkan atau relaps gigi-geligi paska perawatan ortodonti, merupakan salah satu efek samping yang tidak diharapkan. Berbagai alat mekanik ortodonti telah digunakan guna mencegah hilangnya penjangkaran, baik alat ekstra oral dan intra oral. Namun, pada penggunaan alat-alat ini masih dijumpai kehilangan penjangkaran dan menimbulkan efek-efek samping seperti resorpsi akar, lesi white spot, karies, gingivitis dan sebagainya.Selain alat mekanik, agen farmakologi juga potensial untuk menyediakan penjangkaran. Agen farmakologi terbaru yang dapat menghambat pergerakan gigi ortodonti adalah Bisphosphonate. Penulis melakukan studi literatur ini guna mengetahui lebih jauh tentang senyawa Bisphosphonate dan efek farmakodinamik serta farmakokinetiknya sehingga mungkin dapat dijadikan sebagai agen farmakologi guna menghambat pergerakan gigi ortodonti. Hasil penelusuran pada berbagai pustaka menunjukkan bahwa Bisphosphosphonate dapat menghambat pergerakan gigi ortodonti. Temuan ini membuka peluang penggunaan Bisphosphonate guna menambah sifat penjangkaran pada perawatan ortodonsi. Namun perlu penelitian lebih lanjut, agar senyawa ini dapat digunakan secara klinik untuk menghambat pergerakan gigi ortodonti. ABSTRACT: Effect of bisphosphonate administrations on orthodontic tooth movement. Undesirable movement of anchorage tooth or dental relapse of the moved tooth to its initial position after orthodontic treatment are the some unexpected side effects. Various mechanical appliances have been used to prevent anchorage loss, both extra oral and intra oral appliance. However, even with the use of all of these appliances, anchorage loss and other unexpected side effects such as root resorption, white spot lesion, caries, gingivitis, etc were still can be found. Besides mechanical appliances, pharmacological agent also has potential to provide anchorage. The most recent pharmacological agent that can prevent orthodontic tooth movement is Bisphosphonate. The author conduct this literature study in order to have further understanding about bisphosphonate and its pharmacodynamics and pharmacokinetics effects as pharmacological agent to hamper orthodontic tooth movements. Literature studies from numerous references show that Bisphosphonate can prevent orthodontic tooth movement.This finding opens the opportunity of Bisphosphonate administration in order to increase anchorage properties during orthodontic treatment. However, the use of Bisphosphonate clinically to prevent orthodontic tooth movement still require further research.

ANTIBACTERIAL EFFECT OF TITANIUM DIOXIDE NANOPARTICLES AND CHITOSAN NANOPARTICLES IN ORTHODONTIC ADHESIVE RESIN ON STREPTOCOCCUS MUTANS COLONY Wulandani Liza Putri; Erwin Siregar; Haru Setyo Anggani
Dentino : Jurnal Kedokteran Gigi Vol 6, No 1 (2021)
Publisher : FKG Unlam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/dentino.v6i1.10651

ABSTRACTBack ground:Strepococcus mutans colonization around orthodontic bracket is the common thing that may commence the development of white spot lesion.Objectives: This research is to analyze antibacterial effect of titanium dioxide nanoparticles and chitosan nanoparticles in orthodontic adhesive resin toward Streptococcus mutans colony. Methods: This research was conducted at RSKGM University of Indonesia on August 2019. Thirty extracted premolars were randomly allocated into three groups. Bracket was bonded to each specimen using orthodontic adhesive resin (Transbond XT) that was incorporated with titanium dioxide/chitosan nanoparticles. Each sample was submerged in bacterial suspension and was incubated for 24 hours. Streptococcus mutans colony around orthodontic bracket was counted with Total Plate Count methodandthen analyzed using statistical analysis. Results: There is no difference in Streptococcus mutans colony around orthodontic brackets among three treatment groups. Conclusion: Antibacterial effect of orthodontic adhesive resins incorporated with titanium dioxide nanoparticles did not differ from orthodontic adhesive resins incorporated with or without chitosan nanoparticles. This is depicted from the number of Streptococcus mutans colonies around the orthodontic brackets.Keywords: Chitosan nanoparticles, Orthodontic adhesive resin, Streptococcus mutans, Titanium dioxide nanoparticles

Special considerations for orthodontic treatment in patients with root resorption Haru S. Anggani
Dental Journal (Majalah Kedokteran Gigi) Vol. 43 No. 1 (2010): March 2010
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Background: Orthodontic treatment needs good consideration especially when there are unfavorable conditions for orthodontic treatment, such as periodontal diseases or tooth with root resorption. Root resorption should not become worse due to orthodontic treatment., All risk factors should be eliminated before orthodontic treatment is started. Otherwise, the goal of orthodontic treatment could be difficult to achieve because of poor dental and or oral health. Purpose: The purpose of this study was to learn more about mechanical factors that could worsen the root resorption that has already been there or even provoke root resorption to develop during orthodontic treatment. Reviews: Resorption of dental root surface is the condition in which cementum is depraved and the damage could also include dentin of dental root. It can occur either physiologically or pathologically due to some causes. The occurrence of the root resorption is suspected because of the biological factor, the tooth condition, the supportive tissue and the mechanical factors. Panoramic x-ray which routinely used to support diagnose in orthodontic cases, can detect root resorption in general, although sometimes periapical x-ray with parallel technique is needed to enhance the diagnosis. Before starting a treatment, the risk factors that suspected as the causes of root resorption should be eliminated, thus the mechanical treatment can be calculated. Conclusion: Orthodontic treatment in patient with root resorption should not escalate the root resorption which already occurs. The treatment should be done effectively by using optimal forces. Giving discontinued forces and avoiding intrusion and torque movements could reduce the risk factors of root resorption.Latar belakang: Keadaan gigi dan jaringan pendukung yang kurang menguntungkan bagi perawatan ortodontik hendaknya membutuhkan perhatian ekstra para klinisi. Kondisi tersebut misalnya adanya penyakit periodontal ataupun adanya gigi dengan resorpsi akar. Perawatan ortodontik yang dilakukan hendaknya tidak menambah parah resorpsi akar yang telah ada sebelumnya. Sebelum memulai perawatan, seluruh faktor yang diduga sebagai faktor resiko dihilangkan terlebih dahulu. Sebaliknya, tujuan perawatan ortodontik akan sulit dicapai akibat buruknya keadaan gigi dan jaringan pendukungnya. Tujuan: Mempelajari lebih jauh mengenai faktor mekanik yang dapat menyebabkan resorpsi akar atau bahkan memperparah terjadinya resorpsi akar yang telah ada akibat perawatan ortodontik. Tinjauan pustaka: Resorpsi permukaan akar gigi adalah kondisi rusaknya jaringan sementum akar gigi yang dapat berlanjut hingga ke jaringan dentin akar gigi. Resorpsi akar dapat terjadi secara fisiologis atau patologis. Terjadinya resorpsi akar ini diduga karena adanya faktor biologis, kondisi gigi dan jaringan pendukung serta adanya faktor mekanik. Foto ronsen panoramik yang rutin digunakan sebagai penunjang diagnosa pada perawatan ortodontik dapat mendeteksi secara umum adanya resorpsi akar, meskipun terkadang dibutuhkan foto ronsen periapikal teknik paralel untuk memperjelasnya. Sebelum memulai perawatan, faktor resiko yang diduga sebagai penyebab terjadinya resorpsi akar hendaknya dihilangkan lebih dahulu, baru kemudian mempertimbangkan biomekanika perawatan ortodontik. Kesimpulan: Perawatan ortodontik pada pasien dengan resorpsi akar hendaknya tidak memperparah resorpsi akar yang telah ada. Perawatan yang dilakukan haruslah seefektif dan seefisien mungkin dengan menggunakan gaya yang optimal. Selain itu pemberian gaya secara diskontinyu dan menghindaripemberian gaya intrust dan torquing dapat mengurangi terjadinya resorpsi akar gigi.

Efektivitas antibakteri gel chitosan dengan berat molekul berbeda terhadap jumlah koloni bakteri Streptococcus mutans pada permukaan email sekitar braket ortodonti Antibacterial effectiveness of chitosan gel with different molecular weights on the number of Streptococcus mutans colonies in the enamel surface around orthodontic bracket Della Noor Insany; Haru Setyo Anggani; Widya Kusumadewi
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 33, No 3 (2021): Desember 2021
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v33i3.32598

Pendahuluan: Chitosan merupakan bahan alami, bersifat antibakteri, dan dapat dibentuk menjadi gel sehingga berpotensi sebagai agen profilaksis terhadap Streptococcus mutans, penyebab demineralisasi email. Lesi white spot merupakan salah satu risiko penggunaan alat ortodonti cekat. Berat molekul merupakan salah satu faktor yang memengaruhi efektivitas antibakteri chitosan, namun hubungannya masih memberikan hasil yang inkonsisten. Penelitian ini bertujuan menganalisis perbedaan efektivitas gel chitosan dengan berat molekul berbeda terhadap jumlah koloni bakteri Streptococcus mutans pada permukaan email sekitar braket ortodonti. Metode: Penelitian ini menggunakan metode eksperimen laboratoy dengan menggunakan 24 sampel gigi dengan braket dioles gel chitosan A (50-80 kDa), gel chitosan B (50-150 kDa), gel chitosan C (190-310 kDa), dan gel kontrol klorheksidin diglukonat 0,2% (CHX) masing-masing 6 sampel. Seluruh sampel diinkubasi dalam biakan Streptococcus mutans secara bertahap, 10 μl suspensi dari plak yang terbentuk pada sampel dibiakkan untuk memperoleh koloni pada biakan agar. Data dianalisis dengan uji one-way ANOVA dan Least Significant Difference (LSD). Hasil: Jumlah koloni bakteri Streptococcus mutans setelah aplikasi gel chitosan A, B, C, dan gel klorheksidin diglukonat 0,2% (CHX) didapatkan sebesar 10,05x106 CFU/ml; 9,72x106 CFU/ml; 10,96x106 CFU/ml; dan 4,35x106 CFU/ml sehingga tidak terdapat perbedaan bermakna jumlah koloni bakteri Streptococcus mutans antara ketiga kelompok gel chitosan (p>0,05) dan terdapat perbedaan jumlah koloni bakteri Streptococcus mutans yang bermakna antara ketiga gel chitosan dengan gel kontrol (p<0,05). Simpulan: Efektivitas antibakteri gel chitosan dengan berat molekul berbeda terhadap jumlah koloni bakteri Streptococcus mutans pada permukaan email sekitar braket ortodonti adalah sama besar, namun lebih rendah daripada efektivitas antibakteri gel klorheksidin diglukonat 0,2% pada studi ini.Kata kunci: berat molekul; braket ortodontik; kitosan; email; Streptococcus mutans ABSTRACTIntroduction: Chitosan is a natural ingredient, antibacterial, and can be formed into a gel so that it has the potential as a prophylactic agent against Streptococcus mutans, the cause of enamel demineralization. White spot lesions are one of the risks of using fixed orthodontic appliances. Molecular weight is one factor that affects the antibacterial effectiveness of chitosan, but the relationship still gives inconsistent results. This study aimed to analyze the differences in the effectiveness of chitosan gels with different molecular weights on the number of Streptococcus mutans bacteria colonies on the enamel surface around orthodontic brackets. Methods: This study used an experimental laboratory method using 24 dental samples with brackets smeared with chitosan A gel (50-80 kDa), chitosan B gel (50-150 kDa), chitosan C gel (190-310 kDa), and chlorhexidine control gel. digluconate 0.2% (CHX) each of 6 samples. All samples were incubated in Streptococcus mutans culture in stages, 10 l suspension of the plaque formed on the samples was cultured to obtain colonies on agar cultures. Data were analyzed by one-way ANOVA and Least Significant Difference (LSD). Results: The number of Streptococcus mutans colonies after application of chitosan gel A, B, C, and 0.2% chlorhexidine digluconate (CHX) gel was 10.05x106 CFU/ml; 9.72x106 CFU/ml; 10.96x106 CFU/ml; and 4.35x106 CFU/ml, so that there was no significant difference in the number of Streptococcus mutans colonies between the three chitosan gel groups (p>0.05) and there was a significant difference in the number of Streptococcus mutans bacteria colonies between the three chitosan gels and the control gel (p<0.05). Conclusions: The antibacterial effectiveness of chitosan gel with different molecular weights on the number of Streptococcus mutans bacterial colonies on the enamel surface around orthodontic brackets was simi-lar but lower than the antibacterial effectiveness of 0.2% chlorhexidine digluconate gel.Keywords: molecular weight; orthodontic bracket; chitosan; enamel; Streptococcus mutans

Perawatan ortodonti kamuflase pada maloklusi skeletal kelas II dengan penjangkaran mini implant ortodonti, dengan system MBTCamouflage orthodontic treatment in class II skeletal malocclusion with the orthodontic mini implant by the MBT system Rani Setyawati Moekti; Haru Setyo Anggani
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 33, No 3 (2022): Maret 2022 (Suplemen 3)
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v33i3.36466

ABSTRAKPendahuluan: Maloklusi kelas II skeletal memiliki gambaran klinis yang khas yang sulit diubah secara ortodonti konvensional, bahkan terkadang harus dikelola secara ortodonti bedah. Maloklusi skeletal kelas II yang tidak terlalu berat dikatakan masih dapat disamarkan dengan perawatan ortodonti kamuflase. Pencabutan dua premolar atas seringkali dilakukan dalam upaya mendapatkan ruang bagi pergerakan ortodonti yang dilakukan. Upaya ini membutuhkan penjangkaran tambahan agar ruang yang diperoleh sesudah pencabutan dua premolar tersebut tidak berkurang atau hilang karena gagalnya sistem penjangkaran yang dipakai. Mini implant ortodonti pada saat ini menjadi pilihan yang banyak dipakai karena kemampuannya sebagai penjangkaran absolut. Tujuan laporan kasus ini menyampaikan penatalaksanaan perawatan ortodonti kamuflase pada maloklusi kelas II dengan penjangkaran mini implant ortodonti. Laporan kasus: Maloklusi kelas II skeletal dirawat dengan alat ortodonti cekat sistem McLauhglin, Bennett, Trevisi, dengan pencabutan 2 gigi premolar rahang atas disertai alat penambah penjangkaran berupa mini implant ortodonti. Kasus selesai dirawat setelah 24 bulan. Simpulan: Perawatan ortodonti kamuflase pada maloklusi skeletal kelas II menunjukkan Inklinasi gigi anterior, overjet dan overbite terkoreksi, serta kecembungan wajah berkurang. Upaya ini terbantu dengan adanya tambahan penjangkaran berupa mini implant ortodonti, sebagai penjangkaran langsung saat retraksi anterior.Kata kunci: maloklusi kelas II; MBT; perawatan kamuflase; mini implant ortodonti ABSTRACTIntroduction: Class II skeletal malocclusion has a characteristic clinical feature that is difficult to change by conventional orthodontics and sometimes even requires surgical orthodontic management. Class II skeletal malocclusions that are less severe are said to be camouflaged by camouflage orthodontic treatment. The extraction of the two upper premolars is often done to make room for orthodontic movement. This effort requires additional anchoring so that the space obtained after the removal of the two premolars is not reduced or lost due to the failure of the anchoring system used. Mini orthodontic implants are currently the most widely used option because of their ability to act as absolute anchors. This case report aims to present the management of camouflage orthodontic treatment in class II malocclusion by anchoring mini orthodontic implants. Case report: Skeletal class II malocclusion was treated with fixed orthodontic appliance McLauhglin, Bennett, Trevisi system, with extraction of 2 maxillary premolars accompanied by an anchoring device in the form of mini orthodontic implants. Cases were completed after 24 months. Conclusions: Camouflage orthodontic treatment for skeletal malocclusion class II showed anterior tooth inclination, corrected overjet and overbite, and reduced facial curvature. This effort was helped by the additional anchorage in the form of a mini orthodontic implant, as a direct anchor during anterior retraction.Keywords: class II malocclusion; MBT system; camouflage treatment; orthodontic mini implant

Mini implant orthodontic sebagai penjangkaran pada perawatan maloklusi kelas II skeletal dengan protrusi beratMini implant orthodontic as an anchorage in skeletal class II malocclusion treatment with severe dental protrusion Maureen Antolis; Haru Setyo Anggani
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 33, No 1 (2021): April 2021
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v33i1.30591

Pendahuluan: Maloklusi kelas II skeletal memiliki gambaran morfologis yang khas, antara lain adalah protrusi gigi anterior atas, serta profil skeletal dan jaringan lunak cembung. Penatalaksanaan yang cermat terutama penjangkaran, diperlukan agar perawatan ortodonti berhasil, guna mengurangi derajat protrusi gigi anterior atas serta perbaikan profil. Tujuan laporan kasus ini menyampaikan keberhasilan mini implant orthodontic sebagai penjangkaran pada perawatan maloklusi kelas II skeletal dengan protrusi berat.Laporan kasus: Kasus pasien perempuan usia 22 tahun 2 bulan dengan maloklusi kelas II skeletal, yang memiliki profil cembung, mandibula retrognatis, tipe wajah dolichofacial, jarak gigit besar, dengan riwayat rhinitis. Perawatan preadjusted edgewise dilakukan setelah ekstraksi kedua gigi premolar pertama atas yang diikuti dengan pemasangan mini implant orthodontic sebagai penjangkaran. Total waktu perawatan adalah 38 bulan. Jarak dan tumpang gigit normal berhasil dicapai pada akhir perawatan, adapun profil wajah pasien menunjukkan perubahan yang cukup bermakna. Simpulan: Perawatan ortodonti dengan penjangkaran mini implant orthodontic efektif dalam penatalaksanaan pasien pada maloklusi kelas II skeletal dengan protrusi berat.Kata kunci: Mini implant orthodontic, maloklusi kelas II skeletal, protrusi gigi. ABSTRACTIntroduction: Skeletal Class II malocclusion has characteristic morphological features, including the protrusion of the upper anterior teeth and a skeletal profile and convex soft tissue. Careful management, especially anchoring, is necessary for successful orthodontic treatment to reduce the degree of protrusion of the upper anterior teeth and improve the profile. This case report was aimed to address the success of orthodontic mini-implants as anchoring in the treatment of severe protrusion of skeletal Class II malocclusion. Case report: A 22 years two months old female patient with skeletal Class II malocclusion, who had a convex profile, retrognathic mandible, dolichofacial face type, large bite distance, with a history of rhinitis. The preadjusted edgewise treatment was performed after extraction of the two upper first premolars followed by orthodontic mini implant placement as anchors. The total treatment time was 38 months. Normal bite distance and overlap were achieved at the end of treatment, while the patient's facial profile showed significant changes. Conclusion: Orthodontic treatment with orthodontic mini implant anchoring is effective in the management of patients in skeletal Class II malocclusion with severe protrusion.Keywords: Mini implant orthodontic, skeletal class II malocclusion, dental protrusion.

Peran nance holding arch dalam perawatan ortodonti kasus maloklusi kelas I dengan overjet besarThe role of nance holding arch in orthodontic treatment of class I malocclusion case with large overjet Erlina Hasriati; Haru Setyo Anggani
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 32, No 2 (2020): November 2020 (Suplemen 1)
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v32i1.27467

ABSTRAKPendahuluan: Gigi yang protrusif dan berjejal parah sangat mempengaruhi estetika wajah seseorang, oleh karena itu kondisi ini perlu diatasi secara ortodonti karena dapat mempengaruhi kepercayaan diri dan kualitas hidup seseorang terutama wanita. Selain kebutuhan ruang, perawatan ortodonti yang dilakukan haruslah juga memperhatikankontrol penjangkaran yang optimal. Tujuan laporan kasus ini menyampaikan penatalaksanaan perawatan ortodonti maloklusi kelas I dengan overjet besar Laporan kasus: Seorang pasien wanita usia 25 tahun datang ke Klinik Spesialis Ortodonti RSKGM FKG UI untuk mendapatkan perawatan ortodonti karena kondisi giginya yang sangat protusif. Secara klinis diketahui bahwa pasien memiliki maloklusi kelas I dengan overjet 10 mm. Perawatan ortodonti dilakukan menggunakan breket preadjusted sistem MBT slot.022 serta penjangkaran NHA. Simpulan: Hasil perawatan menunjukkan senyum pasien yang lebih estetik dengan inklinasi gigi anterior dan overjet yang terkoreksi dengan baik. NHA bermanfaat sebagai penambah penjangkaran pada kasus overjet besar yang membutuhkan penjangkaran maksimum, sehingga dapat dijadikan alternatif pilihan alat penambah penjangkaran dalam perawatan ortodonti cekat.Kata Kunci: Protrusif, nance holding arch (NHA), overjet besar. ABSTRACTIntroduction: Protrusive teeth and severe congestion highly affect the face aesthetical aspects; therefore, this condition needs to be treated orthodontically because it can affect the self-confidence and quality of life, especially in women. In addition to space requirements, orthodontic treatment must also pay attention to optimal anchoring control. The purpose of this case report was to deliver the management of class I malocclusion orthodontic with a large overjet. Case report: A 25-years-old female patient came to the Orthodontic Specialist Clinics of University of Indonesia Dental Hospital to get orthodontic treatment because of very protrusive teeth. From the clinical examination, the patient has a class I malocclusion with a 10 mm overjet. Orthodontic treatment was performed using pre-adjusted brackets with MBT slot .022 system and NHA anchoring. Conclusion: The treatment result showed a more aesthetic smile of the patient with well corrected anterior tooth inclination and overjet. NHA is useful as an anchoring enhancer in large overjet cases which require maximum anchoring so that it can be used as an alternative anchor enhancement tool in fixed orthodontic treatment.Keywords: Protrusive, nance holding arch (NHA), large overjet.

Penggunaan trans palatal arch untuk mengatasi penjangkaran pada kasus maloklusi kelas II skeletal disertai crowding yang parahThe use of trans palatal arch as anchorage control for skeletal class II malocclusion with severe crowding Jenny Augusta Arnis; Haru Setyo Anggani
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 32, No 2 (2020): Agustus 2020
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v32i2.26931

Pendahuluan: Maloklusi kelas II skeletal disertai crowding yang parah dapat menambah kompleksitas perawatan ortodontik. Umumnya dibutuhkan pencabutan gigi premolar sehingga dibutuhkan upaya untuk mempertahankan ruangan yang telah diperoleh karena kebutuhan ruangan yang cukup besar. Tujuan penulisan laporan kasus ini adalah menjelaskan perawatan ortodontik kasus maloklusi kelas II skeletal disertai crowding yang parah dengan penjangkaran trans palatal arch (TPA). Laporan kasus: Pasien laki-laki 34 tahun datang ke klinik Ortodonti RSGM FKG UI dengan keluhan gigi berjejal. Hasil diagnosis memperlihatkan adanya maloklusi kelas II skeletal disertai dengan crowding yang parah pada lengkung gigi atas dan bawah, serta profil muka cembung. Kasus ini dirawat dengan pencabutan gigi premolar pertama di rahang atas maupun bawah di kedua sisi menggunakan peranti ortodontik cekat sistem breket pre-adjusted edgewise MBT, dan ditambahkan TPA di rahang atas. Hasil perawatan menunjukkan crowding pada lengkung gigi atas dan bawah terkoreksi setelah 20 bulan perawatan. Simpulan: Penatalaksanaan maloklusi kelas II yang kompleks memerlukan pertimbangan dan perencanaan yang seksama terutama dalam hal penjangkaran. Perawatan ortodontik konvensional menggunakan penjangkaran tambahan berupa TPA terbukti efektif dalam mengoreksi crowding yang parah, mengubah hubungan molar dan kaninus menjadi kelas I, serta memperoleh oklusi yang baik secara merata di regio atas dan bawah di kedua sisi.Kata kunci: Trans palatal arch, crowding, maloklusi kelas II skeletal. ABSTRACTIntroduction: Skeletal class II malocclusion with severe crowding may contribute to the complexity level of orthodontic treatment. During the treatment with premolar extraction, space created needs to be maintained due to the more substantial space requirement. The purpose of this case report was to determine the orthodontic treatment of class II malocclusion with severe crowding using a trans palatal arch (TPA) to reinforce the anchorage. Case report: A 34-year man came to Orthodontic Clinics of the Faculty of Dentistry University of Indonesia Dental Hospital with a chief complaint of dental crowding. Diagnosis result showed the skeletal class II malocclusion along with severe maxillary and mandibular crowding and a convex face profile. Treatment with four first premolar extraction was performed with a pre-adjusted edgewise MBT system with TPA in the upper arch. The treatment results showed that severe crowding was corrected after 20 months of treatment. Conclusion: Due to the complexity of class II malocclusion, arrangement and implementation of this case need proper consideration and strategic planning, especially regarding anchorage control. Conventional orthodontic treatment using TPA is proven to be effective to eliminate severe crowding, obtain bilateral class I canine and molar relationship, and to achieve a right balance and occlusal function in the upper and lower regions of both sides.Keywords: Trans palatal arch, dental crowding, skeletal class II malocclusion.

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