title: Can cone-beam computed tomography superimposition help orthodontists better understand relapse in surgical patients?
abstract: This case report describes the interdisciplinary treatment of a 19-year-old Brazilian man with a Class I malocclusion, a hyperdivergent profile, an anterior open bite, and signs of temporomandibular joint internal derangement. The treatment plan included evaluation with a temporomandibular joint specialist and a rheumatologist, orthodontic appliances, and maxillomandibular surgical advancement with counterclockwise rotation. Cone-beam computed tomography images were taken before and after surgery at different times and superimposed at the cranial base to assess the changes after orthognathic surgery and to monitor quantitatively the internal derangement of the temporomandibular joints and surgical relapse. Our protocol can improve the orthodontist's understanding of surgical instability, demonstrate the clinical value of cone-beam computed tomography analysis beyond the multiplanar reconstruction, and guide patient management for the best outcome possible.
authors.affiliation: Postgraduate student, Department of Pediatric Dentistry, Araraquara Dental School, State University of São Paulo, Araraquara, São Paulo, Brazil. Electronic address: podontog@yahoo.com.br.
authors.forename: Guilherme Machado
authors.initials: GM
authors.lastname: Porciúncula
authors.affiliation: Private practice, Charlotte, NC.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Koerich
authors.affiliation: Private practice, Charlotte, NC.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Eidson
authors.affiliation: Adjunct clinical professor, Department of Pediatric Dentistry, Araraquara Dental School, State University of São Paulo, Araraquara, São Paulo, Brazil.
authors.forename: Luiz Gonzaga
authors.initials: LG
authors.lastname: Gandini Junior
authors.affiliation: Clinical professor, Department of Pediatric Dentistry, Araraquara Dental School, State University of São Paulo, Araraquara, São Paulo, Brazil.
authors.forename: João Roberto
authors.initials: JR
authors.lastname: Gonçalves
mesh_terms: D002508:Cephalometry / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007180:Incisor / Q000000981:diagnostic imaging; D008297:Male; D008311:Malocclusion, Angle Class I / Q000000981:diagnostic imaging / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging; D019186:Mandibular Advancement / Q000379:methods; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008437:Maxilla / Q000000981:diagnostic imaging; D024343:Open Bite / Q000000981:diagnostic imaging / Q000601:surgery; D009967:Orthodontic Appliances; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D019340:Osteotomy, Le Fort / Q000379:methods; D059229:Osteotomy, Sagittal Split Ramus / Q000379:methods; D010347:Patient Care Planning; D012008:Recurrence; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D055815:Young Adult