Pendahuluan: Profil wajah cekung dan anterior crossbite merupakan gambaran morfologi wajah khas pada maloklusi kelas III dan diperkuat oleh hasil analisis sefalometri lateral. Terkadang maloklusi kelas III disertai dengan ukuran gigi yang lebih kecil dari normal sehingga menyebabkan terbentuknya gigi bercelah. Gambaran tersebut tentu semakin mengurangi estetika wajah pasien maloklusi kelas III. Tujuan laporan kasus ini adalah menyampaikan perawatan maloklusi kelas III yang memiliki malposisi anterior crossbite dan central diastema. Laporan kasus: Seorang pasien wanita usia 32 tahun, berprofesi sebagai jurnalis datang ke RSKGM FKG UI dengan keluhan gigi atas bercelah, gigi bawah maju serta merasa senyum kurang menarik. Perawatan ortodontik dilakukan menggunakan protraction arch dengan tujuan menghilangkan anterior crossbite serta menutup gigi bercelah. Hasil perawatan selama 18 bulan, anterior crossbite dan celah gigi sudah terkoreksi, tercapai overjet positif, gigi insisif atas memberi dukungan bagi bibir sehingga profil wajah menjadi lurus dan penampilan menjadi lebih baik. Simpulan: Perawatan ortodontik menggunakan protraction arch pada kasus prognati mandibula dengan anterior crossbite dan central diastema memberikan hasil yang cukup baik karena diskrepansi dentoalveolar masih tergolong ringan, tidak terdapat diskrepansi transversal dan didukung oleh pola pertumbuhan wajah dalam rentang normal atau cenderung ke arah horizontal dan dapat memperbaiki fungsi pengunyahan dan estetika.Kata kunci: Anterior crossbite, maloklusi kelas III, central diastema, protraction arch. ABSTRACT Introduction: Concave profile and anterior crossbite are common facial deformity appear in skeletal class III, besides the lateral cephalometric analysis. Frequently, small-sized teeth appear in class III malocclusion cases which causes spacing. Spaced teeth caused unpleasing appearance. This case report described conventional orthodontic treatment for skeletal class III with anterior crossbite and central diastema. Case report: A 32 years-old-female journalist came to the Dental Hospital of the Faculty of Dentistry University of Indonesia complaining about her central diastema in the upper arch, forwardly lower jaw position and unpleasant smile. The orthodontic treatment using protraction arch aimed at correcting anterior crossbite and eliminating spaced teeth. An 18-months treatment successfully fixed the anterior crossbite and spaced teeth. Ideal overjet was achieved, upper teeth camouflaged the mid-face deficiency; therefore, create a balanced facial profile. Conclusion: Orthodontic treatment using arch protraction in the case of mandibular prognosis with anterior crossbite and central diastema gives good results because dentoalveolar discrepancy is still relatively mild. There is no transversal discrepancy and supported by facial growth patterns in the normal range, or tends to be horizontal, and proven to be able to improve the mastication and aesthetical function.Keywords: Anterior crossbite, malocclusion class III, central diastema, protraction arch.
Pendahuluan: Maloklusi kelas II divisi 1 dilaporkan seringkali memicu terjadinya gangguan sendi temporomandibula. Posisi kondilus mengalami perubahan pada akhir perawatan ortodontik dengan pencabutan premolar pada maloklusi kelas II divisi 1. Tujuan penelitian menganalisis posisi kondilus pada akhir perawatan ortodontik supaya dapat memberikan pelayanan yang efektif dan komprehensif kepada pasien. Metode: Jenis penelitian deskriptif observasional dengan desain kohort dilakukan pada Klinik Spesialis RSKGM FKG UI dari Maret sampai Mei 2019. Subjek sebanyak 30 orang mengalami maloklusi kelas II divisi 1 yang memiliki gejala gangguan temporomandibular yang memenuhi kriteria inklusi. Metode sampling yang digunakan adalah sampling konsekutif. Foto transkranial dibandingkan dan diukur ruang sendinya bagian anterior, posterior dan superior dan dianalisis menggunakan uji Mc Nemar. Hasil: Sebelum dan sesudah perawatan ortodontik, posisi kondilus kanan dan kiri tidak mengalami perubahan yang signifikan (p>0,05). Sebelum dan sesudah perawatan ortodontik, AJS (Anterior Joint Space), PJS (Posterior Joint Space), SS (Superior Space) kanan dan kiri tidak mengalami perubahan yang signifikan (p>0,05). Gejala gangguan sendi temporomandibula pada akhir perawatan ortodontik adalah kliking dan krepitasi dilaporkan masih ada sedangkan gejala tidak nyaman dan keterbatasan membuka mulut dilaporkan sudah hilang. Simpulan: Tidak terdapat perbedaan posisi kondilus kanan dan kiri, sebelum dan sesudah perawatan ortodontik dengan pencabutan premolar pada maloklusi kelas II divisi 1. Keluhan gangguan sendi temporomandibular tidak ditemukan lagi pada akhir perawatan ortodontik.Kata kunci: Posisi kondilus, perawatan ortodontik, maloklusi kelas II divisi 1, pencabutan premolar. ABSTRACTIntroduction: Class II division 1 malocclusion is reported to trigger temporomandibular joint disorders often. The position of the condyles changed at the end of orthodontic treatment with premolar removal in class II division 1 malocclusion. This study aimed to analyse the position of the condyles at the end of orthodontic treatment to provide effective and comprehensive services to patients. Methods: This type of descriptive observational study with a cohort design was conducted at the Specialist Clinic of University of Indonesia Dental Hospital from March to May 2019. Thirty subjects experienced class II division 1 malocclusion who had temporomandibular disorders that met the inclusion criteria. The sampling method used was consecutive sampling. Transcranial radiographs were compared, and anterior, posterior and superior joint spaces were measured and analysed using the McNemar test. Results: Before and after orthodontic treatment, the position of the right and left condyles did not change significantly (p>0.05). Before and after orthodontic treatment, AJS (Anterior Joint Space), PJS (Posterior Joint Space), SS (Superior Space) right and left did not change significantly (p>0.05). Symptoms of temporomandibular joint disorder at the end of orthodontic treatment were clicking, and crepitus was reported to be present, while the symptoms of discomfort and limited opening of the mouth were reported to have disappeared. Conclusion: There is no difference in the position of the right and left condyles before and after orthodontic treatment with premolar extraction in class II division 1 malocclusion. Complaints of temporomandibular joint disorders were not found again at the end of orthodontic treatment. Keywords: Condyle position, orthodontic treatment, class II division 1 malocclusion, premolar extraction.
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