Study on Cephalometric Changes after Orthodontic Treatment and Fixed Oral Rehabilitation in Adult Patient

Aim: The aim of the present study was to investigate the long-term changes of craniofacial structures, teeth and soft-tissues after extended fixed oral rehabilitation over a period of 23 years.

Background: Oral rehabilitation has to fulfill high claims to aesthetics and function but also should provide long-term stability. lf an extended fixed dental rehabilitation is planned a detailed diagnosis including cast and clinical functional analysis, axiography, muscle and temporo-mandibular joint (TMJ) evaluation, cephalometric analysis, and a careful treatment planning is essential.

Materials and Methods: A total of 15 selected patients (13 women, 2 men; mean age 42.04±10.05 years) obtained extended fixed dental restorations by utilization of the principles of the occlusal concept of sequential guidance with front-canine- dominance. The measurements were based on lateral cephalometric roentgenograms which were taken shortly, 10, 15 and 23 years after dental rehabilitation of each participant of the study. The lateral roentgenograms were traced and distances were measured with a digital calliper.

Results: The data showed an increase of 2.67 mm of the lower face height (PP-Me), the distance between the palatal plane and the incisal edge of the upper central incisor (PP-ls) increases by 1.49 mm, implying a downward movement of the upper incisors. Corresponding to these changes in the upper jaw, the distance from palatal plane to the incisal edge of the lower central incisor increases by 1.10 mm, vertical overbite increases by 0.39 mm, and the distance between Sella and Gnathion increases by 4.99 mm. The lip seal slides downward by 3.31 mm on average over 23 years after rehabilitation.

Conclusion: Significant changes in the lower face can be estimated which are in harmonious accord with the natural changes in the adult aging craniofacial complex.