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Revista da Associacao Paulista de Cirurgioes Dentistas

  ISSN 0004-5276

SANTO, Marinho Del; JACOB, Helder    BOSIO, José A.. The challenge of the orthodontic treatment of the hyperdivergent facial phenotype patient. Rev. Assoc. Paul. Cir. Dent. []. 2016, 70, 2, pp. 204-209. ISSN 0004-5276.

Goal: the goal of the paper is to inform orthodontic professionals about the challenges to diagnose and to treat patients presenting hyperdivergent facial phenotype. Materials and methods: a systematic review of the literature was conducted using PubMed and Google Academics, and the best descriptive and experimental studies in the related areas were identified. From the initial selection, 30 papers were revised and discussed. Results: although the prevalence of individuals presenting hyperdivergent facial phenotype in the USA population (since no Brazilian epidemiologic is available) is considerably low, diagnosis and treatment are challenging. The major causal factors involved in its development are: a) genetic; b) epigenetic and; c) environmental. The mandibular posture has a fundamental role in the establishment of such facial type, and some morphological features are pathognomonic: a) excessive inferior anterior facial height; b) lack of posterior facial height; c) increased goniac angle; d) unfavorable mandibular rotation; e) occlusal plane anteriorly tilted down; f) higher and thinner mandibular symphysis and; g) thinner maxillary and mandibular cortical bones. Furthermore, these individuals present respiratory and masticatory functions deficiences. In general, they present anterior open bite and possibly posterior cross bite. Conclusion: settling of the hyperdivergent facial phenotype is complex and multifactorial. The occurrence of sequential severe morphofunctional phenomena is hardly controlled or reverted, while therapeutic options are limited and still experimental.

: orthodontics; face; mandible..

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