In recent years, orthodontic treatment involving the combined use of temporary anchorage devices, such as anchor screws and plates, and periodontal bone regeneration has been clinically applied, followed by improvements in diagnosis and treatment results. The emergence of anchor screws markedly changed the concept of anchorage units in dynamic orthodontic treatment, leading to effective tooth movement. Because the combined use of anchor plates enables orthodontic forces to be directly applied to bone, the effective application of an orthopedic force to the jaw became possible. Furthermore, orthodontic treatment with the combined use of periodontal bone regeneration increases the bucco-lingual width of the alveolar bone, expanding the alveolar bone housing and tooth movement region.
Jaw deformity is a skeletal maxillo-facial morphological abnormality composed of positional abnormality of the jaw bone and teeth, and deformation of the alveolar bone. In conventional surgical orthodontic treatment, jaw deformity is treated with decompensation of the tooth position, and repositioning of the jaw bone by orthognathic surgery. However, when the new orthodontic treatment technology mentioned above is applied to jaw deformity treatment, composite orthognathic surgery can be simplified, and safe and secure jaw deformity treatment becomes possible. Jaw deformity treatment in Japan, differing from that in European and other Asian countries, has markedly advanced owing to pioneers' devoted efforts, and it became covered by the national health insurance system in 1996. However, regarding the new treatment method with the technical innovation mentioned above, only anchor screws were adopted in the insurance coverage revision in April 2014. The paradigm shift of jaw deformity treatment is now at a turning point. This article explains the approach to orthodontic treatment by orthopedic application of anchor plates to the jaws - that to achieve compensation of the teeth and jaw - and the application of orthodontic treatment by the combined use of periodontal bone regeneration, which is a new treatment concept, and evaluates minimal intervention in jaw deformity treatment.

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Objectives: Newspapers are one of the major sources of health information for the general public. The aim of the present study was to review the information about jaw deformities in Japanese newspapers.
Methods: We used the Nikkei Telecom 21 Database to obtain articles published from January 1994 to December 2013 in five major Japanese newspapers, using the keywords “jaw” and “deformity”.
Results: We identified 53 newspaper articles. Medical insurance coverage (n = 17) was the most frequently mentioned, followed by medical accident (n = 15), surgical treatment (n = 11), and orthodontic treatment (n = 11). No trend of an increase or decrease in the number of articles was found.
Conclusion: Most newspaper coverage provided brief, appropriate information about jaw deformities.

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The purpose of this study was to elucidate the influence of profile patterns on the predictability of soft tissue profile changes following surgical orthodontic treatment in mandibular prognathism. The subjects of this study were 101 Japanese adult females who underwent surgical orthodontic treatment for skeletal mandibular prognathism. Lateral cephalograms taken at the start of pre-surgical orthodontics (mean age: 22.0 ± 5.5 years) and just after post-surgical orthodontics (mean age: 25.6 ± 5.8 years) were used for the analysis. Forty hard tissue landmarks and 25 soft tissue landmarks were digitized on the cephalometric tracings. Pre-treatment facial patterns composed of soft and hard tissue profiles were obtained by a self-organizing map (SOM) with 2 × 2 processing units. The X and Y coordinates of the total of 65 landmarks were repeatedly put into the SOM as 130 dimensional data. After one million learning events, the final map was obtained with 4 virtual profile patterns on each of the 4 units. The 101 subjects were classified into the 4 patterns by calculating the Euclidean distance based on the 65 landmarks between the obtained patterns and each subject. The hard tissue changes due to surgical orthodontic treatment were analyzed using pre- and post-treatment cephalograms. The prediction of soft tissue changes was performed according to the Wolford's Surgical Treatment Objective with the actual hard tissue changes, and the predicted and the actual post-treatment soft tissue profiles were compared. As a result, the post-treatment soft tissue B point was located further backward than the predicted point in the facial patterns with a high mandibular plane angle and long lower anterior facial height. In the facial patterns with a low mandibular plane angle, the post-treatment line of the lower lip was positioned more inferiorly and further backward than the predicted lower lip line. The influence on the predictability of post-treatment soft tissue profiles might differ depending on lower lip tonicity associated with profile patterns in mandibular prognathism.

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Objective: This study aimed to confirm the usefulness of cephalometric prediction (CP) in the diagnostic and treatment planning stages of surgical-orthodontic treatment. Few reports have been published on the prediction accuracy of manual CP and it has not been sufficiently investigated. Therefore, this study compared treatment predictions based on manual CP and treatment outcomes in cases of skeletal maxillary protrusion.
Methods: The subjects were 28 patients with skeletal maxillary protrusions who underwent orthodontic treatment at Tokyo Dental College Chiba Hospital. Subjects were divided into the following two groups: patients treated surgically with sagittal split ramus osteotomy (SSRO) only (1-jaw group; n = 13), and patients who underwent both SSRO and Le Fort I osteotomy (2-jaw group; n = 15). Distances and angles were measured and compared between manual CP prepared from lateral cephalograms taken at the initial examination and lateral cephalograms at the completion of treatment.
Results: Tests of the difference in the predicted amount of movement and the actual movement revealed no significant differences in the 1-jaw group, and no significant differences except for Gonion in the 2-jaw group. The predicted positioning and actual positioning resulting from treatment were also compared. In the maxilla, no significant differences were seen between the treatment predictions and surgical results in the 2-jaw group. In the mandible, there were no significant differences in both the 1-jaw and 2-jaw groups.
Conclusion: Manual CP accurately predicted the positioning of the maxillary and mandibular bones in surgical-orthodontic treatment for skeletal maxillary protrusion, and is useful both at diagnosis and when establishing a treatment plan.

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The present study reports the management of a growing patient with Crouzon syndrome and sleep disorder breathing. A boy aged 14 years and 4 months presented to our hospital with severe midface retrusion and malocclusion. Orthognathic treatment including Le Fort III osteotomy was planned in this patient. At age 16 years and 6 months, Le Fort III osteotomy was performed for mid-face advancement after presurgical orthodontic treatment. There was no relapse of the advanced midfacial region and the mandible showed a clockwise rotation after the surgery. The occlusion and facial profile were greatly improved and the pharyngeal airway was enlarged. However, the condition of obstructive sleep apnea did not change after the orthognathic treatment. This study demonstrates the difficulty of managing a Crouzon syndrome patient who has obstructive breathing disorder.

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