Dugoni, Steven A; Aubert, Maryse M
The age at which children should start orthodontic treatment has been debated amongst orthodontists for many decades. Orthodontists can agree on what is a quality orthodontic result, but disagree as to how and when to best obtain this result Some orthodontists contend that starting treatment in the primary dentition is the most effective means of orthodontic care. Other orthodontists would prefer to begin in the early or late mixed dentition. Still others would rather postpone treatment until the permanent dentition at approximately age 12. This article will evaluate the pros and cons of initiating treatment at different ages.
daCosta, Oluranti Olatokunbo; Aikins, Elfleda Angelina; Isiekwe, Gerald Ikenna; Adediran, Virginia Efunyemi
Introduction: The aims of this study were to establish the prevalence of dental features that indicate a need for early intervention and to ascertain the prevalence of different methods of early treatment among a population of Nigerian children in mixed dentition. Methods: Occlusal relationships were evaluated in 101 children in mixed dentition between the ages of 6 and 12 years who presented at the Orthodontic Unit, Department of Child Dental Health, Lagos University Teaching Hospital over a 2 years period. The need for different modes of early orthodontic treatment was also recorded. Results: Anterior tooth rotations (61.4%) and increased overjet (44.6%) were the most prevalent occlusal anomalies. Others included deep bite (31.7%), reverse overjet (13.9%), and anterior open bite (14.8%). Severe maxillary spacing and crowding were exhibited in 12.0% and 5.0%, respectively. About a third (35.7%) of the subjects presented with crossbite while lip incompetence was observed in 43.6% of the subjects. About 44% of the subjects also presented with various oral habits with digit (15.8%) and lip sucking (9.9%) being the most prevalent. Subjects were recommended for treatment with 2 by 4 fixed orthodontic appliances (22.3%), habit breakers (20.7%), removable orthodontic appliances (16.5%), and extractions (15.7%). Conclusions: Increased overjet and anterior tooth rotation were the majority of occlusal anomalies seen, which are not only esthetically displeasing but may also cause an increased susceptibility to trauma to these teeth. Treatment options varied from extractions only to the use of appliance therapy. PMID:27556019
Kalha, Anmol S
The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Embase. Randomised controlled trials (RCTs) of orthodontic treatments (either one- or two-phase) with any type of orthodontic braces (removable, fixed, functional) or head-braces compared with late treatment with any type of orthodontic braces or head-braces; or, on any type of orthodontic braces or head-braces compared with no treatment or another type of orthodontic brace or appliance to correct prominent upper front teeth. Study selection, risk of bias assessment and data extraction were carried out independently by at least two reviewers. The primary measure of effect was over jet measured in millimetres or by any index of malocclusion. Odds ratios (ORs) and 95% confidence intervals (CIs) were used for dichotomous outcomes, mean differences (MDs) and 95% CIs for continuous outcomes and a fixed- effect model for meta-analyses as there were fewer than four studies. Seventeen studies involving 791 patients were included. The overall quality of the evidence was low with only two of the 17 studies being assessed as at low risk of bias. Three trials (n = 343) compared early (two-phase) treatment (7-11 years of age) with a functional appliance with adolescent (one-phase) treatment.Statistically significant differences in over jet, ANB and PAR scores were found in favour of functional appliance when the first phase of early treatment was compared with observation in the children due to receive treatment in adolescence. However, there was no evidence of a difference in the over jet between the groups at the end of treatment. A statistically significant reduction in the incidence of incisal trauma (OR 0.59, 95% CI 0.35 to 0.99, P = 0.04) in favour of two-phase treatment with functional appliance was seen. The incidence of incisal trauma was clinically significant with 29% (54/185) of patients reporting new trauma incidence in the adolescent (one
The papers summarized here indicate that TMJ dysfunction remains a complicated problem, requiring a multidisciplinary team approach. Psychological stress is an important factor in diagnosis. New concepts of joint function must be considered. The functional anatomy of the TMJ from an arthroscopic perspective should be studied. New treatment methods, such as the polycentric hinge joint articulator, should be considered. And finally, orthodontic diagnosis and treatment conventions need to be modified, from obtaining a complete history, clinical examination, arriving at a diagnosis and obtaining informed consent for treatment that may include psychological counseling, splint therapy, simultaneous fixed orthodontics and splint therapy and possible TMJ arthroscopic surgery for nearly all orthodontic patients.
Sarul, Michał; Kawala, Beata; Kozanecka, Anna; Łyczek, Jan; Antoszewska-Smith, Joanna
Objective assessment of daily wear time of removable appliances is possible, so the next step is to ascertain whether the severity of malocclusion influences patients' compliance. This could help resolve the controversy over the question of whether removable appliance therapy truly works. The aim of the study was to investigate whether the patient's orthodontic treatment needs affect the cooperation between the patient and the doctor, and to find a correlation that could affect recommendations for orthodontic treatment. The study involved 58 patients (29 boys, 29 girls) aged 9-12 years, who qualified for treatment with removable appliances equipped with a sensor system. The patients were divided into four groups according to their Index of Orthodontic Treatment Need dental health component scores. Over a 9-month period, data stored in the sensors were compared with the recommended daily wear time (DWT) of the appliances, and a statistical analysis was conducted. DWT differed considerably in all the groups. Statistically significant differences in the mean DWT values occurred only when extreme values of the IOTN DHC were compared. The degree of patient compliance depends to a small extent on the severity of malocclusion. Patients with mild malocclusion will probably be less likely to cooperate. Among patients with severe malocclusion, compliance may be unpredictable. Patient compliance is an important background factor that can explain a lot of the controversy over the effectiveness of treatment with removable appliances.
Woon, See Choong; Thiruvenkatachari, Badri
Class III malocclusion affects between 5% and 15% of our population. The 2 most common dilemmas surrounding Class III treatment are the timing of treatment and the type of appliance. A number of appliances have been used to correct a Class III skeletal discrepancy, but there is little evidence available on their effectiveness in the long term. Similarly, early treatment of Class III malocclusion has been practiced with increasing interest. However, there has been no solid evidence on the benefits in the long term. The aim of this systematic review was to evaluate the effectiveness of orthodontic/orthopedic methods used in the early treatment of Class III malocclusion in the short and long terms. Several sources were used to identify all relevant studies independently of language. The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase (Ovid), and MEDLINE (Ovid) were searched to June 2016. The selection criteria included randomized controlled trials (RCTs) and prospective controlled clinical trials (CCTs) of children between the ages of 7 and 12 years on early treatment with any type of orthodontic/orthopedic appliance compared with another appliance to correct Class III malocclusion or with an untreated control group. The primary outcome measure was correction of reverse overjet, and the secondary outcomes included skeletal changes, soft tissue changes, quality of life, patient compliance, adverse effect, Peer Assessment Rating score, and treatment time. The search results were screened for inclusion, and the data extracted by 2 independent authors. The data were analyzed using software (version 5.1, Review Manager; The Nordic Cochrane Centre, The Cochrane Collaboration; Copenhagen, Denmark). The mean differences with 95% confidence intervals were expressed for the continuous data. Random effects were carried out with high levels of clinical or statistical heterogeneity and fixed affects when the heterogeneity was low
Clijmans, Maïté; Medhat, Aly; Geest, An De; van Gastel, Johannes; Kellens, Annelies; Fieuws, Steffen; Willems, Guy
Objective: The aim of the present study was to investigate possible relations between anticipated overall treatment complexity (AOTC) of an orthodontic case and malocclusion characteristics. Methods: Two groups of orthodontists (groups A and B) were asked to define perceived treatment complexity (PTC) of orthodontic cases based on 16 characteristics of malocclusion by means of a questionnaire. Each question was answered on a six-point ordinal scale, with one "not applicable" option (score 0). Group A was also asked to give the AOTC of the specific case on a five-point ordinal scale. The index of orthodontic treatment need (IOTN) score of the specific cases as well as the malocclusion characteristics were assessed by one author. Results: There is a significant relationship between IOTN and AOTC (p< 0.0001), 22% of variability is explained by differences in IOTN. Adding objective characteristics of malocclusion to explain AOTC does not significantly increase the explained variability (p = 0.086). In judging interobserver agreement, a weighted Kappa of 0.60 for group A and 0.56 for group B was found. The weighted Kappa for agreement in AOTC equals 0.06. Conclusion: The relation between IOTN and AOTC was found to be significant. Moderate agreement on PTC among observers and a low level agreement regarding AOTC were found in the present study. PMID:27007763
Almadih, Ahmed; Al-Zayer, Maryam; Dabel, Sukainh; Alkhalaf, Ahmed; Al Mayyad, Ali; Bardisi, Wajdi; Alshammari, Shouq; Alsihati, Zainab
Although orthodontic treatment is commonly indicated for young healthy individuals, recent trends showed an increase in number of older individuals undergoing orthodontic interventions. The increased age resulted in a proportionate increase in the prevalence of systemic diseases facing dentists during orthodontic procedures, especially diabetes mellitus. This necessitates that dentists should be aware of the diagnosis of diabetes mellitus and its early signs particularly in teeth and oral cavity. It is also essential for them to understand the implications of diabetes on orthodontic treatment and the measures to be considered during managing those patients. In this review, we focused on the impact of diabetes mellitus on orthodontic treatment. We also summarized the data from previous studies that had explained the measures required to be taken into consideration during managing those patients. We included both human and animal studies to review in depth the pathophysiological mechanisms by which diabetes affects orthodontic treatment outcome. In conclusion, this review emphasizes the need to carefully identify early signs and symptoms of diabetes mellitus in patients demanding orthodontic treatment and to understand the considerations to be adopted before and during treating these patients. PMID:29317952
Anterior crossbite with functional shift also called pseudo Class III is a malocclusion in which the incisal edges of one or more maxillary incisors occlude with the incisal edges of the mandibular incisors in centric relationship: the mandible and mandibular incisors are then guided anteriorly in central occlusion resulting in an anterior crossbite. Early correction, at the mixed dentition stage, is recommended, in order to avoid a compromising dentofacial condition which could result in the development of a true Class III malocclusion and temporomandibular symptoms. Various treatment options are available. The method of choice for orthodontic correction of this condition should not only be clinically effective, with long-term stability, but also cost-effective and have high patient acceptance, i.e. minimal perceived pain and discomfort. At the mixed dentition stage, the condition may be treated by fixed (FA) or removable appliance (RA). To date there is insufficient evidence to determine the preferred method. The overall aim of this thesis was therefore to compare and evaluate the use of FA and RA for correcting anterior crossbite with functional shift in the mixed dentition, with special reference to clinical effectiveness, stability, cost-effectiveness and patient perceptions. Evidence-based, randomized controlled trial (RCT) methodology was used, in order to generate a high level of evidence. The thesis is based on the following studies: The material comprised 64 patients, consecutively recruited from the Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden and from one Public Dental Health Service Clinic in Malmö, Skane County Council, Sweden. The patients were no syndrome and no cleft patients. The following inclusion criteria were applied: early to late mixed dentition, anterior crossbite affecting one or more incisors with functional shift, moderate space deficiency in the maxilla, no inherent skeletal Class III discrepancy, ANB
Kuijpers, M A R; Loomans, B
In patients with agenesis or enamel anomalies in anterior teeth combined orthodontic and restorative treatment is often necessary to achieve an optimal aesthetic result. How both can best be achieved, but also how to maintain the result, requires communication between the dentist and the orthodontist. The orthodontic treatment plan needs to be established in cooperation with the dentist who will carry out the restorative treatment while the patient is at a young age. Since with these young patients, who are still growing craniofacially and whose teeth are still developing, possible future restorative and/or orthodontic treatment, as well as the means of orthodontic retention, need to be included in the treatment plan. In cleft palate patients, it is also important that methods of orthodontic retention of maxillary arch width are given timely attention in the restorative treatment plan because it is especially vulnerable to relapse.
Thiruvenkatachari, Badri; Harrison, Jayne; Worthington, Helen; O'Brien, Kevin
In this article, we summarize the most clinically relevant findings of our recently updated Cochrane systematic review into the treatment of Class II Division 1 malocclusion. A systematic review of the databases was performed to identify all randomized controlled trials evaluating early treatment with functional appliances to correct Class II Division 1 malocclusion. Three early treatment studies with data from 353 participants were included in this review. The results showed no significant difference for any outcomes, except new incidence of incisor trauma, which was significantly less for the early treatment group. The risk ratio analysis for new incisor trauma showed that providing early treatment reduced the risk of trauma by 33% and 41% in the functional and headgear groups, respectively. However, when the numbers needed to treat were calculated, early treatment with functional appliances prevents 1 incidence of incisal trauma for every 10 patients (95% CI, 5-174), and headgear treatment prevents 1 incidence of incisal trauma for every 6 patients (95% CI, 3-23). Orthodontic treatment for young children, followed by a later phase of treatment when the child is in early adolescence, appears to reduce the incidence of new incisal trauma significantly compared with treatment that is provided in 1 phase when the child is in early adolescence. However, these data should be interpreted with caution because of the high degree of uncertainty. There are no other advantages in providing 2-phase treatment compared with 1 phase in early adolescence. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Saleh, M; Hajeer, M Y; Al-Jundi, A
To determine the degree of pain and discomfort during the orthodontic treatment of skeletal Class III malocclusion using the Removable Mandibular Retractor (RMR). The sample consisted of 33 skeletal Class III patients (17 males and 16 females; average age: 7.5 ± 1.33 years) who had been assigned to the RMR treatment group in a randomised controlled trial comparing this treatment versus a control group of no treatment at the Orthodontic Department, University of Al-Baath Dental School in Syria. Pain and discomfort were assessed using standardised questionnaires at the following assessment times: 7 days (T1), 14 days (T2), 6 weeks (T3), 3 months (T4) and 6 months (T5) after appliance insertion. Levels of pain and discomfort decreased gradually by time in general. No significant changes in the levels of pain, tooth sensitivity and soft tissues tension were detected, whereas a significant decrease in the levels of pressure, impaired speech, impaired swallowing and lack of confidence in public was observed two weeks following appliance insertion. Mandibular constraint feeling required three months to decrease significantly. No difference was found between males and females with regard to acceptance. The RMR is well accepted by Class III patients in the early mixed dentition.
Javaheri, Homan H
The side effects of orthodontic mechanics at each tissue level (alveolar bone, periodontal ligament, gingiva, pulp, cementum, and enamel) are addressed, along with the issue of pain following orthodontic appointments, and psychobehavioral alterations observed in orthodontic patients. It is necessary to know how orthodontic treatment affects enamel health, including methods to manage these side effects, which are still a dilemma for orthodontic clinicians. It is interesting to note that the dental pulp, which lies deep in the tooth core, also reacts to orthodontic force. The way the periodontal ligament responds to light and heavy forces, in young and adult patients, with or without periodontal disease, should be considered. Root resorption is a well-recognized phenomenon following orthodontic treatment. Advances made in this area of research to identify the parameters and genes associated with this process are developing.
Virkkula, Tarja; Kantomaa, Tuomo; Julku, Johanna; Pirttiniemi, Pertti
The purpose of this longitudinal randomized investigation was to determine the long-term changes in the soft-tissue profile during orthodontic treatment when treatment is started with headgear (HG) in the early mixed dentition. The subjects were 68 children (28 girls, 40 boys; mean age, 7.6 years; SD, 0.3 years) with a Class II tendency in occlusion and moderate crowding. They were randomly divided into 2 groups. In the HG group, treatment began immediately. No other appliances were used during the first 2 years. In the control group, only minor interceptive procedures were performed during the first follow-up period of 2 years. During the 8-year follow-up, orthodontic treatment, if needed, comprised fixed appliances and possible extractions in both groups. Twenty linear and 5 angular soft-tissue measurements were registered from lateral cephalograms taken before treatment and after follow-up-periods of 2, 4, and 8 years. The major findings were that, at the 8-year follow-up, the soft-tissue chin and the lower lip were significantly thicker, and the mentolabial sulcus was significantly deeper in the HG group than in the control group. In the control group, a larger variation in the upper lip position was found because of more extractions in this group. Early HG treatment has only a minor effect on the soft-tissue profile. The main effects are on the thickness of the soft-tissue chin and the contour of the lower lip. The differences were not otherwise significant during the long-term follow-up.
Robinson, S N
Many children are learning to play musical instruments at the same time as they are undergoing orthodontic treatment. If a patient or parent enquires about how orthodontic treatment might affect their child's playing, what advice could you give them?
Hassan, Ali H.; Al-Saeed, Samar H.; Al-Maghlouth, Basma A.; Bahammam, Maha A.; Linjawi, Amal I.; El-Bialy, Tarek H.
Objectives: To systematically review the literature to assess the quality of evidence related to corticotomy-assisted orthodontic treatment (CAOT) as adjunctive treatment in orthodontics. Methods: The study was conducted in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia between 2013 and 2014. Various electronic databases were searched and abstracts were retrieved. Defined inclusion criteria were then applied to the obtained original articles for further evaluation by 2 examiners independently. The criteria of selection included human, or animal studies, which assessed some aspects of CAOT and/or the biological principles behind it. Case reports and series were excluded. The quality of the studies was evaluated by the methodological score for clinical trials developed. Results: Fourteen articles were retrieved initially, but only 12 articles were finally selected for the study. The CAOT was found to accelerate tooth movement by 2-2.5 folds when compared with conventional orthodontic tooth movement. The CAOT was found safe on periodontal health and exhibits no or little risk of root resorption. A localized turnover of alveolar spongiosa and the absence of a hyalinized zone was the acceptable biological explanation of CAOT. There is no evidence to support that CAOT enhances the movement of ankylosed teeth, closing old extraction sites, post-orthodontic stability, or transverse expansion. Conclusions: Corticotomy-assisted orthodontic treatment should be considered with caution. Long term randomized clinical trials are still needed. PMID:26108582
Mártha, Krisztina; Lőrinczi, Lilla; Bică, Cristina; Gyergyay, Réka; Petcu, Blanka; Lazăr, Luminița
To assess the prevalence and occurrence of eleven periodontopathogens in subgingival biofilm of banded and bonded molars during the first period of fixed orthodontic treatment. Subjects were selected from patients referred to orthodontic treatment and were divided in two groups: group A comprised fifteen patients (14.4±2.45 years of age) who received orthodontic bands on first permanent molars and group B of ten patients (15.7±1.87 years of age) with directly bonded tubes on the labial surface of the same teeth. Subgingival sample collection was performed before bands and tubes application and 4-7 weeks after attachment placement. DNA-strip tehnique was used to assess the presence of eleven putative periodontopathogens at each time point. Fusobacterium nucleatum, Eikenella corrodens and Capnocytophaga spp. were found in a large number of samples, other periodontopathogens were present in a smaller rate. The 4-7 weeks after attachment placement a slight increase of putative species was observed in both groups. The presence of orthodontic tubes and bands influence the accumulation and composition of subgingival microbiota. Higher level of oral hygiene should be achieved before and during orthodontic treatment in order to prevent any side effects on periodontal tissues.
Hiemstra, Renske; Bos, Annemieke; Hoogstraten, Johan
To investigate the expectations of children and their primary care-givers towards orthodontic treatment and to compare the results with those of a UK sample. A questionnaire survey of children and their primary care-givers attending for their first consultation. The Department of Orthodontics at the Academic Centre for Dentistry Amsterdam (ACTA), the Netherlands. A total of 168 subjects (84 patients and 84 parents) completed the questionnaire. The children were aged 10 to 14 years. The responses of the children and parents and differences between boys and girls were examined using parametric statistical methods. The data from the Dutch sample were compared with a similar UK sample. Patients and parents shared similar expectations of orthodontic treatment, with the exception of expectations of having a brace fitted at the first appointment, orthodontic treatment involving headgear, any problems with orthodontic treatment, duration of orthodontic treatment and concerning reactions from the public. Among the child participants, boys and girls only differed in their expectations of orthodontic treatment involving jaw surgery. Differences between Dutch and English participants were found regarding the first visit, type of orthodontic treatment, reactions from the public, and pain and problems with orthodontic treatment. Since the expectations of patients and their parents differ on several aspects, effective communication between the orthodontist, patient and parent is considered to be essential. Our hypothesis that Dutch patients' and parents' expectations of orthodontic treatment differ from the expectations of English patients and parents was supported.
Hassan, Ali H; Al-Fraidi, Ahmad A; Al-Saeed, Samar H
Corticotomy-assisted orthodontic treatment is an established and efficient orthodontic technique that has recently been studied in a number of publications. It has gradually gained popularity as an adjunct treatment option for the orthodontic treatment of adults. It involves selective alveolar decortication in the form of decortication lines and dots performed around the teeth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. This technique has several advantages, including faster tooth movement, shorter treatment time, safer expansion of constricted arches, enhanced post-orthodontic treatment stability and extended envelope of tooth movement. The aim of this article is to present a comprehensive review of the literature, including historical background, contemporary clinical techniques, indications, contraindications, complications and side effects. PMID:21228919
Atwan, S M; Turner, D; Khalid, A
Recognition of dental anomalies is essential in determining appropriate treatment for each patient. Diagnosis and assessment of mesiodens are critical in avoiding complications such as blocking the eruption of the maxillary central incisors, cyst formation, and dilaceration of the permanent incisors. Collecting data for diagnostic criteria, utilizing diagnostic radiographs, and determining when to refer to a specialist are important steps in the treatment of mesiodens. Early diagnosis and timely intervention could reduce or eliminate the need for orthodontic treatment and prevent serious complications.
Over the last ten years there has been a steady increase in the volume of private dental treatment and numerous finance schemes have been developed to help both patients and dentists. Private orthodontic treatment is increasing and the purpose of this article is to summarise the main features of the schemes currently available to fund private orthodontic treatment and to provide a source of reference.
Henrikson, T; Nilner, M
To prospectively and longitudinally study symptoms and signs of temporomandibular disorders (TMD) and occlusal changes in girls with Class II malocclusion receiving orthodontic fixed appliance treatment in comparison with untreated Class II malocclusions and with normal occlusion subjects. Prospective observational cohort. Sixty-five girls with Class II malocclusion who received orthodontic treatment, 58 girls with no treatment, and 60 girls with normal occlusion. The girls were examined for symptoms and signs of TMD and re-examined 2 years later. Additional records were taken in the orthodontic group during active treatment and 1 year after treatment All three groups included subjects with more or less pronounced TMD, which showed individual fluctuation during the ongoing study. In the orthodontic group, the prevalence of muscular signs of TMD was significantly less common post-treatment. Temporomandibular joint clicking increased in all three groups over the 2 years, but was less common in the normal group. The normal group also had a lower overall prevalence of TMD than the orthodontic and the Class II group at both registrations. Functional occlusal interferences decreased in the orthodontic group, but remained the same in the other groups over the 2 years. (i) Orthodontic treatment either with or without extractions did not increase the prevalence or worsen pre-treatment symptoms and signs of TMD. (ii) Individually, TMD fluctuated substantially over time with no predictable pattern. However, on a group basis, the type of occlusion may play a role as a contributing factor for the development of TMD. (iii) The large fluctuation of TMD over time leads us to suggest a conservative treatment approach when stomatognathic treatment in children and adolescents is considered.
Aldrees, Abdullah M.; Tashkandi, Nada E.; AlWanis, Areej A.; AlSanouni, Munerah S.; Al-Hamlan, Nasir H.
Objective This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists. Materials and methods Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions. Results In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder (TMD) symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups. Conclusions The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners. PMID:25544812
Aldrees, Abdullah M; Tashkandi, Nada E; AlWanis, Areej A; AlSanouni, Munerah S; Al-Hamlan, Nasir H
This study aims to assess the orthodontic diagnostic skills, referral patterns, and the perceptions of orthodontic benefits of pediatric and general dentists in comparison with orthodontists. Two online surveys were e-mailed to pediatric dentists, general dentistry practitioners, and orthodontists registered as members of the Saudi Dental Society and the Saudi Orthodontic Society. The surveys included questions about the type of orthodontic treatment provided, referral trends, and timing; presumed benefits associated with successful orthodontic treatment; and diagnosis and treatment plans of seven cases representing different malocclusions. In total, 25 orthodontists, 18 pediatric dentists, and 14 general practitioners completed the survey. Only 38.8% of pediatric dentists and 7.1% of general practitioners reported that they practiced orthodontics clinically. The perceptions of the three groups toward the benefits of orthodontic treatment were comparable in the psychosocial areas. However, the orthodontists perceived significantly lesser effects of orthodontic treatment on the amelioration of temporomandibular disorder (TMD) symptoms. Pediatric dentists tended to rate the need and urgency of treatment higher, while general practitioners tended to rate the need of treatment lower. The selected treatment plans for three early malocclusion cases showed the greatest discrepancies between the orthodontists and the other two groups. The orthodontists consistently and significantly downplayed the perceived benefit of orthodontic treatment to reduce TMD symptoms. Also, while there was a similarity in the diagnosis, there were notable differences in the proposed treatment approaches, perceived treatment need, and timing of intervention between the three groups of practitioners.
Slavnic, Snjezana; Marcusson, Agneta
Patients considering undergoing combined orthodontic-orthognathic treatment for correction of malocclusion require appropriate information, particularly with respect to duration of treatment. The primary aim of this study was to determine the duration of orthodontic treatment carried out in conjunction with orthognathic surgery and to analyze the influence of selected explanatory variables. A further aim was to compare the duration of orthodontic treatment in patients treated by orthodontists at Linköping University hospital orthodontic clinic and six regional orthodontic clinics. This is a retrospective study, based on data from the orthodontic records of patients who had undergone orthognathic surgery at the University Hospital Maxillofacial Unit in Linköping, Sweden, from 2000 to 2005. The subjects comprised 207 out of 233 patients (107 women and 100 men), aged 15.8-56.9 years, median 24.2 years at the time of surgery: 26 patients were excluded, either diagnosed with a syndrome, or because it was impossible to follow up the entire treatment. 59 subjects had undergone orthodontic treatment at the University hospital orthodontic clinic and 148 at the 6 regional orthodontic clinics. The variables recorded were gender, malocclusion, the number of appointments (scheduled and emergency) and treatment setting. The median value for pre-operative orthodontic treatment time was 19.2 months (range 2.4-68.4); for postoperative orthodontic treatment 4.6 months (range 0-18.8) and for total orthodontic treatment 27.8 months (range 5.9-79.1). For the University hospital orthodontic clinic, pre-operative (16.7 months) and total orthodontic treatment times (25 months) were significantly shorter than for the regional clinics; the duration of postoperative treatment was significantly longer (4.1 months). No other explanatory variables had a significant influence on the duration of orthodontic treatment. Compared with the regional orthodontic clinics, there were significantly
Fábián, Gábor; Bálint, Mária; Fábían, Tibor Károly
Psychosomatic problems related to orthodontic treatment are a special group of oral psychosomatic disorders. The most frequent complaints are related to aesthetics and occlusion. Most of the patients are children, adolescence or young adults, with special emotional problems. Authors reviewed the most important knowledge related to this specific field, but some general aspects of oral psychosomatics are also discussed.
Aksakalli, S; Demir, A
To successfully meet expectations on facial esthetics, it is important to understand normal craniofacial growth and the impact of orthodontic treatment thereon. To date, there have been few studies documenting changes in facial esthetics through photography. The objective of this study was to compare facial soft tissue esthetics before and after orthodontic treatment by means of photographic analysis. The 45 children were divided into 3 groups according to Angle's classification: Groups I, II, and III comprised children with class I, II, and III malocclusion, respectively. Photographs were analyzed with a software. Twenty-one soft tissue landmarks were identified on profile and frontal photographs, ratios and angles were calculated. For group I, there was no difference between pre- and post-treatment facial analysis. For group II, there were significant changes in 5 values. The most significant changes were observed for A-N-B and Al-Me/Ch-Me. For group III, we noted significant changes for 5 values. The most significant change was observed for N-Pn-Pog. There were significant changes in facial soft tissue esthetics after orthodontic treatment for class II and III cases. Changes in A-N-B and nose tip angle (N-Pn-Cm) were observed for class II and class III subjects.
Obilade, Omolara Abiodun; da Costa, Oluranti Olatokunbo; Sanu, Oluwatosin Oluyemi
Expectations of orthodontic treatment may differ between the patient and their parents, as the parents' expectations may not reflect those of the child. The aim of this study, therefore, was to determine the expectations of patients and their parents. This was a clinic-based, comparative, cross-sectional study involving 110 patients aged between 10 and 19 years, as well as their accompanying parents or guardians. The expectations of both patients and parents were determined using a questionnaire developed by Sayers and Newton. Results showed that the expectations of the patients and parents differed significantly in a number of areas with the parents' expectations often exceeding those of the patients. Both patients and parents were found to be ignorant about some aspects of orthodontic treatment, with 47.3% of patients and 39.1% of parents unaware of the duration of orthodontic treatment and, as such, requiring information from their clinicians. The results highlight the importance of patient education and counseling as well as the need to focus on the individual patient and not assume that their expectations mirror those of the accompanying parent. Copyright © 2016. Published by Elsevier Masson SAS.
Nasri, Farah Amirah Mohd; Wahab, Rohaya Megat Abdul; Karsani, Saiful Anuar; Ariffin, Shahrul Hisham Zainal
Mechanical forces in orthodontic treatment used to treat malocclusion can cause inflamed gingival tissue and the process of tooth movement may resorb dental root. Root resorption is an iatrogenic effect of orthodontic treatment but it can be monitored using protein biomarker. This study aims to investigate the differences of protein profile before and after orthodontic treatment using different staining methods. Human gingival crevicular fluid and saliva were collected from orthodontic patients before and after treatment. Protein profile were observed using SDS-PAGE. Our study shows down regulation of proteins after 3 months of treatment. Hence, there are potential values from this study to aid in investigation for specific biomarkers for root resorption.
Choi, Hyung-Joo; Kim, Tae-Woo
Alveolar augmented corticotomy is effective in accelerating orthodontic tooth movement, but the effect only lasts for a relatively short time. Therefore, the purpose of this study was to investigate the underlying biology of the immediate periodontal response to orthodontic tooth movement after a corticotomy with alloplastic bone grafts. The results demonstrated that measurable tooth movement began as early as 3 days after the intervention in beagle dogs. Based on the results and histological findings, augmented corticotomy-facilitated orthodontic tooth movement might enhance the condition of the periodontal tissue and the stability of the outcomes of orthodontic treatment. PMID:25276787
Fleming, Padhraig S; Strydom, Hardus; Katsaros, Christos; MacDonald, Lci; Curatolo, Michele; Fudalej, Piotr; Pandis, Nikolaos
Pain is prevalent during orthodontics, particularly during the early stages of treatment. To ensure patient comfort and compliance during treatment, the prevention or management of pain is of major importance. While pharmacological means are the first line of treatment for alleviation of orthodontic pain, a range of non-pharmacological approaches have been proposed recently as viable alternatives. To assess the effects of non-pharmacological interventions to alleviate pain associated with orthodontic treatment. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 6 October 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 9), MEDLINE Ovid (1946 to 6 October 2016), Embase Ovid (1980 to 6 October 2016) and EThOS (to 6 October 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) comparing a non-pharmacological orthodontic pain intervention to a placebo, no intervention or another non-pharmacological pain intervention were eligible for inclusion. We included any type of orthodontic treatment but excluded trials involving the use of pre-emptive analgesia or pain relief following orthognathic (jaw) surgery or dental extractions in combination with orthodontic treatment. We excluded split-mouth trials (in which each participant receives two or more treatments, each to a separate section of the mouth) and cross-over trials. At least two review authors independently assessed risk of bias and extracted data. We used the random-effects model and expressed results as mean differences (MD) with 95% confidence intervals (CI). We investigated heterogeneity with reference to both clinical and methodological factors. We included 14
Cañigral, Aránzazu; López-Caballo, José L.; Brizuela, Aritza; Moreno-Hay, Isabel; del Río-Highsmith, Jaime; Vega, José A.
Objectives The aim of this literature systematic review was to evaluate the possible association between malocclusions, orthodontic treatment and development of temporomandibular disorders. Material and Methods: A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Material and Methods A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Results The search strategy resulted in 61 articles. After selection according to the inclusion/exclusion criteria 9 articles qualified for the final analysis. The articles which linked orthodontics and development of temporomandibular disorders showed very discrepant results. Some indicated that orthodontic treatment could improve signs and symptoms of temporomandibular disorders, but none of them obtained statistically significant differences. Conclusions According to the authors examined, there is no evidence for a cause-effect relationship between orthodontic treatment and temporomandibular disorders, or that such treatment might improve or prevent them. More longitudinal studies are needed to verify any possible interrelationship. Key words:Malocclusion and temporomandibular disorders, orthodontics and facial pain, orthodontics and temporomandibular disorders, temporomandibular disorders, temporomandibular dysfunction. PMID:26155354
Abu Alhaija, Elham S; Abu Nabaa, Mona A; Al Maaitah, Emad F; Al-Omairi, Mahmoud K
To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment. One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences. Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P < .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P < .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P = .11). Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.
Yu, Wenjing; Zhang, Yueling; Jiang, Chunmiao; He, Wei; Yi, Yating; Wang, Jun
Orthodontic treatment induces dental tissue remodeling; however, dental pulp stem cell (DPSC)-mediated pulp micro-environmental alteration is still largely uncharacterized. In the present study, we identified elevated interleukin-17A (IL17A) in the dental pulp, which induced the osteogenesis of DPSCs after orthodontic force loading. Tooth movement animal models were established in Sprague-Dawley rats, and samples were harvested at 1, 4, 7, 14, and 21 days after orthodontic treatment loading. DPSC self-renewal and differentiation at different time points were examined, as well as the alteration of the microenvironment of dental pulp tissue by histological analysis and the systemic serum IL17A expression level by an ELISA assay. In vitro recombinant IL17A treatment was used to confirm the effect of IL17A on the enhancement of DPSC self-renewal and differentiation. Orthodontic treatment altered the dental pulp microenvironment by activation of the pro-inflammatory cytokine IL17A in vivo. Orthodontic loading significantly promoted the self-renewal and differentiation of DPSCs. Inflammation and elevated IL17A secretion occurred in the dental pulp during orthodontic tooth movement. Moreover, in vitro recombinant IL17A treatment mimicked the enhancement of the self-renewal and differentiation of DPSCs. Orthodontic treatment enhanced the differentiation and self-renewal of DPSCs, mediated by orthodontic-induced inflammation and subsequent elevation of IL17A level in the dental pulp microenvironment. Copyright © 2016 Elsevier Ltd. All rights reserved.
The etiology of malocclusions basically involves both congenital and environmental factors. Malocclusion is the result of the abnormal development of the orofacial complex (including tooth, dental alveolar bone, upper and lower jaws). Early orthodontic interceptive treatments involve the elimination of all congenital and environmental factors that contribute to the malformation of the orofacial complex, as well as interrupt the deviated development of the orofacial complex and the occlusion. Early orthodontic interceptive treatments mainly aim to use children's growth potential to correct abnormal developments of occlusions and orthodontically treat malocclusions more efficiently. The early orthodontic interceptive treatments include correcting the child's bad oral habits, training the abnormal functioned para-oral muscles, maintaining the normal eruptions of succeeding permanent teeth, applying interceptive treatments to the mal-developed teeth, and employing functional orthopedic treatments for abnormal growths of the upper and lower jaws. In orthodontics, correcting mal-positioned teeth is called orthodontic treatment, while rectifying the abnormal relationships of the upper and lower jaws is called functional orthopedic treatment. However, no clear definition is available as regards to the early orthodontic interceptive treatment of malocclusions caused by the deviated development of the dental alveolar bone. This new theory of "early dental alveolar bone and dental arch remodeling technique" was proposed by Professor Li Xiaobing of the Department of Pediatric Dentistry, Faculty of Pediatric Dentistry and Orthodontics in West China Hospital of Stomatology through his clinical analyses and investigation of his early orthodontic interceptive treatments. He defined the early orthodontic corrections of abnormal growth of dental alveolar bone as "remodel". The "early dental alveolar bone and dental arch remodeling theory and technique" is proved useful in
Baird, Jessica F; Kiyak, H Asuman
In both medical and dental settings, researchers have found that patients do not always adequately comprehend the information given during informed consent discussions. The objective of this study was to evaluate patient and parent understanding of the child's orthodontic treatment in a dental school population, compare this with information in patients' charts, and assess the effects of vocabulary and educational level on patients' and parents' comprehension. Interviews were conducted with 21 children, ages 7 to 12 years, undergoing early orthodontic treatment at a dental school and 1 parent or guardian per child. Open-ended questions were asked regarding reasons for treatment, risks, and patient and parent responsibilities. Children had been in treatment for 1 to 24 months (mean = 7.84 +/- 9.42). Patient and parent responses were compared with information in the children's charts. On average, parents recalled only 2.1 reasons for treatment and children recalled only 1.24; the charts listed an average of 4.1 diagnoses. Children could recall only 0.67 risks and parents 0.60 risks, yet many patients had already experienced problems with their treatment on average. The vocabulary levels of the children and their parents were low; parents' vocabulary and educational levels were correlated with their comprehension of this material. Further research should be aimed at improving methods of preparing child patients and their parents for major dental procedures, especially in a publicly funded clinic.
Johal, Ama; Joury, Easter
Our aim was to evaluate the factors that predict orthodontic treatment uptake among adults attending a specialist practice. A cross-sectional controlled design was adopted in a private practice setting. The test group included 62 adults seeking fixed orthodontic treatment. The controls were 52 parents of children undergoing orthodontics but who had not undergone treatment themselves. All subjects completed a set of validated questionnaires: the Rosenberg Self-Esteem Scale, the shortened version of the Oral Health Impact Profile, and the demographic and socioeconomic position characteristics. The Dental Health Component and the Aesthetic Component of the Index of Orthodontic Treatment Need were used to assess the severity of the malocclusions. A 100% response rate was achieved. Subjects without a partner (P <0.001), with a high oral health impact (P <0.001), or with a need for orthodontic treatment (as assessed by the clinician or the subject using the Aesthetic Component of the Index of Orthodontic Treatment Need; P = 0.003 and P = 0.031, respectively) were more likely to have orthodontic treatment than were their counterparts with a partner (odds ratio [OR] = 20.8; 95% confidence interval [CI] = 4.63-93.25), with a low oral health impact (OR = 5.3; 95% CI = 2.36-11.88), or with no treatment need (OR = 3.6 and 4.4; 95% CI = 1.57-8.99 and 1.15-16.77, respectively). Self-esteem and demographic and socioeconomic position characteristics were not significantly associated with orthodontic treatment uptake (P >0.05). The significance of age, marital status, and the shortened version of the Oral Health Impact Profile in predicting the uptake of orthodontic treatment among adults was demonstrated. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
O'Dowling, I B; O'Mullane, D F
An assessment of the orthodontic treatment need among a group of 6th Class pupils in the Southern Health Board area was carried out. It was found that 25.4% of these children had malocclusions severe enough to be offered treatment according to the Guidelines issued by the Department of Health. Two-thirds of these patients would require the use of fixed appliance orthodontic treatment.
Montiel-Company, José M.; Manzanera-Pastor, David; Almerich-Silla, José M.
Objectives: Orthodontic treatment need has often been assessed in child populations, but few studies employing internationally-recognized indices have been conducted in adult or young adult populations. The aim of this study was to determine the orthodontic treatment need of a young adult population in Spain by means of the Dental Aesthetic Index (DAI), the Index of Orthodontic Treatment Need (IOTN) and the need perceived by the patients. Study design: A cross-sectional epidemiological study was conducted in a broad, representative sample of 671 adults aged between 35 and 44 years using health centers in the Valencia Region of Spain, following the recommendations of the World Health Organization (WHO). Results: Orthodontic treatment was required by 31.3% of the sample according to the DAI and 19.2% according to the IOTN (DHC). The orthodontic treatment need perceived by the patients was 21.1%. On relating treatment need to different variables, significant differences in patient perception were encountered by gender, as women perceived a greater need (23.9%) than men (14.4%). Significant differences in previous orthodontic treatment history were found between middle/high (15%) and low (9%) social class and between secondary/tertiary (14%) and primary (3.3%) education. Conclusions: There was no agreement between the treatment need assessed objectively by the indices and that perceived by the patient, or between the indices themselves. The decision to undergo orthodontic treatment can depend on socioeconomic and psychological factors and on values and principles that do not easily lend themselves to objective measurement. Key words:Orthodontics, epidemiology, adult, malocclusion. PMID:22322504
Winnier, J Jasmin; Nayak, Ullal Anand; Rupesh, S; Rao, Arun Prasad; Reddy, N Venugopal
The study was conducted to evaluate the relationship between the Dental Aesthetic Index (DAI) and Index of Orthodontic Treatment Need (IOTN) with subjective perceptions of dental aesthetics, function, speech and orthodontic treatment need. This is an observational cross-sectional study. The children were assessed using the DAI and IOTN. A questionnaire pertaining to dental aesthetics and function was recorded. The aesthetic components of the indices correlated well with aesthetic perceptions of patients, whereas functional components did not have a significant correlation with functional perceptions. The two indices could be used consistently in the present population.
McGuinness, Niall J P
As a result of recent innovations and improvements, orthodontic treatment has become easier and more efficient to carry out, allowing greater numbers of patients to receive treatment. The main result of orthodontic treatment is improved dental alignment and aesthetics. Treatment has no effect on caries or periodontal disease, and the dental health gain is modest, apart from a very small percentage of destructive malocclusions. Psychological improvements using different psychological parameters show differing results and it is not clear that any psychological gains are long lasting. Social gain (greater willingness to smile, feeling good about oneself, satisfaction with dental appearance, etc.), and reported improved quality of life (QoL measures), are now becoming more important as consumer-related outcomes and may, ultimately, contribute to psychosocial and psychological status. Stability of orthodontic treatment results cannot be guaranteed and all patients need to be informed of this, and of the need for long-term retention. Malocclusion has little or no relationship to temporo-mandibular joint dysfunction and orthodontic treatment neither causes nor cures such problems. Extractions as part of orthodontic treatment do not cause TMD, nor do they cause collapse of the vertical dimension. The major improvements in dental health in the last 40 years have been accompanied by a great increase in demand for treatment. In any public health service that is free at the point of use, demand for treatment invariably exceeds the ability of resources to supply this. Indices of treatment need are widely used to determine treatment need and eligibility for treatment in public health systems. Demand for orthodontic treatment among adolescents can be as high as 60% in the general population, while the professionally-assessed need for treatment is approximately half this figure. Age, sex, socio-economic status, perceived unattractiveness of dental appearance, and availability of
Espeland, L V; Grønlund, G; Stenvik, A
The purpose of the present study was to examine orthodontic concern among orthodontically untreated young adults living in an area where the relative number of children receiving treatment was only 15-20% and to compare orthodontic concern among these individuals with that of untreated persons from an area with a higher treatment frequency. All the subjects were clinically examined and impressions for dental study casts, radiographs and photographs were taken. The subject's occlusion was classified according to two methods: 1) allocation to one of four groups according to the national Need for Orthodontic Treatment Index (NOTI), and 2) allocation to one of three groups according to presence or absence of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated that in the study group more individuals were in need of treatment relative to the comparison group. Reported concern was at the same level in both groups, and significantly related to NOTI and AOT scores. The individuals in the area with the low treatment frequency were generally less aware of their anterior traits compared to the individuals in the area with a higher treatment frequency. The results indicated that a long-term low uptake of orthodontic treatment among children in the particular area was not accompanied by a similar increase in concern about own dental appearance in early adulthood.
Furquim, Bruna Alves; de Freitas, Karina Maria Salvatore; Janson, Guilherme; Simoneti, Luis Fernando; de Freitas, Marcos Roberto; de Freitas, Daniel Salvatore
The aim of the present case report is to describe the orthodontic-surgical treatment of a 17-year-and-9-month-old female patient with a Class III malocclusion, poor facial esthetics, and mandibular and chin protrusion. She had significant anteroposterior and transverse discrepancies, a concave profile, and strained lip closure. Intraorally, she had a negative overjet of 5 mm and an overbite of 5 mm. The treatment objectives were to correct the malocclusion, and facial esthetic and also return the correct function. The surgical procedures included a Le Fort I osteotomy for expansion, advancement, impaction, and rotation of the maxilla to correct the occlusal plane inclination. There was 2 mm of impaction of the anterior portion of the maxilla and 5 mm of extrusion in the posterior region. A bilateral sagittal split osteotomy was performed in order to allow counterclockwise rotation of the mandible and anterior projection of the chin, accompanying the maxillary occlusal plane. Rigid internal fixation was used without any intermaxillary fixation. It was concluded that these procedures were very effective in producing a pleasing facial esthetic result, showing stability 7 years posttreatment.
Jeong, Tae-Min; Kim, Yoon-Ho; Song, Seung-Il
The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. The mean skeletal change was posterior movement by 13.87±4.95 mm based on pogonion from T0 to T1, and anterior movement by 1.54±2.18 mm from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P <0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P <0.05). This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative orthodontic treatment. Thus, we
Jeong, Tae-Min; Kim, Yoon-Ho; Song, Seung-Il
Purpose: The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. Methods: The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. Results: The mean skeletal change was posterior movement by 13.87±4.95 mm based on pogonion from T0 to T1, and anterior movement by 1.54±2.18 mm from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P <0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P <0.05). Conclusion: This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative
Yu, Jian-Hong; Huang, Heng-Li; Liu, Chien-Feng; Wu, Jay; Li, Yu-Fen; Tsai, Ming-Tzu; Hsu, Jui-Ting
Abstract Few studies involving human participants have been conducted to investigate the effect of orthodontic treatment on alveolar bone density around the teeth. Our previous study revealed that patients who received 6 months of active orthodontic treatment exhibited an ∼24% decrease in alveolar bone density around the teeth. However, after an extensive retention period following orthodontic treatment, whether the bone density around the teeth can recover to its original state from before the treatment remains unclear, thus warranting further investigation. The purpose of this study was to assess the bone density changes around the teeth before, during, and after orthodontic treatment. Dental cone-beam computed tomography (CBCT) was used to measure the changes in bone density around 6 teeth in the anterior maxilla (maxilla central incisors, lateral incisors, and canines) of 8 patients before and after orthodontic treatment. Each patient underwent 3 dental CBCT scans: before treatment (T0); at the end of 7 months of active orthodontic treatment (T1); after several months (20–22 months) of retention (T2). The Friedman test was applied to evaluate the changes in the alveolar bone density around the teeth according to the 3 dental CBCT scans. From T0 to T1, a significant reduction in bone density was observed around the teeth (23.36 ± 10.33%); by contrast, a significant increase was observed from T1 to T2 (31.81 ± 23.80%). From the perspective of the overall orthodontic treatment, comparing the T0 and T2 scans revealed that the bone density around the teeth was relatively constant (a reduction of only 0.75 ± 19.85%). The results of the statistical test also confirmed that the difference in bone density between T0 and T2 was nonsignificant. During orthodontic tooth movement, the alveolar bone density around the teeth was reduced. However, after a period of bone recovery, the reduced bone density recovered to its previous state from before the
Rodriguez Flores, José Maria
There is currently great demand among adult patients for aesthetic solutions. In the great majority of cases, patients present with serious oral problems in their mouths, such as over-crowding, ageneses, edentulous spaces from old extractions, periodontal problems, etc. In the face of all these problems we need interdisciplinary strategies that will help us carry out the complex and imaginative treatments that these cases require. In this article we are going to describe the interdisciplinary treatment that we provided to two adult patients. 1--On a 25 year old male patient with significant upper maxillary crowding with transversal constriction and absence of the upper right lateral incisor; through correction of the over-crowding, the maxillary constriction and rehabilitation with an implant-supported fixed prosthesis in the edentulous space, we will treat and correct this case. 2--A 29 year old male patient with agenesis of the superior canines and edentulous gap in the inferior dental arch.
Giuca, Maria Rita; Caruso, Silvia; Tecco, Simona; Necozione, Stefano; Gatto, Roberto
Aim. This case-control retrospective study is aimed at assessing if obese adolescents need more orthodontic treatment in comparison with normal-weight patients of the same age. Methods. The test group included 100 obese subjects (50 males and 50 females; average age: 13.09 ± 1.19 years old) and the control group included 100 normal-weight patients matched for age and sex (50 males and 50 females; average age: 13.07 ± 1.26 years old). Clinical examinations were conducted on dental casts to assess the need of orthodontic treatment, by using the Index of Orthodontic Treatment Need (IOTN) (DHC, dental health component; AC, aesthetic components). Results. No statistically significant difference (P > 0.05) was observed between the two groups with regard to AC. Obese females showed a significant (P < 0.05) higher percentage of DHC 3 (32%) in comparison to the normal-weight girls (22%); for the other grades of DHC and for the single kind of malocclusion, no significant difference was found. Conclusions. Obese adolescents showed a similar need for orthodontic treatment compared to normal-weight patients of the same age. However, in obese females, a slightly greater need for orthodontic treatment was observed, compared to normal-weight patients. PMID:25945093
Campbell, Charee L; Roberts, W Eugene; Hartsfield, James K; Qi, Rong
The American Board of Orthodontics (ABO) discrepancy index (DI) quantifies the severity of a malocclusion. The ABO objective grading system (OGS) assesses the quality of orthodontic finishing. Indiana University's comprehensive clinical assessment (CCA) supplements the OGS to provide an instrument to determine clinical outcomes. The purposes of this article were to (1) determine whether treatment outcome is related to the type of malocclusion as defined by the ABO classification, (2) determine the fraction of finished orthodontic cases in the graduate orthodontics clinic that are within the ABO standards for passing the phase III clinical examination, (3) evaluate the contribution of each component of the OGS and the CCA to the total OGS and CCA scores, (4) determine the percentage of finished cases that meet the ABO case category specifications, and (5) identify problem areas to improve the quality of treatment for challenging malocclusions. Three hundred eighty-two cases that satisfied requirements for 8 of the ABO's malocclusion categories were selected from 989 consecutively finished cases from 1998 through 2003. They were evaluated by using the OGS, the CCA, and the DI. The average OGS score was 32.64, the average CCA score was 5.62, and the average DI score was 20.94. There was no significant difference in the OGS and the CCA scores among the categories. Categories 2, 5, 7, and 8 had a DI score that was significantly higher than the average for the entire sample. The OGS and CCA scores were positively correlated with the DI score, meaning that complex malocclusions are challenging to finish well. The most points lost for the OGS and the CCA were for occlusal contacts and treatment efficiency (length of treatment relative to the result), respectively. The fewest points lost were for interproximal contacts and vertical control, respectively. Furthermore, prematurely terminated cases (early debonds) had longer treatment times and higher (worse) OGS and CCA
Marques, Leandro Silva; Freitas Junior, Nacler de; Pereira, Luciano José; Ramos-Jorge, Maria Letícia
To perform a blind comparative evaluation of the quality of orthodontic treatment provided by orthodontists and general dentists. Sixty cases of orthodontic treatment were evaluated-30 treated by specialists in orthodontics and 30 treated by general dentists with no specialization course. Orthodontists were selected randomly by lots, in a population of 1596 professionals, and recordings were performed based on the guideline established by the Objective Grading System proposed by the American Board of Orthodontics. Each participant was asked to present a case considered representative of the best outcome among the cases treated, regardless of the type or initial severity of the malocclusion. Statistical analysis involved the chi-square, Wilcoxon, and Mann-Whitney tests. The level of significance was set at P = .05 for the statistical tests. The results showed that 29 orthodontists (96.7%) presented cases considered satisfactory and would be approved on the qualification exam, whereas only 15 dentists (50%) had cases considered satisfactory. Moreover, treatment time was significantly shorter among the orthodontists (P = .022), and the posttreatment comparison revealed that orthodontists achieved better outcomes considering all the variables studied. Orthodontists spend less time on treatment and achieve better quality outcomes than cases treated by general dentists who have not undergone a specialization course in orthodontics.
Bennett, M. Elizabeth; Vig, Katherine W. L.; Phillips, Ceib L.
Objectives The aims of this study were to develop a reliable self-report measure of consumer satisfaction with orthodontic treatment, and to preliminarily assess its validity. Method Transcripts of qualitative interviews with patients, their parents, and practicing orthodontists together with items from existing dental satisfaction questionnaires were used to develop a pool of 41 items assessing satisfaction with various aspects of orthodontic care. These items were paired with five-point Likert scales (1=strongly disagree, 5=strongly agree) and were administered to 299 parents of children who had completed orthodontic treatment at two university-based clinics. Results Factor analyses and reliability analyses identified three main subscales with high reliabilities: 13 items assessing satisfaction with treatment process (Cronbach’s alpha=.92), seven items assessing satisfaction with psychosocial effects of treatment (Cronbach’s alpha=.87), and five items assessing satisfaction with overall treatment outcome (Cronbach’s alpha=. 79). Relationships among these three subscales and pre- and posttreatment variables were examined in a subset of 86 parent/patients. Forward stepwise regression with backward overlook revealed no significant relationships between any satisfaction subscale and demographic variables. Posttreatment overjet was inversely related to parental satisfaction with orthodontic treatment process (R2=.13; P<.001), and parent satisfaction with treatment outcome (R2=.28; P<.0001). Improvement in esthetics as measured by improvement in IOTN Aesthetic Component scores was positively related to satisfaction with psychosocial outcomes (R2=.28; P<.0001). Conclusions The present instrument is reliable and can be used to assess three dimensions of parental satisfaction with their child‘s orthodontic treatment. Relationships between visible orthodontic outcome variables and parent satisfaction provide preliminary validity support for the instrument. PMID
Mártha, Krisztina; Mezei, T; Jánosi, Kinga
The aim of this histological study was to analyze the gingival reaction to fixed orthodontic appliances. Gingival specimens were obtained with minimal trauma from 11 patients treated with fixed appliances in different intervals during the orthodontic treatment, including post-treatment periods. Serial sections were stained with Hematoxylin-Eosin. T- and B-cells were identified by specific antibodies, using a double staining technique with Avidin-Biotin method. Histological observations demonstrated and confirmed the presence of gingivitis during orthodontic treatment. According to the usual histological evaluation, the biopsies revealed the presence of hyperplastic chronic inflammatory changes from mild to moderate severity. The lack of rapid increase of CD20+ cells demonstrated that the gingival inflammation did not cause overall tissue destruction.
Hackett, Paul M. W.; And Others
Motivation for receiving orthodontic treatment was studied among 109 young adults, and a multivariate model of the process is proposed. The combination of smallest scale analysis and Partial Order Scalogram Analysis by base Coordinates (POSAC) illustrates an interesting methodology for health treatment studies and explores motivation for dental…
Talic, Nabeel F.
Orthodontic treatment is associated with a number of adverse effects, such as root resorption, pain, pulpal changes, periodontal disease, and temporomandibular dysfunction (TMD). Orthodontists should be aware of these effects and associated risk factors. Risk factors linked to root resorption include the duration of treatment, length, and shape of the root, trauma history, habits, and genetic predisposition. PMID:24151415
Pandian, Akshaya; Ranganathan, Sukanya; Padmanabhan, Sridevi
To evaluate and compare the effect of various orthodontic bonding systems and clean up procedures on quantitative enamel colour change. A literature search was done to identify the studies that assessed the quantitative enamel colour change associated with the various bonding systems and cleanup procedures. Electronic database (Pub Med, Cochrane and Google Scholar) were searched. First stage screening was performed and the abstracts were selected according to the initial selection criteria. Full text articles were retrieved and analyzed during second stage screening. The bibliographies were reviewed to identify additional relevant studies. Sixteen full text articles were retrieved. Six were rejected because the methodology was different. There was significant enamel colour change following orthodontic bonding, debonding and clean up procedures. Self-etching primers produce less enamel colour change compared to conventional etching. Resin Modified GIC produces least colour change compared to other light cure and chemical cure systems. Polishing following the clean-up procedure reduces the colour change of the enamel.
Soldatova, L N; Horoshilkina, F Ya; Iordanishvili, A K
The aim of the study was to estimate dental health of servicemen of young and middle age using PMA index, Schiller-Pisarev assay, iodic number of Svrakov, OHI-S. Hundred and six servicemen were enrolled in the study: control group (n=35) with no orthodontic treatment and groups 2 (n=34) and 3 (n=37) group undergoing orthodontic treatment with bracket-systems. All patients had professional oral hygiene and received standard oral care recommendations. Group 3 participants additionally used dental foam (Splat, Russia) after meal. All patients were examined at baseline and 12 months later. In the presence of orthodontic appliances standard oral care products were not enough to maintain proper oral health. Dental foam improved both periodontal condition and OHI-S.
Bai, Y X
Three-dimensional(3D)digital technology has been widely used in the field of orthodontics in clinical examination, diagnosis, treatment and curative effect evaluation. 3D digital technology greatly improves the accuracy of diagnosis and treatment, and provides effective means for personalized orthodontic treatment. This review focuses on the application of 3D digital technology in the field of orthodontics.
Meeran, Nazeer Ahmed
The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks. PMID:24987646
Kokai, Satoshi; Kanno, Zuisei; Koike, Sarina; Uesugi, Shunsuke; Takahashi, Yuzo; Ono, Takashi; Soma, Kunimichi
Autotransplantation has become a major therapeutic option for replacing missing teeth in adult orthodontic patients. However, little systematic information is available about the long-term stability of autotransplanted teeth with complete root formation after the application of an orthodontic force. The objective of this study was to investigate the outcomes of autotransplanted teeth with complete root formation that underwent orthodontic treatment. One hundred teeth, autotransplanted in 89 patients, were examined over a mean observation period of 5.8 years. Orthodontic force was applied with nickel-titanium wires 4 to 8 weeks after autotransplantation. Root resorption, ankylosis, mobility, pocket depth, and inflammation at the recipient site were investigated clinically and with radiographs. The survival rate of the autotransplanted teeth was 93.0%. Abnormal findings were found in 29 teeth, including 7 lost teeth, for a success rate of 71.0%. Donor tooth type and occlusal condition of the donor tooth before transplantation were associated with abnormal findings. The early application of orthodontic force may increase the success rate of autotransplanted teeth, and the type and presurgical occlusal condition of donor teeth affect the success rate. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Edwards, Daenya T; Shroff, Bhavna; Lindauer, Steven J; Fowler, Chad E; Tufekci, Eser
To determine the effect of media advertising on consumer perception of orthodontic treatment quality. A survey instrument was designed to evaluate factors influencing consumer selection of an orthodontist and consumer perception of different forms of media advertising (radio, television, newspaper, magazine, direct mail, and billboard) by orthodontic practices. The surveys were distributed by eight orthodontic offices in and around the Richmond, Virginia area. The survey return rate was 97%. Respondents most often cited dentist and patient referrals as how they learned of the orthodontic practices they visited (50% to 57%). A caring attitude and good practitioner reputation were the top reasons influencing actual selection of an orthodontist (53% and 49%, respectively). Of respondents, 14% to 24% felt that advertising orthodontists would offer a lower quality of care than nonadvertising orthodontists. Newspaper, magazine, and direct mail advertisements were viewed more favorably than radio, television, and billboard advertisements. Chi-square analyses revealed few statistically significant differences in perception between different income and education groups. The majority of patients do not perceive advertising to reflect poorly on the quality of orthodontic care. However, patients with different income and education levels perceive media advertising differently.
Tung, A W; Kiyak, H A
Debates about the "ideal" timing of orthodontic treatment have focused on issues of biologic development and readiness. In this article we examine psychologic issues that should be considered in the decision to initiate orthodontics in the younger child or to wait until adolescence or later. Psychologic development during the preadolescent and adolescent stages may influence the child's motive for, understanding of, and adherence to treatment regimens. Results of a study of some personality characteristics, motives, and aesthetic values of young phase I patients are presented. Questionnaires were completed by 75 children (mean age 10.85 years, 52.1% female, 84% white) and their parents. Children's perceived reasons for treatment were consistent with their parents' reports (chi 2 = 76.08, p < .001); most were referred for crowded teeth (56%) and overbite (17.3%). Although body image and self-concept scores were within the normal range, both children and their parents expected the most improvement in self-image and oral function, with greater expectations by parents on self-image (p < .0001), oral function (p < .0001), and social life (p < .03) than children themselves. Although white and minority children were similar in their self-ratings and expectations from orthodontics, the former were more critical in their aesthetic judgments. They rated faces with crowded teeth (p < .02), overbite (p < .02), and diastema (p < .01) more negatively than did ethnic minorities. These results suggest that younger children are good candidates for Phase I orthodontics, have high self-esteem and body-image, and expect orthodontics to improve their lives. White children who have been referred for Phase I orthodontics appear to have a narrower range of aesthetic acceptability than minority children.
Luppanapornlarp, Suwannee; Leelataweewud, Pattarawadee; Putongkam, Pongstorn; Ketanont, Sutasinee
To evaluate the periodontal status and orthodontic treatment need of autistic children and compare these findings to nonaffected, same-age individuals. The periodontal status and orthodontic treatment need were evaluated in 32 autistic and 48 nonautistic boys and girls age 8 years to 12 years (mean 9.7 ± 1.2 years and 9.9 ± 1.1 years, respectively). The periodontal status of all subjects was recorded using the Community Periodontal Index of Treatment Need (CPITN) with a slight modification. The orthodontic treatment need was determined using the Dental Aesthetic Index (DAI). Chi-square test and odds ratio were used for statistical analysis. No significant sex differences were found in the autistic or nonautistic groups. The autistic children presented with a significantly poorer periodontal status than the nonautistic children (P<.05). No significant differences in terms of the various malocclusion categories were found between both groups (P>.05); however, children with autism showed missing teeth, spacing, diastemas, reverse overjets, open bites, and Class II molar relationship tendencies in a higher percentage than nonautistic individuals. In all, autistic children and nonautistic children frequently needed orthodontic treatment. This study suggests that children with autism require special dental management to improve their oral hygiene as well as their dental esthetics. More care from parents, general dentists, and pedodontists/orthodontists should be provided routinely to autistic children. © 2010 BY QUINTESSENCE PUBLISHING CO, INC.
Sadr Haghighi, Hooman; Skandarinejad, Mahsa; Abdollahi, Amir Ardalan
One common negative side effect of orthodontic treatment with fixed appliances is the development of incipient caries lesions around brackets, particularly in patients with poor oral hygiene. Different methods have been used to prevent demineralization such as fluoride therapy and application of sealant to prevent caries. The recent effort to improve the resistance against the demineralization is by the application of different types of lasers. The purpose of this review article is discussing the effects of laser in prevention of demineralization in orthodontic patients. PMID:25606317
Bourzgui, Farid; Aghoutan, Hakima; Diouny, Samir
The aim of this paper is to bring into focus the literature on the choice of the mandibular reference position in orthodontic treatment; of a particular reference to this paper is intercuspal position, centric relation position, or therapeutic position. To give a comprehensive account of the literature review on craniomandibular disorders (CMD), we have relied on books and articles using both Google Scholar and PubMed. Selection criteria included a combination of Mesh and type of article. Article classification was made by two authors, using the following structure outline: prevalence of craniomandibular disorders, its etiology and pathophysiology, occlusion and craniomandibular disorders, orthodontic treatment and CMD, and the mandibular reference position in orthodontics. An important conclusion that emerged from the present literature review is that CMD do not seem to be directly related to orthodontic treatment, and their appearance cannot be predicted or prevented by any means. Therefore, orthodontists must adopt a mandibular reference suitable to their patients and which best respects the balance existing in the stomatognathic system. PMID:24101929
Khoroushi, Maryam; Kachuie, Marzie
Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence. PMID:28566845
Khoroushi, Maryam; Kachuie, Marzie
Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.
Need--Dental Health Component" (IOTN-DHC) grades 4 and 5, ranged from 30 to 40 per cent, without any inter-group differences. There were strong associations between subjects perceiving a need for orthodontic treatment and IOTN-DHC grades 4 and 5, anterior crossbite and avoiding smiling because they were self-conscious about their teeth. At the age of 18-19 years, the frequency of malocclusion was similar in all groups. Subjects of Asian origin had a higher self-perceived orthodontic treatment need than their Swedish counterparts and a higher frequency of headache than those of Eastern/Southeastern European origin. Psychological wellbeing was reduced in nearly one quarter of the sample, more frequently in girls than boys. No association was found between self-perceived orthodontic treatment need and psychological wellbeing. The theory "Being under the pressure of social norms" was generated in Paper V, and it can be applied to improve our understanding of young adults who have adjusted to living with poor dental aesthetics and also aid to identify those who are not as well-adjusted and would probably benefit from treatment. Undisclosed dental fear is an important barrier to acceptance of orthodontic treatment in early adolescence. Despite demographic changes due to immigration, no major change in the prevalence of malocclusion and normative orthodontic treatment need has been disclosed. This does not apply to adolescents and adults who immigrated at an older age.
Spalj, Stjepan; Slaj, Martina; Varga, Suzana; Strujic, Mihovil; Slaj, Mladen
Patients' and parents' perception of malocclusion are important in determining orthodontic treatment demand, motivation, and cooperation. The aim of this study was to investigate differences in perception of treatment need in currently orthodontically treated, previously treated, and untreated subjects. The sample comprised 3196 children and adolescents (1593 males and 1603 females) aged 8-19 years (mean age 13.0 +/- 3.6 years) from 24 randomly selected public schools in Zagreb, Croatia. Objective treatment need was assessed clinically using the Dental Aesthetic Index (DAI). Subjective treatment need was estimated separately by an orthodontic resident, the child/adolescent and his/her parent using the Standardized Continuum of Aesthetic Need (SCAN) procedure. The children/adolescents completed a questionnaire that had five questions with five-point Likert-type scale answers concerning satisfaction with dental appearance, importance of teeth for facial appearance, and malocclusion-related quality of life. Spearman correlation and logistic regression were used for statistical analysis. Associations between objective and subjective orthodontic treatment need were weak but statistically significant (Rho from 0.20 to 0.50; P < 0.05). Malocclusion-related quality of life was poorly associated with treatment need. Satisfaction with tooth appearance showed the most frequent statistically significant correlation (Rho from -0.14 to -0.35; P < 0.05), while importance of aligned teeth for facial appearance and social contacts had the weakest correlation with treatment need. Perception of treatment need was greater in previously treated subjects. Parents' perception had a low predictive value. The findings of this study show that malocclusion has more impact on emotional well-being than on function or social contacts.
Janson, Guilherme; de Souza, José Eduardo Prado; Barros, Sérgio Estelita Cavalcante; Andrade, Pedro; Nakamura, Alexandre Yudi
Class III malocclusions are considered one of the most complex and difficult orthodontic problems to diagnose and treat. Skeletal and/or dental asymmetries in patients presenting with Class III malocclusions can worsen the prognosis. Recognizing the dentoalveolar and skeletal characteristics of subdivision malocclusions and their treatment possibilities is essential for a favorable nonsurgical correction. Therefore, this article presents a nonsurgical asymmetric extraction approach to Class III subdivision malocclusion treatment which can significantly improve the occlusal and facial discrepancies. PMID:19668997
Salih, Firas Nafi; Lindsten, Rune; Bågesund, Mats
Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19. A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo. The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2 ± 1.5), than among subjects, age 15 (3.6 ± 1.2) (p = .0009), and subjects, age 19 (3.5 ± 1.2) (p = .00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p = .002 and .001, respectively) and (ii) previous orthodontic treatment (p = .005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p = .002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p = .047) than Swedes, age 19. The lower limit for orthodontic treatment need among subjects, age 10, was higher - compared to subjects, ages 15 and 19 - and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.
Burstone, C; Filleul, M P; Pigeot, V
A common finding in orthodontic patients is asymmetric occlusion. These asymmetries can be dental, skeletal, or functional in origin. Since many patients have typical posterior overjet the use of Class II-Class III and anterior crisscross elastics are contra-indicated. Even in skeletal discrepancies axial inclination compensation can produce relatively normal overjet in the arch. The best strategy for non-extraction therapy is to move teeth around the arch rather than an en-masse movement of the entire arch. A number of methods for unilateral distalization are discussed. Midline correction requires the determination of facial, apical base, and posterior midpoints. Differential mechanics between patients with apical base discrepancies and no apical base is presented. Although intermaxillary elastics can be indicated the undesirable effects of eruption and frontal occlusal plane tilt should be considered. Advantages in control and ease of occlusal correction rest with intra-arch mechanics. The use of intermaxillary elastics for the correction subdivision cases can lead to instability and or mandibular shifts.
Stojkovic, Goran; Stojkovic, Miodrag; Stojkovic, Jasna; Nikolic, Dejan; Stajcic, Zoran
Surgical and orthodontic treatment of a teenage cleft patient. Authors describe the case of a 13 year old female cleft patient presented with class III malocclusion RESULT: The patient underwent comprehensive surgical secondary bone grafting and orthodontic treatment. Stable skeletal and occlusal class I relationship was achived and maintained in the post treatment observation period till the age of 16. Although several authors suggests primary gingivoperiosteoplasty, other advocates that such early intervention can cause later restrictions in maxillary growth. For alveolar reconstruction, maxillary growth and dental age were the main considerations in determining the timing of surgical intervention. This case showed that borderline cases of complex dentoalveolar and skeletal anomaly in cleft patients could be successfully treated with comprehensive secondary bone grafting and orthodontic treatment thus avoiding the need for orthognatic surgery. Alveolar bone grafting, Cleft, Malocclusion.
Farronato, G; Giannini, L; Galbiati, G; Cannalire, P; Martinelli, G; Tubertini, I; Maspero, C
The aim of this paper was to provide a literature review about the problems that can occur during orthodontic treatment. Using the PubMed database we collected items that would provide information regarding the direct consequences of the placement of an orthodontic appliance: coming to the discussion of the following topics: candida infections, the effects on the soft tissues, the effects on periodontal tissues and effects on hard tissues. The presence of appliances in the oral cavity increases the prevalence of people with candida, specifically the species Candida Albicans is the most frequently isolated. The balance between the clearance of the microorganism, the colonization and the state of candidiasis depends both on the virulence of the fungus, and the competence of the host immune system. On soft tissues, cases of ulceration of the upper jaw by a rapid palatal expander and pyogenic granuloma due to quad helix appliance have been reported. The second one is mostly observed on vestibular gingiva. The first one was found, however, in patients suffering from diabetes mellitus type 1 because of the tissue modifications induced by this pathological condition. The more severe periodontic effects are those caused by incorrect use of orthodontic elastic separators. Finally, the White Spot Lesions are the direct consequences of a wrong conditioning of enamel when attaching the bracket. They represent a first stage of caries in the positioning area of the bracket. The orthodontist is required to intercept these issues not to affect the success of the treatment.
Pazzini, Camila A; Pereira, Luciano J; Peconick, Ana P; Marques, Leandro S; Paiva, Saul M
The aim of this study was to assess periodontal status and blood parameters in orthodontic patients with nickel allergy one month after removal of brackets. Ninety-six randomly selected patients were initially evaluated. Allergy to nickel was diagnosed using a patch test. After determining the prevalence of subjects allergic to nickel, two groups were formed: 16 allergic (experimental) and 16 non-allergic (control) patients. Their periodontal status was determined regularly by a single, blinded, duly calibrated examiner using the Löe Index (GI) and their blood was tested (complete blood test, including nickel and IgE levels) after nine months of orthodontic treatment and again one month after removing the orthodontic appliances. Statistical analyses included paired and non-paired t-tests, Mann-Whitney, Wilcoxon, McNemar and linear trend chi-square tests (p≤0.05). Comparison of the values recorded during orthodontic treatment and one month after removing the appliances showed that in the allergic group there was significant increase in eosinophils (p=0.046), basophils (p=0.001) and monocytes (p=0.002), and decrease in number of bands (p=0.000), while in the control group, there was increase in lymphocytes (p=0.039) and decrease in segmented neutrophils (p=0.030) and IgE levels (p=0.001). In both groups, plasma nickel levels increased (p=0.010; p=0.039) and GI scores decreased. One month after removing the brackets, blood and periodontal parameters from patients with and without nickel allergy were similar. Sociedad Argentina de Investigación Odontológica.
Monk, Aoife B; Harrison, Jayne E; Worthington, Helen V; Teague, Annabel
Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial. We conducted this Cochrane Review to assess and summarize the international evidence relating to the effectiveness of analgesics for preventing this unwanted side effect associated with orthodontic treatment. The objectives of this review are to determine:- the effectiveness of drug interventions for pain relief during orthodontic treatment; and- whether there is a difference in the analgesic effect provided by different types, forms and doses of analgesia taken during orthodontic treatment. Cochrane Oral Health's Information Specialist searched the following databases: the Cochrane Oral Health Trials Register (to 19 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL;the Cochrane Library 2016, Issue 7), MEDLINE Ovid (1946 to 19 June 2017), Embase Ovid (1980 to 19 June 2017) and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 19 June 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched on the 19 June 2017 for ongoing studies. We placed no restrictions on language or date of publication when searching the electronic databases. We included randomized controlled trials (RCTs) relating to pain control during orthodontic treatment. Pain could be measured on a visual analogue scale (VAS), numerical
Kapoor, Pooja; Singh, Harpreet
Aim of the Study: The purpose was to assess orthodontic treatment need in a subpopulation as assessed by the orthodontists. Materials and Methods: The study was conducted on a sample population of 753 patients aged 20–25 years to assess the need for orthodontic treatment using the esthetic component (AC) of the index of orthodontic treatment need (IOTN). Results: The AC revealed that 78.1% of the sample exhibited no or slight need for treatment, 13.2% demonstrated moderate to borderline need, and 8.7% proved to have a definite need for orthodontic treatment. Conclusions: The AC-IOTN can definitely be considered to be used as a powerful tool for prioritizing orthodontic triage, patient counseling, and planning desired orthodontic mechanotherapy. PMID:26752877
Vasilakou, Nefeli; Araujo, Eustaquio A; Kim, Ki Beom; Oliver, Donald R
This retrospective study included a sample of 300 randomly selected patients from the archived records of Saint Louis University's graduate orthodontic clinic, St. Louis, Mo, from 1990 to 2012. The objective of this study was to quantify the changes obtained in phase 1 of orthodontic treatment and determine how much improvement, if any, has occurred before the initiation of the second phase. For the purpose of this study, prephase 1 and prephase 2 records of 300 subjects were gathered. All were measured using the American Board of Ortodontics Discrepancy Index (DI), and a score was given for each phase. The difference of the 2 scores indicated the quantitative change of the complexity of the treatment. Paired t tests were used to compare the scores. Additionally, the sample was categorized into 3 groups according to the Angle classifications, and the same statistics were used to identify significant changes between the 2 scores. Analysis of variance was applied to compare the 3 groups and determine which had the most change. Percentages of change were calculated for the significant scores. The total DI score overall and the scores of all 3 groups were significantly reduced from before to after phase 1. Overall, 42% improvement was observed. The Class I group showed 49.3% improvement, the Class II group 34.5% and the Class III group 58.5%. Most components of the DI improved significantly, but a few showed negative changes. Significant reductions of DI scores were observed in the total sample and in all Angle classification groups. This indicates that early treatment reduces the complexity of the malocclusions. Only 2 components of the DI showed statistically significant negative changes. Copyright Â© 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
van Wezel, Naomi A; Bos, Annemieke; Prahl, Charlotte
Satisfaction with dentofacial appearance and expectations of orthodontic treatment have been analyzed in many studies. In 2002, in a study in The Netherlands, significant correlations were found between dental satisfaction and orthodontic treatment expectations. Satisfaction significantly decreased with increasing age. The aim of this study was to compare the satisfaction and expectations of current patients with the results of a study 10 years ago. A questionnaire about dentofacial satisfaction and a questionnaire about the expectations of orthodontic treatment were completed by 146 subjects. The mean scores in the present study were compared with the mean scores 10 years ago. The subjects in the present study were more satisfied with their dental appearance. Differences in expectations were found on the subscales of general well-being and self-image. As in the study in 2002, no significant correlations were found between sex, satisfaction, and expectations of orthodontic treatment. Dentofacial satisfaction predicts expectations about orthodontic treatment, especially in the group of subjects aged 17 years and above. The subjects in this study had greater expectations of orthodontic treatment about general well-being and were more satisfied with their dental appearance than were the subjects studied 10 years ago. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Luzzi, Valeria; Ierardo, Gaetano; Corridore, Denise; Di Carlo, Gabriele; Di Giorgio, Gianni; Leonardi, Emanuele; Campus, Guglielmo-Giuseppe; Vozza, Iole; Polimeni, Antonella; Bossù, Maurizio
Data from epidemiological studies investigating the prevalence and severity of malocclusions in children are of great relevance to public health programs aimed at orthodontic prevention. Previous epidemiological studies focused mainly on the adolescence age group and reported a prevalence of malocclusion with a high variability, going from 32% to 93%. Aim of our study was to assess the need for orthodontic treatment in a paediatric sample from Southern Italy in order to improve awareness among paediatricians about oral health preventive strategies in pediatric dentistry. The study used the IOTN-DHC index to evaluate the need for orthodontic treatment for several malocclusions (overjet, reverse overjet, overbite, openbite, crossbite) in a sample of 579 children in the 2-9 years age range. The most frequently altered occlusal parameter was the overbite (prevalence: 24.5%), while the occlusal anomaly that most frequently presented a need for orthodontic treatment was the crossbite (8.8%). The overall prevalence of need for orthodontic treatment was of 19.3%, while 49% of the sample showed one or more altered occlusal parameters. No statistically significant difference was found between males and females. Results from this study support the idea that the establishment of a malocclusion is a gradual process starting at an early age. Effective orthodontic prevention programs should therefore include preschool children being aware paediatricians of the importance of early first dental visit. Key words: Orthodontic treatment, malocclusion, oral health, pediatric dentistry.
Lapenaite, Egle; Lopatiene, Kristina
Interproximal enamel reduction is a part of orthodontic treatment for gaining a modest amount of space in the treatment of crowding. Today interproximal enamel reduction has become a viable alternative to the extraction of permanent teeth, and helps to adjust the Bolton Index discrepancy. The aim of the study is to evaluate various interproximal enamel reduction techniques, its indications, contraindications and complications presented in recent scientific studies. Papers published in English language between 2003 and 2012 were searched in PubMed, ScienceDirect and The Cochrane Library databases, as well as the Web search Google Scholar. Initial searches were made to find peer-reviewed systematic reviews, meta-analyses, literature reviews, clinical trials, which analysed at least one interproximal enamel reduction method. 31 published data fulfilled the inclusion criteria. According to the study, abrasive metal strips, diamond-coated stripping disks, and air-rotor stripping are the main interproximal enamel reduction techniques. Indications for use are mild or moderate crowding in dental arches, Bolton Index discrepancy, changes in tooth shape and dental esthetics within the enamel, enhancement of retention and stability after orthodontic treatment, normalization of gingival contour, elimination of black gingival triangles, and correction of the Curve of Spee. Complications of interproximal enamel reduction are hypersensitivity, irreversible damage of dental pulp, increased formation of plaque, the risk of caries in the stripped enamel areas and periodontal diseases. Interproximal enamel reduction is an important part of orthodontic treatment for gaining space in the dental arch, and for the correction of the Bolton index discrepancy.
Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M
Objective To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. Materials and methods This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13–21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Results Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics (P=0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics (P<0.0001). Conclusion Young Saudis receiving free orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics. PMID:27843351
Coêlho, Thaís Gonzalez da Silveira; Caracas, Hugo Cesar Pinto Marques
INTRODUCTION: The consensus about the relationship between TMD and orthodontic treatment has gone from a cause and effect association between TMD and orthodontic treatment to the idea that there is no reliable evidence supporting this statement. OBJECTIVE: To assess the beliefs, despite scientific evidence, of Brazilian orthodontists about the relationship between TMD and orthodontic treatment with regards to treatment, prevention and etiology of TMD. METHODS: A survey about the relationship between TMD and orthodontic treatment was prepared and sent to Brazilian orthodontists by e-mail and social networks. Answers were treated by means of descriptive statistics and strong associations between variables were assessed by qui-square test. RESULTS: The majority of orthodontists believe that orthodontic treatment not only is not the best treatment option for TMD, but also is not able to prevent TMD. Nevertheless, the majority of orthodontists believe that orthodontic treatment can cause TMD symptoms. CONCLUSION: This study suggests that orthodontists' beliefs about the relationship between orthodontic treatment and TMD are in accordance with scientific evidence only when referring to treatment and prevention of TMD. The majority of orthodontists believe that, despite scientific evidence, orthodontic treatment can cause TMD. PMID:25741824
Coêlho, Thaís Gonzalez da Silveira; Caracas, Hugo Cesar Pinto Marques
The consensus about the relationship between TMD and orthodontic treatment has gone from a cause and effect association between TMD and orthodontic treatment to the idea that there is no reliable evidence supporting this statement. To assess the beliefs, despite scientific evidence, of Brazilian orthodontists about the relationship between TMD and orthodontic treatment with regards to treatment, prevention and etiology of TMD. A survey about the relationship between TMD and orthodontic treatment was prepared and sent to Brazilian orthodontists by e-mail and social networks. Answers were treated by means of descriptive statistics and strong associations between variables were assessed by qui-square test. The majority of orthodontists believe that orthodontic treatment not only is not the best treatment option for TMD, but also is not able to prevent TMD. Nevertheless, the majority of orthodontists believe that orthodontic treatment can cause TMD symptoms. This study suggests that orthodontists' beliefs about the relationship between orthodontic treatment and TMD are in accordance with scientific evidence only when referring to treatment and prevention of TMD. The majority of orthodontists believe that, despite scientific evidence, orthodontic treatment can cause TMD.
Stenvik, A; Espeland, L; Linge, B O; Linge, L
In provision of advice about aesthetic treatment need, visual stimuli as a tool in communication may have some advantages compared with verbal descriptions, in particular when children are addressed. The Aesthetic Component (AC) of the Index of Orthodontic Treatment Need is an illustrated scale for rating of dental attractiveness developed in the UK and based on lay adults' ratings of dental photographs. This scale has also been recommended for use in patient education. The purpose of the present study was to establish a sociocultural standard of reference for Norway related to the AC, in order to examine the applicability of the scale as a tool in patient information. Samples of 137 children, 126 of their parents and 98 young adults were shown the 10 photographs comprising the AC. The subjects were asked to assess the photographs for dental attractiveness and orthodontic treatment need on a four-category rating scale. The findings indicated that, in general, photographs with an increasing scale point were rated as increasingly more unattractive. The majority (80-100 per cent) of the parents and young adults rated the five photographs on the unattractive end of the scale to be in need of treatment. The children were significantly less critical in their aesthetic judgements. Photographs representing borderline need, identified for these groups to be scale points 5 and 6, have a potential in guiding patients and parents in making informed decisions about aesthetic treatment need.
Janson, Marcos; Janson, Guilherme; Sant'Ana, Eduardo; Simão, Tassiana Mesquita; de Freitas, Marcos Roberto
Despite the different orthodontic approaches to Class II subdivision malocclusions one has also to consider the skeletal components before undertaking any treatment protocol. Significant involvement of the skeletal structures may require a combined surgical orthodontic treatment, which has remained stable for more than four years, as illustrated in this case report.
Suda, Naoto; Handa, Sachiko; Higashihori, Norihisa; Ogawa, Takuya; Tsuji, Michiko; Ohyama, Kimie
Stickler syndrome (MIM 108300, 604841, 184840) is an autosomal dominant disease characterized by midfacial flattening and variable disorders of vision, hearing and articulation. There are three types of the syndrome caused by mutations in different genes (type 1, COL2A1; type 2, COL11A1; and type 3, COL11A2). About 20% of type 1 patients have cleft palate or bifid uvula, but there have been no case reports of orthodontic treatment of this syndrome so far. The Japanese female patient presented here with Stickler syndrome was characterized by a flat midface and had high myopia, sensorineural hearing loss, enlarged joints, and cleft of the soft palate. She had fairly small SNA and SNB angles and a steep mandibular plane with an enlarged gonial angle. The incisors of both arches were retroclined, and a large overjet and overbite were noted. Orthodontic treatment was initiated at 11 years of age using a lingual arch appliance followed by an edgewise multibracket appliance. Stable functional occlusion was obtained after the treatment. Most of the other seven Stickler syndrome patients exhibited pretreatment characteristics of small SNA and SNB angles, steep mandibular planes, enlarged gonial angles, and retroclined incisors of both arches, demonstrating the characteristic skeletal and occlusal features of this syndrome.
Susami, T; Kuroda, T; Amagasa, T
Some adult cleft palate patients show severe maxillary transverse contraction and posterior crossbite. This case report demonstrates successful surgical-orthodontic treatment of such a patient. Surgically assisted rapid maxillary expansion (SA-RME) was completed prior to comprehensive orthodontic treatment. The osteotomy was performed on both the buccal and lingual aspects of the posterior maxillary alveolus. A Hyrax-type maxillary-expansion appliance was used, and the screw (0.2 mm, one quarter turn) was turned two or three times per day. Comprehensive orthodontic treatment was initiated after extraction of the mandibular first premolars and four third molars. The maxillary lateral incisors were also extracted after active orthodontic treatment. The amount of expansion achieved using SA-RME was greater at the posterior than at the anterior maxilla. Midpalatal suture opening occurred. After orthodontic treatment, occlusal stability was satisfactory. This case demonstrates the effectiveness of SA-RME in adult cleft palate patients with severe posterior crossbite.
Singh, Jaideep; Dixit, Pankaj; Singh, Prerana; Kedia, Neal Bharat; Tiwari, Manish Kumar; Kumar, Amit
The study was done to evaluate the pain perception, attitude, and personality trait of the patient toward orthodontic treatment. In this cross-sectional questionnaire survey, 100 patients were divided into Group 1, 150 (75 males and 75 females) as untreated group and Group 2, 150 as treated group (75 males and 75 females). Evaluation of the patients was done based on pain perception, attitude, and personality trait. Set of questionnaire was used to assess attitude and pain perception on visual analog scale. The data were tabulated, and statistical evaluation was done using statistical software IBM SPSS Statistics for Windows, (Version 21.0. Armonk, NY: IBM Corp.) using t -test and Tukey's test. The mean pain perception for Group 1 was 4.8 ± 1.30 and 4.17 ± 1.58 in Group 2; the difference was not statistically significant ( P = 0.26). The mean value for attitude in Group 1 was 3.57 ± 1.21, and in Group 2, it was 3.39 ± 1.60 ( P = 0.09). There was statistically significant difference in pain perception between low (L) level to high level (H) neuroticism ( P = 0.009). There was significant difference ( P = 0.021) in pain for conscientiousness from very low to very high levels which is directly proportional. The present study indicated that attitude, personality traits, and pain perception have a definite role in patient cooperation and success of orthodontic treatment.
Ackerman, J L; Proffit, W R
Orthodontists have traditionally viewed structural discrepancies as the major limitation of treatment. In reality, it is the soft tissues that more closely determine therapeutic modifiability. The boundaries of dental compensation for an underlying jaw discrepancy are established by pressures exerted on the teeth by the lips, cheeks, and tongue; limitations of the periodontal attachment; neuromuscular influences on mandibular position; and the contours of the soft tissue facial mask. The ability of the soft tissues to adapt to changes in tooth-jaw relationships are far narrower than the anatomic limits in correcting occlusal relationships. The tolerances for soft tissue adaptation from equilibrium, periodontal, and facial balance standpoints are in the range of 2 to 3 mm for expansion of the mandibular arch and even less for changes in condylar position. Thus, analysis of the soft tissues is the critical step in orthodontic decision making, and this can only be accomplished through physical examination of the patient. Although quantitative measurements cannot be rigorously applied, guidelines for soft tissue assessment, with particular emphasis on facial esthetics, are proposed. From this perspective, a contemporary philosophy of orthodontic practice is offered, with general indications and contraindications for nonextraction, extraction, and surgical treatment.
Stadelmann, Pascale; Zemp, Elisabeth; Weiss, Carine; Weiger, Roland; Menghini, Giorgio; Zitzmann, Nicola U
Since the first survey in 1992/93, the Swiss Health Survey (SHS) has been repeated every 5 years (1997, 2002 and 2007). In the present study, dental visits (dental care utilisation within the last 12 months), oral hygiene measures and the frequency of orthodontic treatments in the Swiss population in 2002 were examined and dental visits were compared with the years 1992/93, 1997 and 2007. Weighted data were analysed regarding different sociodemographic factors. From 1992 to 2002, dental visits among the 15-74-year-old declined continuously (1992/93: 70%, 1997: 66%, 2002: 63%), whereas in 2007 a slight increase (66%) was documented. In the survey from 2002, a large proportion (74%) of the population stated to clean their teeth or prostheses several times a day, predominantly with a manual toothbrush, whereas 28% applied an electric toothbrush and almost half of the respondents also used dental floss or toothpicks. Fewer visits and less intensive oral hygiene measures were observed among the elderly, men, weak social strata, smokers, persons with more than 8 missing teeth and in the group with removable dentures. Almost a quarter of the population had orthodontic treatment with the highest proportion among the 15-24-year-old (56%).
Yi, Song; Zhang, Chuqin; Ni, Chulei; Qian, Ying; Zhang, Jun
The objective of this study is to evaluate the psychosocial impact of dental aesthetics in undergraduate students in the People's Republic of China and to investigate the association between normal orthodontic treatment needs, psychosocial impact of dental aesthetics, and desire for orthodontic treatment. A cross-sectional study was carried out in two universities in a city of the People's Republic of China with 374 young adults aged between 19 years and 24 years. The students answered a Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and addressed their desire for orthodontic treatment. Objective malocclusion severity was assessed with the Index of Orthodontic Treatment Need (IOTN). Statistical analysis was performed by the SPSS software (Version 15.0). There was no statistical sex difference in relation to the dental health component of IOTN (P=0.893) and PIDAQ scores (P=0.06), but it was found that the desire for orthodontic treatment was significantly stronger among females. The total and subscale PIDAQ scores and malocclusion severity differed significantly among the five grades of desire (P<0.01). Significant positive correlation was found among desire for orthodontic treatment, IOTN-dental health component grades, and total or subscale PIDAQ scores (P<0.01). High correlation was found between desire and PIDAQ score (r=0.93). The desire for orthodontic treatment is higher among female young adults who have the same orthodontic treatment needs compared to males. The desire for orthodontic treatment has high positive correlation with PIDAQ scores and increases with the increase in self-perceived psychosocial impacts of malocclusion and the needs for orthodontic treatment.
Thiruvenkatachari, Badri; Harrison, Jayne E; Worthington, Helen V; O'Brien, Kevin D
Prominent upper front teeth are a common problem affecting about a quarter of 12-year old children in the UK. The correction of this condition is one of the most common treatments performed by orthodontists. This condition develops when the child's permanent teeth erupt and children are often referred to an orthodontist for treatment with dental braces to reduce the prominence of the teeth. These teeth are more likely to be injured and their appearance can cause significant distress.If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait until the child is older and provide treatment in early adolescence. To assess the effects of orthodontic treatment for prominent upper front teeth when this treatment is initiated when the child is seven to 11 years old compared to when they are in early adolescence, or when treatment uses different types of orthodontic braces. We searched the following databases: Cochrane Oral Health Group's Trials Register (to 17 April 2013), CENTRAL (The Cochrane Library 2013, Issue 3), MEDLINE (OVID) (1946 to 17 April 2013) and EMBASE (OVID) (1980 to 17 April 2013). There were no restrictions regarding language or publication date. Randomised controlled trials of children and/or adolescents (age < 16 years) on early treatment (either one or two-phase) with any type of orthodontic braces (removable, fixed, functional) or head-braces compared with late treatment with any type of orthodontic braces or head-braces; or, on any type of orthodontic braces or head-braces compared with no treatment or another type of orthodontic brace or appliance (with treatment starting in children of similar ages in both groups) to correct prominent upper front teeth. Review authors screened the search results, extracted data and assessed risk of bias independently, used odds ratios (ORs) and 95% confidence intervals (CIs) for dichotomous outcomes, mean differences (MDs) and 95% CIs for
Valladares Neto, José
Introduction This case report describes the orthodontic treatment of an adult patient with skeletal Class III malocclusion and anterior crossbite. A short cranial base led to difficulties in establishing a cephalometric diagnosis. The patient's main complaint comprised esthetics of his smile and difficulties in mastication. Methods The patient did not have the maxillary first premolars and refused orthognathic surgery. Therefore, the treatment chosen was orthodontic camouflage and extraction of mandibular first premolars. For maxillary retraction, the vertical dimension was temporarily increased to avoid obstacles to orthodontic movement. Results At the end of the treatment, ideal overjet and overbite were achieved. Conclusion Examination eight years after orthodontic treatment revealed adequate clinical stability. This case report was submitted to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO) as part of the requirements to become a BBO diplomate. PMID:24713568
Lin, Feiou; Ren, Manman; Yao, Linjie; He, Yan; Guo, Jing; Ye, Qingsong
The aim of this study was to evaluate the psychosocial impact of dental esthetics for adults seeking orthodontic treatment. The Chinese version of the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was administered to 393 adults, aged 18 to 30 years. The participants were divided into 2 groups: an intervention group (received orthodontic treatment) and a control group (rejected orthodontic treatment). Baseline malocclusion severity was assessed using the Index of Orthodontic Treatment Need (IOTN). The Wilcoxon signed rank test showed no statistically significant difference between the groups for the dental health component (DHC) of the IOTN (P = 0.134). Total and subscale PIDAQ scores of the intervention group were higher than those of the control group and differed significantly in each group among the 4 IOTN-DHC grades; self-confidence scores in the control group (F = 1.802; P >0.05) were the exception. Correlations between the PIDAQ scores and the IOTN-DHC grades were strong in each group. DHC grades, psychological impact, social impact, and aesthetic concern had significant impacts on patients accepting orthodontic treatment. The psychosocial impact of dental esthetics played an important role in the decision-making process of adults seeking orthodontic treatment. Importantly, participants with low self-awareness of the potential psychosocial impact rejected orthodontic treatment, despite the need for severe normative treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Mahobia, Yogesh; Agarwal, Abhay Prem Prakash; Gupta, Akhil; Quaraishi, Dilshad; Khan, Kishwar Zahoor; Agrawal, Anil
Objective The study was done to determine the quantity of orthodontics and the type of appliance used for orthodontic treatment by general dentist. Materials and Methods A total of 410 dentists completely participated in the study. The study included questions to know the positive effects of orthodontic treatment done by general dentists and their opinions and qualities regarding the provision of treatment. Statistical Analysis Statistical analysis was done using SPSS version of 16.0 was used at p ≤ 0.05. Results One forty six (35.6%) dentists answered that they practice orthodontic treatment to their patients, of which most were providing removable appliances (39.5%). There was a significant difference between the groups toward the benefits of orthodontic treatment according to experience of service and locality. General dentist were providing this treatment mainly in the mixed dentition period i.e. 96(65.8%). Most of the participants gave positive response regarding expansion of their syllabus related to orthodontics. Conclusion A significant difference in response to the benefits of the treatment were seen according to experience and are of practice and most of the participants showed positive response increasing their courses in orthodontics at undergraduate level. PMID:26266210
Galbiati, Guido; Maspero, Cinzia; Giannini, Lucia; Guenza, Guia C; Zanoni, Federica; Farronato, Giampietro
Several correlations between morphological and/or positional alterations of the jaws and respiratory functional impairments have been reported. Nasal airway obstruction represents a critical issue with no clearly defined gold standard as for its measurement. Rhinomanometry was adopted by multiple Authors to evaluate whether patients with malocclusion developed respiratory functional changes after an orthodontic-surgical treatment. However, there are contrasting findings in the literature regarding the possibility of improving the respiratory function by means of surgically-assisted rapid palatal expansion (SARPE) or bimaxillary repositioning of the bony bases. Ten patients aged from 18 to 30 years and scheduled for orthodontic-surgical treatment of maxillary constriction volunteered as participants for this study. Orthognathic surgery consisted in: 1) SARPE in 4 patients; 2) Le Fort I down fracture combined with a bilateral sagittal split osteotomy (BSSO) in 6 patients. All patients underwent a computerized rhinomanometric test before treatment (T0) and 40 days after surgery, at the time of the inter-maxillary splint removal (T1). Specifically, all 10 patients received AAR evaluations, while 6 patients received both active anterior (AAR) and active posterior rhinomanometry (APR). Both AAR and APR tests showed a decrease in mean nasal resistance following the intervention. As for the AAR, a difference of 0.19 Pa/s/cm3 was found. The difference found for APR at a reference pressure of 75 Pa was 0.24 Pascal/s/cm3, while for APR at 150 Pa it was 0.20 Pa/s/cm3. This study helps to confirm respiratory benefits obtainable after mono and bi-maxillary orthognathic surgery.
Balakrishna, A.; Vamsi, Ch. Raghu; Rao, V. D. Prasad; Swamy, Ch. Kishore; Kuladeep, B.
Orthodontic Treatment is being widely practiced around the world for teeth straightening and extraction to improve alignment of remaining teeth. Here, forces are applied to correct the position of teeth. The force applied on the teeth isn't calibrated and applied arbitrarily based on the recommendations from scientific research and experience of the orthodontist. The number of settings and the total time required for the completion of treatment also remains arbitrary. So, there is a need for determining the force which is actually acting on the teeth and determining the optimal force required for the treatment of each and every individual case. In this paper a mathematical relation is derived between the force applied on the tooth and tooth displacement by considering a 2nd order non-homogeneous linear differential equation. As the tooth displacement is not a direct function of force applied, Biomechanical parameters like mass of tooth, stiffness and damping coefficient of periodontal ligament & alveolar bone are involved in the differential equation. By solving the equation, tooth displacement thereby, tooth velocity can be obtained for a particular force. On the other hand, based on the dimensions of the model, orthodontist could determine the total tooth displacement required for each setting of the treatment, so that, the total displacement is covered. The orthodontist uses the data and applies the required force on to the teeth, based on which the orthodontist can plan his treatment procedure and reduce the number of settings, total treatment time and also increases the success rate of the treatment.
Singh, Jaideep; Dixit, Pankaj; Singh, Prerana; Kedia, Neal Bharat; Tiwari, Manish Kumar; Kumar, Amit
Aim: The study was done to evaluate the pain perception, attitude, and personality trait of the patient toward orthodontic treatment. Materials and Methods: In this cross-sectional questionnaire survey, 100 patients were divided into Group 1, 150 (75 males and 75 females) as untreated group and Group 2, 150 as treated group (75 males and 75 females). Evaluation of the patients was done based on pain perception, attitude, and personality trait. Set of questionnaire was used to assess attitude and pain perception on visual analog scale. The data were tabulated, and statistical evaluation was done using statistical software IBM SPSS Statistics for Windows, (Version 21.0. Armonk, NY: IBM Corp.) using t-test and Tukey's test. Results: The mean pain perception for Group 1 was 4.8 ± 1.30 and 4.17 ± 1.58 in Group 2; the difference was not statistically significant (P = 0.26). The mean value for attitude in Group 1 was 3.57 ± 1.21, and in Group 2, it was 3.39 ± 1.60 (P = 0.09). There was statistically significant difference in pain perception between low (L) level to high level (H) neuroticism (P = 0.009). There was significant difference (P = 0.021) in pain for conscientiousness from very low to very high levels which is directly proportional. Conclusion: The present study indicated that attitude, personality traits, and pain perception have a definite role in patient cooperation and success of orthodontic treatment. PMID:29387624
Milling Tania, S. D.; Sathiasekar, Cynthia; Anison, Job Jacob; Samyukta Reddy, B. V.
Since the introduction of lasers in dentistry in the mid-1990's, research in laser supported dental therapies is progressing at a rapid pace. Orthodontics is no exception. In orthodontics, lasers have many diagnostic, therapeutic, and biomodulating applications. To update the various applications of lasers in orthodontics. Lasers work by delivering energy in the form of light. Laser, striking the biological tissues can either get reflected, absorbed or scattered depending on several factors. Depending on the fate of the emitted laser, it can be applied for different diagnostic, therapeutic and surgical procedures. The knowledge and understanding of different types of lasers and its specific applications is a prerequisite before it can be applied beneficially. In Orthodontics, the versatility of laser has expanded into bonding, curing, debonding, imaging, growth modification, pain reduction, etc. Definitely laser has extended its tentacles from diagnosis to treatment in orthodontics. PMID:26538884
Mandall, N A; Matthew, S; Fox, D; Wright, J; Conboy, F M; O'Brien, K D
The main aim of the present investigation was to evaluate whether there is an association between completion of orthodontic treatment and quality of life measures, i.e. age, gender, socio-economic status, type of appliance and need for orthodontic treatment. The secondary aim was to evaluate whether compliance with orthodontic treatment (missed appointments and appliance breakages) was associated with age, gender, socio-economic status, or type of appliance. This was a multi-centre longitudinal observational study carried out on 144 patients (65 males and 79 females) aged 10-19 years. Baseline data were collected: patient age, gender, socio-economic status, Index of Orthodontic Treatment Need (IOTN), and type of appliance. Quality of life information, including orthodontic utility values and oral aesthetic subjective impact score (OASIS), were also collected at the start of treatment. The main outcome measure was whether a patient completed treatment. Compliance was assessed by recording the number of failed appointments and appliance breakages. Multiple regression analysis was used to investigate the association between independent and dependent variables. None of the baseline variables, including quality of life measures, were associated with a patient completing treatment, or their compliance with treatment (P > 0.05). Thus, quality of life measures (utility values or OASIS) do not add to our knowledge of who may complete, or co-operate with, orthodontic treatment. In addition, neither age, gender, socio-economic status nor clinical treatment need (IOTN) were useful in helping a clinician to choose potentially co-operative patients.
Aljhani, Ali S.; Zawawi, Khalid H.
This paper illustrates the combined nonextraction orthodontic treatment with the corticotomy technique in an adult patient (age: 25 years and 3 months) with severely crowded arches to accelerate tooth movement and shorten the treatment time. Both her upper lateral incisors were congenitally absent and both upper central incisors' roots were short. Initial fixed orthodontic appliances (bidimensional) were bonded and one week later buccal and lingual corticotomy with alveolar augmentation procedure in the maxilla and mandible was performed. Orthodontic activation to level and align and unravel the crowding was performed every two weeks. The total treatment time was 8 months with no adverse effects observed at the end of active treatment. The addition of the decortication procedure to the conventional orthodontic therapy decreased the duration of treatment significantly. Successful alignment of both arches with ideal overbite and overjet as well as adequate occlusion was achieved. PMID:22848854
Souki, Marcelo Quiroga
The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate.
Souki, Marcelo Quiroga
ABSTRACT The present case report describes the orthodontic treatment of a young adult patient (18y / 1m), Class III skeletal malocclusion, with mandibular prognathism and significant dental compensation. The canine relation was Class III, incisors with tendency to crossbite and open bite, moderate inferior crowding, and concave profile. Skeletal correction of malocclusion, facial profile harmony with satisfactory labial relationship, correction of tooth compensation and normal occlusal relationship were obtained with orthodontic treatment associated to orthognathic surgery. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requirements to become a BBO diplomate. PMID:28125146
Li, Zi-Jian; Wang, Jun-Yan; Gao, Ming-Fei; Wu, Da-Lei; Chang, Xin
Cleidocranial dysplasia (CCD) is a rare autosomal dominant condition that affects ossification. The dental abnormalities associated with CCD present an obstacle to orthodontic treatment planning. Early diagnosis is crucial to provide the patient with different treatment modalities that will suit the particular patient. In the present case, combined surgical and orthodontic treatment were performed to guide multiple impacted teeth. A single nucleotide missense variation was identified in exon 3 of runt-related transcription factor 2 ( RUNX2 ) in this patient. The current results suggest a correlation between dental alterations and mutations in the runt domain of RUNX2 in CCD patients. Further clinical and genetic studies may required to confirm the association between phenotypes and genotypes in CCD and to identify other factors that may influence the clinical features of this disease. Patients with cleidocranial dysplasia require a team approach which demands good communication and cooperation from the patient. Timing of the intervention is critical, and numerous surgeries may be required. The patient in the present case report was treated by a team of practitioners, which involved several dental specialties to achieve an optimal result.
Oltramari-Navarro, Paula Vanessa Pedron; de Almeida, Renato Rodrigues; Conti, Ana Cláudia de Castro Ferreira; Navarro, Ricardo de Lima; de Almeida, Marcio Rodrigues; Fernandes, Leandra Sant'Anna Ferreira Parron
Skeletal Class III malocclusion, with its unpredictable and unfavorable nature, has been characterized by a growth pattern with doubtful prognosis regarding orthodontic mechanics, even when performed early. For a long time, Class III malocclusion was regarded as a synonym of mandibular prognathism, regardless of the affected skeletal structures. Mandibular growth, essentially determined by genetic factors, could barely be controlled by early orthodontic interventions. Therefore, the treatment choice was to wait for the patient to grow, and then make an orthodontic intervention associated with an orthognathic surgery. Maxillary involvement in the etiology of Class III malocclusion was conclusive to change orthodontic therapeutics. Maxillary intramembranous growth has a better response to orthopedic treatment, based on growth control and redirection, thus contributing for early intervention success. In several cases, excellent results have been achieved with rapid maxillary expansion and protraction. The aim of this study was to describe and discuss the treatment of a patient with Class III malocclusion, whose treatment planning comprised two phases: interceptive (mechanical orthopedic appliances) and comprehensive (fixed orthodontic appliance). The results of this case showed that Class III malocclusion should be intercepted as early as possible to permit growth redirection, mainly when the maxilla is the primary etiologic factor or dental and/or functional factors are involved. Diagnosis, treatment planning and prognosis depend on patient age, growth potential and severity of malocclusion. Early intervention, adequate indication of appliances, and patient compliance are key factors for good outcomes.
Background In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents. Methods The sample consisted of 403 subjects aged 14 to 18 years, selected randomly from a population of 182,291 schoolchildren in the same age group. The outcome variable "desire for orthodontic treatment" was assessed through a questionnaire. Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and the Dental Aesthetic Index (DAI) was used for clinical assessment. Statistical analysis involved the chi-square test as well as both simple and multiple logistic regression analyses. Results The majority (78%) of the Brazilian adolescents desired orthodontic treatment and 69% of the parents reported that their children were not in orthodontic treatment due to the high costs involved. There was significant association (p ≤ 0.05) between the desire for orthodontic treatment and most types of malocclusion. However, there was no significant association between the desire for orthodontic treatment and the variables gender and age. Conclusions The following were considered factors associated to the desire for treatment: upper anterior crowding ≥ 2 mm and parents' perception of their child's need for treatment. PMID:20021649
Marques, Leandro S; Pordeus, Isabela A; Ramos-Jorge, Maria L; Filogônio, Cid A; Filogônio, Cintia B; Pereira, Luciano J; Paiva, Saul M
In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents. The sample consisted of 403 subjects aged 14 to 18 years, selected randomly from a population of 182,291 schoolchildren in the same age group. The outcome variable "desire for orthodontic treatment" was assessed through a questionnaire. Self-perception of dental aesthetics was assessed using the Oral Aesthetic Subjective Impact Scale (OASIS) and the Dental Aesthetic Index (DAI) was used for clinical assessment. Statistical analysis involved the chi-square test as well as both simple and multiple logistic regression analyses. The majority (78%) of the Brazilian adolescents desired orthodontic treatment and 69% of the parents reported that their children were not in orthodontic treatment due to the high costs involved. There was significant association (p < or = 0.05) between the desire for orthodontic treatment and most types of malocclusion. However, there was no significant association between the desire for orthodontic treatment and the variables gender and age. The following were considered factors associated to the desire for treatment: upper anterior crowding > or = 2 mm and parents' perception of their child's need for treatment.
Klages, Ulrich; Bruckner, Aladàr; Guld, Yvette; Zentner, Andrej
The aim of this study was to investigate whether young adults with varying dental esthetics and histories of orthodontic treatment also differ in oral-health attitudes, preventive behaviors, and self-perceived oral health. The sample comprised 298 young adults, 18 to 30 years old, with at least 13 years of primary and secondary school education. The subjects were asked to complete questionnaires dealing with various measures related to oral-health attitudes, preventive behaviors, and perceptions of oral health. Dental esthetics were assessed by means of the aesthetic component of the index of orthodontic treatment need. Dental plaque accumulation was assessed in a subsample of respondents. Subjects with high dental-esthetics scores reported more favorable oral-health attitudes, such as internal control, dental awareness, value of occlusion, and preventive behavior expectations than subjects with lower scores. Subjects with previous orthodontic treatment showed greater internal control and dental awareness than those who had not previously been treated. Subjects ranking high in dental esthetics and those with previous orthodontic treatment reported stricter oral-hygiene adherence than others. Self-perceived oral health was better in high scorers on dental esthetics. Less plaque accumulation was found in subjects with higher dental esthetic scores and in those with previous orthodontic treatment. These findings suggest that favorable dental esthetics and previous orthodontic treatment might be important variables in explaining individual differences in oral-health attitudes and behaviors.
Gölz, Lina; Papageorgiou, Spyridon N; Jäger, Andreas
Nickel-containing alloys are widely used in orthodontic appliances, even though nickel is by far the most common contact allergen. However, the scientific evidence concerning allergic reactions to nickel in orthodontic patients has not been evaluated systematically. The objective of this study was to investigate whether the prevalence of nickel hypersensitivity is affected by orthodontic treatment. Unrestricted electronic and manual searches were performed until July 2013 for human clinical studies assessing orthodontic treatment and nickel hypersensitivity. Methodological limitations were evaluated with the Downs and Black tool. Crude and adjusted odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated from random-effects meta-analyses, followed by subgroup and sensitivity analyses. Thirty studies were included in the review, and 24 datasets with 10 184 patients in the meta-analyses. Orthodontic treatment had no significant effect on nickel hypersensitivity (n = 11; crude OR 0.99; 95%CI: 0.78-1.25; p = 0.914). However, when confounding from factors such as sex and piercings was taken into account, orthodontic treatment was associated with a lower risk of hypersensitivity (n = 1; adjusted OR 0.60; 95%CI: 0.40-0.80; p < 0.001). This was even more pronounced when orthodontic treatment was performed prior to piercing (n = 7; crude OR 0.35; 95%CI: 0.24-0.50; p < 0.001). Orthodontic treatment seems to have a protective role against nickel hypersensitivity, especially when it precedes piercings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Kumar, Prasanna; Londhe, S.M.; Kotwal, Atul; Mitra, Rajat
Background To ascertain the prevalence of malocclusion and orthodontic treatment need in schoolchildren dependent on armed forces personnel. To review the overall oral health using DMFT index and to evaluate any relation between increased DMFT index to existing orthodontic problems. Method Five schools were randomly selected among Army/KV/AF schools and a random sample of 1200 children aged 10–15 years old attending these schools dependant on armed forces personnel were selected. A survey form was filled up after the examination of children by the principal worker and need for orthodontic treatment was assessed using index for orthodontic treatment need (IOTN) and overall oral health status by DMFT index and totaled. Frontal intra oral photograph in centric occlusion were taken. Dental Health Component (DHC) of IOTN for all the patients was marked by one set of orthodontists. The most severe occlusal trait was identified by the examiner for any particular patient and the patient was then categorized according to this most severe trait. AC of the IOTN was assessed by second orthodontist, individual and a layperson. Results It was observed that prevalence of malocclusion in the sample was 53.7%. 32.8% (239 males & 154 females) of samples are in need of orthodontic treatment. 55.1% of samples shown no caries risk, 38.1% had moderate caries risk and 6.8% had high caries risk. Conclusion Significant percentage of the samples are in need for orthodontic treatment. There is significant relation between higher DMFT index and orthodontic treatment need. It was found that IOTN is a reliable and user-friendly index, which can be used for orthodontic surveys. PMID:24600146
Thilander, Birgit; Bjerklin, Krister
The aim of this work was to update the bibliography regarding the concept of 'temporomandibular disorder (TMD)' and 'posterior crossbite' and try to find out if there is any association between some special signs/symptoms of TMD and type of posterior crossbite. A literature search from 1970 to 2009, due to specified criterion, resulted in 14 publications that were found to be relevant for the present systematic review. An association between TMD and posterior crossbite (Yes-group) was reported as often as absence of such a relationship (No-group). The samples in the two groups showed similarities as well as differences with respect to number, gender, and age. Most articles reported only on 'presence' or 'absence' of crossbite and only few on type of crossbite opposite to a thorough account of clinical signs and symptoms of TMD. This review seems, however, to state that a functional posterior crossbite (mandibular guidance with midline deviation) is associated with headache, temporomandibular joint and muscular pain, and clicking. As evident from the discussion, such type needs orthodontic treatment to rehabilitate the asymmetric muscular activity between the crossbite and non-crossbite sides and the changed condyle/temporal relationship caused by mandibular deviation. Whether this treatment also will avoid future TMD problems can be answered only after clinical follow-up studies have been performed.
Batra, Puneet; Duggal, Ritu; Kharbanda, Om Prakash; Parkash, Hari
Two cases are presented where the odontomas had caused the impaction of the anterior teeth and required a combined surgical and orthodontic treatment to bring these teeth into the arch. In the first case a large a complex odontome had caused the impaction of the right central incisor, lateral incisor and canine. In the second case a compound odontome blocked the eruption pathway of the right central incisor. It is emphasised that radiographic examination of all pediatric patients that present clinical evidence of delayed permanent tooth eruption or temporary tooth displacement with or without a history of previous dental trauma should be performed. Early diagnosis of odontomas allows adoption of a less complex and less expensive treatment and ensures a better prognosis.
Lee, Robert J; Weissheimer, Andre; Pham, John; Go, Leslie; de Menezes, Luciane Macedo; Redmond, W Ronald; Loos, James F; Sameshima, Glenn T; Tong, Hongsheng
A significant objective of orthodontic treatment is to achieve proper and stable tooth positions that involve not only the crowns, but also their roots. However, the current methods of clinically monitoring root alignment are unreliable and inaccurate. Therefore, the purpose of this study was to develop a methodology that can accurately identify root position in a clinical situation. Pretreatment and posttreatment cone-beam computed tomography (CBCT) and extraoral laser scans of study models of a patient were obtained. Threshold segmentation of the CBCT scans was performed, resulting in 3-dimensional surface models. The pretreatment CBCT teeth were isolated from their respective arches for individual tooth manipulation. These isolated pretreatment CBCT teeth were superimposed onto the posttreatment surface scan depicting the expected root position setup. To validate the accuracy of the expected root position setup, it was compared with the true root position represented by the posttreatment CBCT scan. Color displacement maps were generated to measure any differences between the expected and true root positions. Color map analysis through crown superimposition showed displacement differences of 0.148 ± 0.411 mm for the maxillary roots and 0.065 ± 0.364 mm for the mandibular roots. This methodology has been demonstrated to be an accurate and reliable approach to visualize the 3-dimensional positions of all teeth, including the roots, with no additional radiation applied. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Christopherson, Elizabeth A; Briskie, Dan; Inglehart, Marita Rohr
In the age of evidence-based dentistry, an interesting question is whether dentists' subjective or general assessments of preadolescent orthodontic treatment need are correlated with objectively determined need. In addition, because children from socioeconomically disadvantaged and underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment, it is worthwhile to investigate whether unmet orthodontic treatment need is correlated with preadolescent smile assessments and desire for braces. Our objectives were to explore (1) whether pediatric residents' objective and subjective assessments of preadolescent orthodontic treatment need are correlated and also correlate with the treatment recommendations made, (2) whether preadolescent responses concerning their smile-related quality of life and desire for braces are correlate, and (3) whether dentist and patient assessments are related. Data were collected from 1566 preadolescents (age range, 8-11 years; 47.3% boys, 52.7% girls; 55.7% black, 39.7% white, 2.9% Hispanic) in oral examinations and face-to-face interviews. Malocclusion was determined with the index of orthodontic treatment need. Objective and subjective orthodontic treatment need indicators were correlated (r = .719, P <0.001). Pediatric residents' recommendations for orthodontic treatment were correlated with both the objective assessment of treatment need (r = .547, P <0.001) and the subjective assessment of treatment need (r = .522, P <0.001). Both sets of malocclusion indicators correlated with the patients' self-perceptions (r = -.145, P <0.001; r = -.177, P <0.001) and their desire for braces (r = .106, P = 0.001; r = .141, P <0.001). Patient desire for braces was significantly correlated with smile-related quality-of-life scores (r = .665, P <0.001). Although subjective and objective assessments of preadolescent orthodontic treatment need are rather consistent, the percentage of actual treatment
Esa, R; Razak, I A; Allister, J H
Data on malocclusion and orthodontic treatment need in Malaysia are limited. The purpose of this study was to evaluate malocclusion and orthodontic treatment need in a sample of 12-13-year-old schoolchildren using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and socio-demographic variables, perceptions of need for orthodontic treatment, aesthetic perception and social functioning. The sampling procedure involved a multistage, clustered and stratified random sampling. The sample comprised of 1,519 schoolchildren attending 20 secondary government and government-aided schools in urban and rural areas of Klang District in Peninsular Malaysia. There were 772 males and 747 females. Each subject was administered a questionnaire eliciting standard demographic information such as gender, parents' income and ethnic origin and questions on perception of need for orthodontic treatment and satisfaction with dental appearance and function. Intra-oral examination for occlusal status using the DAI was performed for each subject. Most subjects (62.6%) require no orthodontic treatment. Only about 7% had handicapping malocclusion that needed mandatory treatment. Malocclusion, as defined in this study, was found to be significantly associated with gender and subjects' area of residence. There were no significant differences in mean DAI scores for Malays, Chinese and Indian children. Significant associations were found between DAI scores and perception of need for orthodontic treatment, satisfaction with dental appearance and social functioning (P<0.01). The findings will be useful for the public dental service to determine priority for orthodontic treatment as part of the comprehensive care provided by the School Dental Service (SDS).
de Freitas, Carolina Vieira; Souza, João Gabriel Silva; Mendes, Danilo Cangussu; Pordeus, Isabela Almeida; Jones, Kimberly Marie; Martins, Andréa Maria Eleutério de Barros Lima
OBJECTIVE: To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents. METHODS: This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003). Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable need orthodontic treatment was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated. RESULTS: The majority of the adolescents needed orthodontic treatment (53.2%). In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad. CONCLUSIONS: There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system. PMID:25769190
Germa, Alice; Kaminski, Monique; Nabet, Cathy
Objectives This study aimed to estimate the prevalence of orthodontic treatment in France among children and teenagers aged 8 to 18 years, by sex and by age, and to investigate the specific role of social and economic characteristics on use of orthodontic treatment. Methods We analysed data from the cross-sectional national health survey conducted in France in 2002–2003, which included a sample of 5988 children aged 8 to 18 years. All data were collected by interview including the question on orthodontic treatment. Other data used in our study were family social status and income, maternal educational attainment and place of birth, whether the child was covered by a supplementary health insurance and whether the residence was urban or rural. We also calculated the density of orthodontists in the district. Multivariate logistic regression analyses were used to study the relationships between these social and economic factors and orthodontic treatment. Results The prevalence of orthodontic treatment was 14% of all children aged 8 to 18, 15% for girls, and 13% for boys, and 23% in the 12 to 15-year age group. Children were less likely to have orthodontic treatment when parents were service or sales workers compared with children whose parents were managers or professionals (aOR=0.50; 95%CI: [0.34;0.76]), when family income was in the lowest, compared with highest quartile (aOR=0,62; 95%CI: [0.45;0.85]), when children had no supplementary insurance compared with children covered by private insurance (aOR=0.53; 95%CI: [0.34;0.81]), or when they lived in rural compared with urban areas (aOR=0.70; 95%CI: [0.54;0.91]). Conclusion There are social inequalities in orthodontic treatment in France, associated mainly with social status, annual income, supplementary insurance, and the residence area. PMID:20002629
Freitas, Carolina Vieira de; Souza, João Gabriel Silva; Mendes, Danilo Cangussu; Pordeus, Isabela Almeida; Jones, Kimberly Marie; Martins, Andréa Maria Eleutério de Barros Lima
To identify the prevalence and the severity of malocclusions and to analyze factors associated with the need for orthodontic treatment of Brazilian adolescents. This exploratory, cross-sectional study was carried out based on secondary data from the national epidemiological survey on oral health in Brazil (2002-2003). Socio-demographic conditions, self-perception, and the existence and degree of malocclusion, using the Dental Aesthetic Index, were evaluated in 16,833 adolescent Brazilians selected by probabilistic sample by conglomerates. The dependent variable - need orthodontic treatment - was estimated from the severity of malocclusion. The magnitude and direction of the association in bivariate and multivariate analyzes from a Robust Poisson regression was estimated. The majority of the adolescents needed orthodontic treatment (53.2%). In the multivariate analysis, the prevalence of the need for orthodontic treatment was larger among females, non-whites, those that perceived a need for treatment, and those that perceived their appearance as normal, bad, or very bad. The need for orthodontic treatment was smaller among those that lived in the Northeast and Central West macro-regions compared to those living in Southeast Brazil and it was also smaller among those that perceived their chewing to be normal or their oral health to be bad or very bad. There was a high prevalence of orthodontic treatment need among adolescents in Brazil and this need was associated with demographic and subjective issues. The high prevalence of orthodontic needs in adolescents is a challenge to the goals of Brazil's universal public health system. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Dianiskova, Simona; Calzolari, Chiara; Migliorati, Marco; Silvestrini-Biavati, Armando; Isola, Gaetano; Savoldi, Fabio; Dalessandri, Domenico; Paganelli, Corrado
The use of elastics to close a diastema or correct tooth malpositions can create unintended consequences if not properly controlled. The American Association of Orthodontists recently issued a consumer alert, warning of “a substantial risk for irreparable damage” from a new trend called “do-it-yourself” orthodontics, consisting of patients autonomously using elastics to correct tooth position. The elastics can work their way below the gums and around the roots of the teeth, causing damage to the periodontium and even resulting in tooth loss. The cost of implants to replace these teeth would well exceed the cost of proper orthodontic care. This damage could also occur in a dental office, when a general dentist tries to perform a simplified orthodontic correction of a minor tooth malposition. The present case report describes a case of tooth loss caused by a displaced intraoral elastic, which occurred during a simple preprosthetic orthodontic treatment. PMID:27672645
Shargill, I; Nandra, S; Day, P; Houghton, N
To survey patient and parent satisfaction with premolar transplantation and the associated orthodontic treatment. A postal service evaluation questionnaire was used to survey patient and parent satisfaction for children who had completed treatment involving premolar transplantation and the associated orthodontics. Patients and parents each completed separate questionnaires. For some questions a Likert scale from 1 to 10 was used. Questionnaires were sent to 41 patients and their parents who had premolar transplants and orthodontic treatment. Following repeat mailing of the questionnaires: 20 of the patient and 25 parent questionnaires were completed and returned. Patients and parents felt there was a large improvement in dental appearance (median scores 8 and 10) and were highly satisfied with the final appearance (median scores 8 and 9). Both groups felt that treatment transition between departments was very good (median scores 9 and 9). Patients experienced moderate discomfort during their premolar transplant surgery and during their orthodontic treatment (scores 6 and 5, respectively). Most patients and parents would recommend this type of treatment (92 and 88%, respectively). Overall, patients and parents report high levels of satisfaction with all aspects of their premolar transplant and their associated orthodontic treatment.
Rafiuddin, Syed; YG, Pradeep Kumar; Biswas, Shriparna; Prabhu, Sandeep S; BM, Chandrashekar; MP, Rakesh
In orthodontic treatment, teeth are moved in to new positions and relationships and the soft tissue and underlying bone are altered to accommodate changes in esthetics and function. Function is more important than esthetics. The speciality of orthodontics has in addition to its benefits, complications as well as risks associated with its procedures. However the benefits outweigh the risks & complications in most of the treatment cases. Few of the unwanted side effects associated with treatment are tooth discolorations, enamel decalcification, periodontal complications like open gingival embrasures, root resorption, allergic reactions to nickel & chromium as well as treatment failure in the form of relapse. PMID:26312093
Sastri, Murlidhar R; Tanpure, Vijaysinh Ramchandra; Palagi, Firoz Babu; Shinde, Sagar Kundlik; Ladhe, Kapil; Polepalle, Tejaswin
Background: General dental practitioners and non-orthodontic specialty can play an essential role of education and motivation of their patients about the principles and practice of orthodontic treatment; which can be very beneficial to the patient’s lifestyle. It is, therefore, important to identify their level of knowledge and attitude toward orthodontic treatment. This study was planned to study this aspect in the form of comparative analysis in general dental practitioners and other specialties (except orthodontia) in dentistry. Materials and Methods: The study was done on 78 dentists, which was divided into two groups. Group I consisted of 46 general dental practitioners and Group II consisted of 32 non-orthodontic specialties. The study was carried out with the help of 21 questionnaires, which consisted of 13 questions of orthodontic knowledge and 08 questions about the attitude toward orthodontic practice. The scores were calculated, and statistical analysis was done with the help of IBM SPSS statistics 20, using Student’s t-test. Results: The comparative analysis showed highly significant difference of knowledge and attitude score between general dental practitioners and non-orthodontic specialties (Student’s t-test, P < 0.001). Also the comparison was made between male and female practitioners, who showed more scores in case of male practitioners; but the difference was not significant statistically (Student’s t-test, P > 0.01). Conclusion: The results of the study were moderately satisfactory, and it showed the need for increased clinically oriented education of practice and concepts of orthodontic treatment. PMID:25878478
Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis. PMID:28299350
Chen, Wei; Chen, Rong-jing
The purpose of this study was to evaluate the effect of high pull J hook headgear(HPHG) on root resorption of maxillary incisors during orthodontic treatment. Sixty female adolescent subjects who had finished orthodontic treatment were selected. They were either Class I or Class II division I cases treated with standard edgewise appliances. Half of the patients(30 cases) had an additional HPHG to assist upper anterior teeth retraction. They were matched to the other 30 cases with age and type of malocclusion. Panoramic radiographs taken before and after the orthodontic treatment were used to evaluate the degree of root resorption on upper incisors. Chi(2) test was used for statistical analysis. The incidence of root resorption on upper incisors was significantly increased after orthodontic treatment in both HPHG and non-HPHG groups (P<0.01). Compared to the non-HPHG group, more teeth in HPHG group showed moderate or severe root resorption (P<0.01). Some cases even encountered extremely severe root resorption. A combination of HPHG might lead to more severe root resorption on maxillary incisors during orthodontic treatment.
Puertes-Fernández, Neus; Montiel-Company, José María; Almerich-Silla, José Manuel; Manzanera, David
The aim of this study was to establish orthodontic treatment need according to the Dental Aesthetic Index (DAI) and Aesthetic Component (AC) and Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and to determine its association with gender among Saharan schoolchildren. The study was carried out in accordance with World Health Organization (WHO) recommendations for oral health surveys at 12 years of age. The sample comprised 248 Sahrawi children (135 girls and 113 boys) living in refugee camps in Tindouf, Algeria. None of the children had previously received any orthodontic treatment. A chi-square test was used to analyse the IOTN results by gender, and a Student's t-test was employed for the DAI results. The mean DAI was 23.32 with a standard deviation of 6.05, 4 percent with a very severe and 9.2 per cent with severe malocclusion. Orthodontic treatment need was 16.1 and 2.0 percent, respectively, according to grades 4 and 5 of the IOTN DHC, 13.7 percent according to the IOTN AC, and 28.6 percent according to the modified IOTN (IOTN DHC grades 4-5 and/or IOTN AC grades 8-10). There were no statistically significant differences by gender. The orthodontic treatment need of Western Saharan schoolchildren is similar to that reported by many recent studies in European and in Sub-Saharan countries.
Tuzuner, Tamer; Ozel, Mehmet B.; Bostanoglu, Ozge
Objective: To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Study design: Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (Cervitec®Plus); Group 2 (n=20): Cervitec®Plus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (Cervitec®Gel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector®). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T1, one week after orthodontic bonding; T2, one week; and T3, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P<0.017). Results: Significantly lower MS and LB levels were found in Group 2 than Group 1 (T2) and 3 (T2, T3) (P<0.017). Groups 1-2 (T2) showed significantly higher BC (P<0.017) and lower VPI and GBI (P<0.017) scores compared with Group 3. Decreased MS levels at T2 (P<0.017) and T3 (P>0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T2 compared with T0 (P<0.017) while no significant differences were seen in Group 1 and 3 (P>0.017). Conclusions: Addition of Cervitec®Plus+Cervitec®Gel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis. Key words:Chlorhexidine, flouride, mutans streptococci, lactobacilli, antibacterial effect, plaque, gingivitis, orthodontic treatment. PMID:23385499
Yamamoto, Zulham; Jaafar, Ikmal Mohamad; Rohaya, M. A. W.; Abidin, Intan Zarina Zainol; Senafi, Sahidan; Ariffin, Zaidah Zainal; Ariffin, Shahrul Hisham Zainal
Periodontal tissue changes exerted by external forces in orthodontic treatment allow tooth movement. The changes in periodontal tissues i.e. inflammation can be monitored using gingival crevicular fluid (GCF). GCF is a component of saliva. Saliva could be used to monitor periodontal disease progression. The use of saliva to monitor periodontal tissues changes during orthodontic treatment is still unknown. Therefore, we observed the profiles of inflammatory markers namely creatine kinase ('CK), nitric oxide (NO), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in saliva of orthodontic patients to evaluate their importance in orthodontic treatment. A total of 21 subjects (13 female and 8 male) participated in this study. Samples were collected from gingival crevicular fluid at three period of archwire changes: baseline (M0), 2 weeks after 0.014" NiTi archwire (M1), and 2 weeks after 0.018" NiTi archwire (M2). All enzyme activities i.e. CK, LDH and AST were measured spectrophotometrically at 340 nm. Griess assay was used to measure nitric oxide level. CK activity, NO level, LDH activity and AST activity in saliva samples did not show significant differences among period of archwire changes. The use of inflammatory marker profiles in saliva may not represent the changes in periodontal tissues during orthodontic treatment.
Billings, Branson; Helms, Lana; Kula, Katherine; Utreja, Achint; Eckert, George; Ghoneima, Ahmed
The purpose of this study was to measure changes in buccolingual inclination and in thickness of maxillary and mandibular buccal and lingual bone of maxillary and mandibular molars following orthodontic treatment using edgewise mechanics. Cone-beam computed tomography scans of 48 patients taken before and after completion of comprehensive orthodontic treatment were collected for this retrospective study. Buccolingual molar inclinations were reported as angular measurements using the long axis of the teeth and inferior border of the nasal floor and inferior border of the mandible, respectively. Distances between the buccal and lingual cusps of maxillary and mandibular molars, respectively, were measured to the occlusal plane to assess the change in buccolingual inclination after orthodontic treatment. The amount of buccal and lingual bone at the level of the root apex of each molar was also evaluated before and after orthodontic treatment. Orthodontic edgewise mechanics caused significant increases in mandibular first molars' inclination angle, lingual bone, and mandibular second molars' buccal bone and inclination angle. Significant decreases were noted in mandibular first molars' buccal bone, inclination distance and mandibular second molars' lingual bone and inclination distance. Maxillary teeth had fewer significant changes than the mandibular teeth. Significant decreases were found for maxillary first molars' buccal bone, inclination distance, and maxillary second molar buccal bone. Published by Elsevier Masson SAS.
Piccoli, Luca; Migliau, Guido; Besharat, Laith Konstantinos; Di Carlo, Stefano; Pompa, Giorgio; Di Giorgio, Roberto
Summary Aim The purpose of this research is to investigate whether and how the adhesive bond failure site varied in relation to the material used for the orthodontic bonding and debonding technique applied. Materials and methods Two different methods of orthodontic debonding were included in our survey; cutters for orthodontics and debonding plier. Three different materials for the adhesion of the bracket: composite light curing, self-curing composite and glass ionomer cement. The remaining amount of adhesive on the tooth surface is an important parameter that gives information on how the location of the posting site varied during the debonding. 60 dental elements, maxillary and mandibular, previously extracted for orthodontic reasons, as well as periodontal, were included in our research. We investigated a possible significant correlation between different variables (debonding technique and materials for membership) and the ARI index. Conclusions The use of orthodontic cutters or debonding pliers does not affect the adhesive bond failure site and both techniques have a tendency to leave a significant amount of adhesive on the surface enamel. In the resin-reinforced glass ionomer cements, detachment occurs at the interface enamel-adhesive and this pattern of detachment increases the risk of the enamel damage during debonding. In both types of composite resins (photopolymerizable or self-curing), the detachment occurs at the interface bracketing adhesive. In this case the amount of remaining adhesive material on the tooth must be removed with further methods, which in addition, increase the risk of iatrogenic injury as well as the working hours. PMID:29299191
Singh, Sarabjeet; Sharma, Abhishek; Sandhu, Navreet; Mehta, Kavita
The aim of this study was to determine the prevalence of malocclusion and orthodontic treatment need in 13-18-year-old schoolchildren of Nalagarh, Himachal Pradesh, India using the Index of Orthodontic Treatment need (IOTN) and to analyze the treatment needs between males and females and correlation between the esthetic component (AC) and dental health component (DHC) of IOTN. The sample comprised 2000 school children (1125 females and 875 males) who had not undergone orthodontic treatment. No radiographs, study casts, were used; IOTN was calculated from clinical examination. DHC results showed that little need for orthodontic treatment was found in 31.6% and moderate need in 30.85%. A great need was estimated at 37.55%. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by increased overjet, impeded eruption of teeth, and anterior or posterior cross bite. AC results showed that little need for orthodontic treatment was in 86.15%, moderate need in 8.90%, and great need in 4.95%. Index does not consider midline discrepancy, soft tissue abnormalities, and AC does not include Class III and Class II div 2 malocclusion photographs. There seems a discrepancy in the proportion of children needing orthodontic treatment on esthetic and dental health grounds. This study provides baseline data on the need and demand for orthodontic treatment among the sample which is important for planning public orthodontic and dental services.
Rischen, Robine J.; Breuning, K. Hero; Bronkhorst, Ewald M.; Kuijpers-Jagtman, Anne Marie
Background Traditionally, dental models, facial and intra-oral photographs and a set of two-dimensional radiographs are used for orthodontic diagnosis and treatment planning. As evidence is lacking, the discussion is ongoing which specific records are needed for the process of making an orthodontic treatment plan. Objective To estimate the contribution and importance of different diagnostic records for making an orthodontic diagnosis and treatment plan. Data sources An electronic search in PubMed (1948–July 2012), EMBASE Excerpta Medica (1980–July 2012), CINAHL (1982–July 2012), Web of Science (1945–July 2012), Scopus (1996–July 2012), and Cochrane Library (1993–July 2012) was performed. Additionally, a hand search of the reference lists of included studies was performed to identify potentially eligible studies. There was no language restriction. Study selection The patient, intervention, comparator, outcome (PICO) question formulated for this study was as follows: for patients who need orthodontic treatment (P), will the use of record set X (I) compared with record set Y (C) change the treatment plan (O)? Only primary publications were included. Data extraction Independent extraction of data and quality assessment was performed by two observers. Results Of the 1041 publications retrieved, 17 met the inclusion criteria. Of these, 4 studies were of high quality. Because of the limited number of high quality studies and the differences in study designs, patient characteristics, and reference standard or index test, a meta-analysis was not possible. Conclusion Cephalograms are not routinely needed for orthodontic treatment planning in Class II malocclusions, digital models can be used to replace plaster casts, and cone-beam computed tomography radiographs can be indicated for impacted canines. Based on the findings of this review, the minimum record set required for orthodontic diagnosis and treatment planning could not be defined. Systematic review
Sundfeld, Renato Herman; Rahal, Vanessa; Croll, Theodore P; De Aalexandre, Rodrigo Sversut; Briso, Andre Luiz Fraga
This article reports clinical procedures used to remove residual bonded resin and enamel stains following bracket "debonding" at the conclusion of orthodontic treatment. A water-cooled fine-tapered diamond bur was used for resin removal, followed by enamel surface finishing using a commercially available microabrasion paste. It was noted that residual tooth coloration remained yellowish because of enamel translucency; the yellow dentin shade showed through. Additional tooth shade lightening was achieved using carbamide peroxide dental bleaching solution in custom-formed trays. This report describes a safe and effective technique that optimizes tooth appearance at the conclusion of orthodontic therapy. Mechanical resin removal, enamel microabrasion, and tooth bleaching are employed. A combination of treatment methods are sometimes required for the best esthetic result. After orthodontic treatment, mechanical resin removal followed successively by enamel microabrasion and tooth bleaching can yield ideal long-lasting improvement.
Background Electromyographic analysis of the masticatory muscles provides useful data on the behavior of these muscles during stomatognathic system functioning and allows a functional assessment of orthodontic treatments. This study was undertaken to verify if achieving an Angle Class I bite through orthodontic treatment can lead to neuromuscular balance. Methods This study enrolled 30 patients (20 females, 10 males, mean age: 15.78 years) with an Angle Class II, division 1 malocclusion that was orthodontically treated. A group of 30 subjects (19 females, 11 males; mean age: 16.15 years), randomly selected among subjects with an Angle Class II, division 1 malocclusion that had not been orthodontically treated served as the Control group. Both groups were subjected to electromyography to study their neuromuscular characteristics. The Shapiro-Wilk's test revealed a non normal distribution, therefore we used a Friedman two way ANOVA by ranks test to compare differences of surface electromyography values between treated and untreated subjects at closed and open eyes condition. Results A statistically significant interaction between orthodontic treatment and open eyes conditions was detected for anterior temporal muscles. A significant imbalance of the anterior temporal muscles, which is indicative of an asymmetric electromyographic pattern, was also found. Conclusions The present data indicate that achieving a correct occlusal target does not necessarily correspond to a neuromuscular balance. PMID:24152806
Mendoza-García, Luz-Victoria; Vaillard-Jiménez, Esther; García-Rocha, Araceli; Bellot-Arcís, Carlos; Paredes-Gallardo, Vanessa
Third molars present more problems than other teeth because they are the last teeth to erupt, and so it is important to assess their development when designing an orthodontic treatment plan. The aim of this study was to compare the angulation of the mandibular third molar and retromolar space before and after orthodontic treatment in cases involving first premolar extraction. 76 patients, 59 women (77.63%) and 17 men (22.36%), were recruited from the Orthodontics Clinic at Benemérita Universidad Autónoma de Puebla (Mexico). Panoramic radiographs were analyzed before and after orthodontic treatment that included first premolar extractions, measuring retromolar space (RS) and the angles formed by the intersection of the axes of the third and second molar (α) and the intersection of the axis of the mandibular plane and third molar (β). The data obtained underwent statistical analysis. The angle α and β showed statistically significant differences on the left side in women. In men, only the right side α angle showed significant differences. Retromolar space increased significantly on both sides for both sexes. Third molar angulation presents different behaviors between men and women, with greater verticalization in women. Key words: Third molar, retromolar space, orthodontics.
Vaillard-Jiménez, Esther; García-Rocha, Araceli; Bellot-Arcís, Carlos; Paredes-Gallardo, Vanessa
Background Third molars present more problems than other teeth because they are the last teeth to erupt, and so it is important to assess their development when designing an orthodontic treatment plan. The aim of this study was to compare the angulation of the mandibular third molar and retromolar space before and after orthodontic treatment in cases involving first premolar extraction. Material and Methods 76 patients, 59 women (77.63%) and 17 men (22.36%), were recruited from the Orthodontics Clinic at Benemérita Universidad Autónoma de Puebla (Mexico). Panoramic radiographs were analyzed before and after orthodontic treatment that included first premolar extractions, measuring retromolar space (RS) and the angles formed by the intersection of the axes of the third and second molar (α) and the intersection of the axis of the mandibular plane and third molar (β). Results The data obtained underwent statistical analysis. The angle α and β showed statistically significant differences on the left side in women. In men, only the right side α angle showed significant differences. Retromolar space increased significantly on both sides for both sexes. Conclusions Third molar angulation presents different behaviors between men and women, with greater verticalization in women. Key words:Third molar, retromolar space, orthodontics. PMID:28298970
Perinetti, Giuseppe; Paolantonio, Michele; D'Attilio, Michele; D'Archivio, Domenico; Dolci, Marco; Femminella, Beatrice; Festa, Felice; Spoto, Giuseppe
During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress involves an acute inflammatory response, with a sequence characterized by periods of activation, resorption, reversal, and formation in both tension and compression sites. This study used a longitudinal design to examine aspartate aminotransferase (AST) activity in gingival crevicular fluid (GCF) in order to assess whether AST in GCF has potential as a possible diagnostic aid to monitor tooth movement and tissue response during orthodontic treatment. Eighteen patients (mean age, 16.1 years) participated in the study. An upper first molar from each patient undergoing treatment for distal movement served as the test tooth (TT), with its contralateral (CC) and antagonist (AC) first molars used as controls. The CC was included in the orthodontic appliance, but was not subjected to the orthodontic force; the AC was free from any orthodontic appliance. The GCF around the experimental teeth was collected from both mesial and distal tooth sites immediately before appliance activation, 1 hour after, and weekly over the following 4 weeks. Clinical gingival condition was evaluated at baseline and at the end of the experimental period. AST activity was determined spectrophotometrically at 30 degrees C, and the results were expressed as total AST activity (mU/sample). Throughout the experiment, AST levels were significantly elevated in all sites from the TT and CC groups compared to the AC group where, conversely, AST activity remained at the baseline level. However, enzyme levels in the TT group were significantly greater than in the CCs at tension sites on day 14, and in compression sites on days 7 and 14. Moreover, AST activity from the TT group was significantly greater in compression sites than in tension sites on day 7; this was not observed for the CCs. Our results suggest that AST levels in GCF reflect the biological activity which occurs in the periodontium during
Clijmans, Maïté; Lemiere, Jurgen; Fieuws, Steffen; Willems, Guy
The aim of this study was to investigate whether an association exists between orthodontic treatment need and oral health-related quality of life (OHRQoL) and whether this association is moderated by self-esteem (SE) and/or personality traits. In this cross-sectional study comprising 189 adults (55 males and 134 females) aged 17 or older (mean age 31.3 years), the OHRQoL was scored by the use of the shortened version of the Oral Health Impact Profile-14 (OHIP-14). The Rosenberg self-esteem scale was used to evaluate SE, and the Dutch adaptation of the Neuroticism Extraversion Openness Five-Factor Inventory was used to assess personality profiles. Need for treatment was defined by the Index of Orthodontic Treatment Need. Spearman correlations, Mann-Whitney U-tests, and regression models were used to analyse the data. There is a modest to weak association between treatment need (Dental Health Component and aesthetic component) and OHRQoL as measured by the total OHIP-14 score (ρ = 0.21, P = 0.01216; ρ = 0.18, P = 0.02960, respectively). A significant, yet modest to weak, association between SE and the total OHIP-14 score was found (ρ = -0.34, P = 0.00057). Moreover, significant associations were found for the total OHIP-14 score and neuroticism and extraversion. Significant associations can be found between SE and all personality traits. There was a significant association between orthodontic treatment need and OHRQoL. Moreover, a significant association can be found between SE and OHRQoL, as well as certain personality traits and OHRQoL. No evidence was found that SE or personality traits moderate the association between OHRQoL and treatment need. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Bichara, Lívia Monteiro; de Aragón, Mônica Lídia Castro; Brandão, Gustavo Antônio Martins; Normando, David
ABSTRACT To improve orthodontic treatment efficiency, orthodontists must know which variables could interfere with orthodontic treatment time. Objective: To identify variables and their effect size on orthodontic treatment time of Class III malocclusion. Material and Methods: Forty-five Class III malocclusion cases were selected from 2008 patients’ records. Clinical charts, cephalometric radiographs, and pre and posttreatment dental casts were evaluated. Age, sex, PAR index at T1 and T2, overjet, missing teeth, extractions, number of treatment phases, missed appointments, appliance breakages, and cephalometric variables SNA, SNB, ANB, Wits, SnGoGn, CoA, CoGn, IMPA, 1.PP were investigated by multiple linear regression analysis and stepwise method at p<0.05. The sample was also divided into two groups: Group 0-2 (patients who had missed two clinical appointments or less) and Group >2 (patients who missed more than 2 appointments), to detect the influence of this data on treatment time and the quality of the treatment (PAR T2). Results: Average treatment time was 30.27 months. Multiple regression analysis showed that missed appointment (R2=0.4345) and appliance breakages (R2=0.0596) are the only variables able to significantly predict treatment duration. Treatment time for patients who missed more than 2 appointments was nearly one year longer. However, no significant influence on PAR T2 was observed for those patients. Conclusion: Orthodontic treatment duration in Class III patients is mainly influenced by factors related to patient compliance. Patients who missed more appointments did not show worse orthodontic finishing, but longer treatment. No occlusal, cephalometric, or demographic variable obtained before treatment was able to give some significant prediction about treatment time in Class III patients. PMID:27812612
Hodges, Ryan J; Atchison, Kathryn A; White, Stuart C
In this study, we measured the impact of cone-beam computed tomography (CBCT) on orthodontic diagnosis and treatment planning. Participant orthodontists shown traditional orthodontic records for 6 patients were asked to provide a diagnostic problem list, a hypothetical treatment plan, and a clinical certainty. They then evaluated a CBCT scan for each patient and noted any changes, confirmations, or enhancements to their diagnosis and treatment plan. The number of diagnosis and treatment plan changes varied widely by patient characteristics. The most frequently reported diagnosis and treatment plan changes occurred in patients with unerupted teeth, severe root resorption, or severe skeletal discrepancies. We found no benefit in terms of changes in treatment plan for patients when the reason for obtaining a CBCT scan was to examine for abnormalities of the temporomandibular joint or airway, or crowding. Orthodontic participants who own CBCT machines or use CBCT scans frequently in practice reported significantly more diagnosis and treatment plan changes and greater confidence after viewing the CBCT scans during the study. The results of this study support obtaining a CBCT scan before orthodontic diagnosis and treatment planning when a patient has an unerupted tooth with delayed eruption or a questionable location, severe root resorption as diagnosed with a periapical or panoramic radiograph, or a severe skeletal discrepancy. We propose that CBCT scans should be ordered only when there is clear, specific, individual clinical justification. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Kulal, Rithesh; Thomas, Biju; Ravi, M. S.; Shetty, Suchetha
Background: Therapeutic goal in patients with cleft lip and palate is esthetics and long-term health of the stomatognathic system. Patients with cleft lip and palate routinely require extensive and prolonged orthodontic treatment. The osseous structures are absent or poorly developed in the osseous clefts and may be traumatized in the course of orthodontic therapy; hence require constant monitoring during orthodontic treatment. The aim of the study was to evaluate the tissue response of cleft palate patients by quantitative analysis of enzyme activity during orthodontic treatment and assess any difference in the tissue response with that of noncleft patients undergoing orthodontic treatment. Materials and Methods: 20 patients requiring orthodontic treatment agedbetween 15 to 25 years were included to participate in the studyof which ten were cleft palate patients (group I) and ten noncleft patients (group II). The GCF samples were collected at incisor and molar sites during orthodontic treatment on days as per the study design in both the groups. The GCF enzymatic levels were estimated and compared. Results: Both groups showed significant increased enzyme activity at the incisor site compared to molar site corresponding to the phases of tooth movement. Conclusion: There was significant difference in enzyme activity between the incisor adjacent to the cleft site and molar site. There was no difference in the tissue response between cleft palate patients and noncleft patients during orthodontic treatment. PMID:24049331
Ong, H B
Case report of an adult Caucasian female aged 23 years and nine months who complained of some difficulty in chewing and talking. Patient was diagnosed to have a mild Class III skeletal malocclusion with an anterior open bite of 4 mm. Treatment included combined orthodontic and orthognathic surgical approach. Surgery included surgically assisted maxillary expansion, advancement and impaction, a mandibular setback and a vertical, antero-posterior reduction genioplasty. The present case report illustrates a coordinated orthodontic and orthognathic surgical approach in the treatment of skeletal open bite deformities.
Moon, Ji-Eun; Kim, Sung-Hun; Han, Jung-Suk; Yang, Jae-Ho
If orthodontists and restorative dentists establish the interdisciplinary approach to esthetic dentistry, the esthetic and functional outcome of their combined efforts will be greatly enhanced. This article describes satisfying esthetic results obtained by the distribution of space for restoration by orthodontic treatment and porcelain laminate veneers in uneven space between maxillary anterior teeth. It is proposed that the use of orthodontic treatment for re-distribution of the space and the use of porcelain laminate veneers to alter crown anatomy provide maximum esthetic and functional correction for patients with irregular interdental spacing. PMID:21165191
Ozer, Törün; Başaran, Güvenç; Kama, Jalen Devecioğlu
After fixed appliance treatment, one concern is to restore the enamel surface as closely to its original state as possible. A variety of cleanup processes are available, but all are time-consuming and carry some risk of enamel damage. The purpose of this study was to examine tooth surfaces restored with different cleanup protocols. Ninety-nine premolars extracted for orthodontic purposes were used. The 2 materials tested were Sof-Lex disks (3 M ESPE AG, Seefeld, Germany) and fiberglass burs (Stain Buster, Carbotech, Ganges, France). These were used alone and in combination with high- and low-speed handpieces, with which they were also compared. Eight groups were ultimately tested. All groups were compared with intact enamel, which served as the control group. From each group, 10 samples were examined with profilometry and 1 with scanning electron microscopy. Adhesive remnant index scores were recorded to ensure equal distributions for the groups. The time required for the cleanup processes and profilometry test results were also recorded. The fastest procedure was performed with high-speed handpieces, followed by low-speed handpieces. Sof-Lex disks and fiberglass burs required more time than carbide burs but did not result in significantly longer times for the cleanup procedure when combined with tungsten carbide-driven low- or high-speed handpieces or when used alone with low-speed handpieces. Although Sof-Lex disks were the most successful for restoring the enamel, it was not necessary to restore the enamel to its original surface condition. Generally, all enamel surface-roughness parameters were increased when compared with the values of intact enamel. The average roughness and maximum roughness depth measurements with Sof-Lex disks were statistically similar to measurements of intact enamel. No cleanup procedure used in this study restored the enamel to its original roughness. The most successful was Sof-Lex disks, which restored the enamel closer to its
Wedrychowska-Szulc, Barbara; Syryńska, Maria
The aims of this investigation were to examine patients' and parents/guardians' motivation for seeking orthodontic treatment and to determine the influence of age and gender in this process. The sample comprised 674 subjects (365 girls and 309 boys) aged 7-18 years and 674 of their parents/guardians, as well as 86 adult patients aged 19-42 years (57 females and 29 males). Similar questionnaires, designed to assess motivation for orthodontic treatment, were completed by all subjects. Statistical analysis was undertaken using Pearson's chi-square test. In the patient groups, a desire to improve aesthetics was the main motivational factor for undergoing treatment. With increasing age, 13 per cent more girls (P = 0.039) were more aware of their malocclusion. The influence of their surroundings on the uptake of treatment decreased with increasing age. Less than 5 per cent of the examined subjects started treatment because other children made fun of them, and only 3 per cent of older patients were motivated by future improvements in health. Between 63 and 67 per cent of parents reported pressurizing their children to seek orthodontic treatment in order to avoid possible future claims of neglect. No statistically significant dependence on gender or age of the children was found. Improvement in dental aesthetics was the principle motivational factor for the children (29-48 per cent), their parents/guardians (54 per cent), and adult patients (55 per cent) seeking orthodontic treatment.
Angelieri, Fernanda; Almeida, Renato Rodrigues de; Almeida, Marcio Rodrigues de; Fuziy, Acácio
This prospective clinical study analyzed the distalization of maxillary molars achieved by the pendulum appliance and its effect on the anchorage teeth during and after fixed orthodontic treatment. Lateral cephalograms of 22 adolescents (15 girls, 7 boys) taken pretreatment, after distalization, after leveling and aligning, and after fixed orthodontic treatment were evaluated. The initial mean age was 14.5 years (SD = 1.80). The mean time for distalization of the maxillary molars was 5.85 months (SD = 1.82), and the total treatment time was 3.61 years (SD = 1.83). The pendulum appliance moved the maxillary molars distally, but with significant distal inclination, protrusion of the anterior teeth, and increase in lower anterior facial height (LAFH) due to the clockwise mandibular rotation. After fixed orthodontic treatment, the maxillary incisors and the maxillary first premolars and first molars were returned to their pretreatment anteroposterior positions. Thus, at postdistalization, there was 2.1 mm of protrusion of the maxillary first molars, despite the anchorage reinforcement (Nance button and cervical headgear worn at night during fixed appliance therapy). However, at the end of treatment, all patients had Class I molar relationships. The pendulum appliance followed by fixed orthodontic treatment corrected the Class II sagittal relationship, especially due to the dentoalveolar changes secondary to the spontaneous mandibular growth in the anterior direction during fixed appliance treatment.
Fleming, Padhraig S; Scott, Paul; Heidari, Negan; Dibiase, Andrew T
To investigate the influence of radiographic position of palatally impacted canines on the length of treatment for orthodontic alignment. Treatment records of 45 consecutive successfully treated patients (36 unilateral, 9 bilateral) with ectopic palatal canines treated with surgical exposure and orthodontic traction were analyzed. The sample was based on orthodontic referrals over a 3-year period in Kent and Canterbury Hospital, UK. The duration of treatment was related to radiographic parameters including the height of the impacted canine, angulation of the long axis to the upper midline, mesiodistal position of the canine tip relative to the midline and adjacent incisors, and the anteroposterior position of the canine root apex. Using multiple stepwise regression analysis, the horizontal position of the canine crown relative to adjacent teeth and maxillary dental midline showed a statistically significant correlation with the duration of treatment (P =.042), explaining 7.7% of the overall variance. However, treatment duration was found to be independent of the initial canine angulation (P = .915), vertical height (P =.065), and position of the canine apex (P = .937). Accurate prediction of treatment duration for orthodontic alignment of palatally impacted maxillary canines is difficult. However, the mesiodistal position of the canine may be a useful predictor of treatment duration.
Al-Balbeesi, Hana O; Bin Huraib, Sahar M; AlNahas, Nadia W; AlKawari, Huda M; Abu-Amara, Abdulrahman B; Vellappally, Sajith; Anil, Sukumaran
The objective of the present investigation is to evaluate patients' pain perception and discomfort, the duration of pain and the level of self-medication over time during tooth separation, and the effectiveness of elastomeric and spring types of orthodontic separators in Saudi population. The study group consisted of 30 female adolescent patients who had elastomeric/spring separators as part of their orthodontic treatment. A self-administrated questionnaire comprising 16 multiple choice questions and another with visual analog scale were used to record the patient's pain perceptions at 4 hours, 24 hours, 3 days, 5 days, and 7 days from the time of insertion. The level of pain and discomfort during these time periods were assessed by a visual analog scale. After a separation period of 7 days, the amount of separation was measured with a leaf gauge. Type and frequency of analgesic consumption was also recorded. The Statistical Package for the Social Sciences (SPSS) version 20 (IBM SPSS -Chicago, IL: SPSS Inc.,) was used for statistical analysis. The data showed significant increase in the level of pain at 4 hours, 24 hours, and 3 days from separator placement. The elastomeric separators produced significantly more separation than the spring separators and also caused maximum pain during the first 3 days after insertion. However, there was no significant difference between the score of pain between two separators at all time intervals. Both elastomeric and spring separators showed comparative levels of pain and discomfort during the early phase of separation. Elastomeric separators were found to be more effective in tooth separation than spring separators. However, further studies are necessary to substantiate this preliminary observation.
Objective To determine the changes in dental anxiety, state anxiety, and trait anxiety levels of patients and their parents after 3 months of active orthodontic treatment. Methods We evaluated 120 patients and one parent of each patient. State Anxiety (STAI-S), Trait Anxiety (STAI-T), and Corah's Dental Anxiety Scale (DAS) were administered before orthodontic treatment (T1) and after 3 months of treatment (T2). Differences in scores between T1 and T2 were compared using paired-sample t-tests and the relationship between the scores of the DAS and the STAI were analyzed using a bivariate two-tailed Pearson correlation test. Results Dental anxiety and state anxiety levels decreased among the patients after adjustment to orthodontic treatment (p < 0.001). However, 3 months of treatment was not sufficient to decrease the anxiety levels of parents (p > 0.05). Patient trait anxiety affected patient state anxiety and dental anxiety (p < 0.01). Additionally, a significant correlation was found between patient dental anxiety and parent dental anxiety (p < 0.05). Conclusions Dental anxiety and state anxiety levels decrease after patients become familiar with their orthodontist and they became accustomed to orthodontic treatment. However, 3 months is not a sufficient length of time to decrease parental anxiety levels. PMID:23112951
Objective The purpose of this study was to evaluate the effect of malocclusion or orthodontic treatment on oral health-related quality of life (OHRQoL) in adults. Methods The sample consisted of 860 adults (378 men and 482 women, aged 18-39 years) who were clinically evaluated for malocclusion or orthodontic treatment experience. Participants were divided into 4 groups as follows: normal occlusion, malocclusion, fixed treatment, and retention. OHRQoL was assessed with the short form of the Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Results The malocclusion group and the fixed treatment group had significantly higher OHIP-14 scores than the normal occlusion group and the retention group (p < 0.001). The malocclusion group had the highest PIDAQ score, while the normal occlusion group and the retention group had the lowest PIDAQ score (p < 0.001). Women had higher OHIP-14 and PIDAQ scores than men. A significant positive correlation was found between OHIP-14 and PIDAQ scores (p < 0.01). Conclusions Malocclusion has a negative impact on OHRQoL, but this could be improved in adults through orthodontic treatment. These OHRQoL questionnaires can provide additional useful information on specific aspects of orthodontic patients' psychological state. PMID:25473646
Nanda, Ravindra; Upadhyay, Madhur
Orthodontics has undergone a paradigm shift in the last 40 years. There have been both technical and philosophical changes ushered by the development of new appliances, techniques, and by the explosion in the amount of research being conducted all around the world. However, the application of any new concept requires a firm understanding of the fundamentals of orthodontics. This paper presents a broad review of some fundamental concepts of treatment mechanics that enable us to bring about skeletal and dental correction of the presenting malocclusion. The basic concepts of facemask therapy, mechanics, and biology of tooth movement will be discussed with an insight into the challenges facing us in the future.
McSwiney, Timothy P; Millett, Declan T; McIntyre, Grant T; Barry, Mark K; Cronin, Michael S
To compare mean anterior (AR) and mean overall (OR) tooth size ratios, prevalence of clinically significant tooth size discrepancies (TSDs) and correlation between AR and OR in subjects with Class II division 1 and Class III malocclusion treated by surgical-orthodontic or orthodontic means. Retrospective, cross-sectional. State-funded and private clinics. From pre-treatment cohorts of 770 surgical and 610 non-surgical subjects, Class II division 1 and Class III malocclusion groups were identified with 60 surgical and 60 non-surgical subjects, comprising 30 males and 30 females, in each. AR and OR were calculated by landmarking digital models. Differences in AR and OR and their relationship were analysed using two-way analysis of variance (ANOVA) and a correlation coefficient, respectively. The proportions of the surgical and non-surgical groups with a TSD were assessed using logistic regression. Intra-examiner reproducibility involved re-landmarking 30 randomly selected image sets and differences in ARs and ORs were compared using a paired t-test. Random error was assessed using the intraclass correlation coefficient (ICC). Analyses were performed using SAS (SAS Institute Inc., Cary, NC, USA) at the 5% level of significance. There were no statistically significant differences associated with the measurement of either the mean AR (P = 0·913) or the mean OR (P = 0·874). ICC values were very high (AR = 0·95; OR = 0·90). Differences existed between both Class II and Class III surgical (AR: P<0·001; OR: P<0·001) and non-surgical groups (AR: P = 0·012; OR: P = 0·003). The AR and OR relationship was strong (correlation coefficient = 0·72). The highest percentage of clinically significant TSDs was seen in the AR of both Class II and Class III surgical groups (23·3%). In the cohort examined: AR and OR differed significantly for malocclusion groups. The prevalence of clinically significant TSDs did not differ significantly between
Gansukh, Odontuya; Jeong, Jong-Wha; Kim, Jong-Wan; Lee, Jong-Ho; Kim, Tae-Woo
Introduction. This study aimed to evaluate the effects of resorbable blasting media (RBM) treatment on early stability of orthodontic mini-implants by mechanical, histomorphometric, and histological analyses. Methods. Ninety-six (64 for mechanical study and 32 for histological study and histomorphometric analysis) titanium orthodontic mini-implants (OMIs) with machined (machined group) or RBM-treated (CaP) surface (RBM group) were implanted in the tibiae of 24 rabbits. Maximum initial torque (MIT) was measured during insertion, and maximum removal torque (MRT) and removal angular momentum (RAM) were measured at 2 and 4 weeks after implantation. Bone-to-implant contact (BIC) and bone area (BA) were analyzed at 4 weeks after implantation. Results. RBM group exhibited significantly lower MIT and significantly higher MRT and RAM at 2 weeks than machined group. No significant difference in MRT, RAM, and BIC between the two groups was noted at 4 weeks, although BA was significantly higher in RBM group than in machined group. RBM group showed little bone resorption, whereas machined group showed new bone formation after bone resorption. Conclusions. RBM surface treatment can provide early stability of OMIs around 2 weeks after insertion, whereas stability of machined surface OMIs may decrease in early stages because of bone resorption, although it can subsequently recover by new bone apposition.
Introduction. This study aimed to evaluate the effects of resorbable blasting media (RBM) treatment on early stability of orthodontic mini-implants by mechanical, histomorphometric, and histological analyses. Methods. Ninety-six (64 for mechanical study and 32 for histological study and histomorphometric analysis) titanium orthodontic mini-implants (OMIs) with machined (machined group) or RBM-treated (CaP) surface (RBM group) were implanted in the tibiae of 24 rabbits. Maximum initial torque (MIT) was measured during insertion, and maximum removal torque (MRT) and removal angular momentum (RAM) were measured at 2 and 4 weeks after implantation. Bone-to-implant contact (BIC) and bone area (BA) were analyzed at 4 weeks after implantation. Results. RBM group exhibited significantly lower MIT and significantly higher MRT and RAM at 2 weeks than machined group. No significant difference in MRT, RAM, and BIC between the two groups was noted at 4 weeks, although BA was significantly higher in RBM group than in machined group. RBM group showed little bone resorption, whereas machined group showed new bone formation after bone resorption. Conclusions. RBM surface treatment can provide early stability of OMIs around 2 weeks after insertion, whereas stability of machined surface OMIs may decrease in early stages because of bone resorption, although it can subsequently recover by new bone apposition. PMID:26942200
Barcia, Jorge M.; Portolés, Sandra; Portolés, Laura; Urdaneta, Alba C.; Ausina, Verónica; Pérez-Pastor, Gema M. A.; Romero, Francisco J.; Villar, Vincent M.
HIGHLIGHTS Ethanol, Periodontal ligament, Extracellular matrix, Orthodontic movement. Alcohol is a legal drug present in several drinks commonly used worldwide (chemically known as ethyl alcohol or ethanol). Alcohol consumption is associated with several disease conditions, ranging from mental disorders to organic alterations. One of the most deleterious effects of ethanol metabolism is related to oxidative stress. This promotes cellular alterations associated with inflammatory processes that eventually lead to cell death or cell cycle arrest, among others. Alcohol intake leads to bone destruction and modifies the expression of interleukins, metalloproteinases and other pro-inflammatory signals involving GSKβ, Rho, and ERK pathways. Orthodontic treatment implicates mechanical forces on teeth. Interestingly, the extra- and intra-cellular responses of periodontal cells to mechanical movement show a suggestive similarity with the effects induced by ethanol metabolism on bone and other cell types. Several clinical traits such as age, presence of systemic diseases or pharmacological treatments, are taken into account when planning orthodontic treatments. However, little is known about the potential role of the oxidative conditions induced by ethanol intake as a possible setback for orthodontic treatment in adults. PMID:28179886
Haddad, Stéphanie; Kerbrat, Jean-Baptiste; Schouman, Thomas; Goudot, Patrick
A possible relation between an upper airway space decrease and the development of obstructive sleep apnea syndrom explains the importance to know the effect of the modification of dental arch length on the upper airway during orthodontic treatment. The aim of this article is to expose recent knowledge about upper airway development and dental arch length decrease factors, to determine the influence of this decrease on upper airway development. A review was done to determine the upper airway normal development, to define dental arch to specify if an ideal position of dental arch on apical base exists. All of the length dental arch decrease factors during orthodontic treatment (dental extraction, dental agenesis and dental malpositions) and their upper airway resounding were searched. Some authors found a diminution of upper airway space after premolars extractions while others didn't found this diminution after extractions premolars when incisor retraction is finished. A decrease of transversal maxillary diameter and nasal cavity may be due to absence of permanent teeth. The effect of dental arch length decrease during orthodontic treatment in the upper airway development was not scientifically proved. However we had to be vigilant and adapt our orthodontic treatment case by case to avoid an upper airway modification. © EDP Sciences, SFODF, 2017.
Stojanović, Ljiljana S; Mileusnić, Ivan; Mileusnić, Budimir; Cutović, Tatjana
Class III malocclusions are considered to be ones of the most difficult problems to treat. Their causes are multifactorial and include genetic and/or environmental factors. Class III malocclusions are generally classified into 2 categories: skeletal and dental. The diagnosis is important due to the different treatment approaches. Generally a dental class III can be treated with orthodontics alone, while a true skeletal class III requires a combination of orthodontics and surgery. We presented a female patient with skeletal Class III malocclusion. The treatment was complete with positive overbite and acceptable occlusion using a combination of fixed orthodontic appliance treatment as well as the surgical operation. The patient was happy with her new appearance and function. Class III discrepancy should be diagnosed and classified according to its etiology and treated with appropriate surgery, including, if necessary, not only mandibular, but also maxillary surgery, in order to achieve a normal facial appearance. In any case, as the field of orthodontics continues to develop technologically and philosophically, we can expect that advances in diagnosis and treatment planning are im minent and inevitable.
Mattos, Claudia Trindade; Gomes, Ana Carolina Rodrigues; Ribeiro, Alexandre Antônio; Nojima, Lincoln Issamu; Nojima, Matilde da Cunha Gonçalves
The aim of this study was to address the importance of the diagnostic setup by examining two cases where diagnostic setups were made in order to determine the treatment plan. The diagnostic setup is a fundamental aid and should be used when there are doubts in the orthodontic planning.
Kiekens, Rosemie M A; Maltha, Jaap C; van 't Hof, Martin A; Straatman, Huub; Kuijpers-Jagtman, Anne M
The aim of the study was to evaluate the influence of the characteristics of panel members, the effects of gender and Angle Class of adolescent patients on their change in facial aesthetics following orthodontic treatment, and to assess the optimal panel size for epidemiological studies on changes in facial aesthetics after orthodontic treatment. A panel of 74 adult laymen (35 males and 39 females) and a panel of 87 orthodontists (37 males and 50 females) evaluated sets of three post-treatment standardized photographs (one frontal, one three-quarter smiling, and one lateral) of 64 adolescent orthodontic patients in relation to the pre-treatment sets of the same patient on a five-point scale. The main effects of professional background, age, gender, and geographic region of the panel members on the aesthetic scores, as well as their first order interactions were evaluated by multilevel models. Professional background, age, gender, and geographical region of panel members have an influence on the evaluation of the change of facial aesthetics following orthodontic treatment. The effect of gender and Angle Class of the patients on the scores was evaluated by two-way analysis of variance. There was no difference in the mean scores for boys and girls. Improvement of facial aesthetics by orthodontic treatment was significant for Class I, Class II division 1, and Class II division 2 patients, but not for Class III patients. Based on the intraclass correlation coefficient, a panel of nine randomly selected orthodontists, a panel of 14 randomly selected laymen, or a mixed panel of 13 individuals is sufficient to obtain reliable results in the aesthetic evaluation of adolescent faces, using photographs and a five-point scale.
Yang, Q; Wang, C H L; Fan, C; Chen, J
The aim of this study was to observe the influence of orthodontic treatment on the hyoid position of patients with different vertical skeletal craniofacial patterns of mandibular deviations. A total of 60 patients with mandibular deviations, including 30 males and 30 females with a mean age of 15.4 years, were recruited. They were equally divided into average angle, high angle, and low angle groups, with a 1:1 gender ratio. Their hyoid position was measured before and after orthodontic treatment. The data were analysed using paired t-tests and analysis of variance (ANOVA). After treatment, the hyoid body in the high angle group presented significant forward and upward movements (p = 0.012 and p = 0.005). The hyoid body in the low angle group exhibited significant forward movement (p = 0.048) and a significant increase in the hyoid inclination (p = 0.00). In the average angle group, the hyoid body significantly moved downward (p = 0.031) and the thyrohyoid moved upward (p = 0.046). The ANOVA showed that orthodontic treatment significantly influenced the vertical position and inclination degree of the hyoid (F = 6.37, p = 0.003; F = 6.204, p = 0.004; and F = 3.393, p = 0.025). The average angle group displayed significant differences in these indices compared with the high angle and low angle groups. Orthodontic treatment significantly influenced the mandibular plane angle in the high angle group (p = 0.012). Orthodontic treatment influences the hyoid position of patients with different vertical skeletal craniofacial patterns of mandibular deviations by varying degrees.
Ajayi, Emmanuel O
The availability of information on the individual perception of own's dental appearance and desire to uptake orthodontic treatment is of importance in the planning of orthodontic care within a population. The subjective assessment of personal dental appearance and desire for orthodontic treatment was appraised among Nigerian children. The study was conducted among 91 school children (33 boys, 58 girls) aged 12 years old in Benin City, south-southern region of Nigeria. The satisfaction of the subjects with the arrangement of their anterior teeth and desire to straighten their teeth was determined using a questionnaire. The subjects were further asked to rank their dental attractiveness in relation to the photographs in the Aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). The need for orthodontic treatment among the subjects was also assessed by the examiner with the Aesthetic component of IOTN. Chi-square tests were used for data analysis. The result revealed that more than three-quarters (76.9%) of the subjects were satisfied with their dental aesthetics while 23.1% desired to have orthodontic treatment. The boys expressed significantly higher level of dissatisfaction with their dental aesthetics and a greater desire to have orthodontic treatment (P < 0.05). Most subjects (92.3%) rated their dental attractiveness in the "little to no need" orthodontic treatment grade on the AC scale. The normative borderline treatment need was higher than subjective borderline need but there was consistency in distribution of 4.4% in definite need treatment grade by the subjects and examiner. The majority of the children rated their teeth as aesthetically satisfactory but there were gender differences in perception of dental aesthetics and desire for orthodontic treatment among this sample of Nigerian children.
Maxfield, Blake J; Hamdan, Ahmad M; Tüfekçi, Eser; Shroff, Bhavna; Best, Al M; Lindauer, Steven J
Despite the many advances to improve the practice of orthodontics, white spot lesions, or decalcifications, remain a common complication in patients with poor oral hygiene. The purpose of this study was to assess the perceptions and level of awareness of patients, parents, orthodontists, and general dentists toward the development of white spot lesions during orthodontic treatment. This was a prospective epidemiologic survey of the perceptions of orthodontic patients (n = 315), parents (n = 279), orthodontists (n = 305), and general dentists (n = 191) regarding the significance, prevention, and treatment of white spot lesions. All surveyed groups indicated that white spot lesions detracted from the overall appearance of straight teeth, attributed primary responsibility for the prevention of white spot lesions to the patients themselves, and thought that the general dentist should be responsible for treating white spot lesions. Patients regarded themselves as ultimately responsible for the prevention of white spot lesions (P <0.05). The patients, parents, orthodontists, and general dentists had similar perceptions regarding the significance, prevention, and treatment of white spot lesions. All groups indicated that patients were the most responsible for the prevention of white spot lesions. Communication among patients, parents, orthodontists, and general dentists needs to improve to decrease the incidence of white spot lesions in the orthodontic population. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Tai, K; Park, J H; Kanao, A
It can be difficult to formulate a definitive diagnosis and treatment plan for patients with hypodontia while dental development is still in progress. Proper radiographs should be used periodically to check for the possibility of delayed tooth development to reduce the potential of misdiagnosis and improper treatment. This article presents a case with orthodontic treatment of hypodontia and delayed development of a maxillary second premolar.
Berlin-Broner, Y; Levin, L; Ashkenazi, M
The aim of the present study was orthodontist's awareness for maintenance of several home and professional prevention measures during active orthodontic treatment according to patients' report. A structured questionnaire was distributed to 122 patients undergoing active orthodontic treatment with fixed appliances. Patients were treated by 38 different orthodontists. The questionnaire accessed information regarding instructions patients received from their orthodontist concerning maintenance of their oral hygiene during orthodontic treatment. Most of the patients (94%) reported that their orthodontists informed them at least once about the importance of tooth-brushing, and 74.5% received instructions for correct performance of tooth brushing or alternatively were referred to dental hygienist. However, only 24.5% of the patients reported that their orthodontist instructed them to use the correct fluoride concentration in their toothpaste, to use daily fluoride mouthwash (31.5%) and to brush their teeth once a week with high concentration of fluoride gel (Elmex gel; 10.2%). Only 13.8% received application of high concentration of fluoride gel or varnish at the dental office, and 52% of the patients reported that their orthodontist verified that they attend regular check-ups by their dentist. A significant positive correlation was found between explaining the patients the importance of tooth brushing and the following variables: instructing them on how to brush their teeth correctly (p<0.0001), explaining them which type of toothbrush is recommended for orthodontic patients (p=0.002), recommending to perform daily fluoride oral rinse (p=0.036) and referring them to periodic check-ups (p=0.024). Orthodontists should increase their awareness and commitment for instructing their patient on how to maintain good oral hygiene in order to prevent caries and periodontal disease during orthodontic treatment.
Alqerban, Ali; Willems, Guy; Bernaerts, Christien; Vangastel, Jan; Politis, Constantinus; Jacobs, Reinhilde
The aim of this study was to compare the orthodontic treatment planning for impacted maxillary canines based on conventional orthodontic treatment records versus three-dimensional (3D) information taken from single cone beam computed tomography (CBCT) scans. This study consisted of 40 individuals with impacted maxillary canines. Patients were identified from among those referred for orthodontic treatment (26 females, 14 males) with a mean age of 12.5 years (± SD 3). In total, 64 impacted canines were identified, justifying the need for CBCT scans by the treating orthodontist. Two sets of information were obtained. The first set consisted of conventional planning records [two-dimensional (2D) panoramic, 2D lateral cephalograms, and dental casts] and the second set of 3D volumetric images obtained from a single CBCT scan (3D panoramic, 3D lateral cephalograms, 3D virtual study model). For both sets, intra- and extraoral images were included. The radiographic diagnostic features, treatment planning, orthodontists' opinions, and case classifications of both sets were produced and subsequently analysed by four orthodontists. There was no statistically significant difference in treatment planning between the use of both sets, in terms of either orthopaedic growth modification or orthodontic compensation. Also, anticipated complications during treatment and expected treatment duration did not differ significantly. Orthodontists found the conventional set to be insufficient for treatment planning in 22.5 per cent and requested additional radiographs needed in 63 per cent of cases, compared with 1.3 and 0.5 per cent, respectively (P < 0.001). The observers' confidence level was higher for therapy based on the 3D set compared with the conventional set (96.3 per cent versus 61.9 per cent, P < 0.001). There was no statistically significant difference in treatment planning between the use of conventional and CBCT sets. CBCT images have been shown to offer useful orthodontic
Patroni, Stefano; Cocconi, Renato
Several treatment options are described in the literature to solve the microdontia-related problems of maxillary anterior teeth. These options are often focused on an orthodontic rather than a restorative approach. The case presented here started with an orthodontic phase followed by a restorative one. The aim of the orthodontic phase was to achieve the correct spacing, respecting ideal average tooth proportions. This was done using a digital setup to restore the six anterior teeth, so that an optimal esthetic and functional result was achieved by the end of the orthodontic treatment. The purpose of the restorative phase was to contribute to the esthetic outcome and occlusal stability. The 12-year-old patient was treated utilizing a CAD/CAM procedure, which took advantage of the mechanical properties and reasonable cost of the chosen resin matrix ceramic material (Vita Enamic). Once stability has been attained and proper periodontal tissue maturation has been reached at the end of the patient's growth, there will then be the option of improving the esthetics by replacing these restorations with ceramic veneers.
Lippold, Carsten; Stamm, Thomas; Meyer, Ulrich; Végh, András; Moiseenko, Tatjana; Danesh, Gholamreza
The aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis. This randomised clinical trial was assessed to analyse the orthodontic treatment effects for patients with functional unilateral posterior crossbite in the late deciduous and early mixed dentition using a two-step procedure: initial maxillary expansion followed by a U-bow activator therapy. In the treatment group 31 patients and in the control group 35 patients with a mean age of 7.3 years (SD 2.1) were monitored. The time between the initial assessment (T1) and the follow-up (T2) was one year. The orthodontic analysis was done by a three-dimensional digital model analysis. Using the 'Digimodel' software, the orthodontic measurements in the maxilla and mandible and for the midline deviation, the overjet and overbite were recorded. Significant differences between the control and the therapy group at T2 were detected for the anterior, median and posterior transversal dimensions of the maxilla, the palatal depth, the palatal base arch length, the maxillary arch length and inclination, the midline deviation, the overjet and the overbite. Orthodontic treatment of a functional unilateral posterior crossbite with a bonded maxillary expansion device followed by U-bow activator therapy in the late deciduous and early mixed dentition is an effective therapeutic method, as evidenced by the results of this RCT. It leads to three-dimensional therapeutically induced maxillary growth effects. Dental occlusion is significantly improved, and the prognosis for normal craniofacial growth is enhanced. Registration trial DRKS00003497 on DRKS.
Background The aim of this randomised clinical trial was to assess the effect of early orthodontic treatment in contrast to normal growth effects for functional unilateral posterior crossbite in the late deciduous and early mixed dentition by means of three-dimensional digital model analysis. Methods This randomised clinical trial was assessed to analyse the orthodontic treatment effects for patients with functional unilateral posterior crossbite in the late deciduous and early mixed dentition using a two-step procedure: initial maxillary expansion followed by a U-bow activator therapy. In the treatment group 31 patients and in the control group 35 patients with a mean age of 7.3 years (SD 2.1) were monitored. The time between the initial assessment (T1) and the follow-up (T2) was one year. The orthodontic analysis was done by a three-dimensional digital model analysis. Using the ‘Digimodel’ software, the orthodontic measurements in the maxilla and mandible and for the midline deviation, the overjet and overbite were recorded. Results Significant differences between the control and the therapy group at T2 were detected for the anterior, median and posterior transversal dimensions of the maxilla, the palatal depth, the palatal base arch length, the maxillary arch length and inclination, the midline deviation, the overjet and the overbite. Conclusions Orthodontic treatment of a functional unilateral posterior crossbite with a bonded maxillary expansion device followed by U-bow activator therapy in the late deciduous and early mixed dentition is an effective therapeutic method, as evidenced by the results of this RCT. It leads to three-dimensional therapeutically induced maxillary growth effects. Dental occlusion is significantly improved, and the prognosis for normal craniofacial growth is enhanced. Trial registration Registration trial DRKS00003497 on DRKS PMID:23339736
Le Gall, Michel; Philip, Camille; Salvadori, André
Optimum treatment timing for orthodontic problems continues to be one of the more controversial topics in orthodontics. Especially regarding the correction of Class III malocclusion, there is little consensus as to proper timing or methods for correcting these problems. The orthopedic approach for growth modification is usually limited to children with growth remaining subjected to non hereditary pattern. If the skeletal malocclusion is within the range of an orthodontic treatment, fixed orthodontic appliances with dentoalveolar compensation mechanism can achieve a normal occlusion. Otherwise in patients with a severe skeletal discrepancy, it will be necessary to consider a combined surgical and orthodontic approach. The purpose of this study was to describe treatment planning according to the age and to the initial diagnosis. The management of skeletal Class III malocclusion is still a challenge to orthodontists especially because of relapse due to the late growth of the mandible. © EDP Sciences, SFODF, 2011.
Iramaneerat, S; Cunningham, S J; Horrocks, E N
The aim of this study was to compare the effectiveness, in terms of orthodontic treatment duration, of two methods of canine exposure. This was a retrospective study using patients' records and lateral cephalometric radiographs. 50 patients were selected, 25 in each group. In all subjects the impaction was categorized as being 'intermediate'. The methods of canine exposure were: (i) simple surgical exposure; (ii) surgical exposure and placement of an orthodontic attachment, followed by flap replacement. The treatment duration until the canine was in the line of the arch was 17.7 months in the simple exposure group and 19.3 months in the bonded attachment group. The mean treatment duration (from exposure to debond) was 28.8 months for both groups. In terms of treatment duration, no significant difference could be demonstrated between the two methods of surgical exposure to palatally impacted canines.
Monserrat, Carlos; Alcaniz-Raya, Mariano L.; Juan, M. Carmen; Grau Colomer, Vincente; Albalat, Salvador E.
This paper describes a new method for 3D orthodontics treatment simulation developed for an orthodontics planning system (MAGALLANES). We develop an original system for 3D capturing and reconstruction of dental anatomy that avoid use of dental casts in orthodontic treatments. Two original techniques are presented, one direct in which data are acquired directly form patient's mouth by mean of low cost 3D digitizers, and one mixed in which data are obtained by 3D digitizing of hydrocollids molds. FOr this purpose we have designed and manufactured an optimized optical measuring system based on laser structured light. We apply these 3D dental models to simulate 3D movement of teeth, including rotations, during orthodontic treatment. The proposed algorithms enable to quantify the effect of orthodontic appliance on tooth movement. The developed techniques has been integrated in a system named MAGALLANES. This original system present several tools for 3D simulation and planning of orthodontic treatments. The prototype system has been tested in several orthodontic clinic with very good results.
Bichu, Yashodhan M; Kamat, Nandini; Chandra, Pavan Kumar; Kapoor, Aditi; Razmus, Thomas; Aravind, N K S
Enamel demineralization is considered to be the most prevalent and significant iatrogenic effect associated with fixed orthodontic treatment and can seriously jeopardize both tooth longevity and dental esthetics. This in vitro study was undertaken to compare the effectiveness of four different commercially available surface treatment medicaments for the inhibition of enamel demineralization. Seventy-five intact maxillary premolars extracted from patients undergoing orthodontic treatment were divided into five equal groups and were subjected to one of the following protocols: no treatment (control group) or treatment with one of the following four medicaments: fluoride varnish (Fluor Protector [FP]), casein phosphopeptide-amorphous calcium phosphate (GC Tooth Mousse [TM]), calcium sodium phosphosilicate (SHY-NM), and casein phosphopeptide-amorphous calcium phosphate with fluoride (GC Tooth Mousse Plus [TMP]). All the teeth were subjected to ten Cate demineralization solution?for 96 hours and subsequently evaluated under polarized light microscopy to obtain the mean depths of enamel demineralization. One-way analysis of variance and Bonferroni comparison tests were used to obtain statistically significant differences between the five different groups at P < .05. All four surface treatment medicaments provided statistically significant reduction in the depths of enamel demineralization as compared with the control group. FP provided the greatest protection of enamel surface in terms of reduction of lesion depth, followed by TMP, SHY-NM, and TM. The use of these commercially available medicaments could prove to be beneficial for patients undergoing orthodontic treatment and who are at a risk for developing enamel decalcification.
Durão, Ana Reis; Alqerban, Ali; Ferreira, Afonso Pinhão; Jacobs, Reinhilde
To evaluate the impact of additional lateral cephalometric radiography in orthodontic diagnosis and treatment planning. Forty-three patients seeking orthodontic treatment, and for whom pretreatment diagnostic records were available, were randomly selected. Ten qualified orthodontists were involved in this study. The patients' records included three photographs of the angle trimmed dental casts, digital lateral cephalometric and panoramic radiographs, and standard clinical photographs comprising seven intra- and four extraoral pictures. Records were evaluated in two sessions. At the first session, orthodontists evaluated records without lateral cephalometric radiography (LCR). In the second session, the same information was presented, but with LCR. Between the two sessions the order in which the cases were presented was altered to avoid bias. The percentage of agreement between sessions was lower for diagnosis than for treatment planning. Concerning skeletal classification, the least experienced orthodontist was the least consistent (28%), while the more experienced orthodontist was the more reliable (67%). In terms of treatment modalities, in general there was an agreement of 64%. The most frequent modifications in treatment modalities were seen in Class II malocclusion patients. The results of our study suggest that the majority of Portuguese orthodontists judge that LCR is important to producing a treatment plan. Despite that, it does not seem to have an influence on orthodontic treatment planning.
Postnikov, M A; Trunin, D A; Pankratova, N V; Nesterov, A M; Sadykov, M I; Ostankov, S A
The diagnostics and treatment of malocclusion Class III in patients aged 6-12 is an vital problem in orthodontics. Method of orthodontic treatment of malocclusion Class III in patients with the help of improved and patented orthodontic construction - 'Postnikov appliance' - and face mask and bracket system is analysed in the article. Orthodontic treatment of malocclusion Class III was examined in 24 patients aged 6-12 by the suggested method. All patients were examined clinically and with the help af additional diagnostic methods: head cephalometry in lateral position with further data analysis in Dolphin Imaging (USA). The use of computer technologies in Dolphin Imaging helps to controll the process of correction of dentition correlation in different stages of treatment, to reduce the period of treatment of malocclusion Class III in patients aged 6-12 and to improve face esthetics and life quality ratio.
Goursand, Daniela; Ramos-Jorge, Maria Leticia; de Oliveria, Gomes Carlos; Drummond, Alexandre Fortes; de Araujo, Zarzar Patricia Maria Pereira; Paiva, Saul Martins
This article reports a clinical case involving an 8-year-old boy with two mesiodentes. The supernumerary teeth caused both a functional alteration (malocclusion) and an esthetic one (interincisal diastema), both of which affected his quality of living. Surgical removal of the supernumerary teeth and orthodontic follow-up was proposed, in agreement with the treatment established in the literature. This treatment produced satisfactory results in terms of both esthetics and functionality.
Schäfer, Katharina; Ludwig, Björn; Meyer-Gutknecht, Hannes; Schott, Timm Cornelius
The aim of this study was to quantify the wear times of removable appliances during active orthodontic treatment. The wear times of 141 orthodontic patients treated with active removable appliances in different locations were documented over a period of 3 months using an incorporated microsensor. Gender, age, treatment location, health insurance status, and type of device were evaluated with respect to wear time. Significant associations between wear times and patient factors were calculated using non-parametric tests. The median daily wear time was 9.7 hours/day for the entire cohort, far less than the 15 hours/day prescribed. Younger patients wore their appliances for longer than older patients (7-9 years 12.1 hours/day, 10-12 years 9.8 hours/day, and 13-15 years 8.5 hours/day; P < 0.0001). The median wear time for females (10.6 hours/day) was 1.4 hours/day longer than males (9.3 hours/day; P = 0.017). Patients treated at different locations wore their devices with a difference of up to 5.0 hours/day. Privately insured patients had significantly longer median wear times than statutorily insured patients. No significant difference in wear time was noted according to device type. The daily wear time of removable appliances during the active phase of orthodontic therapy can be routinely quantified using integrated microelectronic sensors. The relationship between orthodontist and patient seems to play a key role in patient adherence. Wear-time documentation provides the basis for more individualized wear-time recommendations for patients with removable appliances. This could result in a more efficient, shorter, and less painful orthodontic therapy. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: email@example.com.
Crismani, Adriano G; Bertl, Michael H; Celar, Ales G; Bantleon, Hans-Peter; Burstone, Charles J
A systematic review of effects related to patient, screw, surgery, and loading on the stability of miniscrews was conducted. Reports of clinical trials published before September 2007 with at least 30 miniscrews were reviewed. Parameters examined were patient sex and age, location and method of screw placement, screw length and diameter, time, and amount of loading. Fourteen clinical trials included 452 patients and 1519 screws. The mean overall success rate was 83.8% + or - 7.4%. Patient sex showed no significant differences. In terms of age, 1 of 5 studies with patients over 30 years of age showed a significant difference (P <0.05). Screw diameters of 1 to 1.1 mm yielded significantly lower success rates than those of 1.5 to 2.3 mm. One study reported significantly lower success rates for 6-mm vs 8-mm long miniscrews (72% vs 90%). Screw placement with or without a surgical flap showed contradictory results between studies. Three studies showed significantly higher success rates for maxillary than for mandibular screws. Loading and healing period were not significant in the miniscrews' success rates. All 14 articles described success rates sufficient for orthodontic treatment. Placement protocols varied markedly. Screws under 8 mm in length and 1.2 mm in diameter should be avoided. Immediate or early loading up to 200 cN was adequate and showed no significant influence on screw stability. Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Uribe, Flavio; Agarwal, Sachin; Shafer, David; Nanda, Ravindra
This case report describes the treatment of a 33-year-old white man who had a skeletal Class III and dental Class II subdivision malocclusion caused by a retrognathic maxilla, with severe maxillary crowding, a highly placed maxillary left canine, mild mandibular crowding, and a bilateral posterior crossbite. Treatment was performed with a modified surgery-first approach, which included a short presurgical alignment phase for the correction of the significant maxillary crowding while controlling the incisal angulation, followed by LeFort I maxillary advancement surgery. The short presurgical orthodontic phase aimed at eliminating the anterior dental interferences before the maxillary advancement, and the use of the inherent increased bone turnover in the postsurgical phase helped to reduce the total orthodontic treatment time to 12 months. Pleasing esthetic results and a good functional occlusion were achieved. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Swinnen, K; Politis, C; Willems, G; De Bruyne, I; Fieuws, S; Heidbuchel, K; van Erum, R; Verdonck, A; Carels, C
The aim of this investigation was to assess skeletal and dento-alveolar stability after surgical-orthodontic correction of skeletal anterior open bite treated by maxillary intrusion (group A) versus extrusion (group B). The cephalometric records of 49 adult anterior open bite patients (group A: n = 38, group B: n = 11), treated by the same maxillofacial surgeon, were examined at different timepoints, i.e. at the start of the orthodontic treatment (T1), before surgery (T2), immediately after surgery (T3), early post-operatively (+/- 20 weeks, T4) and one year post-operatively (T5). A bimaxillary operation was performed in 31 of the patients in group A and in six in group B. Rigid internal fixation was standard. If maxillary expansion was necessary, surgically assisted rapid palatal expansion (SRPE) was performed at least 9 months before the Le Fort I osteotomy. Forty-five patients received combined surgical and orthodontic treatment. The surgical open bite reduction (A, mean 3.9 mm; B, mean 7.7 mm) and the increase of overbite (A, mean 2.4 mm; B, mean 2.7 mm), remained stable one year post-operatively. SNA (T2-T3), showed a high tendency for relapse. The clockwise rotation of the palatal plane (1.7 degrees; T2-T3), relapsed completely within the first post-operative year. Anterior facial height reduction (A, mean -5.5 mm; B, mean -0.8 mm) occurred at the time of surgery. It can be concluded that open bite patients, treated by posterior Le Fort I impaction as well as with anterior extrusion, with or without an additional bilateral sagittal split osteotomy (BSSO), one year post-surgery, exhibit relatively good clinical dental and skeletal stability.
Pachêco-Pereira, Camila; Pereira, José Roberto; Dick, Bruce D; Perez, Arnaldo; Flores-Mir, Carlos
Our objective was to identify factors associated with orthodontic treatment satisfaction of patients and their caregivers, when applicable. MEDLINE via Ovid, PubMed, EBM Reviews and EMBASE via OVIDSP, LILACS, Web of Science, and Google Scholar were searched electronically. Reference lists of included articles were also screened for potential relevant studies missed during the electronic searches. Studies evaluating the satisfaction levels of patients or caregivers after orthodontic treatment were considered. Methodologic quality of the included studies was assessed using a modified Newcastle-Ottawa scale. Eighteen studies satisfied the inclusion criteria, representing 2891 patients and 464 parents. The risk of bias was moderate in 13 and low in 4 of the included articles. The studies used different questionnaires and timings to assess postorthodontic treatment satisfaction. Based on the available limited evidence, satisfaction was associated with perceived esthetic outcomes, psychological benefits, and quality of care. The latter was specifically linked to dentist-staff-patient interactions. Dissatisfaction was associated with treatment duration, pain levels and discomfort, and the use of retention appliances. When both assessments were available, the patient's and the parent's satisfaction levels were strongly correlated. Based on the limited available evidence with moderate risk of bias, we identified factors that appear to be more commonly associated with a high or low level of satisfaction. Consideration of these factors could be important for practitioners attempting to set realistic expectations of their patients and caregivers regarding orthodontic treatment outcomes. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Akinci Cansunar, Hatice; Uysal, Tancan
The aim of this study was to evaluate the clinical outcomes of three different Class II treatment modalities followed by fixed orthodontic therapy, using the American Board of Orthodontics Model Grading System (ABO-MGS). As a retrospective study, files of patients treated at postgraduate orthodontic clinics in different cities in Turkey was randomly selected. From 1684 posttreatment records, 669 patients were divided into three groups: 269 patients treated with extraction of two upper premolars, 198 patients treated with cervical headgear, and 202 patients treated with functional appliances. All the cases were evaluated by one researcher using ABO-MGS. The χ (2), Z test, and multivariate analysis of variance were used for statistical evaluation (p < 0.05). No significant differences were found among the groups in buccolingual inclination, overjet, occlusal relationship, and root angulation. However, there were significant differences in alignment, marginal ridge height, occlusal contact, interproximal contact measurements, and overall MGS average scores. The mean treatment time between the extraction and functional appliance groups was significantly different (p = 0.017). According to total ABO-MGS scores, headgear treatment had better results than functional appliances. The headgear group had better tooth alignment than the extraction group. Headgear treatment resulted in better occlusal contacts than the functional appliances and had lower average scores for interproximal contact measurements. Functional appliances had the worst average scores for marginal ridge height. Finally, the functional appliance group had the longest treatment times.
Manosudprasit, Amornrut; Haghi, Arshan; Allareddy, Veerasathpurush; Masoud, Mohamed I
Cephalometrics has been the foundation of orthodontic diagnosis for many years. However, for many orthodontic patients, a lateral cephalogram might not be necessary. The aim of this study was to compare the diagnosis and treatment planning agreement between standard records and nonradiographic 3-dimensional (3D) dentofacial photogrammetry records. Twenty patients had standard orthodontic records taken for their treatment as well as extraoral and intraoral 3D images. Twelve evaluators examined the standard records and then completed diagnosis and treatment planning questionnaires. They repeated the process 4 to 6 weeks later by using 3D photographic images along with the panoramic radiographs. Each evaluator also evaluated 2 random orthodontic cases twice with each method to evaluate consistency within each method. At the end of study, each evaluator was asked to complete a survey to document his or her experiences with the 3D photogrammetry method. Descriptive and kappa statistics were used to determine the agreement. Most diagnosis parameters had fair agreement between the methods and within each method. Skeletal and dental relationships had excellent agreement between and within the methods as well as most treatment decisions such as the need for extractions and surgery. Most evaluators (91.7%) thought that cephalometric x-rays would be needed only some of the time in diagnosis and treatment planning. Most evaluators (83.33%) thought that cephalometric radiographs are not needed in patients with a Class I ± a quarter cusp with crowding or spacing. Most diagnostic decisions had fair agreement within and between the 2 methods. The decision to extract and the need for orthognathic surgery had excellent agreement between the cephalometric and photogrammetric methods. The majority of examiners agreed that patients with Class I malocclusions ± a quarter cusp with no obvious skeletal discrepancy can be diagnosed and planned without a cephalometric radiograph
Rabie, A-Bakr M.; Wong, Ricky W.K.; Min, G.U.
Aims: To investigate the differences in morphological characteristics of borderline class III patients who had undergone camouflage orthodontic treatment or orthognathic surgery, and to compare the treatment effects between these two modalities. Materials and Methods: Cephalograms of 25 patients (13 orthodontic, 12 surgical) with class III malocclusion were analyzed. All had a pretreatment ANB angle greater than -5º. Results: Using discriminant analysis, only Holdaway angle was selected to differentiate patients in the pretreatment stage. Seventy-two per cent patients were correctly classified. In the orthodontic group, reverse overjet was corrected by retraction of the lower incisors and downward and backward rotation of the mandible. The surgical group was corrected by setback of the lower anterior dentoalveolus and uprighting of the lower incisors. No difference was found in posttreatment soft tissue measurements between the two groups. Conclusions: Twelve degree for the Holdaway angle can be a guideline in determining the treatment modalities for borderline class III patients, but the preferences of operators and patients are also important. (2) Both therapeutic options should highlight changes in the lower dentoalveolus and lower incisors. (3) Both treatment modalities can achieve satisfactory improvements to the people. PMID:19088881
Gameiro, Gustavo Hauber; Magalhães, Isabela Brandão; Szymanski, Mariana Marcon; Andrade, Annicele Silva
ABSTRACT Objective: To investigate the masticatory and swallowing performances in patients with malocclusions before and after orthodontic treatment, comparing them to an age- and gender-matched control group with normal occlusion. Methods: Twenty-three patients with malocclusions requiring orthodontic treatment were included in this prospective study. One month after appliance removal, seventeen patients completed a follow-up examination and the data were compared with those of a control group with thirty subjects with normal occlusion. Masticatory performance was determined by the median particle size for the Optocal Plus® test food after 15 chewing strokes, and three variables related to swallowing were assessed: a) time and b) number of strokes needed to prepare the test-food for swallowing, and c) median particle size of the crushed particles at the moment of swallowing. Results: At the baseline examination, the malocclusion group had a significantly lower masticatory performance and did not reach the particle size reduction at the moment of swallowing, when compared with the control group. After treatment, the masticatory performance significantly improved in the malocclusion group and the particle size reduction at swallowing reached the same level as in the control group. Conclusions: The present results showed that the correction of malocclusions with fixed appliances can objectively provide positive effects in both mastication and deglutition processes, reinforcing that besides aesthetic reasons, there are also functional indications for orthodontic treatment. PMID:28746490
Sinescu, Cosmin; Negrutiu, Meda L.; Hughes, Michael; Bradu, Adrian; Todea, Carmen; Rominu, Roxana; Dodenciu, Dorin; Laissue, Philippe L.; Podoleanu, Adrian G.
Despite good diagnosis and treatment planning, orthodontic treatment can fail if bonding fails. It is now common practice to address the aesthetic appearance of patients using aesthetic brackets instead of metal ones. Therefore, bonding aesthetic brackets has become an issue for orthodontists today. Orthodontic bonding is mainly achieved using composite resin but can also be performed with glass ionomer or resin cements. For improving the quality of bonding, the enamel is acid etched for 30 seconds with 38% phosphoric acid and then a bonding agent is applied. In our study we investigated and compared the quality of bonding between ceramic brackets, polymeric brackets and enamel, respectively using a new investigation method-OCT. The aim of our study was to evaluate the resin layer at the bracket base-tooth interface.
Bakathir, Manal A; Hassan, Ali H; Bahammam, Maha A
Piezocision (corticotomy) is a minimally invasive approach that involves micro-incisions, piezoelectric incisions, and selective tunnelling for soft or hard tissue grafting. Piezocision has many uses in orthodontics, but its uses in cross-bite cases are limited. This case report illustrates the outcomes of a 19-year-old female patient with unilateral cross-bite that was treated with a minimally invasive piezocision with bone grafting in the affected side. In addition, she also had a functional shift, severe crowding, and mid-line shift. Therefore, the shift was eliminated using a quad helix expansion, she was treated with a fixed appliance, and a bimaxillary extraction of the first premolars was performed. The patient followed-up at 18 months, and the occlusion was stable with a pleasant profile. Piezocision can be used as an adjunct to the orthodontic treatment of adults to facilitate the treatment of complicated cases.
Strohl, Alexis M; Vitkus, Lauren
The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.
Sayinsu, Korkmaz; Nalbantgil, Didem
Obtaining and retaining a good treatment result for traumatically lost incisors can be difficult for the clinician. In this case report, the management of a patient with the chief complaint of missing maxillary central incisors due to trauma is presented. The patient had a constricted maxilla with a bilateral posterior crossbite and an end-to-end relationship anteriorly. Orthodontic intervention took 19 months. The cusps and palatal surfaces of the canines were ground and flattened to meet the patient's esthetic requests.
Hwang, Soon-Kong; Ha, Jung-Hong; Jin, Myoung-Uk; Kim, Sung-Kyo; Kim, Young-Kyung
Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result.
Glez, Dominique; Hourdin, Solenn; Sorel, Olivier
The Er:YAG laser is used in periodontal surgery to remove excess tissue formations and to clean periodontal pockets. Combined with ultrasonic procedures lasers have significantly advanced the parameters of periodontal surgery. The goal of this article is to review the working mechanisms of the Er:YAG laser in the wide variety of its applications in complex treatment situations in both periodontics and orthodontics. EDP Sciences, SFODF, 2010.
Bergamo, Ana Zilda Nazar; Andrucioli, Marcela Cristina Damião; Romano, Fábio Lourenço; Ferreira, José Tarcísio Lima; Matsumoto, Mírian Aiko Nakane
Class III skeletal malocclusion may present several etiologies, among which maxillary deficiency is the most frequent. Bone discrepancy may have an unfavorable impact on esthetics, which is frequently aggravated by the presence of accentuated facial asymmetries. This type of malocclusion is usually treated with association of Orthodontics and orthognathic surgery for correction of occlusion and facial esthetics. This report presents the treatment of a patient aged 15 years and 1 month with Class III skeletal malocclusion, having narrow maxilla, posterior open bite on the left side, anterior crossbite and unilateral posterior crossbite, accentuated negative dentoalveolar discrepancy in the maxillary arch, and maxillary and mandibular midline shift. Clinical examination also revealed maxillary hypoplasia, increased lower one third of the face, concave bone and facial profiles and facial asymmetry with mandibular deviation to the left side. The treatment was performed in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. In reviewing the patient's final records, the major goals set at the beginning of treatment were successfully achieved, providing the patient with adequate masticatory function and pleasant facial esthetics.
Choi, Yoon Jeong; Chung, Chooryung J; Kim, Kyung-Ho
To test the hypothesis that periodontal changes are similar between proclined and minimal-changed mandibular incisor position groups during presurgical orthodontic treatment for Class III orthognathic surgery. The following measurements were performed before and after presurgical orthodontic treatment of 75 patients (proclination group, 39 subjects; minimal-change group, 36 subjects): clinical crown length, sulcus and bone probing depths, and width of attached gingiva from clinical examination; infradentale-to-MP (perpendicular distance of infradentale to mandibular plane) from examination of lateral cephalograms; and the distance between the cementoenamel junction and alveolar crest from examination of periapical radiographs. Data were compared between the two groups, and a regression analysis was performed to investigate factors affecting the periodontal changes. In both groups, clinical crown length and bone probing depth increased during presurgical orthodontics (P < .05). Infradentale-to-MP and the width of attached gingiva decreased more in the proclination group than in the minimal-change group (P < .05). Proclination and protrusion of the mandibular incisors, and treatment duration affected the periodontal changes. The null hypothesis was rejected. Proclination of the mandibular incisors for decompensation in Class III surgery patients seems to result in labial alveolar bone recession and a decrease in width of attached gingiva. However, the amount of the periodontal recession appeared to be clinically insignificant.
Vieira, Bruno Boaventura; Sanguino, Ana Carolina Meng; Moreira, Marilia Rodrigues; Morizono, Elizabeth Norie; Matsumoto, Mírian Aiko Nakane
Orthodontic-surgical treatment was performed in patient with skeletal Class III malocclusion due to exceeding mandibular growth. Patient also presented upper and lower dental protrusion, overjet of -3.0 mm, overbite of -1.0 mm, congenital absence of tooth #22, teeth #13 and supernumerary impaction, tooth #12 with conoid shape and partly erupted in supraversion, prolonged retention of tooth #53, tendency to vertical growth of the face and facial asymmetry. The discrepancy on the upper arch was -2.0 mm and -5.0 mm on the lower arch. The presurgical orthodontic treatment was performed with extraction of the teeth #35 and #45. On the upper arch, teeth #53, #12 and supernumerary were extracted to accomplish the traction of the impacted canine. The spaces of the lower extractions were closed with mesialization of posterior segment. After aligning and leveling the teeth, extractions spaces closure and correct positioning of teeth on the bone bases, the correct intercuspation of the dental arch, with molars and canines in Angle's Class I, coincident midline, normal overjet and overbite and ideal torques, were evaluated through study models. The patient was submitted to orthognathic surgery and then the postsurgical orthodontic treatment was finished. The Class III malocclusion was treated establishing occlusal and facial normal standards.
Bichara, Lívia Monteiro; Aragón, Mônica Lídia Castro de; Brandão, Gustavo Antônio Martins; Normando, David
To identify variables and their effect size on orthodontic treatment time of Class III malocclusion. Forty-five Class III malocclusion cases were selected from 2008 patients' records. Clinical charts, cephalometric radiographs, and pre and posttreatment dental casts were evaluated. Age, sex, PAR index at T1 and T2, overjet, missing teeth, extractions, number of treatment phases, missed appointments, appliance breakages, and cephalometric variables SNA, SNB, ANB, Wits, SnGoGn, CoA, CoGn, IMPA, 1.PP were investigated by multiple linear regression analysis and stepwise method at p<0.05. The sample was also divided into two groups: Group 0-2 (patients who had missed two clinical appointments or less) and Group >2 (patients who missed more than 2 appointments), to detect the influence of this data on treatment time and the quality of the treatment (PAR T2). Average treatment time was 30.27 months. Multiple regression analysis showed that missed appointment (R2=0.4345) and appliance breakages (R2=0.0596) are the only variables able to significantly predict treatment duration. Treatment time for patients who missed more than 2 appointments was nearly one year longer. However, no significant influence on PAR T2 was observed for those patients. Orthodontic treatment duration in Class III patients is mainly influenced by factors related to patient compliance. Patients who missed more appointments did not show worse orthodontic finishing, but longer treatment. No occlusal, cephalometric, or demographic variable obtained before treatment was able to give some significant prediction about treatment time in Class III patients.
Zhang, Chen Ying; Si, Yan; Wang, Xiao Zhe; Sun, Xiang Yu; Yan, Wen Juan; Zheng, Shu Guo
To explore the early dental interventional strategies for adolescent patients and a child patient with cleidocranial dysplasia (CCD). Surgical exposure using the apically repositioned flap technique combined with orthodontic traction was used in the adolescent patients whose ideal treatment time for initiating treatment was missed. For the child patient whose ideal treatment time for initiating treatment was not missed, the simple surgical exposure method was carried out in order to promote the eruption of the impacted incisors. All the impacted maxillary incisors of the three CCD patients were successfully positioned into a proper alignment either through the two stages of crown exposure and the elastic traction or simple surgical exposure. Crown exposure surgery combined with light force orthodontic traction provides an effective approach to treat the typical dental abnormalities of adolescent CCD patients. Simple surgical exposure was also an effective way for a child CCD patient for whom the most ideal time for initiation of treatment was not missed.
Mousoulea, Sophia; Papageorgiou, Spyridon N; Eliades, Theodore
Although several prescriptions and techniques exist for comprehensive fixed appliance treatment, their treatment effects have not yet been adequately assessed in an evidence-based manner. The aim of this systematic review was to assess the therapeutic and adverse effects of various prescriptions or techniques for orthodontic appliances from randomized clinical trials on human patients. Eight databases were searched up to July 2016 for randomized trials assessing any orthodontic prescriptions or techniques in human patients. After elimination of duplicate studies, data extraction, and risk of bias assessment according to the Cochrane guidelines, random effects meta-analyses with mean differences (MD) and their 95% confidence intervals (CIs) were performed. Compared to Roth preadjusted appliances, both Begg and modified Begg appliances were associated with statistically significantly worse occlusal outcome assessed with Peer Assessment Review (PAR) scores (1 trial, MD 3.1 points, 95% CI 1.9-4.3 points and 1 trial, MD 2.4 points, 95% CI 1.2-3.6 points, respectively) with low quality of evidence, due to bias and imprecision. Compared to a partially programmed fixed orthodontic appliance, a fully programmed appliance was associated with a statistically significant, but clinically irrelevant increase in treatment duration (1 trial, MD 2.4 months, 95% CI 0.6-4.2 months), supported by high quality of evidence. However, caution is needed in the interpretation of these results as only a limited number of small trials with methodological issues were available. Based on existing trials, there is limited evidence to support any robust clinical recommendation regarding the prescriptions or techniques for fixed orthodontic appliances. Registration: PROSPERO (CRD42016042727). None.
Angelieri, Fernanda; de Almeida, Renato Rodrigues; Janson, Guilherme; Castanha Henriques, José Fernando; Pinzan, Arnaldo
This study compared the effects produced by two different molar distalizers, namely cervical headgear (CHG) and the intraoral pendulum appliance, associated with fixed orthodontic appliances. The headgear group comprised 30 patients (19 females, 11 males), with an initial age of 13.07 years [standard deviation (SD) = 1.3], treated with CHG and fixed orthodontic appliances for a mean period of 3.28 years, and the pendulum group 22 patients (15 females, 7 males), with initial age of 13.75 years (SD = 1.86), treated with the pendulum appliance followed by fixed orthodontic appliances for a mean period of 4.12 years. Lateral cephalograms were taken at the start (T1) and on completion (T2) of orthodontic treatment. The pendulum and CHG groups were similar as to initial age, severity of the Class II malocclusion, gender distribution, initial cephalometric characteristics, and initial and final treatment priority index (TPI). Only treatment time was not similar between the groups, with a need for annualization for data for the pendulum group. The data were compared with independent t-tests. There was significantly greater restriction of maxillary forward growth and improvement of the skeletal maxillomandibular relationship in the CHG group (P < 0.05). The maxillary molars were more mesially tipped and extruded and the mandibular molars more uprighted in the CHG group compared with the pendulum group (P < 0.05). There was more labial tipping of the mandibular incisors and greater overbite reduction in the pendulum group. The pendulum appliance produced only dentoalveolar effects, different from the CHG appliance, which restricted maxillary forward displacement, thus improving the skeletal maxillomandibular relationship.
de Sousa, Emerson Tavares; da Silva, Beatriz Feitosa; Maia, Fabiana Barros Marinho; Forte, Franklin Delano Soares; Sampaio, Fábio Correia
The normative orthodontic treatment need, established by dental professionals during the dental appointment, becomes ineffective when it does not evaluate all the factors that influence the decision-making process, including individuals' perception and satisfaction with their dental appearance. Therefore, the purpose of this study was to investigate the perception of children and their mothers as regards orthodontic treatment need and satisfaction with dental aesthetics and test if these variables are associated with the objective orthodontic treatment needs, assessed by the Dental Aesthetic Index (DAI). A cross-sectional study was conducted on 308 children aged 12 years, and their mothers were randomly selected by cluster sampling (primary schools). The variables "orthodontic treatment need," "satisfaction with chewing," and "dental appearance" were assessed by means of a questionnaire. The questions were answered individually at school or home, in cases of children or mothers, respectively. DAI was assessed to make an objective clinical assessment. The variables were dichotomized and statistically analyzed by the chi-square and Fisher's exact tests, contingency coefficient C, and logistic regression. The results of the clinical evaluation (DAI) were statistically associated with the perception of orthodontic treatment need and satisfaction with dental appearance in children (p ≤ 0.01). However, no association was observed with regard to satisfaction with chewing and DAI (p = 0.10). The children's perception of orthodontic treatment need and satisfaction with the appearance of their teeth was statistically associated (p ≤ 0.01) with their mothers' perception. Maxillary overjet, maxillary and mandibular misalignment, and dental crowding were associated with the orthodontic treatment need by children and their mothers, with p value -0.05 and 5 % level of significance. Maxillary overjet was a significant predictor for the perception of orthodontic
McKeta, Nathan; Rinchuse, Daniel J; Close, John M
As dentists embrace evidence-based clinical practice, we place increased emphasis on patient values. Standards like Angle Classification are not related to patient perceptions of the tangible benefits of treatment. This study quantifies the differences dentists and patients perceive in orthodontic treatment outcome. A survey is used to quantify a patient's perception of orthodontic treatment. It was completed by 30 patients who completed treatment at the University of Pittsburgh School of Dental Medicine. Their responses were compared with the perceptions of five orthodontists, three general dentists, and two prosthodontists. Multivariate analysis of variance found the differences between and within the subjects to be significant at p < 0.004. Univariate analysis of variance of the initial scores showed the data to be significant at p < 0.002 and pairwise comparisons showed significant mean differences. Final score analysis of variance was significant at p < 0.001 and pairwise comparison showed significant mean differences. Patients and general dentists have a significantly less favorable initial perception of their dental esthetics and function when compared with orthodontists. Final scores of esthetic and functional perceptions between the patients and all three dentist groups showed significant differences, with patients perceiving the results of their treatment more favorably than practitioners. The data herein elucidates differences in the value systems of professionals and patients. It is meant to encourage dentists to consider whether these differences justify the persistence of traditional orthodontic treatment goals or if treatment planning should incorporate consideration of each individual patient's preferences to maximize utility. © 2011 Wiley Periodicals, Inc.
Johansson, Anneli M; Follin, Marie E
The aim of the present study was to evaluate if orthodontists in Sweden agree with the grading in the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need, to analyze if certain malocclusions are graded differently, and to determine if there are any background factors among Swedish orthodontists that could be related to their judgements. Two questionnaires were sent to 272 orthodontists in Sweden. In one questionnaire, they were asked to grade different malocclusions (defined in the DHC) according to the need for orthodontic treatment and in the other to provide details of their background. Eighty-one per cent (219) answered one or both questionnaires and 216 answered the questions concerning the need for orthodontic treatment. The Swedish orthodontists' judgements were then compared with the gradings in the DHC. Statistical analysis was undertaken using chi-square, likelihood ratio chi-square, phi coefficient, contingency coefficient, and Cramer's V tests. The result showed that almost all participating orthodontists agreed that grade 1 of the index indicated no need for treatment. For grade 2 (little need), the opinions differed, but still the majority were in agreement with the index. The judgements for malocclusions in grade 3 (borderline need) were widespread, but the majority considered 3a, 3c, and 3f to have a need or a great treatment need. The only statistical correlation with background factors was that female orthodontists graded 3f higher than borderline. For grades 4 and 5 (need and great need), the Swedish orthodontists thought that all the malocclusions required treatment except 4x, which the majority considered to be borderline. The participating Swedish orthodontists in this study graded fewer malocclusions in grade 3 and the majority were of the opinion that compared with the DHC, more malocclusions needed treatment.
Fuck, Lars-Michael; Drescher, Dieter
The determination of orthodontically-effective forces and moments places great demands on the technical equipment. Many patients report severe pain after fixed appliance insertion. Since it is assumed that pain from orthodontic appliances is associated with the force and moment levels applied to the teeth and since the occurrence of root resorption is a common therapeutic side effect, it would seem important to know the actual magnitudes of the components of the active orthodontic force systems. The aim of the present study was therefore to measure initial force systems produced by different leveling arch-wires in a complete multi-bracket appliance and to assess whether force and moment levels can be regarded as biologically acceptable or not. The actual bracket position in 42 patients was transferred onto a measurement model. Forces and moments produced by a super-elastic nickel-titanium (NiTi) archwire, a 6-strand stainless steel archwire, and a 7-strand super-elastic NiTi archwire were determined experimentally on different teeth. Average forces and moments produced by the super-elastic NiTi arch wires were found to be the highest. In spite if their larger diameter, the stranded arch wires' average force and moment levels were lower, especially that of the stranded super-elastic archwire. Nevertheless, maximum force levels sometimes exceeded recommended values in the literature and must be considered as too high. The measured arch wires' initial force systems differed significantly depending on the type of archwire and its material structure. Stranded arch wires produced lower force and moment levels, and we recommend their use in the initial phase of orthodontic treatment.
Boyd, R L; Leggott, P J; Quinn, R S; Eakle, W S; Chambers, D
This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3-month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease.
Nakamura, Yoshiki; Miyamoto, Yutaka; Kanzaki, Hiroyuki; Wada, Satoshi
This case report describes the importance of preventing more excessive transverse dental compensation during orthodontic treatment for a patient with severe transverse skeletal discrepancy. The patient, a 33-years-old Japanese woman, had severe transverse skeletal discrepancy involving the maxilla and mandible. In addition, she had an extreme transverse dental compensation of the posterior teeth in mandibular arch (i.e. excessive lingual inclination of mandibular molars). Therefore, the main treatment objectives were to prevent more excessive transverse dental compensation by orthodontic treatment and improve the occlusal function. We chose non-surgical orthodontic treatment. Because this patient did not think that the esthetic improvement with surgery would be worth the risk. The orthodontic treatment resulted in sufficient elimination of the transverse dental compensation and movement of the teeth into their proper position where basal bone firmly support them. Anterior crossbite was corrected with remaining buccal crossbite, facial profile was improved and functional occlusion was obtained. At 2 years 2 months after the orthodontic treatment, the facial profile and occlusion remained favorable. This report would become an alternative to ideal treatment for a case with transverse skeletal discrepancy.
Aragón, Mônica L C; Bichara, Lívia M; Flores-Mir, Carlos; Almeida, Guilherme; Normando, David
The purpose of this study was to assess the efficiency of compensatory orthodontic treatment of patients with mild Class III malocclusion with two preadjusted bracket systems. Fifty-six matched patients consecutively treated for mild Class III malocclusion through compensatory dentoalveolar movements were retrospectively evaluated after analysis of orthodontic records. The sample was divided into two groups according to the brackets used: Group 1 = non-Class III compensated preadjusted brackets, Roth prescription (n = 28); Group 2 = compensated Class III preadjusted brackets, Capelozza III prescription (n = 28). Cephalometric analysis, number of appointments and missed appointments, months using Class III elastics, and bond/band failures were considered. Treatment time, Peer Assessment Rating (PAR) index at the beginning (PAR T1) and end of treatment (PAR T2) were used to calculate treatment efficiency. Comparison was performed using a MANOVA at p< 0.05. Missed appointments, bond or band failures, number of months using the Class III intermaxillary elastics, and cephalometric measurements showed no statistically significant difference (p> 0.05) between groups. Patients treated with Roth brackets had a treatment time 7 months longer (p= 0.01). Significant improvement in the patient's occlusion (PAR T2-T1) was observed for both groups without difference (p= 0.22). Orthodontic brackets designed for compensation of mild Class III malocclusions appear to be more efficient than non-compensated straight-wire prescription brackets. Treatment time for Class III patients treated with brackets designed for compensation was shorter than with Roth prescription and no difference in the quality of the occlusal outcome was observed. A prospective randomized study is suggested to provide a deeper look into this subject.
Tang, Xia; Cai, Jiaxin; Lin, Beibei; Yao, Linjie; Lin, Feiou
Background Motivation is the impetus for patients to seek orthodontic treatment, affecting adherence, treatment outcomes, and satisfaction. The aim of this study was to assess the motivation of adult female patients seeking orthodontic treatment, and classify the patients according to their motivations. Methods This study used Q-methodology as the main tool. Q-samples were collected and categorized (35 items). Forty-two adult female patients were interviewed before treatment as the P-sample, and their responses were categorized into the Q-methodology grid. Participants were asked to rank-order a set of 35 statements (Q-sample) from “agree most” to “disagree most” (Q-sorting). The finished Q-grids were analyzed using PQ method 2.35. Results Four main factors were identified based on how adult female patients ranked statements: factor 1, patients who focus on their self-perception of their appearance; factor 2, patients who are concerned about the esthetics and function of their teeth; factor 3, patients who are easily influenced by others; factor 4, patients who want to improve their confidence and avoid negative thoughts caused by their teeth. The remaining patients who had other views did not match any of the above four groups. Conclusion The motivations of adult female patients seeking orthodontic treatment are complex. This study found that most adult female patients fell into one of four typical factor groups. Our findings may improve the adherence of adult female patients by developing a more ideal treatment program. PMID:25709410
Award Number: W81XWH-06-1-0530 TITLE: Early Treatment in Shock PRINCIPAL INVESTIGATOR: Dr. Charles Van Way, III, M.D. CONTRACTING ORGANIZATION...Early Treatment in Shock W81XWH-06-1-0530 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Charles W. Van Way, III...immunosuppression, and rendering the patient vulnerable to sepsis and its sequelae. The goal of this research program is to develop new treatments for hemorrhagic
Liu, Y S; Li, Z; Zhao, Y J; Ye, H Q; Zhou, Y Q; Hu, W J; Liu, Y S; Xun, C L; Zhou, Y S
To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. The medians of scores of DP treatment plan and OP treatment plan were calculated and
Tuncer, C; Canigur Bavbek, N; Balos Tuncer, B; Ayhan Bani, A; Çelik, B
To examine patients' and parents' perceptions and expectations from orthodontic treatment. 491 patients (274 female, 217 male) aged 14-22 years, and 399 parents (245 female, 154 male) completed a questionnaire about preferences, needs and expectations about orthodontic treatment, and scored the present problem. Continuous variables were compared by Mann-Whitney U and Kruskal-Wallis tests, whereas Chi-square test was used for categorical variables. Patients'(77.1%) and parents'(84.6%), decision about orthodontic treatments were influenced by suggestion of dentists. Patients who decided to attend to clinic by themselves were higher than parents (p=0.006). Dental aesthetics was the determinant factor for treatment demand for patients(61.0%) and parents(57.3%). Improvement in oral functions was more important for Class III patients than Class I patients (p=0.040). Adult patients/parents with higher education gave more importance to oral functions as well as dental aesthetics (p=0.031). There was no difference among Angle classifications regarding orthodontic problem scores. Parents found media sources valuable (p=0.018) but majority expected dentists for information about orthodontic treatments. Education degree of adult patients/parents effected this decision(p=0.002). Desire to have better dental aesthetics was the primary motivating factor for all participants. Clinicians should consider concerns of Class III patients about oral functions during treatment planning.
Nervina, J M
Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics. PMID:25358833
Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; Xu, Tian-Min
This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from –0.08 to +0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component (R2=0.86, P<0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R2=0.96, P<0.000 1). Grading scores for SC+LX and SC+PH were highly significantly correlated with those for SC+LX+PH (r(SC+LX)vs.(SC+LX+PH)=0.96, r(SC+PH)vs.(SC+LX+PH)=0.97), showing that either SC+LX or SC+PH is an excellent substitute for all three combined assessment. PMID:24136673
Siddiqui, Tania Arshad; Shaikh, Attiya; Fida, Mubassar
The primary objective of the study was to assess the agreement between orthodontist and patient perception regarding the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) at pre-orthodontic treatment levels. The secondary objective was to determine how well the subjective assessment of malocclusion (IOTN-AC) correlated with the normative Dental Health Component of the IOTN (IOTN-DC). A cross-sectional analytical study was conducted on patients between the ages of 16 and 25, presenting for initiation of orthodontic treatment with no history of prior orthodontic treatment. The mean age of the total sample population was 19.50 ± 3.15 years. The mean age of the males was 19.05 ± 3.09 years and for females it was 19.75 ± 3.18 years. The sample consisted of 41 males and 80 females. Patients were shown their pretreatment monochrome intraoral frontal photographs to rate according to the IOTN-AC. Simultaneously, the orthodontist reviewed the photographs with each patient. The IOTN-DHC of pretreatment casts was also recorded by the orthodontist. The frequency of specific traits that had led to increased severity of malocclusion was also identified. All readings were recorded manually on a data collection form. The data were assessed using the chi-square test, Spearman's correlation and Cohen's kappa test. Intra- and inter-examiner reliability was assessed using Spearman's correlation. A significant positive relationship (p < 0.05) was observed between orthodontist and patient perception (r = 0.516), orthodontist perception and the normative need (r = 0.430), and between the patient perception and the normative need (r = 0.252). A statistically significant level of agreement was observed between orthodontist and patient perception (kappa = 0.339, p ⩽ 0.001, 95% CI, 0.207-0.470) and between orthodontist perception and the normative need (kappa = 0.331, p ⩽ 0.001, 95% CI, 0.197-0.424). A weak and insignificant level of
The increasing use of technology is rapidly changing our personal and professional lives. Smartphones allow users to access information in ways previously not possible and our patients may be accessing apps to source information about orthodontics and help them through their treatment. To provide an overview of the orthodontic apps currently available on four of the main operating systems with emphasis on those apps targeted towards new and existing orthodontic patients as well as practising clinicians. Four mobile devices were used to search four mobile operating systems (Android, Apple, Blackberry and Windows) using the key words 'braces', 'orthodontist', 'orthodontic' and 'orthodontics'. Android and Apple operating systems derived all of the apps considered relevant to orthodontic clinicians and patients. Clinician apps (11) related to orthodontic meetings (3), publications (3), products (3) and tooth ratio calculators such as Bolton (2). Patient apps (8) related to reminding patients about elastic wear (2) and aligner wear (2), dealing with orthodontic emergencies (2), orthodontic products (1) and a progress tracker of treatment (1). Apps are available for both orthodontic clinicians and patients; however, much of the information contained within them is often not independent and even more often not validated. Patients are increasingly likely to access apps and clinicians should direct patients to those that are most appropriate and useful.
Tak, Mridula; Nagarajappa, Ramesh; Sharda, Archana J; Asawa, Kailash; Tak, Aniruddh; Jalihal, Sagar; Kakatkar, Gauri
Objective: The objective of the study is to assess the prevalence of malocclusion and orthodontic treatment needs among 12-15 years old school children of Udaipur, India. Materials and Methods: A cross-sectional descriptive survey was conducted among 887 subjects aged 12-15 years. The prevalence of malocclusion and orthodontic treatment needs was assessed using dental aesthetic index (World Health Organization, 1997). General information on demographic data was also recorded. Chi-square test, analysis of variance and Scheffe's test were employed for statistical analysis. Results: Malocclusion and orthodontic treatment need was reported among 33.3% of the study subjects. A significant age and gender difference depicting preponderance among younger age group and a male proclivity was experiential. A significant improvement in anterior crowding and largest anterior maxillary irregularity with age was documented. Males had a significantly higher prevalence of anterior crowding, midline diastema and largest anterior maxillary irregularity than females. Conclusions: The prevalence of malocclusion and orthodontic treatment needs among school children of Udaipur city, Rajasthan, India was found to be 33.3%. A significant age and gender difference was observed in prevalence of malocclusion, crowding and largest anterior maxillary irregularity. Midline diastema showed a significant gender difference. The baseline information outlined in the present study can be appropriately utilized for the future planning to meet the orthodontic treatment need among the population. PMID:24966728
Papakostopoulou, Margarita; Migliorati, Marco; Calzolari, Chiara; Gallo, Fabio; Drago, Sara; Silvestrini Biavati, Armando
The aim of this study was to analyze the psychological aspects of patients during their orthodontic treatment, evaluating their expectations during treatment comparing Greek patients to Italian patients. This cross sectional descriptive study involved a sample of 228 patients (113 Italians -115 Greeks) undergoing fixed or removable orthodontic treatment. A questionnaire comprising of six questions was used and patients scored each question on a 0-10 Scale. Participants completed a validated questionnaire measure of orthodontic expectations that was tested for reliability. Descriptive analysis of the responses was undertaken, and comparisons between boys and girls, as well as between Greek and Italian patients, was made. The expectation score was calculated by summarizing the 6 items (A1 to A6). Reliability Analysis was performed using the Item-test, Item-rest correlation and the Cronbach's α. Items with a Cronbach's α coefficients greater than 0.7 are considered acceptable. To investigate the effect of the City and Gender on the expectation score, an univariate analysis was carried out by the Wilcoxon Rank Sum Test. Differences, with a P value less than 0.05, were selected as significant. Overall expectation Cronbach's α coefficient (internal consistency) was 0.73 (95% CI: 0.64-0.81). The mean of expectation items was 7.8 (SD=1.8). A significant slight correlation was found between motivation (item A1) and main reason of treatment (item A3) (r=0.17; P=0.0122). Moreover, there was a significant moderate correlation between compliance (item A4) and expectation (item A6) (r=0. 58; P<0.0001). Male showed a significant higher overall score compared to female sample, as well as Greek patients compared to Italians.
Larson, Brent E; Vaubel, Christopher J; Grünheid, Thorsten
To evaluate the effectiveness of computer-assisted orthodontic treatment technology to produce the tooth position prescribed by the virtual treatment plan. Posttreatment models of 23 patients treated with SureSmile were digitally superimposed on their corresponding virtual treatment plan models utilizing best-fit surface-based registration. Individual tooth-position discrepancies between virtual treatment plan and actual outcome were computed. Discrepancies less than 0.5 mm in mesial-distal, facial-lingual, and vertical dimensions, and less than 2° for crown torque, tip, and rotation were considered clinically ideal. One-sided test of equivalence was performed on each discrepancy measurement, with P < .05 considered statistically significant. Mesial-distal tooth position was clinically ideal for all teeth with the exception of maxillary lateral incisors and second molars. Facial-lingual tooth position was clinically ideal for all teeth except maxillary central incisors, premolars, and molars, and mandibular incisors and second molars. Vertical tooth position was clinically ideal for all teeth except mandibular second molars. For crown torque, tip, and rotation, discrepancy exceeded the limits considered clinically ideal for all teeth except for crown torque on mandibular second premolars and crown tip on mandibular second premolars and first molars. The effectiveness of computer-assisted orthodontic treatment technology to achieve predicted tooth position varies with tooth type and dimension of movement.
Erbe, Christina; Klukowska, Malgorzata; Tsaknaki, Iris; Timm, Hans; Grender, Julie; Wehrbein, Heinrich
Good oral hygiene is a challenge for orthodontic patients because food readily becomes trapped around the brackets and under the archwires, and appliances are an obstruction to mechanical brushing. The purpose of this study was to compare plaque removal efficacy of 3 toothbrush treatments in orthodontic subjects. This was a replicate-use, single-brushing, 3-treatment, examiner-blind, randomized, 6-period crossover study with washout periods of approximately 24 hours between visits. Forty-six adolescent and young adult patients with fixed orthodontics from a university clinic in Germany were randomized, based on computer-generated randomization, to 1 of 3 treatments: (1) oscillating-rotating electric toothbrush with a specially designed orthodontic brush head (Oral-B Triumph, OD17; Procter & Gamble, Cincinnati, Ohio); (2) the same electric toothbrush handle with a regular brush head (EB25; Procter & Gamble); and (3) a regular manual toothbrush (American Dental Association, Chicago, Ill). The primary outcome was the plaque score change from baseline, which we determined using digital plaque image analysis. Forty-five subjects completed the study. The differences in mean plaque removal (95% confidence interval) between the electric toothbrush with an orthodontic brush head (6% [4.4%-7.6%]) or a regular brush head (3.8% [2.2%-5.3%]) and the manual toothbrush were significant (P <0.001). Plaque removal with the electric toothbrush with the orthodontic brush head was superior (2.2%; P = 0.007) to the regular brush head. No adverse events were seen. The electric toothbrush, with either brush head, demonstrated significantly greater plaque removal over the manual brush. The orthodontic brush head was superior to the regular head. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Huet, A P; Paulus, C
The obstructive sleep apnea syndrome (OSAS) may affect children, especially those with dentofacial disharmonies. Dentofacial orthopedic (DFO) treatments carried out in those patients must take this condition into account and can, in selected cases, improve or even treat the OSAS. The goal of our work was to report our experience about DFO treatments of children affected by OSAS in the department of maxillofacial surgery of Femme-Mère-Enfant hospital of university hospitals of Lyon, France. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
He, Wen-dan; Liu, Ying-zhi; Xu, Yuan-yuan; Chen, Dong
To determine the value of clinical application of CPP-ACP during orthodontic treatment with fixed appliance. Seventy-five subjects were divided randomly into three groups, the control group, experimental group A and experimental group B. The control group were emphasized on daily oral hygiene. Experimental group A used fluor protector every three months under the dentist's guidance. Experimental group B used Casein phosphopeptide amorphous calcium phosphate(CCP-ACP) once a day. After finishing the orthodontic treatment, photos were taken under the same condition ,then the degree of the enamel's demineralization was examined and the enamel decalcification index(EDI) was calculated. SPSS11.0 software package was used for statistical analysis. (1)The incidence of three groups' enamel decalcification declined in sequence as the control group(60%),experimental group A (36%), experimental group B (32%).(2)The incidence of the teeth's enamel calcification of three groups declined in sequence as the control group(14.7%),experimental group A (8.46%), experimental group B (7.72%), the difference between the control group and two experimental groups was significant, while no significant difference was found between the two experimental groups.(3(EDI of the control group was 0.155+/-0.023, EDI of the experimental group A was 0.082+/-0.009,while EDI of the experimental group B was 0.078+/-0.006. The difference between the control group and two experimental groups was statistically significant, while was not statistically significant between the two experimental groups. The application of fluor protector and CPP-ACP can improve the mineralization of the teeth during orthodontic treatment with fixed appliance. CPP-ACP is more convenient for the patients to use. Supported by Research Fund of Bureau of Science and Technology of Futian District Shenzhen City(Grant No.FTWS056).
Aristizabal, Juan Fernando; Smit, Rosana Martínez
INTRODUCTION: Becker muscular dystrophy is an X-chromosomal linked anomaly characterized by progressive muscle wear and weakness. This case report shows the orthodontic treatment of a Becker muscular dystrophy patient with unilateral open bite. METHODS: To correct patient's malocclusion, general anesthesia and orthognathic surgery were not considered as an option. Conventional orthodontic treatment with intermaxillary elastics and muscular functional therapy were employed instead. RESULTS: After 36 months, open bite was corrected. The case remains stable after a 5-year post-treatment retention period. PMID:25628078
Liu, Xiaomo; Lin, Jiuxiang; Ding, Peng
In this study, we tested the surface roughness of bracket slots and the friction coefficient between the bracket and the stainless steel archwire before and after orthodontic treatment. There were four experimental groups: groups 1 and 2 were 3M new and retrieved brackets, respectively, and groups 3 and 4 were BioQuick new and retrieved brackets, respectively. All retrieved brackets were taken from patients with the first premolar extraction and using sliding mechanics to close the extraction space. The surface roughness of specimens was evaluated using an optical interferometry profilometer, which is faster and nondestructive compared with a stylus profilometer, and provided a larger field, needing no sample preparation, compared with atomic force microscopy. Orthodontic treatment resulted in significant increases in surface roughness and coefficient of friction for both brands of brackets. However, there was no significant difference by brand for new or retrieved brackets. These retrieval analysis results highlight the necessity of reevaluating the properties and clinical behavior of brackets during treatment to make appropriate treatment decisions. © Wiley Periodicals, Inc.
Al-Khateeb, Susan N; Abu Alhaija, Elham S; Majzoub, Sami
The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P < 0.001), 58.5±13.0 N in AOBF (P < 0.001), and 69.3±11.6 N IOBF (P < 0.001). Treatment with functional appliance caused a significant reduction in OBF immediately after treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Jung, Seo-Yeon; Park, Jung-Hyun; Park, Hyung-Sik; Baik, Hyoung-Seon
Temporomandibular joint ankylosis manifests a range of clinical characteristics dependent upon the age of onset, the affected side, and the severity. When it occurs during development, mandibular growth is affected, resulting in severe retrusion or asymmetry as well as limitation of mandibular movements. Progressive asymmetric mandibular growth in unilateral ankylosis causes canting of the occlusal plane. In this case report, we present a successful temporomandibular joint reconstruction using transport distraction osteogenesis combined with camouflage orthodontic treatment for occlusal canting correction of a patient with unilateral temporomandibular joint ankylosis and severe facial asymmetry. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Jia, Ying; Chen, Bo; Cai, Shaoxiang; Hu, Tiehan
To observe the clinical efficacy of transcutanclus electrical acupoint stimulation (TEAS) on prevention and treatment of orthodontic toothache and oral dysfunction. A total of 85 patients of malocclusions in the preliminary diagnosis were randomly divided into a control group (20 cases), a psychological intervention group (22 cases), a medication group (20 cases) and a TEAS group (23 cases). Orthodontics treatment was given in all the groups. Patients in the control group received no further treatment; patients in the psychological intervention group received comprehensive psychological intervention, including cognitive education and music therapy; patients in the medication group received oral administration of ibuprofen; patients in the TEAS group received TEAS at Juliao (ST 3), Jiachengjiang (Extra) and auricular point Ya (LO1). The treatment was given twice a day, one in morning and one at night, for 7 days. The pain scores of orthodontic toothache and changes of oral dysfunction were observed in all groups. (1) At 5 time points from the 12th hour to the 4th day, the scores of spontaneous pain in TEAS group were lower than those in the control group (all P < 0.01); during the time points, the scores in TEAS group were lower than those in the psychological intervention group (P < 0.05, P < 0.01), which were similar to those in the medication group (all P > 0.05). (2) During the peak cycle of spontaneous toothache, the scores of irritation pain in TEAS group were significantly lower than those in the control group (all P < O.01), regardless of time-point statistics or general statistics; the scores of irritation pain in the TEAS group were also significantly lower than those in the psychological intervention group (all P < 0.01), which were similar to those in the medication group (all P > 0. 05). (3) Compared with control group, the grading of talking disorder in the remaining groups did not change significantly (P > 0.05). (4) Compared with control group, the
Hwang, Soon-Kong; Ha, Jung-Hong; Jin, Myoung-Uk; Kim, Sung-Kyo
Closure of interdental spaces using proximal build-ups with resin composite is considered to be practical and conservative. However, a comprehensive approach combining two or more treatment modalities may be needed to improve esthetics. This case report describes the management of a patient with multiple diastemas, a peg-shaped lateral incisor and midline deviation in the maxillary anterior area. Direct resin bonding along with orthodontic movement of teeth allows space closure and midline correction, consequently, creating a better esthetic result. PMID:23429455
Gungor, Kahraman; Taner, Lale; Kaygisiz, Emine
To evaluate the prevalence and distribution of posterior crossbite in different dentition stages in a Turkish sample. 1554 subjects (843 girls, 711 boys) aged 4-25 years were evaluated to determine the prevalence of posterior crossbite in a Turkish sample. The subjects were classified according to four dentition stages (primary, early mixed, late mixed and permanent) and transversal occlusal status. The statistical evaluation was done by Chi-square, Fischer exact tests. Bilateral and unilateral crossbite on the right and left sides had the highest frequency in the permanent dentition (51.0%, 47.3%, and 53.6%; respectively). No significant differences were found between unilateral (right and left) and bilateral crossbite with regard to dentition stages. No significant differences were found between unilateral right or left side posterior crossbite with regard to dentition stages. An increasing trend in the prevalence of posterior crossbite was observed from the primary dentition towards permanent dentition in this study.
Pahkala, Riitta H; Kellokoski, Jari K
Surgical-orthodontic treatment is a common treatment approach for adult patients with skeletal maxillomandibular discrepancy. Some patients report improvement in signs and symptoms of temporomandibular disorder (TMD) after surgery. Whether the correction of malocclusion is responsible for the improvement of TMD symptoms after orthognathic surgery is still controversial. The objectives of this prospective study were to evaluate subjective treatment outcomes in patients with bilateral sagittal split osteotomy (BSSO) and to find out whether signs and symptoms of TMD and changes in occlusion are related to patient satisfaction. Eighty-two patients (53 female, 29 male) with a mean age of 32 years (range, 16-53 years) treated with BSSO in the Oral and Maxillofacial Department at Kuopio University Hospital in Finland were examined; 64 had mandibular advancement, and 18 had mandibular setback. Occlusion and signs and symptoms of TMD were registered pre- and postoperatively. At the postoperative examination (mean, 1.8 years after BSSO), the patients were asked to fill out a questionnaire about the influence of treatment on their masticatory function and symptoms of TMD, as well as their satisfaction with the treatment outcome. TMD symptoms were significantly reduced after treatment. Improvements were also reported in facial appearance (82%) and chewing ability (61%); also, facial (56%) and temporomandibular joint (40%) pain disappeared. However, in 12% of the patients, temporomandibular joint problems were worse after treatment. Most patients (73%) were very satisfied with the outcomes; no one expressed dissatisfaction. Multiple logistic regression analysis showed that subjects with improved mastication and self-confidence, and those without long-term neurosensory deficits, expressed high satisfaction with the treatment outcome. Patients with mandibular setback were more pleased with the outcome than those with mandibular advancement. Orthognathic patients generally
Millett, Declan T; Cunningham, Susan J; O'Brien, Kevin D; Benson, Philip E; de Oliveira, Cesar M
A Class II division 2 malocclusion is characterised by upper front teeth that are retroclined (tilted toward the roof of the mouth) and an increased overbite (deep overbite), which can cause oral problems and may affect appearance.This problem can be corrected by the use of special dental braces (functional appliances) that move the upper front teeth forward and change the growth of the upper or lower jaws, or both. Most types of functional appliances are removable and this treatment approach does not usually require extraction of any permanent teeth. Additional treatment with fixed braces may be necessary to ensure the best result.An alternative approach is to provide space for the correction of the front teeth by moving the molar teeth backwards. This is done by applying a force to the teeth from the back of the head using a head brace (headgear) and transmitting this force to part of a fixed or removable dental brace that is attached to the back teeth. The treatment may be carried out with or without extraction of permanent teeth.If headgear use is not feasible, the back teeth may be held in place by bands connected to a fixed bar placed across the roof of the mouth or in contact with the front of the roof of the mouth. This treatment usually requires two permanent teeth to be taken out from the middle of the upper arch (one on each side). To establish whether orthodontic treatment that does not involve extraction of permanent teeth produces a result that is any different from no orthodontic treatment or orthodontic treatment involving extraction of permanent teeth, in children with a Class II division 2 malocclusion. Cochrane Oral Health's Information Specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (to 13 November 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2017, Issue 10), MEDLINE Ovid (1946 to 13 November 2017), and Embase Ovid (1980 to 13 November 2017). To identify
Zhang, Xiaowei; Liang, Jingping
The pathogenesis of pulpal and periapical diseases is related with not only bacterial infection but also physicochemical irritations such as trauma and thermal changes. During orthodontic therapy, the application of orthodontic forces on teeth may produce a series of changes in periodontal ligament, alveolar bone and pulpo-dentinal complex. This article reviewed the influences of orthodontic therapy on dental pulp and periapical tissues.
This was a randomised controlled trial (RCT) set in a community dental practice. The test varnish was a commercially available product, Fluor Protector (Ivoclar Vivadent, Schaan, Liechtenstein), containing 0.1% fluoride as difluorosilane in a polyurethane varnish base. The placebo varnish applied had an identical composition but without fluoride. The incidence and prevalence of white spot lesions (WSL) on the upper incisors, cuspids and premolars were recorded, as scored from digital photographs by two independent examiners. In the case of disagreement, cases were re-examined until a consensus was achieved. The incidence of WSL during the treatment period was 7.4% in the fluoride varnish group compared with 25.3% placebo group (P <0.001). The mean progression score was significantly lower in the fluoride varnish group than in the placebo group, (0.8 +/- 2.0 vs 2.6 +/- 2.8; P <0.001). The absolute risk reduction was 18% and the number-needed-to-treat was calculated to be 5.5 (95% confidence interval, 3.7-10.9). The results strongly suggest that regular topical fluoride varnish applications may reduce the development of WSL adjacent to the bracket base during treatment with fixed appliances.
Valério, R A; Scatena, C; Santos, F R R; Romano, F L; Queiroz, A M; Paula-Silva, F W G
Frontonasal dysplasia is a complex rare malformation, characterised by abnormalities involving the central portion of the face, especially the eyes, nose and forehead. It can manifest independently or associated with other abnormalities as part of some syndromes. The purpose of this case report was to describe a 5-year-old patient, diagnosed with frontonasal dysplasia. Among the abnormalities characterised with this disorder were ocular hypertelorism, broad nose tip with median notch, median facial cleft, bifid anterior skull, low set hairline, Poland's syndactyly and ankyloglossia. Consisted of behavioural management, oral hygiene instruction, prophylaxis, topical fluoride application, extraction of primary teeth, composite resin restorations and sealants in pits and fissures. Preformed metal crowns were also applied to the right and left primary maxillary second molars. Currently, the patient is 11 years-old in the permanent dentition and therefore was referred for corrective orthodontic and periodontal treatments due to the persistence of gingival retraction of the permanent mandibular right central incisor. The treatment in this case was directed to the promotion of oral health and orthodontic corrections, which are of fundamental importance due to medical, physical and social limitations of children affected by this syndrome, hindering healing and rehabilitative treatment. Paediatric dentists should be included in multidisciplinary teams providing care to patients with special needs, improving their quality of life.
Nalcaci, Ruhi; Demirer, Serhat; Ozturk, Firat; Altan, Burcu A.; Sokucu, Oral; Bostanci, Vildan
The aim of this study was to determine the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic status. Our study population consisted of a sample of 836 school children (384 male and 452 female, aged 11–14 years). Four experienced orthodontists and two experienced periodontists performed the clinical examinations. The Treatment Priority Index (TPI), Community Periodontal Index of Treatment Needs (CPITN), decayed, missing, filled teeth (DMFT) scores, and a questionnaire that surveyed socio-demographic status of students were used. Spearman's rank correlation coefficients were used to measure the association between variables. TPI scores showed that 36.4% of the students had normal occlusion, while 41.2% had slight, 15.7% had definite, 4% had severe, and 2.7% had very severe malocclusion. TPI values did not show any significant differences between pupils in different age, gender, socioeconomic status groups, and CPITN scores, whereas there was a significant relationship between TPI and DMFT scores. The orthodontic treatment need was not significantly correlated with CPITN or socio-demographic status; however, the correlation coefficient showed a significant relationship between TPI and DMFT scores. PMID:23193381
Hamdan, Ahmad M; Maxfield, Blake J; Tüfekçi, Eser; Shroff, Bhavna; Lindauer, Steven J
The authors investigated the prevention and treatment of white-spot lesions (WSLs) during and after orthodontic therapy from the perspective of general dentists and orthodontists. The authors administered a cross-sectional survey to general dentists (n = 191) and orthodontists (n = 305) in Virginia, Maryland and North Carolina. Sixty-nine percent of general dentists and 76 percent of orthodontists recommended in-office fluoride treatment for patients with severe WSLs immediately after orthodontic treatment. Sixty-nine percent of general dentists reported that they had treated WSLs during the previous year, and 37 percent of orthodontists reported that they had removed braces because of patients' poor oral hygiene. Sixty percent of orthodontists referred patients with WSLs to general dentists for treatment. Eighty-five percent of orthodontists responded that they encouraged patients to use a fluoride rinse as a preventive measure. More than one-third of general dentists indicated that severe WSLs after orthodontic treatment could have a negative effect on their perception of the treating orthodontist. WSLs are a common complication of orthodontic treatment and their presence can result in a negative perception of the treating orthodontist by the patient's general dentist. Clinical implications. General dentists and orthodontists should work together to prevent the development of WSLs in their patients. Treatment with fluoride supplements and motivating and training patients to practice good oral hygiene will help achieve this goal. Treatment after debonding should include the topical application of low concentrations of fluoride.
Cano, Jorge; Campo, Julián; Bonilla, Elena; Colmenero, César
The use of orthodontic treatment in adult patients is becoming more common and these patients have different requirements specially regarding duration of treatment and facial and dental aesthetics. Alveolar corticotomy is an effective means of accelerating orthodontic treatment. This literature revision include an historical background, biological and orthodontic fundamentals and the most significant clinical applications of this technique. Orthodontic treatment time is reduced with this technique to one-third of that in conventional orthodontics. Alveolar bone grafting of labial and palatal/lingual surfaces ensures root coverage as the dental arch is expanded. Corticotomy-assisted orthodontics has been reported in a few clinical cases, and seems to be a promising adjuvant technique, indicated for many situations in the orthodontic treatment of adults without active periodontal pathology. Its main advantages are reduction of treatment time and postorthodontic stability. Further controlled prospective and histological studies are needed to study tooth movement, post-retention stability, and microstructural features of teeth, periodontium, and regenerated bone after using this procedure. Key words:Corticotomy, osteotomy, accelerated orthodontics. PMID:24558526
Yi, Yaxing; Li, Zhongke; Wei, Suyuan; Deng, Fanglin; Yao, Sen
The purpose of this article is to introduce the outline of our newly developed computer-aided 3D dental cast analyzing system with laser scanning, and its preliminary clinical applications. The system is composed of a scanning device and a personal computer as a scanning controller and post processor. The scanning device is composed of a laser beam emitter, two sets of linear CCD cameras and a table which is rotatable by two-degree-of-freedom. The rotating is controlled precisely by a personal computer. The dental cast is projected and scanned with a laser beam. Triangulation is applied to determine the location of each point. Generation of 3D graphics of the dental cast takes approximately 40 minutes. About 170,000 sets of X,Y,Z coordinates are store for one dental cast. Besides the conventional linear and angular measurements of the dental cast, we are also able to demonstrate the size of the top surface area of each molar. The advantage of this system is that it facilitates the otherwise complicated and time- consuming mock surgery necessary for treatment planning in orthognathic surgery.
Oland, Jesper; Jensen, John; Elklit, Ask; Melsen, Birte
A prospective, controlled study of consecutive surgical-orthodontic patients was performed to assess how treatment affects the patients' psychosocial well-being. We evaluated patients' treatment motivations and motive fulfillment in relation to their satisfaction with the treatment and assessed the correlation between their satisfaction and their psychosocial well-being. A total of 118 adult patients (51 men and 67 women, mean age 25 years) who had undergone surgical-orthodontic treatment were examined before the preoperative orthodontic treatment and 12 months after surgery or later. The motives for treatment, fulfillment of those motives, psychosocial well-being, and degree of post-treatment satisfaction were assessed using questionnaires validated for Danish patients. A total of 47 age- and gender-matched subjects without any current or previous need for orthodontic or surgical-orthodontic treatment served as the controls. The patients stated oral function and appearance as their main treatment motives, and most reported that their motives had been fulfilled. Both their motives and the actual fulfillment of their motives influenced their treatment satisfaction. Another significant outcome of treatment was improved self-concept and social interaction. The more self-concept and social interaction were improved by treatment, the greater the post-treatment satisfaction the patients expressed. Surgical-orthodontic treatment has significant potential to improve patients' psychosocial well-being. Patients' satisfaction with treatment correlated with the post-treatment psychosocial status. However, pretreatment motives significantly influenced the overall satisfaction after treatment. Thus, patients who weighted oral function motives greatest expressed the lowest degree of treatment satisfaction. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Chakravarthi, Sunitha; Padmanabhan, Sridevi; Chitharanjan, Arun B.
The aim of this paper is to review the current literature on allergy in orthodontics and to identify the predisposing factors and the implications of the allergic reaction in the management of patients during orthodontic treatment. A computerized literature search was conducted in PubMed for articles published on allergy in relation to orthodontics. The MeSH term used was allergy and orthodontics. Allergic response to alloys in orthodontics, particularly nickel, has been extensively studied and several case reports of nickel-induced contact dermatitis have been documented. Current evidence suggests that the most common allergic reaction reported in orthodontics is related to nickel in orthodontic appliances and allergic response is more common in women due to a previous sensitizing exposure from nickel in jewellery. Studies have implicated allergy in the etiology of hypo-dontia. It has also been considered as a high-risk factor for development of extensive root resorption during the course of orthodontic treatment. This review discusses the relationship and implications of allergy in orthodontics. PMID:24987632
Onyeaso, Chukwudi O; daCosta, Oluranti O
This study investigates the relationship between dental aesthetics and orthodontic treatment complexity and need in a group of patients with sickle-cell anemia (SCA) in Nigeria. The study sample consisted of 176 individuals - 77 (43.8%) male and 99 (56.3%) female subjects with SCA (aged 10 to 35 years) who were coming for routine medical care to two outpatient clinics. Dental aesthetics were assessed using the Standardized Continuum of Aesthetic Need component of the Index of Orthodontic Treatment Need. Treatment complexity and need were assessed according to the Index of Complexity, Outcome and Need and Dental Aesthetic Index. Both parametric and nonparametric statistics were employed in the data analysis. Significant positive relationships were found between dental aesthetics and orthodontic treatment complexity as well as treatment need according to both indices (p= .000). The correlations of the scores for dental aesthetics and the objectively derived treatment complexity and need were significant (p= .01). About 50% of the subjects had poor dental aesthetics and this correlated with their high orthodontic treatment complexity and need.
Sam, George; Seehan, Saad; Al-Shayea, Meshari
Background: The objective of the study is to determine whether there is any correlation between demand and need for orthodontic treatment among patients in Sattam Bin Abdulaziz University (SAU) Dental College Clinic. This study also provides a baseline data on the demand and need for orthodontic treatment among a Saudi population, which is important for planning public orthodontic dental services in the Kingdom. Materials and Methods: An epidemiological descriptive survey was conducted using two sets of questionnaire in the orthodontic clinic of Prince SAU, Al-Kharj among Saudi subjects with angle’s Class I, Class II, and Class III malocclusions, between the ages of 10 and 30 years for a period of 6 months with purposive sampling method. Results: Using Spearman’s rank correlation coefficient a significant correlation (0.482) was observed in male and female patients respectively with orthodontic demand (2) and treatment need (1) at 0.05 level of significance. A significant correlation (0.326) was observed for the study subjects (both males and females) with orthodontic demand (4) and treatment need (1) at 0.05 level of significance. A significant correlation (0.325) was observed in male patients with orthodontic demand (4) and treatment need (5) at 0.05 level of significance. Conclusions: Patients with the higher orthodontic demand required high treatment needs and vice versa. PMID:26668479
Anastasi, Giuseppe; Cordasco, Giancarlo; Matarese, Giovanni; Rizzo, Giuseppina; Nucera, Riccardo; Mazza, Manuela; Militi, Angela; Portelli, Marco; Cutroneo, Giuseppina; Favaloro, Angelo
The periodontal ligament lies between the hard tissues of alveolar bone and cementum of teeth and serves to anchor the tooth to the alveolus and functions as a cushion between these hard tissues to migrate occlusal force during mastication. This tissue is always exposed to mechanical stress during mastication. When occlusal forces exceed the adaptive capacity of the periodontal ligament, the periodontal ligament tissue will be injured and then occlusal trauma will occur. The different modifications of periodontal ligament during load deformation can be monitored by analysis of the expression of different collagen types and fibronectin, with immunohistochemical techniques, and by morphological study of ligament, with light- and transmission electron-microscopic techniques. The use of continued and light orthodontic force generates a pressure of ligament with ejection of parodontal fluid externally and partial closing of vessels. On these basis we performed a study in order to evaluate periodontal ligament collagen types I and IV and the fibronectin modifications induced by application of a precalibrated orthodontic strength. We integrated these results, with light and transmission electron-microscopic observations, in order to evaluate the morphological modifications of periodontal tissue. Our observations showed that the type I collagen immunofluorescence staining is increased in the pressure side; in the tension side, it shows prior to treatment an increase, and after 72 h of treatment, a diminution of the staining pattern. Type IV collagen staining is reduced in both sides, but increased gradually after 7 days from treatment; finally, fibronectin staining pattern is gradually increased in the pressure side and reduced in the tension side. In light and transmission electron-microscopic observations it is possible to show a reduction of vessels at 72 h from treatment, and an increase of vessels after 7 days from treatment. The Malassez's epithelial residues are
Galli, Carlo; Piemontese, Marilina; Ravanetti, Francesca; Lumetti, Simone; Passeri, Giovanni; Gandolfini, Mauro; Macaluso, Guido M
Mini-implants are used to improve orthodontic anchorage, but optimal composition and surface characteristics have yet to be determined. We investigated the behavior of osteoblast-like cells on grade 4 commercially pure titanium and grade 5 titanium alloy with different surface treatments for mini-implants. MC3T3 cells were plated on machined, acid-etched, or acid-etched grade 4 titanium enriched with calcium phosphate, or machined, anodized, or anodized and calcium phosphate-enriched grade 5 titanium disks. Surface and cell morphologies were assessed by scanning electron microscopy. Cell viability was measured by chemiluminescence, cytoskeletal organization was investigated by immunofluorescence, and real-time polymerase chain reaction for osteoblast-specific genes was performed to measure cell differentiation. Flattened shapes and strong stress fibers were observed on the machined surfaces; cells on the rough surfaces had a spindle shape, with lower cytoskeletal polarization. Cell proliferation was highest on smooth grade 4 titanium surfaces, whereas cells quickly reached a plateau on rough grade 4 titanium; no difference was observed after 72 hours in the grade 5 titanium groups. Calcium phosphate enrichment on grade 4 titanium significantly increased the messenger RNA levels for alkaline phosphatase and osteocalcin. Osteoblastic markers were higher on the grade 5 titanium machined surfaces than on the rough surfaces, and comparable with acid-etched grade 4 titanium. Although the grade 4 titanium enriched with calcium phosphate had the highest level of differentiation in vitro, the grade 5 titanium machined surfaces supported cell proliferation and matrix synthesis, and induced high expression of early differentiation markers. Increased mechanical resistance of grade 5 titanium makes it a potential candidate for orthodontic mini-implants. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Baygin, Ozgul; Tuzuner, Tamer; Ozel, Mehmet-Birol; Bostanoglu, Ozge
To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (CervitecPlus); Group 2 (n=20): CervitecPlus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (CervitecGel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T₁, one week after orthodontic bonding; T₂, one week; and T₃, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P<0.017). Significantly lower MS and LB levels were found in Group 2 than Group 1 (T₂) and 3 (T₂, T₃) (P<0.017). Groups 1-2 (T₂) showed significantly higher BC (P<0.017) and lower VPI and GBI (P<0.017) scores compared with Group 3. Decreased MS levels at T₂ (P<0.017) and T₃ (P>0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T₂ compared with T₀ (P<0.017) while no significant differences were seen in Group 1 and 3 (P>0.017). Addition of CervitecPlus+CervitecGel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis.
Baheti, Mayuresh Jagannath; Toshniwal, Nandlal
Smartphone usage has spread to many settings including that of healthcare and dentistry with numerous potential and realized benefits. The ability to download custom-built software applications (apps) has created new opportunities for orthodontists to integrate technology into clinical practice and patients to collect the information about orthodontics and help them during their treatment. The purpose of this study is to provide a summary of the orthodontic apps currently available for orthodontic patients as well as 'practicing clinicians'. Three smartphones and two tablets were used to search three operating systems (Android, Apple, and Windows) using the keywords 'braces', 'orthodontist', 'model analysis', and 'orthodontics'. Android and Apple operating systems accumulate all of the apps that are thought to be related to orthodontic clinicians and patients. Clinician's apps (17) are those related to orthodontic news (2), publication (4), products (3), and diagnosis (4) and practice management (3) while patient apps (17) are those related to orthodontic education (4), simulator (5), related to reminding patients about elastic wear (3), progress tracker of treatment (4), and orthodontic products (1). In the generation of technology, the use of smartphones and tablets has made life simple. The use of these technologies can be a boon both for the orthodontist and the patients as it aids both in treatment planning and progress in enhancing the treatment outcome.
Romeo García, A; González Blanco, A
Quick Ceph is a program to help in orthodontic diagnosis, which is not limited to lateral cephalometric analysis but also allows, thanks to the Macintosh graphic interface the simulation of all orthodontic and surgical movements and so this to establish a treatment plan.
Akharzouz, Caroline; Chauty, Sarah; Bodard, Anne-Gaëlle
Currently, 1 out of 900 adults from the ages of 16 to 44 is a survivor of childhood cancer. The global rate of survival for all types of childhood cancer is close to 80% and progress in treatment and care continues to offer promising results. In the years following treatment, these children, just like other healthy children, should have access to orthodontic care in spite of their chronic health problems. A transverse epidemiological study was conducted at the Leon Bernard Cancer Treatment Center in Lyon in order to respond to these requests and to assist orthodontists with the therapeutic difficulties presented by these patients. Our objective was to identify the orthodontic treatment required for children 7 years old or older who received antineoplastic therapy with radiation of the cranio-cervico-facial region. The results show that children who received radiation therapy in the cranio-facial region presented delayed growth, facial asymmetry in 74% of the cases, overbite and overjet increased respectively in 70% and 61% of the cases. Dental discrepancies in development were present in 83% of the patients who presented with stunted teeth, premature closing of the apices and hypoplasias. We found sialopathy such as reduced saliva flow rate. Finally, considerable treatment was necessary in 61% of the cases and moderate treatment for 17% of the cases, because of missing teeth, retained deciduous teeth or an increased overjet. © EDP Sciences, SFODF, 2013.
Sharma, Anshika; Mathur, Anmol; Batra, Manu; Makkar, Diljot Kaur; Aggarwal, Vikram Pal; Goyal, Nikita; Kaur, Puneet
ABSTRACT Objective: To investigate the presence of association between objective and subjective evaluation of orthodontic treatment needs in adolescents and their impact on their self-esteem. Methods: Cross-sectional study with adolescents aged 10-17 years old in Sri Ganganagar city, Rajasthan, India. The objective index of orthodontic treatment need (IOTN) dental health component (DHC) and the subjective aesthetic component (AC) were used to determine the normative and the self-perception need for orthodontic treatment, respectively. The selected students were further examined for dental trauma, tooth loss, and dental caries. Rosenberg Self-Esteem Scale was applied for self-esteem level determination. Linear regression analysis was executed to test the individual association of different independent clinical variables with self-esteem scores. Results: Among 1,140 studied adolescents, the prevalence of dental normative orthodontic treatment need was in 56.9% of individuals, whereas 53.3% of individuals considered themselves as needy for the treatment. Multivariate analyses revealed that out of all dental disorders, DHC followed by AC of IOTN had maximum impact on the self-esteem of the adolescence. Conclusions: Dissatisfaction with dental appearance is a strong predictor for low self-esteem in adolescence. PMID:28977320
Türp, Jens Christoph; Lünsch, Heinz; Radlanski, Ralf Johannes
The aim of this report is to examine clues of a suspected link between the artificial ingestion of human growth hormone (rh- GH) and resulting interdental spaces in adult athletes. We conducted an electronic search in the German-language versions of the search engines Google and Google Scholar as well as in the database PubMed. While no explicit articles could be identified in PubMed, the search in Google and Google Scholar produced 1370 and 6 hits, respectively. Original quotes from 20 sources show that in the media the wearing of orthodontic multibracket appliances among athletes is largely attributed to changes in tooth position as a consequence of the illegal ingestion of rhGH. On the other hand, there are few references to the possibility that orthodontic treatments with fixed appliances might be carried out for reasons unrelated to doping. A definitive assessment of this issue is not possible at present. In view of its major importance of the subject, the relationships depicted here should be investigated in greater depth.
Chojnacka, Katarzyna; Mikulewicz, Marcin
The kinetics of metal ions release from orthodontic appliances in in vitro, in in vivo on pigs, and in vivo trials on patients (where hair samples were taken) was discussed. We have evaluated (by means of ICP-OES and ISO 17025) and compared the mass of Cr and Ni ions released. Not all the metal ions released from the appliance were transferred to hair tissue. The transfer factor was expressed as coefficient ω and evaluated as: ωCr(patients) 33.0%, ωCr(pigs) 17.2%, ωNi(patients) 49.8%, ωNi(pigs) 0.553%. The kinetics was described by a power function. Coefficient ω was used to combine the models: the in vitro and in vivo on animals on the one hand and the in vitro and in vivo on human on the other, which enabled the extrapolation of in vitro and translation of the results into in vivo conditions. The dose of metal ions released during orthodontic treatment was estimated. Copyright © 2014 Elsevier B.V. All rights reserved.
Lin, Jiu-Xiang; Xu, Tian-Min
Orthodontics in China has experienced two important stages. At its early stage from 1950's to 1970's orthodontics was a division of prosthodontic department in China. There were 3 top professors in this field, who got partly training at one time or another in USA and returned to China working in Beijing Medical College, the Fourth Military Medical University and Shanghai Second Medical College. Among them, Professor Mao of Beijing Medical College was regarded as the father of Chinese Orthodontics. Removable appliance was the main tool at that stage and Prof.Mao brought forward Mao's Classification of Malocclusion which is still used in China. The rapid developing stage began in the 1980's when China opened its door to the world. More and more orthodontists got further training abroad and brought back advanced techniques since then. Up to now, we have already had more than one thousand of orthodontic specialists and established its own organization--the Chinese Orthodontic Society (COS), which holds domestic orthodontic meetings and organize its members to attend international meetings. Right now, almost all advanced techniques in diagnosis and treatment are adopted in China, including 3D imaging, self-ligating bracket appliance, and implant anchorage. Chinese orthodontists have started to present or publish papers in international meetings and journals and more than that, started to develop new appliances, such as Driving-Force Straight Wire Appliance, which has shown advantages in treating skeletal Class III malocclusion.
Sabea Hammood, Ali; Faraj Noor, Ahmed; Talib Alkhafagy, Mohammed
Heat treatment is necessary for duplex stainless steel (DSS) to remove or dissolve intermetallic phases, to remove segregation and to relieve any residual thermal stress in DSS, which may be formed during production processes. In the present study, the corrosion resistance of a DSS in artificial saliva was studied by potentiodynamic measurements. The microstructure was investigated by scanning electron microscopy (SEM),x-ray diffraction (XRD) and Vickers hardness (HV). The properties were tested in as–received and in thermally treated conditions (800–900 °C, 2–8 min). The research aims to evaluate the capability of DSS for orthodontic applications, in order to substitute the austenitic grades. The results indicate that the corrosion resistance is mainly affected by the ferrite/austenite ratio. The best result was obtained with a treatment at 900 °C for 2 min.
Siddiqui, Tania Arshad; Shaikh, Attiya; Fida, Mubassar
Objectives The primary objective of the study was to assess the agreement between orthodontist and patient perception regarding the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN-AC) at pre-orthodontic treatment levels. The secondary objective was to determine how well the subjective assessment of malocclusion (IOTN-AC) correlated with the normative Dental Health Component of the IOTN (IOTN-DC). Materials and methods A cross-sectional analytical study was conducted on patients between the ages of 16 and 25, presenting for initiation of orthodontic treatment with no history of prior orthodontic treatment. The mean age of the total sample population was 19.50 ± 3.15 years. The mean age of the males was 19.05 ± 3.09 years and for females it was 19.75 ± 3.18 years. The sample consisted of 41 males and 80 females. Patients were shown their pretreatment monochrome intraoral frontal photographs to rate according to the IOTN-AC. Simultaneously, the orthodontist reviewed the photographs with each patient. The IOTN-DHC of pretreatment casts was also recorded by the orthodontist. The frequency of specific traits that had led to increased severity of malocclusion was also identified. All readings were recorded manually on a data collection form. The data were assessed using the chi-square test, Spearman’s correlation and Cohen’s kappa test. Intra- and inter-examiner reliability was assessed using Spearman’s correlation. Results A significant positive relationship (p < 0.05) was observed between orthodontist and patient perception (r = 0.516), orthodontist perception and the normative need (r = 0.430), and between the patient perception and the normative need (r = 0.252). A statistically significant level of agreement was observed between orthodontist and patient perception (kappa = 0.339, p ⩽ 0.001, 95% CI, 0.207–0.470) and between orthodontist perception and the normative need (kappa = 0.331, p ⩽ 0.001, 95% CI, 0
Cunningham, Susan J; Jones, Steven P; Hodges, Samantha J; Horrocks, Elisabeth N; Hunt, Nigel P; Moseley, Howard C; Noar, Joseph H
There has been tremendous progress in orthodontics since Edward Angle first popularised the fixed orthodontic appliance at the turn of the century. Recent years have seen an increased demand for orthodontic treatment from both adolescents and adults and, in addition, patient and clinician expectations of treatment outcomes continue to rise. A desire for more aesthetic materials has resulted in both smaller and 'tooth-coloured' appliances. Improvements in technology, often outside orthodontics, have also led to the development of new materials. The best example of this was the development of nickel titanium alloy by the NASA space programme, which was subsequently adapted for use in nickel titanium archwires. Other technological advances adopted for use in orthodontics include magnets, computerised imaging systems and distraction osteogenesis. This review paper looks at some of the innovations in the fields of materials as well as in techniques and appliance systems.
Yilmaz, Rahime Burcu Nur; Nalbantgil, Didem; Ozdemir, Fulya
The aims of this study were to evaluate the posttreatment outcomes in a postgraduate orthodontic clinic following a course on American Board of Orthodontics Cast and Radiograph Evaluation (ABO-CRE); to compare the outcomes of postgraduate students who took the course before and after finishing treatment of their cases; and to assess if the need for orthodontic treatment as determined by the Index of Orthodontic Treatment Need (IOTN) at the beginning of treatment affected students' final scores. A course on ABO-CRE was given to second- (group A), third- (group B), and fourth- (group C) year postgraduate students at Yeditepe University, Istanbul, Turkey, in 2012. Pre- and posttreatment plaster models of 253 cases (group A) were treated by students in 2011-12. An additional 251 (group B, 2012-13) and 341 (group C, 2013-14) cases were evaluated in the first and second years after the course, respectively. The models were graded retrospectively using the ABO-CRE and IOTN. The results showed that the total mean scores on the posttreatment plaster models were significantly higher in the pre-course group than the first- and second-year post-course group (p<0.05 and p<0.01, respectively). The borderline cases (grade 3) received a lower score on the ABO-CRE than the cases with need (grade 4) (p<0.01) and severe need (grade 5) (p<0.01) for orthodontic treatment. Increasing awareness by giving information about the ABO-CRE significantly improved the posttreatment success of these postgraduate students. After the course, treatment outcomes in the following year were better than two years later, suggesting it may be useful to teach the course annually to refresh students' knowledge.
Toodehzaeim, Mohammad Hossein; Haerian, Alireza; Alesaeidi, Ali
Proper diagnosis and prevention of malocclusion are superior to treatment. Discrepancy between arch length and tooth size in mixed dentition period is a condition requiring timely diagnosis. Estimating the mesiodistal width of unerupted teeth according to the size of erupted ones can lead to earlier diagnosis of malocclusion. On the other hand, the best timing for serial extractions is before the eruption of lateral incisors. The aim of this study was to present prediction formulas for mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population based on the width of erupted permanent mandibular central incisors and maxillary first molars. A total of 120 dental models (60 males, 60 females) of orthodontic patients between 11-25 years were evaluated in Yazd city. The measurements were made by a digital caliper on the widest mesiodistal width of teeth at the interproximal contacts. Data were analyzed to calculate the prediction equation. The prediction equation in the upper jaw was y=0.57x+10.82 for males, y=0.7x+6.37 for females and y=0.64x+8.46 for both sexes. The equation for the lower jaw was y=0.76x+2.86 for males, y=0.74x+3.53 for females and y=0.77x+2.7 for both sexes. The prediction equations suggested in this study can predict the mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population in early mixed dentition period without taking radiographs.
Toodehzaeim, Mohammad Hossein; Haerian, Alireza
Objectives: Proper diagnosis and prevention of malocclusion are superior to treatment. Discrepancy between arch length and tooth size in mixed dentition period is a condition requiring timely diagnosis. Estimating the mesiodistal width of unerupted teeth according to the size of erupted ones can lead to earlier diagnosis of malocclusion. On the other hand, the best timing for serial extractions is before the eruption of lateral incisors. The aim of this study was to present prediction formulas for mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population based on the width of erupted permanent mandibular central incisors and maxillary first molars. Materials and Methods: A total of 120 dental models (60 males, 60 females) of orthodontic patients between 11–25 years were evaluated in Yazd city. The measurements were made by a digital caliper on the widest mesiodistal width of teeth at the interproximal contacts. Data were analyzed to calculate the prediction equation. Results: The prediction equation in the upper jaw was y=0.57x+10.82 for males, y=0.7x+6.37 for females and y=0.64x+8.46 for both sexes. The equation for the lower jaw was y=0.76x+2.86 for males, y=0.74x+3.53 for females and y=0.77x+2.7 for both sexes. Conclusions: The prediction equations suggested in this study can predict the mesiodistal width of unerupted lateral incisors, canines and premolars in an Iranian population in early mixed dentition period without taking radiographs. PMID:28243298
Baheti, Kamalshikha; Raghav, Shweta; Kanungo, Himanshu; Pharande, Amol J; Patil, Chetan; Jawale, Bhushan
The aim was to evaluate satisfaction of the parents of children who have undergone orthodontic treatment provided by their orthodontists and pediatric dentists in their private practice. A total of 412 parents were interviewed with the help of a questionnaire containing information such as demographic part, experience of braces, motives for orthodontic treatment, complications faced during the procedure and reasoning for satisfaction. Student's t-test was applied to analyze the results. The level of significance was set at P = 0.05. A higher level of satisfaction was seen in parents of children treated by pedodontists (mean score of satisfaction = 0.752) when compared with those treated by orthodontists (mean score of satisfaction = 0.631) which was statistically significant. Parents of girl patients showed a higher mean score of satisfaction (1.021) when compared with those of boy patients (0.321), which was also statistically significant. It can be concluded that the pedodontists performed orthodontic treatment to a similar standard as orthodontists, in fact they proved to be better in terms of patient care and behavior management as the parental satisfaction in the quality of orthodontic care was more with pediatric dentists than with orthodontists in this study.
Chen, Kaiyun; Zheng, Yi; Wang, Xin
One of the prime concerns of both the orthodontist and the oral surgeon must be the final soft tissue profile and the esthetic appearance of the patient. The purpose of this study was to evaluate the amount, direction, and predictability of the soft tissue changes associated with simultaneous skeletal changes. The authors analyzed the recent 22 cases with skeletal class II maloclusion in Orthodontic Department, College of Stomatology, West China University of Medical Sciences with 7 male and 15 female from 20 to 30 years old. Each patient was taken standardized lateral cephalograms before the treatment and 6-12 months after the treatment. A total of 16 hard and soft tissue landmarks were evaluated in both horizontal and vertical directions. In the horizontal directions, the soft tissue maxillary landmarks (superior labial sulcus, labrale superius, and upper lip stomion) moved posterior with a range of 2.17 to 2.33 mm. The strongest correlations were found between the posterior movement of the upper incisal edge and the three soft tissue parameters: superior labial sulcus r = 0.78, labrale superius r = 0.81, upper lip stomion r = 0.75. The soft/hard tissue ratios of the mandible anterior movement is 0.83:1 between inferior labial sulcus and B point, and 0.95:1 for Pog' to Pog. In the vertical directions, all the soft tissue mandible landmarks (Pog', inferior labial sulcus, labrale inferius, lower lip stomion) moved upward more than 2 mm. And the soft/hard tissue ratio is from 1.07:1 to 1.34:1. The combined orthodontic and surgical treatment is an efficient way to cure skeletal class II malocclusion. All the patients regained satisfactory face appearance and profile. Although the soft tissue movement is less than the hard tissue in both jaws in the horizontal direction, the vertical movement of the mandibular soft tissue is greater than that of the underlying hard tissue.
Yagi, Masakazu; Ohno, Hiroko; Takada, Kenji
Development of the decision-making systems has been highly demanded to provide objective evidence for the decisions of experts, especially in medicine, and a variety of systems have been developed by means of the state-of-the-art technology. In orthodontics, there has been no objective criterion for the decisions of whether or not to perform one of the invasive treatments, tooth extraction. Therefore, the prediction system for the extraction-nonextraction decisions was developed by intuitive implementation of expertise knowledge in this study. The system was successfully optimized with respect to knowledge descriptions and an inference algorithm to provide the prediction accuracy of 90.5% and simulations of the decision-making process on the optimized model were performed to obtain the terse representation of the expertise knowledge elements that are assumed to affect the decision-making of experts.
Perillo, Letizia; Esposito, Maria; Caprioglio, Alberto; Attanasio, Stefania; Santini, Annamaria Chiara; Carotenuto, Marco
Background Dental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents. Materials and methods The study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects. Results Pearson’s analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492–8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545–10.678) as risk factors for development of global self-concept score abnormalities. Conclusion Our findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents. PMID:24672229
Bröchner, Ann; Christensen, Carsten; Kristensen, Bjarne; Tranæus, Sofia; Karlsson, Lena; Sonnesen, Liselotte; Twetman, Svante
This study aims to investigate the effect of topical applications of 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSL) detected after treatment with fixed orthodontic appliances. Sixty healthy adolescents with ≥1 clinically visible WSL at debonding were recruited and randomly allocated to a randomised controlled trial with two parallel groups. The intervention group was instructed to topically apply a CPP-ACP -containing agent (Tooth Mousse, GC Europe) once daily and the subjects of the control group brushed their teeth with standard fluoride toothpaste. The intervention period was 4 weeks and the endpoints were quantitative light-induced fluorescence (QLF) on buccal surfaces of the upper incisors, cuspids and first premolars and visual scoring from digital photos. The attrition rate was 15%, mostly due to technical errors, and 327 lesions were included in the final evaluation. A statistically significant (p < 0.05) regression of the WSL was disclosed in both study groups compared to baseline, but there was no difference between the groups. The mean area of the lesions decreased by 58% in the CPP-ACP group and 26% in the fluoride group (p = 0.06). The QLF findings were largely reflected by the clinical scores. No side effects were reported. Topical treatment of white spot lesions after debonding of orthodontic appliances with a casein phosphopeptide-stabilised amorphous calcium phosphate agent resulted in significantly reduced fluorescence and a reduced area of the lesions after 4 weeks as assessed by QLF. The improvement was however not superior to the "natural" regression following daily use of fluoride toothpaste.
Cardoso, Chrystiane F; Drummond, Alexandre F; Lages, Elisabeth M B; Pretti, Henrique; Ferreira, Efigênia F; Abreu, Mauro Henrique N G
The present study assesses the validity and reproducibility of two occlusal indices for epidemiological studies--the Dental Aesthetic Index (DAI) and the Dental Health Component of the Index of Orthodontic Treatment Need (DHC-IOTN) for the identification of orthodontic treatment needs. The total of 131 study models was examined by an examiner (orthodontic specialist) for the determination of the DAI and DHC-IOTN. Thirty days later, further assessment was performed to determine the reproducibility. The duration of each exam was measured in seconds with a stopwatch. The indices were compared by a panel of three experts in orthodontics to evaluate validity. The intra-examiner reliability evaluation resulted in an intraclass correlation coefficient of 0.89 for the DAI (95% CI = 0.64 to 1.0) and 0.87 for the DHC-IOTN (95% CI = 0.56 to 0.96). The time spent on the evaluation of the DHC-IOTN was less than the time spent on that of the DAI (P < 0.001). The accuracy of the indices, as reflected by the area under the receiver-operating characteristic curve, was 61% for the DAI (95% CI = 51 to 70; p = 0.037) and 67% for the DHC-IOTN (95% CI = 58 to 77; p = 0.001). Both indices presented good reproducibility and validity.
Souki, Bernardo Quiroga; Bastos, Barbra Duque Costa; Araujo, Luana Fialho Ferro; Moyses-Braga, Wagner Fernando; Pantuzo, Mariele Garcia; Cheib, Paula Loureiro
The current concept for effective and efficient treatment of skeletal Class II malocclusion prescribes that interceptive approach should be delivered during the pubertal growth stage. However, psychosocial issues and a greater risk of dental trauma are also factors that should be addressed when considering early Class II therapy. This paper reports a case of a patient that sought orthodontic treatment due to aesthetic discomfort with the incisors' protrusion. Two previous treatments failed because patient's collaboration with removable appliances was inadequate. Given his history of no collaboration and because the patient was in the prepubertal stage, it was decided to try a different approach in the third attempt of treatment. Traumatic injury protective devices were used during the prepubertal stage and followed by Herbst appliance and fixed multibrackets therapy during the pubertal stage, resulting in an adequate outcome and long-term stability. PMID:25861486
Ferreira, Hugo M.; Botelho, Filomena; Carrilho, Eunice
Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption. PMID:26295028
Thiruvenkadam, G.; Asokan, Sharath; John, J. Baby; Geetha Priya, P. R.; Prathiba, J.
Aims: The aim of this study was to assess oral health-related quality of life (OHRQoL) using short form (SF) of child oral health impact profile (COHIP) in children aged 11–15 years who sought orthodontic treatment. A comparison was done between these children and age-matched peers who never had or sought orthodontic treatment. Methodology: This cross-sectional study included 227 children aged 11–15 years. A total of 110 participants had sought orthodontic treatment at KSR Institute of Dental Science and Research (orthodontic group) and 117 participants from a nearby school who had never undergone or sought orthodontic treatment (comparison group). OHRQoL was assessed with the SF of the COHIP, and malocclusion severity was assessed with the index of orthodontic treatment needs. Data presentation and statistical analysis were performed with the Statistical Package for the Social Sciences Software (Version 19, SPSS, Chicago, IL, USA). The Chi-square test and Fischer exact tests were used to analyze the qualitative data. Results: Children with little to borderline treatment needs have a better quality of life when compared to children with definitive treatment needs (P = 0.049). No statistically significant difference in COHIP-SF scores was found between boys and girls (P > 1.000). In the orthodontic group, children with little to borderline treatment needs were 4.8 times (P = 0.037) more likely to report better OHRQoL when compared to children with definitive treatment needs. Conclusion: Children who sought orthodontic treatment had lower quality of life scores than those who never had or never sought treatment. PMID:26321842
Boyd, Robert L
In this report, three patients were treated with a new treatment protocol for Invisalign to demonstrate that a variety of complex malocclusions can be successfully treated using this protocol, including correction of moderate crowding, correction of moderate Class II division 1, and deep overbite. Previous studies of Invisalign showed significant limitations for more complex orthodontic treatment, although a few recent case reports have shown successfully completed moderate to difficult orthodontic malocclusions. One reason for the discrepancy is that the earlier studies were done during the first four years of the appliance development (now ten years of clinical use), when significant problems existed with accomplishing bodily movement, torquing of roots, extrusions, and rotations of premolars and canines. The new protocol included new methods for anterior/posterior corrections, showing on the computer the effect of elastics for Class II treatment simulated as a one-stage anterior/posterior movement at the end of treatment. Staging for interproximal reduction (IPR) is now automatically staged when there is better access to interproximal contacts to avoid IPR where significant overlap between teeth is present to avoid performing IPR on surfaces that may be damaged by instruments such as burs, strips, and disks when cut on a sharp angle. Staging for tooth movements is now also done to enable combination movements to occur simultaneously for each tooth with the tooth that needs to move the most (the lead tooth) determining the minimum number of stages required. All other teeth move at a slower rate than the lead tooth throughout the duration of treatment. Attachments are now placed in the middle of the crown automatically for rotation and automatically sized in proportion to the clinical crown. Use of 1 mm thick (buccal-lingual dimension) horizontal beveled rectangular attachments is standard on premolars for retention of aligners during intrusive movements, such as
Dunbar, A Craig; Bearn, David; McIntyre, Grant
The purpose of this pilot study was to assess whether orthodontic treatment planning is reproducible when carried out using digital records compared with clinical examinations or using standard records. The study also assessed patients' opinion of face-to-face consultations and potential use of teleorthodontics. The study was designed as a prospective observational cross-sectional pilot study and carried out in a UK dental teaching hospital involving 27 subjects. Four consultant Orthodontists carried out treatment planning, firstly following a clinical examination, then using standard records, and then using digital records. Each subject completed a questionnaire. Cohen's kappa coefficient and Fleiss' kappa coefficient were used to assess intra-observer reproducibility and inter-observer reproducibility of treatment planning decisions, respectively. A change in the diagnostic information format affected treatment planning reproducibility for half of the observers. Inter-observer reproducibility was greater when using hard copy records in comparison to digital records. No subjects were unsatisfied with their face-to-face consultation.
Messaoudi, Yassine; Coudert, Jean-Loup; Aknin, Jean-Jacques
The aim of this investigation was to present and evaluate an original method of mini-invasive oral surgery and orthodontics based on 3D images from a computed tomography software (3DNEO(®), 3DNEOVISION). Three patients with impacted teeth were examined and their data were analyzed with this software based on the "region growing" method. Several clinical interests emerge : locate and visualize precisely the relationships of the impacted tooth with the adjacent anatomical elements under the desired angle, associate/dissociate the different elements of the 3D scene, measure the distances, calculate the axes of traction, materialize the way of traction and the optimal point for bonding, prepare virtually the surgical exposure and orthodontic treatment plan. This 3D method might provide information for improved diagnosis and treatment plans in order to ultimately result in more successful treatment outcomes and better care for patients. © EDP Sciences, SFODF, 2013.
Huynh, Nelly T; Desplats, Eve; Almeida, Fernanda R
A small maxilla and/or mandible may predispose children to sleep-disordered breathing, which is a continuum of severity from snoring to obstructive sleep apnea. Preliminary studies have suggested that orthodontic treatments, such as orthopedic mandibular advancement or rapid maxillary expansion, may be effective treatments. The aim is to investigate the efficacy of orthopedic mandibular advancement and/or rapid maxillary expansion in the treatment of pediatric obstructive sleep apnea. Pubmed, Medline, Embase, and Internet were searched for eligible studies published until April 2014. Articles with adequate data were selected for the meta-analysis; other articles were reported in the qualitative assessment. Data extraction was conducted by two independent authors. A total of 58 studies were identified. Only eight studies were included in the review; of these, six were included in the meta-analysis. The research yielded only a small number of studies. Consequently, any conclusions from the pooled diagnostic parameters and their interpretation should be treated carefully. Although the included studies were limited, these orthodontic treatments may be effective in managing pediatric snoring and obstructive sleep apnea. Other related health outcomes, such as neurocognitive and cardiovascular functions have not yet been systematically addressed. More studies are needed with larger sample size, specific inclusion and exclusion criteria and standardized data reporting to help establish guidelines for the orthodontic treatment of pediatric obstructive sleep apnea. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ferreira, José Tarcísio Lima; Romano, Fábio Lourenço; Sasso Stuani, Maria Bernadete; Assed Carneiro, Fábio Carvalho; Nakane Matsumoto, Mírian Aiko
This case report describes the successful traction of 2 severely impacted canines. The patient, a 7-year-old girl, had good general health, nasal breathing, crossbite of the lateral incisors and canines, and a Class I molar relationship. The panoramic radiograph showed that the permanent canines were positioned above the roots of the lateral incisors, with the right canine in an accentuated inclination. The cephalometric analysis showed a skeletal Class III malocclusion with a predominance of horizontal growth. The Haas appliance associated with maxillary protraction was used during the first stage of treatment for 14 months. The second stage included the extraction of the deciduous molars, distal movement of the permanent molars to create space, and traction of the canines, and was associated with complete orthodontic treatment. The patient showed good esthetic and functional results at the end of treatment, verified by the stability over a period of 8 years after retention. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
de Almeida Cardoso, Mauricio; de Molon, Rafael Scaf; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo
The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.
Chang, H S; Walsh, L J; Freer, T J
Fixed orthodontic treatment has been shown to cause an increased incidence of enamel demineralisation. The purpose of this study was to investigate the changes in stimulated salivary flow rate, pH, buffer capacity, and the levels of mutans streptococci (MS) and lactobacilli in patients undergoing therapy with fixed orthodontic appliances. Saliva samples, plaque index scores and dietary histories were taken from 21 sequential patients before the start of treatment, and one month and three months after placement of brackets and bands. There was a statistically significant increase in stimulated salivary flow rate, pH, buffer capacity, plaque index scores, and in the levels of MS and lactobacilli after three months of active treatment. It is postulated that the balance between the cariogenic challenge posed by high levels of MS and lactobacilli, and the reparative effects of concurrent increases in salivary flow rate, pH and buffer capacity, determines the likelihood of mineral loss or gain over time. A failure to follow basic preventive measures may increase the risk for some patients of enamel decalcification during orthodontic treatment with fixed appliances.
de Almeida Cardoso, Mauricio; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo
The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects. PMID:26877982
de Couto Nascimento, Vanessa; de Castro Ferreira Conti, Ana Cláudia; de Almeida Cardoso, Maurício; Valarelli, Danilo Pinelli; de Almeida-Pedrin, Renata Rodrigues
To evaluate whether orthodontic treatment in adults requiring oral rehabilitation is effective for increasing patients' self-esteem and quality of life (QoL). The sample consisted of 102 adult patients (77 women and 25 men) aged between 18 and 66 years (mean, 35.1 years) requiring oral rehabilitation and orthodontic treatment simultaneously. Rosenberg's Self-Esteem (RSE) Scale and a questionnaire about QoL based on the Oral Health Impact Profile (OHIP-14) were used to determine self-esteem and QoL scores retrospectively. Questionnaires were carried out in two stages, T1 (start of treatment) and T2 (6 months after). To compare score changes between T1 and T2, the data obtained from the RSE Scale were evaluated with paired t tests, and data from the quality-of-life questionnaire were assessed by applying descriptive statistics. The results showed a statistically significant increase in self-esteem (P < .001) and a great improvement on patients' QoL. Orthodontic treatment causes a significant increase in self-esteem and QoL, providing psychological benefits for adult patients in need of oral rehabilitation.
Takahashi, Ichiro; Kawamura, Hiroshi; Takano-Yamamoto, Teruko
This case report describes the treatment of a woman with severe mandibular retrusion and maxillomandibular transverse deficiency. Her malocclusion was characterized by a large overjet, a deep overbite, and a V-shaped dental arch, and she had a skeletal Class II profile. Treatement included combined maxillary and mandibular midline expansion, maxillary downward repositioning, and mandibular ramus lengthening with distraction osteogenesis with implants as orthodontic anchorage. During the postdistraction orthodontic treatment period, some skeletal relapse occurred. Implants provided absolute orthodontic anchorage to overcome the unexpected skeletal changes. Combined orthodontic treatment with implants for anchorage and distraction osteogenesis successfully expanded the maxilla and the mandible and corrected the mandibular deficiency. Two-year follow-up records show a morphologically and functionally stable result. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Ishihara, Yoshihito; Tomikawa, Kazuya; Deguchi, Toru; Honjo, Tadashi; Suzuki, Koji; Kono, Takayuki; Kuboki, Takuo; Kamioka, Hiroshi; Takashiba, Shogo; Yamashiro, Takashi
Aggressive periodontitis is a great challenge to clinicians when providing orthodontic treatment because of the potential for progression of periodontal disease. In this article, we report the successful comprehensive orthodontic treatment of bimaxillary protrusion and severe crowding in an adult with generalized aggressive periodontitis. A woman, aged 22 years 7 months, with a chief complaint of incisal crowding was diagnosed with a skeletal Class I malocclusion associated with severe anterior crowding, possibly worsened by generalized aggressive periodontitis. In addition to a periodontal examination, a blood IgG antibody titer analysis and microbiologic examination for periodontal pathogens were used to diagnose the type of periodontal disease and determine the proper timing to initiate orthodontic treatment. The total active treatment period was 28 months, followed by periodontal prostheses and regeneration therapy. Consequently, satisfactory facial profile, occlusion, and periodontal health were maintained for at least 36 months. These results indicate that efficient screening is important for providing successful orthodontic treatment in patients with advanced periodontal disease. This report also demonstrates the diagnostic importance of blood IgG antibody titer assays and microbiologic examinations to detect periodontal pathogens. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Shah, Neha D; Arruda, Airton; Inglehart, Marita R
The objectives of this study is to explore the relationship between pediatric patients' orthodontic treatment need, the patients' assessments of their smile-related quality of life (QoL), their parents' proxy assessment of their child's QoL and own assessments of their child's smile, and the patients' objectively assessed smiling patterns. Survey data were collected from 102 patients (53 boys/49 girls; age range: 9-13 years) and their parents. Orthodontic treatment need was assessed with the Index of Complexity, Outcome, and Need (ICON). Smiling patterns were determined by videotaping patients' smiles while they watched a cartoon. Thirty predetermined sections of these tapes were then assessed by two independent raters to measure the patients' smiling patterns. The aesthetic component and total ICON scores correlated with the patients' smile-related QoL (r = 0.25; P = 0.014/r = 0.23; P = 0.024), parental proxy assessments of the child's smile-related QoL (r = 0.29; P= 0.004/r = 0.26; P= 0.009), the parents' own assessments of their child's smile (r= 0.32; P= 0.002/ r = 0.29; P = 0.005), and the number of negative adjectives chosen by the parents to describe their child's smile (r= 0.32; P = 0.002/r = 0.30; P = 0.004). Although the smiling patterns were correlated with the patients' smile-related QoL responses (height of smile: r = 0.29; P = 0.005/number of teeth shown: r = 0.30; P = 0.004), the ICON scores were not correlated with the patients' smiling patterns. Objectively assessed orthodontic treatment need correlates with the patients' and parents' assessments of the child's smile-related QoL scores. However, while objective smiling patterns are related with the patients' smile-related QoL, they are not correlated with the patients' orthodontic treatment need.
Thanks to alignment, bleaching and bonding, cosmetic dentistry is rising. The cases presented in this article are treated through minimal invasive dentistry linked to orthodontics. © EDP Sciences, SFODF, 2013.
Liu, Chang; Jiang, Yu-Xi; Qu, Hong; Li, Cui-Ying; Jiang, Jiu-Hui
Objective In the current study, we aimed to investigate the effects of alveolar decortication on local bone remodeling, and to explore the possible mechanism by which decortication facilitates tooth movement. Materials and Methods Forty rabbits were included in the experiment. The left mandible was subjected to decortication-facilitated orthodontics, and the right mandible underwent traditional orthodontics as a control. The animals were sacrificed on the days 1, 3, 5, 7 and 14, after undergoing orthodontic procedures. Tooth movement was measured by Micro-CT, and the local periodontal tissues were investigated using H&E, Masson's trichrome and tartrate-resistant acid phosphatase (TRAP) staining. The mRNA levels of genes related to bone remodeling in the alveolar bone were analyzed using real-time PCR. Result On days 3, 5, 7 and 14, tooth movement was statistically accelerated by decortication (P < 0.05) and was accompanied by increased hyperemia. Despite the lack of new bone formation in both groups, more osteoclasts were noted in the decorticated group, with two peak counts (P < 0.05). The first peak count was consistent with the maximum values of ctsk and TRAP expression, and the second peak counts accompanied the maximum nfatc1 and jdp2 expression. The increased fra2 expression and the ratio of rankl/opg also accompanied the second peak counts. Conclusions Following alveolar decortication, osteoclastogenesis was initially induced to a greater degree than the new bone formation which was thought to have caused a regional acceleratory phenomenon (RAP). The amount of steoclastogenesis in the decorticated alveolar bone was found to have two peaks, perhaps due to attenuated local resistance. The first peak count in osteoclasts may have been due to previously existing osteoclast precursors, whereas the second may represent the differentiation of peripheral blood mononuclear cells which came from circulation as the result of hyperemia. PMID:27096621
Cumerlato, Marina; Lima, Eduardo Martinelli de; Osorio, Leandro Berni; Mota, Eduardo Gonçalves; Menezes, Luciane Macedo de; Rizzatto, Susana Maria Deon
The aim of this in vitro study was to evaluate and compare the effects of grinding, drilling, sandblasting, and ageing prefabricated teeth (PfT) on the shear bond strength (SBS) of orthodontic brackets, as well as the effects of surface treatments on the adhesive remnant index (ARI). One-hundred-ninety-two PfT were divided into four groups (n = 48): Group 1, no surface treatment was done; Group 2, grinding was performed with a cylindrical diamond bur; Group 3, two drillings were done with a spherical diamond bur; Group 4, sandblasting was performed with 50-µm aluminum oxide. Before the experiment, half of the samples stayed immersed in distilled water at 37oC for 90 days. Brackets were bonded with Transbond XT and shear strength tests were carried out using a universal testing machine. SBS were compared by surface treatment and by ageing with two-way ANOVA, followed by Tukey's test. ARI scores were compared between surface treatments with Kruskal-Wallis test followed by Dunn's test. Surface treatments on PfT enhanced SBS of brackets (p< 0.01), result not observed with ageing (p= 0.45). Groups II, III, and IV showed higher SBS and greater ARI than the Group 1 (p< 0.05). SBS was greater in the groups 3 and 4 (drilling, sandblasting) than in the Group 2 (grinding) (p< 0.05). SBS and ARI showed a positive correlation (Spearman's R2= 0.57; p< 0.05). Surface treatment on PfT enhanced SBS of brackets, however ageing did not show any relevance. Sandblasting and drilling showed greater SBS than grinding. There was a positive correlation between SBS and ARI.
Cumerlato, Marina; de Lima, Eduardo Martinelli; Osorio, Leandro Berni; Mota, Eduardo Gonçalves; de Menezes, Luciane Macedo; Rizzatto, Susana Maria Deon
ABSTRACT Objective: The aim of this in vitro study was to evaluate and compare the effects of grinding, drilling, sandblasting, and ageing prefabricated teeth (PfT) on the shear bond strength (SBS) of orthodontic brackets, as well as the effects of surface treatments on the adhesive remnant index (ARI). Methods: One-hundred-ninety-two PfT were divided into four groups (n = 48): Group 1, no surface treatment was done; Group 2, grinding was performed with a cylindrical diamond bur; Group 3, two drillings were done with a spherical diamond bur; Group 4, sandblasting was performed with 50-µm aluminum oxide. Before the experiment, half of the samples stayed immersed in distilled water at 37oC for 90 days. Brackets were bonded with Transbond XT and shear strength tests were carried out using a universal testing machine. SBS were compared by surface treatment and by ageing with two-way ANOVA, followed by Tukey’s test. ARI scores were compared between surface treatments with Kruskal-Wallis test followed by Dunn’s test. Results: Surface treatments on PfT enhanced SBS of brackets (p< 0.01), result not observed with ageing (p= 0.45). Groups II, III, and IV showed higher SBS and greater ARI than the Group 1 (p< 0.05). SBS was greater in the groups 3 and 4 (drilling, sandblasting) than in the Group 2 (grinding) (p< 0.05). SBS and ARI showed a positive correlation (Spearman’s R2= 0.57; p< 0.05). Conclusion: Surface treatment on PfT enhanced SBS of brackets, however ageing did not show any relevance. Sandblasting and drilling showed greater SBS than grinding. There was a positive correlation between SBS and ARI. PMID:28902249
The purpose of this article is to review human craniofacial growth and development, especially the growth of the mandible, to clarify the relationship between obstructive sleep apnea (OSA) syndrome and craniofacial abnormality, and finally, to propose the hypothesis that negative pressure produced in the chest of the OSA child inhibits the growth of the mandible. Recently, the development of diagnosis and treatment of OSA syndrome has progressed rapidly; however, the prevention of OSA syndrome was merely seen. Craniofacial abnormality is reported as one of the causes of OSA syndrome. If craniofacial abnormality is determined only by genetics, it is difficult to manage the craniofacial skeleton to prevent OSA syndrome. The role of epigenetic factors on craniofacial growth and development is still controversial. However, if we stand on the functional matrix hypothesis, we can manage not only growth of the mandible but also the craniofacial skeleton as a whole. The author proposes the hypothesis that the negative pressure produced in the chest prohibits the growth of the mandible even if the patients have a capacity for growth and development; therefore, if this negative pressure disappears because of the removal of the tonsil and/or adenoids or by an orthodontic treatment to make a patency of the airway, the mandible may grow normally, and we can prevent or reduce a number of OSA syndromes in the future.
Abeleira, María Teresa; Pazos, Elisabeth; Ramos, Isabel; Outumuro, Mercedes; Limeres, Jacobo; Seoane-Romero, Juan; Diniz, Marcio; Diz, Pedro
Many patients with disability require orthodontic treatment (OT) to achieve adequate oral function and aesthetic appearance. The cooperation of disabled patients and of their parents is central to the success of OT, as treatment can involve ethical dilemmas. The aim of this study was to analyze the motivation, expectations and overall satisfaction with OT among parents of patients with disabilities. The parents of 60 disabled Spanish children with physical, mental and/or sensory impairment undergoing OT were surveyed on attitudes to OT and level of satisfaction with the outcomes. The survey consisted of 23 questions in 4 sections: attitude and adaptation, benefits, adverse effects, and level of satisfaction after completion of OT. A control group formed of the parents of 60 healthy children undergoing OT at the same institution were also surveyed. Parents of disabled children undergoing OT showed a high level of motivation and they are willing to collaborate in oral hygiene procedures. Adaptation to the removable appliances was poorer in disabled children but adaptation to fixed appliances was excellent. OT can provide a marked improvement in quality of life, social relationships and oral functionality in disabled children. Among parents of disabled children undergoing OT, the perceived level of overall satisfaction was very high and expectations were often exceeded.
Geramy, A.; Retrouvey, J.M.; Sobuti, F.; Salehi, H.
Objective: Retention after orthodontic treatment is still an important part of the treatment. Splints are considered as an alternative for removable retainers. The main goal of this study was to assess splinting biomechanically. Materials and Methods: Three dimensional finite element models (3D) were designed of a mandibular anterior segment which included six anterior teeth with their supporting tissues (model 1 as control) and with a bonded lingual fixed retainer in the two other models. The wire cross section was round (0.016”) in model 2 and rectangular (0.016” × 0.022”) in model 3. The models were designed in Solid Works 2006 and analyzed in ANSYS Workbench Ver. 11.0 SolidWorks Incisors were loaded with a vertical force of 187 N. PDL stress and tooth displacements were evaluated. Results: The numeric findings showed an increase after splinting in the central incisors [2.42 MPa to 4.57 MPa (round) and 16.66 (rectangular) MPa] in biting with four incisors. Biting with two incisors decreased the stress after splinting [2.42 MPa to 1.7 MPa (round wire) and 1.77 MPa (rectangular wire)]. In lateral movement, all teeth showed an increased stress except for the working side canine. Conclusion: Splinted cases (with round or rectangular wires) can benefit from stress redistribution when biting small food particles and in lateral movement. PMID:23066473
Geramy, A; Retrouvey, J M; Sobuti, F; Salehi, H
Retention after orthodontic treatment is still an important part of the treatment. Splints are considered as an alternative for removable retainers. The main goal of this study was to assess splinting biomechanically. Three dimensional finite element models (3D) were designed of a mandibular anterior segment which included six anterior teeth with their supporting tissues (model 1 as control) and with a bonded lingual fixed retainer in the two other models. The wire cross section was round (0.016") in model 2 and rectangular (0.016" × 0.022") in model 3. The models were designed in Solid Works 2006 and analyzed in ANSYS Workbench Ver. 11.0 SolidWorks Incisors were loaded with a vertical force of 187 N. PDL stress and tooth displacements were evaluated. The numeric findings showed an increase after splinting in the central incisors [2.42 MPa to 4.57 MPa (round) and 16.66 (rectangular) MPa] in biting with four incisors. Biting with two incisors decreased the stress after splinting [2.42 MPa to 1.7 MPa (round wire) and 1.77 MPa (rectangular wire)]. In lateral movement, all teeth showed an increased stress except for the working side canine. Splinted cases (with round or rectangular wires) can benefit from stress redistribution when biting small food particles and in lateral movement.
Shirvani, Amin; Sadeghian, Saeid; Abbasi, Safieh
This was a retrospective cephalometric study to develop a more precise estimation of soft tissue changes related to underlying tooth movment than simple relatioship betweenhard and soft tissues. The lateral cephalograms of 61 adult patients undergoing orthodontic treatment (31 = premolar extraction, 31 = nonextraction) were obtained, scanned and digitized before and immediately after the end of treatment. Hard and soft tissues, angular and linear measures were calculated by Viewbox 4.0 software. The changes of the values were analyzed using paired t-test. The accuracy of predictions of soft tissue changes were compared with two methods: (1) Use of ratios of the means of soft tissue to hard tissue changes (Viewbox 4.0 Software), (2) use of stepwise multivariable regression analysis to create prediction equations for soft tissue changes at superior labial sulcus, labrale superius, stomion superius, inferior labial sulcus, labrale inferius, stomion inferius (all on a horizontal plane). Stepwise multiple regressions to predict lip movements showed strong relations for the upper lip (adjusted R (2) = 0.92) and the lower lip (adjusted R (2) = 0.91) in the extraction group. Regression analysis showed slightly weaker relations in the nonextraction group. Within the limitation of this study, multiple regression technique was slightly more accurate than the ratio of mean prediction (Viewbox4.0 software) and appears to be useful in the prediction of soft tissue changes. As the variability of the predicted individual outcome seems to be relatively high, caution should be taken in predicting hard and soft tissue positional changes.
Chang, Chun-Shin; Wallace, Christopher Glenn; Hsiao, Yen-Chang; Chiu, Yu-Ting; Pai, Betty Chien-Jung; Chen, I.-Ju; Liao, Yu-Fang; Liou, Eric Jen-Wein; Chen, Philip Kuo-Ting; Chen, Jyh-Ping; Noordhoff, M. Samuel
Presurgical orthodontic treatment before secondary alveolar bone grafting (SABG) is widely performed for cleft lip/palate patients. However, no randomized controlled trial has been published comparing SABG outcomes in patients with, and without, presurgical orthodontic treatment. This randomized, prospective, single-blinded trial was conducted between January 2012 and April 2015 to compare ABG volumes 6 months postoperatively between patients with and without presurgical orthodontic treatment. Twenty-four patients were enrolled and randomized and 22 patients completed follow-up. Patients who had presurgical orthodontics before SABG had significantly improved inclination (p < 0.001) and rotation (p < 0.001) of the central incisor adjacent to the defect, significantly improved ABG fill volume (0.81 ± 0.26 cm3 at 6 months compared to 0.59 ± 0.22 cm3 p < 0.05) and less residual alveolar bone defect (0.31 ± 0.08 cm3 at 6 months compared to s 0.55 ± 0.14 cm3 p < 0.001) compared to patients who did not have presurgical orthodontic treatment. In conclusion, orthodontic treatment combined with SABG results in superior bone volume when compared with conventional SABG alone.
The purpose of this study was to evaluate the effects of malocclusion and orthodontic treatment on adolescent self-esteem. A total of 4509 middle school students were clinically evaluated for dental crowding. Lip protrusion was also measured with a specially designed ruler. Rosenberg's self-esteem scale was used to determine each subject's level of self-esteem. The results showed that sex played a role in the relationship between self-esteem and malocclusion. For the girls, crowding of the anterior teeth had significant effects on their self-esteem; however, there was no significant difference in the boys' self-esteem. After fixed orthodontic treatment, the girls had higher self-esteem than the untreated malocclusion group. Girls with an ideal profile and good tooth alignment also showed higher self-esteem than students with crowding or protrusion. This clinical study proved that malocclusion and fixed orthodontic treatment can affect self-esteem in adolescent girls. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Lee, Yun Ju; Lee, Tae Yeon
There is a lack of research to support the belief that root canal treatment can be considered for stopping or decreasing external apical root resorption (EARR). There is conflicting evidence as to whether root-filled teeth are more or less likely to experience EARR after orthodontic treatment. The purpose of this study was to compare the degree of EARR of root-filled teeth with that of contralateral teeth with vital pulp after fixed orthodontic treatment. The study sample consisted of 35 patients aged 25.23 ± 4.92 years who had at least 1 root-filled tooth before orthodontic treatment. Digital panoramic radiographs of each patient taken before and after orthodontic treatment were used to measure the EARR. The Student t test for matched pairs and the Pearson correlation analysis were applied. The mean EARR values were 0.22 (0.14, 0.35) for root-filled teeth and 0.87 (0.59, 1.31) for contralateral teeth with vital pulp, indicating significantly less EARR for root-filled teeth compared with the contralateral teeth with vital pulp after orthodontic treatment. EARR was influenced by the patient's age, treatment duration, treatment type, and periapical pathosis, but not by tooth type and sex. Root-filled teeth appear to be associated with significantly less EARR than are contralateral teeth with vital pulp. This study suggests that the possible complication of EARR in root-filled teeth may not be an important consideration in orthodontic treatment planning, and root canal treatment can be considered for stopping or decreasing EARR when severe EARR occurs during orthodontic treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
... Early menopause can cause symptoms such as hot flashes and vaginal dryness. Your health care provider can ... as natural menopause. Vaginal dryness or tightness Hot flashes Mood changes Lower sex drive Problems sleeping In ...
Zhang, Jin; Zhang, Ai-Min; Zhang, Zong-Mei; Jia, Jin-Lin; Sui, Xin-Xin; Yu, Lu-Rui; Liu, Hai-Tao
In this study, we aimed to investigate the efficacy of combined orthodontic-periodontic treatment in the treatment of patients with periodontitis and its effects on the levels of inflammatory cytokines. A total of 117 patients with periodontitis were randomly assigned to the basic group (receiving basic periodontic treatment, n = 58) and the combined group (receiving combined orthodontic-periodontic treatment, n = 59). In addition, 52 healthy people without periodontal disease were selected as the normal group. Probing depth, tooth mobility, plaque index, clinical attachment level, and sulcus bleeding index were recorded. ELISA was applied to detect gingival crevicular fluid (GCF) and serum levels of inflammatory cytokines. A 2-year clinical follow-up was conducted. Before treatment, the periodontal parameters (probing depth, tooth mobility, plaque index, clinical attachement level, and sulcus bleeding index) and GCF and serum levels of inflammatory cytokines (high-sensitivity C-reactive protein, interleukin-1β, interleukin-5, interleukin-6, interleukin-8, tumor necrosis factor-α, and prostaglandin E2) in the combined and basic groups were higher than those in the normal group. After 6 and 18 months of treatment, the periodontal parameters and GCF and serum levels of inflammatory cytokines decreased in the combined and basic groups. The periodontal parameters and the GCF and serum levels of inflammatory cytokines in the combined group were significantly lower than those in the basic group after 18 months of treatment. The combined group had a lower recurrence rate compared with the basic group. Combined orthodontic-periodontic treatment had good clinical efficacy in the treatment of periodontitis and could effectively decrease the levels of inflammatory cytokines. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Gómez de Diego, Rafael; Montero, Javier; López-Valverde, Nansi; Ignacio de Nieves, José; Prados-Frutos, Juan-Carlos; López-Valverde, Antonio
The aim of this study was to determine the association between facial pattern according to Ricketts cephalometric analysis, and prevalence of third molar agenesis, taking subject age and gender as control variables. An epidemiological survey was conducted based on a sample of 224 candidates for orthodontic treatment aged 12 to 24 (n=224). Third molar agenesis was recorded using Ricketts cephalometric analyses of lateral teleradiographs and panoramic radiographs. The risk for agenesis was predicted considering the 5 Vert Index parameters (facial axis, facial depth, mandibular plane angle, lower facial height and mandibular arch), facial type (brachyfacial, mesofacial, dolichofacial) and sociodemographic variables (age and sex), using odds ratio (OR) calculated by logistic regression. Third molar agenesis was observed in 25% of the sample. Risk for agenesis is significantly determined by sociodemographic factors (age, OR: 1.2), cephalic patterns (mesofacial vs dolichofacial, OR:4.3; and brachyfacial vs dolichofacial OR: 3.2) and cephalometric patterns (facial axis, OR: 0.8; lower facial height, OR: 0.8; and mandibular plane angle, OR:0.9). Facial parameters (facial axis, lower facial height, and mandibular plane angle) proved to be strong predictors of the risk for third molar agenesis, the prevalence of agenesis being significantly lower in dolichofacial individuals. Key words: Facial Pattern, Ricketts Analysis, Third Molar Agenesis.
Cacucci, Laura; Ricci, Beatrice; Moretti, Maria; Gasparini, Giulio; Pelo, Sandro
Myotonic dystrophy, or Steinert's disease, is the most common form of muscular dystrophy that occurs in adults. This multisystemic form involves the skeletal muscles but affects also the eye, the endocrine system, the central nervous system, and the cardiac system. The weakness of the facial muscles causes a characteristic facial appearance frequently associated with malocclusions. Young people with myotonic dystrophy, who also have severe malocclusions, have bad oral functions such as chewing, breathing, and phonation. We present a case report of a 15-year-old boy with anterior open bite, upper and lower dental crowding, bilateral crossbite, and constriction of the upper jaw with a high and narrow palate. The patient's need was to improve his quality of life. Because of the severity of skeletal malocclusion, it was necessary to schedule a combined orthodontic and surgical therapy in order to achieve the highest aesthetic and functional result. Although therapy caused an improvement in patient's quality of life, the clinical management of the case was hard. The article shows a balance between costs and benefits of a therapy that challenges the nature of the main problem of the patient, and it is useful to identify the most appropriate course of treatment for similar cases. PMID:28642828
Watkinson, Simon; Harrison, Jayne E; Furness, Susan; Worthington, Helen V
Prominent lower front teeth (termed reverse bite; under bite; Class III malocclusion) may be due to a combination of the jaw or tooth positions or both. The upper jaw (maxilla) can be too far back or the lower jaw (mandible) too far forward, or both. Prominent lower front teeth can also occur if the upper front teeth (incisors) are tipped back or the lower front teeth are tipped forwards, or both. Various treatment approaches have been described to correct prominent lower front teeth in children and adolescents. To assess the effects of orthodontic treatment for prominent lower front teeth in children and adolescents. We searched the following databases: Cochrane Oral Health Group's Trials Register (to 7 January 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12), MEDLINE via OVID (1946 to 7 January 2013), and EMBASE via OVID (1980 to 7 January 2013). Randomised controlled trials (RCTs) recruiting children or adolescents or both (aged 16 years or less) receiving any type of orthodontic treatment to correct prominent lower front teeth (Class III malocclusion). Orthodontic treatments were compared with control groups who received either no treatment, delayed treatment or a different active intervention. Screening of references, identification of included and excluded studies, data extraction and assessment of the risk of bias of the included studies was performed independently and in duplicate by two review authors. The mean differences with 95% confidence intervals were calculated for continuous data. Meta-analysis was only undertaken when studies of similar comparisons reported comparable outcome measures. A fixed-effect model was used. The I2 statistic was used as a measure of statistical heterogeneity. Seven RCTs with a total of 339 participants were included in this review. One study was assessed as at low risk of bias, three studies were at high risk of bias, and in the remaining three studies risk of bias
Song, Guang-Ying; Baumrind, Sheldon; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Wu, Wei-Zi; Ren, Chong; Weng, Xuan-Rong; Geng, Zhi; Xu, Tian-Min
Orthodontics in China has developed rapidly, but there is no standard index of treatment outcomes. We assessed the validity of the American Board of Orthodontics Objective Grading System (ABO-OGS) for the classification of treatment outcomes in Chinese patients. We randomly selected 108 patients who completed treatment between July 2005 and September 2008 in 6 orthodontic treatment centers across China. Sixty-nine experienced Chinese orthodontists made subjective assessments of the end-of-treatment casts for each patient. Three examiners then used the ABO-OGS to measure the casts. Pearson correlation analysis and receiver operating characteristic curve analysis were conducted to evaluate the correspondence between the ABO-OGS cast measurements and the orthodontists' subjective assessments. The average subjective grading scores were highly correlated with the ABO-OGS scores (r = 0.7042). Four of the 7 study cast components of the ABO-OGS score-occlusal relationship, overjet, interproximal contact, and alignment-were statistically significantly correlated with the judges' subjective assessments. Together, these 4 accounted for 58% of the variability in the average subjective grading scores. The ABO-OGS cutoff score for cases that the judges deemed satisfactory was 16 points; the corresponding cutoff score for cases that the judges considered acceptable was 21 points. The ABO-OGS is a valid index for the assessment of treatment outcomes in Chinese patients. By comparing the objective scores on this modification of the ABO-OGS with the mean subjective assessment of a panel of highly qualified Chinese orthodontists, a cutoff point for satisfactory treatment outcome was defined as 16 points or fewer, with scores of 16 to 21 points denoting less than satisfactory but still acceptable treatment. Cases that scored greater than 21 points were considered unacceptable. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Choi, S-H; Cha, J-Y; Lee, K-J; Yu, H-S; Hwang, C-J
Assessing changes in patient's psychological health and oral health-related quality of life (OHRQoL) over time during orthodontic treatment may help clinicians to treat patients more carefully. To evaluate changes in mental health, self-reported masticatory ability and OHRQoL during orthodontic treatment in adults, this prospective study included 66 adults (30 men, 36 women; mean age, 24·2 ± 5·2 years). Each patient completed the Korean versions of the State-Trait Anxiety Inventory, Zung Self-Rating Depression Scale, Rosenberg self-esteem scale, key subjective food intake ability (KFIA) test for five key foods and Oral Health Impact Profile-14 (OHIP-14K) at baseline (T0), 12 months after treatment initiation (T1) and debonding (T2). All variables changed with time. Self-esteem and the total OHIP-14K score significantly decreased and increased, respectively, at T1, with a particular increase in the psychological and social disabilities scores. There were no significant differences in any questionnaire scores before and after treatment. The total OHIP-14K score was positively correlated with trait anxiety and depression, and negatively correlated with self-esteem and KFIA at T0, regardless of the treatment duration. Older patients showed a significant increase in the total OHIP-14K score at T1 and T2. OHRQoL worsened with an increase in the treatment duration. Our results suggest that OHRQoL temporarily deteriorates, with the development of psychological and social disabilities, during orthodontic treatment. This is related to the baseline age, psychological health and self-reported masticatory function. However, patients recover once the treatment is complete. © 2017 John Wiley & Sons Ltd.
Emami, Elham; St-Georges, Annie; de Grandmont, Pierre
In this case report, we describe the successful long-term treatment of a patient with dental agenesis. The initial treatment plan included an orthodontic phase to provide adequate space for replacing missing lateral incisors with implants. However, because of some complications encountered after 2 years of orthodontic treatment, a revised treatment plan was considered to achieve functional and esthetic goals. The patient was completely satisfied 5 years after being treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost.
Frazier-Bowers, Sylvia A; Simmons, Darrin; Wright, J Timothy; Proffit, William R; Ackerman, James L
Primary failure of eruption (PFE) is characterized by nonsyndromic eruption failure of permanent teeth in the absence of mechanical obstruction. Recent studies support that this dental phenotype is inherited and that mutations in PTH1R genes explain several familial cases of PFE. The objective of our study was to investigate how genetic analysis can be used with clinical diagnostic information for improved orthodontic management of PFE. We evaluated a family (n = 12) that segregated an autosomal dominant form of PFE with 5 affected and 7 unaffected persons. Nine available family members (5 male, 4 female) were enrolled and subsequently characterized clinically and genetically. In this family, PFE segregated with a novel mutation in the PTH1R gene. A heterozygous c.1353-1 G>A sequence alteration caused a putative splice-site mutation and skipping of exon 15 that segregated with the PFE phenotype in all affected family members. A PTH1R mutation is strongly associated with failure of orthodontically assisted eruption or tooth movement and should therefore alert clinicians to treat PFE and ankylosed teeth with similar caution-ie, avoid orthodontic treatment with a continuous archwire.
Rerhrhaye, W; Bahije, L; Zaoui, F; Merzouk, N
The aim of this study was to evaluate knowledge, attitudes and practices (KAP) of Moroccan dentists about allergy to Nickel (Ni) during orthodontic treatment. Dentists of two Moroccan cities (n = 553) were contacted and a questionnaire was distributed to those who have certified of partial or exclusive practice of orthodontics (N = 202). They were asked to specify the adverse reactions observed and the alloys frequently used. KAP about etiology, prevention and therapeutic management of allergic patients were also addressed. Twenty-two percent of the dentists have reported at least one allergic patient reaction with more implication of fixed appliances. Eleven percent of adverse effects locations reported were mucosal area and facial skin near contact area and less than 5% was systemic eruption outside contact site. Only 34% of the respondents knew the Nickel allergy etiology. Nickel-containing orthodontic alloys are generally used even in patient with suspected nickel allergy. It is very important to minimize corrosion factors and use nickel-free appliances in clinical practice.
Larson, Brent E
Orthodontic preparation is critical to the success of orthognathic surgery. Recognition and correction of existing dental compensations allows full correction of skeletal discrepancies. Presurgical orthodontic goals are important to define at the start of treatment and may not always include complete arch leveling or space closure, or ideal interdigitation. Orthodontic preparation dictates the skeletal movements that are possible at the time of surgery. Different malocclusion types have characteristic dental compensations that can be identified and described. Proper planning, monitoring, and communication between surgeon and orthodontist are critical to avoid potential pitfalls in the orthodontic preparation. Copyright © 2014 Elsevier Inc. All rights reserved.
Green, H M; Green, S E
This article identifies, defines and reviews the synergy between orofacial myofunctional and orthodontic health with regard to wind instrument performance, and summarizes the skills involved in playing an instrument. (i.e. embouchure, articulation, breath support.) Criteria and strategies for choosing an instrument are outlined via orthodontic classifications, therapeutic value or contraindication and team approaches. The author concludes that a team-oriented approach on the part of the professions cited in this article are of the ultimate good for the student/patient.
Abreu, Lucas G; Melgaço, Camilo A; Abreu, Mauro H N G; Lages, Elizabeth M B; Paiva, Saul M
To evaluate the impact of the first 8 months of orthodontic treatment with a fixed appliance on the families of adolescent patients and to examine the evaluative properties of the Family Impact Scale (FIS). The study involved a sample of 94 parents/caregivers of adolescents undergoing orthodontic treatment with a fixed appliance. The participants were asked to answer the Brazilian version of the FIS before treatment (T1) and 8 months after the bonding of the fixed appliance (T2). Statistical analysis was carried out using the Wilcoxon signed rank test and the Bonferroni correction for the overall score and FIS subscales. Responsiveness of the measure and the minimal clinically important difference (MCID) were also assessed. Among the 94 participants initially admitted to the present study, two were excluded as a result of treatment dropout and failure to return the second questionnaire. Thus, a sample of 92 parents/caregivers participated (response rate: 97.8%). Among the 92 participants, 70 were the mothers of patients, 16 were fathers, and six were other family members. Statistically significant improvements were found in the overall score (P < .001) as well as in both parental activity and parental emotions subscales (P < .001). The reductions in scores were associated with effect sizes showing moderate clinically meaningful changes in the overall FIS and in the parental/family activity, parental emotions, and family conflict subscales. The MCID was 2.66 for the overall FIS. The first 8 months of orthodontic treatment with a fixed appliance had a positive impact on the families of adolescents.
Farias, Arthur Costa Rodrigues; Cangussu, Maria Cristina Teixeira; Ferreira, Rogério Frederico Alves; de Castellucci, Marcelo
The objective of this article is to evaluate the need of orthodontic treatment, prevalence and severity of the malocclusions in individuals of black ethnicity in a representative sample of schoolchildren of the city of Salvador/Brazil, as well as to verify if the malocclusion was affected by socio-demographic conditions such as age and gender. The reference population was constituted of schoolchildren with age between 12 and 15 years, enrolled in public and private schools. The malocclusion was evaluated in 486 students of black ethnicity, with ages varying from 12 to 15 years, selected in random sample in multiple stages. The adopted significance level was 1% and the power of the test was 90%. A questionnaire registering demographic characteristics was filled out by each individual. The Dental Aesthetics Index (DAI) was used by previously calibrated examiners (kappa 0.89), according to criteria of the World Health Organization. It was verified that most of the individuals (76%) had little or any need for orthodontic treatment. About 24% showed a condition of severe malocclusion, culminating in a vital need for orthodontic treatment. The main occlusal characteristics found in the group with high need of orthodontic treatment were dental crowding and accentuated overjet. The age was positively related to the improvement of the maxillary overjet and to the presence of crowding. The development of public politics that aim the insertion of orthodontic treatment among the procedures of health programs, with the implementation and development of specialized centers, is fundamental.
Amato, Juliana Neide; Tuon, Rogério Antônio; Castelo, Paula Midori; Gavião, Maria Beatriz Duarte; Barbosa, Taís de Souza
To evaluate the sleep bruxism, malocclusions, orofacial dysfunctions and salivary levels of cortisol and alpha-amylase in asthmatic children. 108 7-9-yr-old children were selected from Policlinic Santa Teresinha Doutor Antonio Haddad Dib (asthmatics, n=53) and from public schools (controls, n=55), Piracicaba, SP, Brazil. Sleep bruxism diagnosis was confirmed by parental report of grinding sounds and the presence of shiny and polish facets on incisors and/or first permanent molars. The index of orthodontic treatment need was used for occlusion evaluation. Orofacial dysfunctions were evaluated using the nordic orofacial test-screening (NOT-S). Salivary cortisol and alpha-amylase were expressed as "awakening response" (AR), calculated as the difference between levels immediately after awakening and 30 min after waking, and "diurnal decline" (DD), calculated as the difference between levels at 30 min after waking and at bedtime. Data were analyzed using Shapiro-Wilk/Kolmogorov-Smirnov, Chi-square, unpaired t test/Mann-Whitney and paired t/Wilcoxon tests. Sleep bruxism was more prevalent in children with asthma than controls (47.2% vs. 27.3%, p<0.05). Asthmatics had higher scores of NOT-S total and interview (p<0.05). Dysfunctions on sensory function and chewing and swallowing were more frequent in asthmatics (p<0.05). Salivary cortisol AR on weekend was significantly higher for asthmatics (p<0.05). Salivary cortisol DD was significantly higher on weekday than weekend for controls (p<0.05). There were no significant differences in alpha-amylase values in and between groups. The presence of asthma in children was associated with sleep bruxism, negative perception of sensory, chewing and swallowing functions, and higher concentrations of salivary cortisol on weekend. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gunenkova, I V; Samoylova, N V; Bondarets, A Yu
The data of clinical examination, diagnostic models and panoramic x-rays investigation of the 332 patients at the age from 6 to 18 years with adentia were analysed. The congenital absence of more than 6 teeth was defined as oligodontia. The purpose of the study was to evaluate the prevalence of missing teeth patterns and other dental abnormalities such as microdontia, persistent deciduous teeth, ankylosis, taurodontism, impaction and transposition in children and adolescents with isolated and syndromic oligodontia to optimize the diagnostic and orthodontic treatment plan. The total number of 332 patients were devided into three groups: 1-132 patients with hypodontia, 2-119 subjects with isolated oligodontia and 3 - 81 with syndromic oligodontia. The subgroup comprised of 45 children with ectodermal dysplasia (ED) syndromes and oligodontia 1,5-6 years at baseline examination was selected from the patients of group 3. The main type of inheritance was X-linked recessive and the most spread syndrome was hypohidrotic ectodermal dysplasia or Christ-Siemens-Touraine syndrome. The female patients were twice more than males in hypodontia and isolated oligodontia groups, but in group of 3 syndromic patients the rate of males to females was 1,56:1. The most stable to agenesis teeth were the upper central deciduous and permanent incisors. In group 2 the most often absent teeth were upper second premolars and in group 3-the upper lateral incisors. In syndromic patients with temporary dentition the upper lateral incisors and all lower incisors were always absent. It was concluded that the absence of teeth at the age of 1,5 years, male gender and absense of more than 14 teeth in the temporary dentition and 20 teeth in the permanent dentition were the signs of syndromic oligidontia. It is necessary for such patients to be examined besides dentists and pediatrician by other medical specialist such as dermatologist and geneticist.
Antonarakis, Gregory S; Kalberer, Nicole; Courvoisier, Delphine S; Scolozzi, Paolo
The aim of this study was to identify clinical factors predisposing to the development or worsening of temporomandibular disorders (TMDs) following orthodontic surgical treatment for Class III malocclusion. A retrospective cohort study was performed on 88 patients with Class III malocclusion having undergone a combined orthodontic and orthognathic surgical treatment. Temporomandibular joint and masticatory muscle examinations were available prior to treatment and one year post-operatively. Multivariate logistic regression was used to predict the development of post-operative TMDs, and linear regression was used to predict the worsening of TMDs using Helkimo indices. Patients with Class III malocclusion presenting with pre-treatment anamnestic TMJ clicking (OR = 5.8; p = 0.03) and undergoing bimaxillary osteotomy procedures (OR = 18.6; p = 0.04) were more at risk for the development of TMDs. TMDs must be evaluated, monitored, and managed with caution in patients with Class III malocclusion presenting with pre-treatment joint clicking and who are planned for bimaxillary osteotomies.
Mattick, C R; Gordon, P H; Gillgrass, T J
There is a significant demand for orthodontic treatment within the UK from adolescent girls, a group known to be influenced by the media portrayal of body form and body image, which may extend to the presentation of malocclusions. This study examined the portrayal of malocclusion in a media type that targets teenage girls under 16 years of age. A representative selection of 1 month's magazines targeting this group were investigated, and the frequency and severity of malocclusions displayed were assessed. Two calibrated examiners viewed all the smiles (on two occasions) using a modification of Index of Orthodontic Treatment Need (IOTN) and assigned an Aesthetic Component Score to each smile. It was found that the aesthetic score is low (less than 7) for the majority of models (92.8%) indicating no need or a borderline need for treatment. Only 7.2% of models exhibited a definite need for treatment. It appears that the portrayal of malocclusion in teenage magazines does not reflect the general treatment need of the adolescent population.
Christopherson, Elizabeth A; Briskie, Dan; Inglehart, Marita Rohr
Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES.
Livas, Christos; Delli, Konstantina; Ren, Yijin
To investigate the quality of the data disseminated via the Internet regarding pain experienced by orthodontic patients. A systematic online search was performed for 'orthodontic pain' and 'braces pain' separately using five search engines. The first 25 results from each search term-engine combination were pooled for analysis. After excluding advertising sites, discussion groups, video feeds, and links to scientific articles, 25 Web pages were evaluated in terms of accuracy, readability, accessibility, usability, and reliability using recommended research methodology; reference textbook material, the Flesch Reading Ease Score; and the LIDA instrument. Author and information details were also recorded. Overall, the results indicated a variable quality of the available informational material. Although the readability of the Web sites was generally acceptable, the individual LIDA categories were rated of medium or low quality, with average scores ranging from 16.9% to 86.2%. The orthodontic relevance of the Web sites was not accompanied by the highest assessment results, and vice versa. The quality of the orthodontic pain information cited by Web sources appears to be highly variable. Further structural development of health information technology along with public referral to reliable sources by specialists are recommended.
Kirschneck, Christian; Christl, Jan-Joachim; Reicheneder, Claudia; Proff, Peter
The development of white spot lesions around orthodontic brackets and gingivitis is a common problem during orthodontic treatment with fixed appliances. This prospective randomized double-blind controlled clinical trial investigated the preventive efficacy of a one-time application of two commonly used fluoride varnishes in patients with low to moderate caries risk. Ninety adolescent orthodontic patients with a low to moderate caries risk were prospectively randomized to three groups of 30 patients each: (1) standardized dental hygiene with fluoride toothpaste and one-time application of placebo varnish (control) or (2) of elmex® fluid or (3) of Fluor Protector S on all dental surfaces at the start of fixed therapy. The extent of enamel demineralization and gingivitis was determined with the ICDAS and the gingivitis index (GI) at baseline and after 4, 12, and 20 weeks. Each treatment group showed a significant increase of the ICDAS index, but not of the GI over the course of time with no significant intergroup differences detectable. A one-time application of fluoride varnish at the start of orthodontic treatment did not provide any additional preventive advantage over sufficient dental hygiene with fluoride toothpaste with regard to formation of white spots and gingivitis in patients with a low to moderate caries risk. In dental practice, patients often receive an application of fluoride varnish at the start of orthodontic treatment with fixed appliances. However, the efficacy of this procedure is still unclear.
Abreu, Lucas G; Melgaço, Camilo A; Lages, Elizabeth M B; Abreu, Mauro H N G; Paiva, Saul M
To evaluate adolescents oral health-related quality of life (OHRQoL) in the first 4 months of fixed orthodontic appliance treatment using parents and caregivers as proxies. Descriptive study. Department of Pediatric Dentistry and Orthodontics at Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. A sample of parents and caregivers of 95 adolescents undergoing orthodontic treatment with a fixed appliance. Participants were required to answer the Brazilian version of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) before adolescent's treatment (T1) and 4 months after bonding of the fixed appliance (T2). Statistical analysis was carried out using the Wilcoxon signed rank test and the Bonferroni correction for the domains of P-CPQ. Among the 95 participants, there were 73 mothers, 18 fathers and 4 were other relations. There was a statistically significant improvement in the overall score as well as in both emotional and social wellbeing subscales (P<0·001). Parents and caregivers report an improvement on their adolescent's OHRQoL in the first 4 months of orthodontic treatment with a fixed appliance. © 2014 British Orthodontic Society.
Mislik, Barbara; Konstantonis, Dimitrios; Katsadouris, Alexios; Eliades, Theodore
The aim of this study was to compare treatment outcomes in university vs private practice settings with Class I patients using the American Board of Orthodontics Objective Grading System. A parent sample of 580 Class I patients treated with and without extractions of 4 first premolars was subjected to discriminant analysis to identify a borderline spectrum of 66 patients regarding the extraction modality. Of these patients, 34 were treated in private orthodontic practices, and 32 were treated in a university graduate orthodontic clinic. The treatment outcomes were evaluated using the 8 variables of the American Board of Orthodontics Objective Grading System. The total scores ranged from 10 to 47 (mean, 25.44; SD, 9.8) for the university group and from 14 to 45 (mean, 25.94; SD, 7.7) for the private practice group. The university group achieved better scores for the variables of buccolingual inclination (mean difference, 2.28; 95% confidence interval [CI], 0.59, 3.98; P = 0.01) and marginal ridges (mean difference, 1.32; 95% CI, 0.28, 2.36; P = 0.01), and the private practice group achieved a better score for the variable of root angulation (mean difference, -0.65; 95% CI, -1.26, -0.03; P = 0.04). However, no statistically intergroup differences were found between the total American Board of Orthodontics Objective Grading System scores (mean difference, -0.5; 95% CI, -3.82, 4.82; P = 0.82). Patients can receive similar quality of orthodontic treatment in a private practice and a university clinic. The orthodontists in the private practices were more successful in angulating the roots properly, whereas the orthodontic residents accomplished better torque control of the posterior segments and better marginal ridges. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
The introduction of cone beam computed tomography (CBCT) technology to dentistry and orthodontics revolutionized the diagnosis, treatment and monitoring of orthodontic patients. This review article discusses the use of CBCT in diagnosis and treatment planning in orthodontics. The steps required to install and operate a CBCT facility within the orthodontic practice as well as the challenges are highlighted. The available guidelines in relation to the clinical applications of CBCT in orthodontics are explored. Copyright © 2013. Published by Elsevier Masson SAS.
Xu, Yue; Cai, Bin; Lu, Xin-hua
To analyze the biologic principle of orthodontic treatment in patients with skeletal Class III malocclusion and open bite. Eleven pre-adolescent patients with severe skeletal Class III malocclusion and open bite (age range 7 - 9 years old, mean age 8.3 +/- 0.8) were included. All patients were surgical cases but the patients rejected surgery. The treatment methods used were face mask, rapid maxillary expansion occlusal splint and fixed appliance. Lateral cephalometric films were taken before and after treatment. Cephalometric analysis was performed. After the treatment SNA changed from (79.0 +/- 1.2) degrees to (81.9 +/- 0.8) degrees (P < 0.01). And the inclination of lower incisors was decreased from (25.6 +/- 2.1) degrees to (20.1 +/- 1.4) degrees when measured to the NB line (P < 0.01). The direction of the facial growth was maintained. Good orthodontic results could be achieved in patients with skeletal Class III malocclusion and open bite.
Paduano, S; Iodice, G; Farella, M; Silva, R; Michelotti, A
Congenital insensitivity to pain is a rare clinical syndrome characterized by dramatic impairment of pain perception since birth and is generally caused by a hereditary sensory and autonomic neuropathy with loss of the small-calibre, nociceptive nerve fibres. We report a 9-year-old case, with a generalized congenital insensitivity to pain. The patient was referred to our Department by a private orthodontist for severe limited mouth opening and multiple oral ulcers which greatly worsened after starting the orthodontic treatment. The management of his oral lesions of the limited mouth opening and of the orthodontic treatment are described. The management approach aimed to improve mandibular range of motion and associated stretching and a self-modeling mouthguard to avoid cheek self-biting. This protocol allowed continuing the orthodontic treatment to restore the occlusion. Finally, good occlusion, normal function and better quality of patient's life were achieved.
Philip, S M; Darvell, B W
Elgiloy is the trade name of a cobalt-chromium-nickel superalloy that is offered for orthodontic use as wire. Despite some years of use, there is very little information in the dental literature on its mechanical properties, and especially on the effect of the hardening heat treatment (HT), that may be used after forming, on the tensile strength (TS) in relation to the four 'tempers' that are available. Straight lengths of round wire of the four available tempers, Blue, Yellow, Green and Red, were tested in direct tension at 5mm/min in air at 23°C to fracture, both as-supplied (AS) and with HT at 500°C for 5h, in air. HT was done in a high-uniformity, three-zone tube furnace in an alumina boat. The wires were then allowed to cool to room temperature in the boat, outside the furnace. The nominal (original cross-sectional area) peak stress was calculated. TS varied from 1.4 to 2.1GPa, AS, and 1.6 to 2.8GPa HT, according to temper, but with appreciable variation within tempers. Even so, the TS plot of HT vs. AS was very straight and of narrow distribution (intercept: -0.638±0.064GPa, slope: 1.575±0.036, r(2): 0.994918, n=12, F=1957.7, p∼8×10(-13)). The strengthening due to HT was highly regular and TS can be reliably predicted on the basis of the AS value, but this of course cannot be known without specific batch testing. However, the unexpectedly large variation in the AS values within tempers renders such a prediction of lower reliability and usefulness in practice. Indeed, the distinction between tempers can be negligible, making selection according to application demands problematic, and differential property expectation less than certain. No such product data are provided commercially. Quality control is not as tight as might be expected. The implications for treatment need to be explored. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Leong, Jeffrey W; Kunzel, Carol; Cangialosi, Thomas J
For over 50 years, the American Heart Association has made recommendations for the prevention of infective endocarditis. The first guidelines were published in 1955; since then, they have been updated 9 times, most recently in 2007. There is still confusion about which orthodontic procedures are most prone to generate bacteremias and lead to infective endocarditis in susceptible patients. The aim of this study was to conduct a survey to determine orthodontists' knowledge, attitudes, and in-office behaviors regarding the American Heart Association's guidelines. A 4-page online survey consisting of 3 sections was sent to members of the American Association of Orthodontists by using a random number generator. The first section consisted of demographic information, the second consisted of questions about the respondents' practice characteristics, and the third included questions about the respondents' knowledge and management of the treatment of patients at risk for infective endocarditis. There were 78 responses. Orthodontists are screening for cardiac problems in the patient's medical history but to a lesser extent are requesting written medical clearance from the patient's physician before starting orthodontic treatment. Many of the orthodontists surveyed believed that their knowledge of the American Heart Association's guidelines and management of high-risk patients was in the good-to-excellent range. Orthodontists recommend antibiotic prophylaxis most frequently during band placement and removal. Patients at risk for infective endocarditis are somewhat likely to inquire about possible treatment sequelae associated with previous cardiac problems. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Tanaka, Orlando Motohiro; Fornazari, Isabelle Adad; Parra, Ariane Ximenes Graciano; de Castilhos, Bruno Borges; Franco, Ademir
This case report presents the interceptive orthodontic treatment of a boy, aged 8 years 4 months with a Class I malocclusion with severe transverse maxillary deficiency and complete maxillary crossbite and correction using Haas expansion and fixed appliance. The treatment goals were to correct the posterior crossbite and anterior crossbite and restore the normality of the dentition and occlusion. In phase I, the patient was treated with a modified Haas-type palatal expander, which provided a clinically significant palatal expansion and increased the maxillary arch perimeter with favorable conditions for orthodontic treatment with fixed appliances in phase II. The optimization of E-space and the use of intermaxillary Class III elastics helped to maintain the mandibular incisors upright. A removable wraparound type appliance and a bonded lingual canine-to-canine retainer were used as retention. Although the literature has reported a high rate of relapse after palatal expansion, after 2 years 9 months of posttreatment follow-up, the occlusal result was stable and no skeletal reversals could be detected. PMID:27239351
Jung, Gyeong Bok; Kim, Kyung-A; Han, Ihn; Park, Young-Guk; Park, Hun-Kuk
This study used Raman spectroscopy to report the first human gingival crevicular fluid (GCF) biochemical characterization during the early phase of orthodontic tooth movement. This technique allows for label-free and noninvasive biochemical change monitoring in GCF during orthodontic tooth movement. Ten orthodontic patients (20.8 ± 2.5 years) participated in the study. GCF samples were obtained before (baseline, 0 days) and during orthodontic treatment at 1, 7 and 28 days. For Raman spectroscopic measurement, GCF samples (5 µl) were deposited onto a gold-coated substrate, then dried at room temperature. Raman spectra GCF analysis during orthodontic treatment indicated that the hydroxyapatite to primarily collagen-dominated matrix band (phosphate 984 cm−1/amide I 1667 cm−1) intensity ratio decreased at day 7 (P < 0.05). The carbonate apatite to hydroxyapatite ratio (carbonate 1088 cm−1/phosphate 984 cm−1) was significantly higher on day 7 compared to day 0 (P < 0.05). These results indicate that demineralization occurs during the alveolar bone remodeling process. We also found notable peak shifts in the amide I range during orthodontic tooth movement. The 1658 cm−1 in baseline red shifted to 1667 cm−1 at orthodontic treatment day 7. Curve fitting in the amide I (1615-1725 cm−1) range demonstrated that increased random coil conformation was accompanied by a decrease in β-sheet structure during orthodontic tooth movement. Thus, we suggest Raman spectroscopy could be used for label-free, non-invasive GCF quality assessment during orthodontic tooth movement. Furthermore, this method may prove to be a powerful diagnostic and prognostic tool for monitoring orthodontic tooth movement in a clinical setting. PMID:25360368
Manfredini, Daniele; Stellini, Edoardo; Gracco, Antonio; Lombardo, Luca; Nardini, Luca Guarda; Siciliani, Giuseppe
To assess if subjects with a clinical diagnosis of temporomandibular disorders (TMDs) have a similar prevalence of orthodontic history as a population of TMD-free individuals and to assess if those subjects who have a history of ideal orthodontics have fewer symptoms than those with a history of nonideal orthodontics. Two groups of age- and sex-matched individuals belonging to either a study ("TMD") or a control group were recruited. Subjects who underwent orthodontic treatment were classified as having a history of ideal or nonideal orthodontics based on the current presence of normal values in five reference occlusal features. The correlation with a history of orthodontic treatment was not clinically significant for any of the TMD diagnoses (ie, muscle pain, joint pain, disc displacement, arthrosis), with Phi (Φ) coefficient values within the -0.120 to 0.058 range. Within the subset of patients with a history of orthodontics, the correlation of ideal or nonideal orthodontic treatment with TMD diagnoses was, in general, not clinically relevant or was weakly relevant. Findings confirmed the substantial absence of clinically significant effects of orthodontics as far as TMD is concerned. The very low correlation values of a negative or positive history of ideal or nonideal orthodontics with the different TMD diagnoses suggest that orthodontic treatment could not have a true role for TMD.
Surgically Assisted Rapid Maxillary Expansion (SARME) is frequently used to treat skeletal maxillary transverse deficiency (MTD) in skeletally mature and non-growing individuals. Despite previous research in the field, questions remain with respect to the long-term stability of SARME and its effects on hard and soft tissue. The overall aim of the present doctoral work was to achieve a greater understanding of SARME, using modern image technology and a multidisciplinary approach, with special reference to effects on the hard and soft tissues and respiration. A more specific aim was to evaluate the long-term stability in a retrospective sample of patients treated with SARME and orthodontic treatment and to compare the results with a matched, untreated control group. The studies in this doctoral project are thus based on two different samples and study designs. The first sample, Study I (Paper I), is a retrospective, consecutive, long-term follow-up material of study models from 31 patients (17 males and 14 females) treated with SARME and orthodontic treatment between 1991 and 2000. The mean pre-treatment age was 25.9 years (SD 9.6) with a mean follow-up time of 6.4 years (SD 3.3). Direct measurements on study models were made with a digital sliding caliper at reference points on molars and canines. To evaluate treatment outcome and long-term stability, the results were compared with study models from an untreated control group, matched for age, gender and follow-up time. The second sample, Study II (Papers II-IV), is a prospective consecutive, longitudinal material of 40 patients scheduled to undergo SARME and orthodontic treatment between 2006 and 2009. In Paper II, one patient was excluded because of a planned adenoidectomy. The final sample comprised 39 patients (16 males and 23 females). The mean age at treatment start was 19.9 years (range 15.9 - 43.9). Acoustic rhinometry, rhinomanometry and a questionnaire were used to assess the degree of nasal obstruction at
Kai, Risako; Umeki, Daisuke; Sekiya, Toshiko; Nakamura, Yoshiki
When considering camouflage orthodontic treatment of a malocclusion associated with significant facial asymmetry, it is important to define the location of the dental midline. The patient, a 19-year-old Japanese woman, had an anterior open bite and a dental midline discrepancy associated with facial asymmetry. A nonsurgical treatment plan was considered. The main treatment objective was to correct the anterior open bite and the dental midlines in both arches. The dental midline discrepancy was eliminated, and proper overjet and overbite were achieved. Although the facial asymmetry remained, oral esthetics dramatically improved and a favorable occlusion was obtained. The results suggest that appropriately defining the location of the dental midline is critical for successful camouflage treatment of facial asymmetry. Copyright Â© 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
In modern orthodontics, aesthetics appear to have a decisive influence on orthodontic appliance preferences and acceptability. This paper reports the early application of a newly emerged functional device with enhanced aesthetics in a Class II treatment. Patient perspectives and technical considerations are discussed along with recommendations for further design development. It can be assumed that the use of thermoplastic material-based appliances may meet both the therapeutic and aesthetic demands of young age groups. PMID:23956884
Maetevorakul, Suhatcha; Viteporn, Smorntree
Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. The subjects comprised 104 Thai patients age 8-16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3%. Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R(2) = 0.099), whereas protrusion of the lower lip at the labrale inferius was correlated with initial inclination of
Mary, A. Vinita; John, Joseph; Moses, Joyson; Ebenezar, A.V. Rajesh; Kesavan, R.
Introduction Dental ailments like malocclusion affect not only the functional ability and aesthetic appearance of the person but also the psychological aspect of the individual. Aim The aim of the present study was to the find relationship between quality of life and dental malocclusion among school going adolescents in Tamil Nadu, India. Materials and Methods A cross-sectional study was conducted among 342 subjects of age range 14-19 years. Oral health status was assessed using WHO basic oral health survey (2013), orthodontic treatment needs according to Index of Orthodontic Treatment Needs (IOTN) and oral health quality of life using Oral Health Impact Profile-14 (OHIP-14). Results A total of 342 subjects were interviewed and examined. The mean DMFT score was 1.86±2.77. A 203 (59.4%) did not require any orthodontic treatment while 139 (40.6%) had orthodontic treatment need ranging from mild to very severe. It was seen that malocclusion affected some aspects of OHIP-14 significantly namely functional limitation, psychological discomfort and psychological disability. The comparison of OHIP-14 scores between treatment needed and treatment not needed was highly significant (p<0.001). Conclusion Hence, it is stated that there is an urgent need to educate the school children and in turn their parents regarding the malocclusion for its treatment to prevent any effect on quality of life of the young adults. PMID:28969279
Mary, A Vinita; Mahendra, Jaideep; John, Joseph; Moses, Joyson; Ebenezar, A V Rajesh; Kesavan, R
Dental ailments like malocclusion affect not only the functional ability and aesthetic appearance of the person but also the psychological aspect of the individual. The aim of the present study was to the find relationship between quality of life and dental malocclusion among school going adolescents in Tamil Nadu, India. A cross-sectional study was conducted among 342 subjects of age range 14-19 years. Oral health status was assessed using WHO basic oral health survey (2013), orthodontic treatment needs according to Index of Orthodontic Treatment Needs (IOTN) and oral health quality of life using Oral Health Impact Profile-14 (OHIP-14). A total of 342 subjects were interviewed and examined. The mean DMFT score was 1.86±2.77. A 203 (59.4%) did not require any orthodontic treatment while 139 (40.6%) had orthodontic treatment need ranging from mild to very severe. It was seen that malocclusion affected some aspects of OHIP-14 significantly namely functional limitation, psychological discomfort and psychological disability. The comparison of OHIP-14 scores between treatment needed and treatment not needed was highly significant (p<0.001). Hence, it is stated that there is an urgent need to educate the school children and in turn their parents regarding the malocclusion for its treatment to prevent any effect on quality of life of the young adults.
Hamdan, A M; Singh, V; Rock, W P
To examine the relationship between perceptions of dental aesthetics and demand for orthodontic treatment, and to determine whether the former can be used to predict the latter. A prospective cross sectional epidemiological survey of a random and representative sample of comprehensive primary schools in South Birmingham, UK. Participants were 389 randomly selected school children aged 10-11 years from 7 primary schools in South Birmingham. Their perceptions of dental aesthetics were determined using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Demand for treatment was assessed by asking subjects if they wanted treatment with braces to correct their teeth. Only 2% of subjects assessed their dentition in the "definite need" for orthodontic treatment category. Demand for treatment was significantly greater in girls than boys (49% and 37% respectively, p < 0.05). Total demand (41%) was considerably greater than self assessed aesthetics in the "definite need" and "borderline need" categories combined (14%). Demand was accurately reflected in patients who perceived their dentition as having moderate to severe (AC 6-9) and very mild aesthetic impairment (AC 1). Perceptions of dental aesthetics using the AC of IOTN were able to predict demand for orthodontic treatment in patients with malocclusions of moderate to severe (AC 6-9) aesthetic impairment.
Pahwa, Narinder; Kumar, Atul; Gupta, Siddharth
Objectives To test the short term clinical effectiveness of commercially available 0.07%.cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic treatment as compared to a placebo mouth rinse and patients using toothbrush and toothpaste. Method Forty-five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis), and at the end of one month in all the three groups and compared. Results Paired t test showed significant differences in bleeding index for pre and post treatment recordings for cetylpyridinium group. Modified gingival index showed no significant difference in the cetylpyridinium group. For plaque index significant difference was found for cetylpyridinium and control groups. Conclusion Cetylpyridinium mouth rinse 0.7% was found to be effective in reducing the bleeding and plaque index scores. It was not effective in reducing the modified gingival index scores. Cetylpyridinium mouth rinse 0.07% improves the oral hygiene of orthodontic patients when used as an adjunct to normal oral hygiene measures. PMID:23960507
Shimizu, Noriyoshi; Yamaguchi, Masaru; Goseki, Takemi; Shibata, Yasuko; Takiguchi, Hisashi; Abiko, Yoshimitsu; Iwasawa, Tadamasa
The effects of low-power laser irradiation on prostaglandin (PG)E2 and interleukin(IL)-1(beta) production in stretched human periodontal ligament (PDL) cells were assessed in vitro. PDL cells derived from healthy premolars were utilized for these experiments. Cells were seeded in flexible-bottom culture plates and elongated (18% increase) under a vacuum at 6 cycles per minute for 1 to 5 days. The stretched cells were irradiated with a Ga-Al-As low-power diode laser (60 mW) once a day for 3 to 10 minutes for 1 to 5 days. PGE2 and IL-1(beta) levels in the medium were measured by radio immunoassay. Human PDL cells showed a marked elevation in PGE2 and IL-1(beta) production in response to mechanical stretching. The increase in PGE2 production was significantly inhibited by laser irradiation in a dose-dependent manner. The increase in IL-1(beta) production was also inhibited by laser irradiation, although the inhibition was only partial under this irradiation condition. Since high levels of PGE2 and IL-1(beta) are found in the PDL when teeth are moved during orthodontic treatment and since both factors are involved with the induction of pain, the inhibitory effects of laser irradiation on PGE2 and IL-1(beta) production suggest that laser irradiation may have therapeutic benefits in relieving the pain that accompanies orthodontic treatment.
Petrén, Sofia; Bjerklin, Krister; Hedrén, Pontus; Ecorcheville, Agnes
The aim of the present study was to disclose the treatment procedures most frequently recommended by Swedish orthodontists for use by general practitioners and to determine whether these recommendations are reflected in the undergraduate dental program in orthodontics at Malmö University. Potential differences between the ortho- dontists' recommendations were also investigated. A questionnaire was sent to 169 consulting orthodontists, seeking their recommenda- tions for appliance therapy to be undertaken by general practitioners: 129 (63 males and 66 females) responded. The Quad Helix was the appliance most commonly recommended for correction of posterior crossbite, a plate with Z-springs for correction of anterior crossbite and the headgear activator for correction of Class II malocclusions. A significant gender difference was disclosed with respect to orthodontists' recommendations for treatment of Class II malocclusions by general practitioners, namely that female orthodontists recommended the headgear activator more frequently than males. However, this difference is most likely attributable to the gender distribution among orthodontists qualifying as specialists during the last five decades: more recently qualified orthodontists are predominantly female. The choice of appliances corresponded well with undergraduate training in orthodontics at the Faculty of Odontology in Malmö.
Bradley, T Gerard
STATEMENT OF THE ISSUE: Is there a link between the many perceived advances in orthodontic techniques/therapy and science in the past 20 years? The purpose of this paper is to take five topics and match the perceptions with the scientific evidence. The variety of appliances and the swings in treatment philosophy have been dramatic, including the swing from extraction to non-extraction therapy, the introduction of space-age wires, appliances that grow mandibles, the introduction and extraordinary growth of Invisalign, and reduced friction brackets to reduce treatment time, all with claims by manufacturers of better results than ever before. The focus is on faster treatment, reduced visits/appointments and superior results. Most of these 'advancements' represent what has been the 'juggernaut of technology'. Five questions are posed, and an evidence-based approach is used to critically examine the literature in these selected topics.
Carlson, David S
The field of genetics emerged from the study of heredity early in the 20th century. Since that time, genetics has progressed through a series of defined eras based on a number of major conceptual and technical advances. Orthodontics also progressed through a series of conceptual stages over the past 100 years based in part on the ongoing and often circular debate about the relative importance of heredity (nature) and the local environment (nurture) in the etiology and treatment of malocclusion and dentofacial deformities. During the past 20 years, significant advancements in understanding the genomic basis of craniofacial development and the gene variants associated with dentofacial deformities have resulted in a convergence of the principles and concepts in genetics and in orthodontics that will lead to significant advancement of orthodontic treatments. Fundamental concepts from genetics and applied translational research in orthodontics provide a foundation for a new emphasis on precision orthodontics, which will establish a modern genomic basis for major improvements in the treatment of malocclusion and dentofacial deformities as well as many other areas of concern to orthodontists through the assessment of gene variants on a patient-by-patient basis. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Muthukumar, Kirthika; Vijaykumar, N. M.; Sainath, M. C.
Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results. PMID:27041912
Muthukumar, Kirthika; Vijaykumar, N M; Sainath, M C
Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.
Manière-Ezvan, A; Oueiss, A; Busson, F
In the past, the ATM was mainly associated with the growth of the mandibular condyle. Many studies (on rats) showed the role of condylar cartilage in the growth response following stimulation by orthopedic appliances. From where, Class II dysmorphosis "orthopedic" treatments to grow the mandible; but this concept is discussed in the literature in the absence of fully conclusive results and especially since the contribution of orthognathic surgery. Currently, the operating concept is the mechanical stimulation and therefore the function will shape the ATM during growth and that, from an early age. Prevention of dysmorphoses must go through behavioral counseling to be adopted by parents from the birth of their child: to stimulate mandibular propulsion breastfeeding, then by a hard diet inducing an alternating unilateral chewing. Ignorance of the specificity of temporomandibular dysfunction (TMD) notably among teenagers has, in the past, left a doubt about the positive or negative role that could have orthodontic treatment on the TMJ. Currently, the best knowledge of TMJ and TMD provides a better therapeutic conduct: behavioral counseling especially for the girl hyperdivergente with small condyles, control of the condylar position, occlusal adjustments at the end of orthodontic treatment. The future of TMJ in relation with orthodontics is based on prevention, screening and deepening of our knowledge. The orthodontist will thus not make a treatment in patients at risk or will identify it and finish the treatment perfectly. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Pisani, Lucia; Bonaccorso, Laura; Fastuca, Rosamaria; Spena, Raffaele; Lombardo, Luca; Caprioglio, Alberto
The treatment options for the early treatment of anterior open bite are still controversial. The aim of this study was to evaluate the actual available evidence on treatments of anterior open bite in the mixed dentition in order to assess the effectiveness of the early treatment in reducing open bite, the most efficacious treatment strategy and the stability of the results. A literature survey was done on November 15, 2015, by means of appropriate Medical Subject Headings (MeSH) using the following databases: PubMed, EMBASE, Cochrane Library, LILACS, VHL, and WEB OF SCIENCE. Randomized clinical trials and studies with a control group (treated or untreated) were then selected by two authors. Trials including patients with syndromes or in the permanent dentition and studies concerning treatment with extractions, full-fixed appliances, or surgery were not considered. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Two thousand five hundred sixty-nine studies about open bite were available; the search strategy selected 240 of them. Twenty-four articles have been judged suitably for the final review, and their relevant data were analyzed. Although this review confirms the effectiveness of early treatment of open bite, particularly when no-compliance strategies are employed, meta-analysis was unfeasible due to lack of standardization, important methodological limitations, and shortcomings of the studies. A more robust approach to trial design in terms of methodology and error analysis is needed. Besides, more studies with longer periods of follow-up are required.
Rodrigues, Gustavo Tirado
ABSTRACT Obtaining long term stability allied to functional and aesthetic balance is the main goal of any orthodontic-orthopedic therapy. This case report describes the orthodontic therapy applied to a 7-year-9-month old child, who presented a Class II, division 1 malocclusion associated to skeletal open bite. Functional and skeletal corrections (sagittally and vertically) were obtained by means of mandible advancement achieved with a closed Balter’s bionator appliance followed by a fixed appliance. This approach showed to be efficient in accomplishing both functional and aesthetic goals, that were kept stable five years after the treatment was finished. This case report was presented to the Board of Directors of the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as partial requirement to becoming a Diplomate of the BBO. PMID:29160350
Singh, Vinita; Hamdan, Ahmad; Rock, Peter
The aim of the study was to assess the perception of dental aesthetics and treatment need in 10- to 11-year-old children using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need. Subjects were asked to rank the 10 AC photographs in order from the one which looked the best set of teeth to the worst. They were also asked to say whether or not the teeth in each picture required orthodontic treatment. Three hundred and seventy-nine children completed the first task but only 369 were able to decide on treatment need for every picture. Girls ranked the pictures in the order 1, 3, 2, 4, 5, 6, 7, 9, 8, and 10; the boys' sequence was 1, 2, 3, 4, 5, 6, 9, 7, 8, and 10. Significant differences were found between girls and boys for the median rankings of photographs 2 (P < 0.02), 3 (P < 0.004), 5 (P < 0.03), 6 (P < 0.05), and 8 (P < 0.01). The sequence selected by the total sample was similar to that chosen by boys. The cut-off point for which photograph indicated a need for treatment was grade 4 (54.5 per cent), which was 34.7 per cent above the grade 3 score of 19.8 per cent. Three pairs of photographs were allocated similar median ranks, two and three received a rank of 3; five and six a rank of 6; and seven and nine a rank of 7. It is therefore possible that the number of AC grades could be reduced to the five photographs: 1, 4, 6, 8, and 10 in order to simplify the index without reducing its reliability. This premise could be tested by presenting firstly the five photographs and then the 10 on a separate occasion to see how the same participants rated the two sets of pictures.
Kararia, Vandana; Jain, Pradeep; Chaudhary, Seema; Kararia, Nitin
The biocompatibility of orthodontic dental alloys has been investigated over the past 20 years, but the results have been inconclusive. The study compares standard 3 M Unitek nickel-titanium (NiTi) and stainless steel archwires with locally available JJ orthodontics wires. Scanning electron microscope (SEM) study of surface changes and complexometric titration to study compositional change was performed. Ten archwires each of group 1-3 M 0.016" NiTi, group 2-JJ 0.016" NiTi, group 3-3 M 0.019" *0.025" SS and group 4-JJ SS contributed a 10 mm piece of wire for analysis prior to insertion in the patient and 6 weeks post insertion. SEM images were recorded at ×2000, ×4000 and ×6000 magnification. The same samples were subjected to complexiometric titration using ethylenediaminetetraacetic acid to gauge the actual change in the composition. The SEM images of all the archwires showed marked changes with deep scratches and grooves and dark pitting corrosion areas post intraoral use. 3M wires showed an uniform criss-cross pattern in as received wires indicating a coating which was absent after intraoral use. There was a significant release of Nickel and Chromium from both group 3 and 4. Group 2 wires released ions significantly more than group 1 (P = 0.0). Extensive and stringent trials are required before certifying any product to be used in Orthodontics.
Lin, Chia-Hung; Short, Lesley L; Banting, David W
The decision regarding extraction or non-extraction orthodontic treatment for patients with different skeletal facial patterns is more commonly based on traditional concepts rather than scientific facts. The present study aimed to investigate whether dolichofacial patients responded differently compared with mesofacial patients to non-extraction orthodontic treatment with respect to vertical changes in facial height. Twenty-eight dolichofacial patients and 29 mesofacial patients who underwent non-extraction orthodontic treatment were selected. All patients commenced treatment prior to 15 years of age and had a mean age of 12.3 years for the dolichofacial group and 12.6 years for the mesofacial group. Serial lateral cephalometric radiographs were traced by hand on acetate paper and digitised using the Rocky Mountain Orthodontics JOE 32 programme. Statistical analysis examined the recorded changes in facial axis angle, facial angle, menton-to-ANS distance and facial convexity. An increase in menton-to-ANS distance and facial angle and a decrease in facial convexity were observed in both groups to a similar extent. Interestingly, the facial axis of both groups remained constant throughout treatment and up to two years post-treatment. Both groups showed slightly increased facial axis angle beyond the original value at two years post-treatment. No statistically significant difference between the two groups was observed in the changes of any of the variables over time. The results countered the traditional concept that dolichofacial patients would have an increased facial height after being subjected to non-extraction orthodontic mechanics. It appeared that long-term vertical height of the face was more dependent on genetics rather than environmental influences.
Frapier, Laure; Garcia, Claude; Pic, Emmanuel; Morant, Flora; Belguendouz, Samir; Gauthier, Aurélie; Raynal, Perrine
Adult patients who consult an orthodontist are looking for dental rehabilitation underpinned by an implicit esthetic demand, which needs to be analyzed. When the discrepancy involves more than the teeth and cannot be corrected by dentoalveolar compensation alone, there is a need, on account of the lack of growth, the periodontal setting and underlying dysfunctions, for an orthodontic-surgical solution. A clear understanding of the required future functional balance will help achieve a satisfactory esthetic target and give stable, lasting results. Copyright © 2013. Published by Elsevier Masson SAS.
Choi, Jong Woo; Bradley, James P
"Surgery-First" for patients with malocclusion and skeletal disharmony is a new process of employing bony corrective surgery (first) without removal of dental compensations followed by orthodontic finishing (second). This process breaks with the time-tested principles of traditional orthognathic surgery. Not unexpectedly, there is slow adoption of this new process, particularly in the West. Ten frequently asked questions regarding Surgery First are asked and answered in this report in an attempt to provide an increased level of comfort for Plastic and Maxillofacial Surgeons in instituting this process in their practice.
Demirci, Mustafa; Tuncer, Safa; Öztaş, Evren; Tekçe, Neslihan; Uysal, Ömer
To evaluate the medium-term clinical performance of direct composite build-ups for diastema closures and teeth recontouring using a nano and a nanohybrid composite in combination with three- or two-step etch-and-rinse adhesives following treatment with fixed orthodontic appliances. A total of 30 patients (mean age, 19.5 years) received 147 direct composite additions for teeth recontouring and diastema closures. A nano and a nanohybrid composite (Filtek Supreme XT and CeramX Duo) were bonded to tooth structure by using a three-step (Scotchbond Multipurpose) or a two-step (XP Bond) etch and rinse adhesive. Ten out of 147 composite build-ups (composite addition) constituted tooth recontouring cases, and the remaining 137 constituted diastema closure cases. The restorations were evaluated by two experienced, calibrated examiners according to modified Ryge criteria at the following time intervals: baseline, 1, 2, 3, and 4 years. The 4-year survival rates were 92.8 % for Filtek Supreme XT/Scotchbond Multi-Purpose Plus and 93 % for CeramX Duo/XP Bond. Only ten restorations failed (5 Filtek Supreme XT and 5 CeramX Duo). Statistical analysis revealed no significant differences between the two composite-adhesive combinations with respect to color match, marginal discoloration, wear/loss of anatomical form, caries formation, marginal adaptation, and surface texture on comparing the five time periods (baseline, 1, 2, 3, and 4 years) The 4-year survival rates in the present study were favorable. The restorations exhibited excellent scores with regard to color match, marginal adaptation, surface texture, marginal discoloration, wear/loss of anatomical form, and caries formation, after 4 years of clinical evaluation. Clinical relevance An alternative clinical approach for correcting discrepancies in tooth size and form, such as performing direct composite restorations following fixed orthodontic treatment, may be an excellent and minimally invasive treatment.
Yuksel, Sengul; Ozturk, Firat; Karatas, Orhan Hakki; Yalcin, Muhammet
Objective This study evaluated the cytotoxicity and genotoxicity of fixed orthodontic treatment with three different light-cured orthodontic bonding composites by analyzing micronucleus (MN) formation in the buccal mucosa during a 6-month period. Methods Thirty healthy volunteers were selected from consecutive patients referred for orthodontic treatment. Equilibrium 2 brackets and molar tubes (Dentaurum) were bonded with three different light-cured orthodontic bonding composites-Transbond XT (3M Unitek), Kurasper F (Kuraray Europe), or GrenGloo (Ormco Corporation)- to all teeth in both arches. Exfoliated buccal epithelial cells were scraped from the middle part of the inner cheeks with sterile cement spatulas before treatment and at 1, 3, and 6 months after treatment. MNs and nuclear alterations, such as karyorrhexis (KR), karyolysis (KL), and binucleated cells (BNs), were scored under a light microscope. Repeated measure ANOVA was used to calculate statistical differences in degenerative nuclear abnormalities. Results MN rates did not significantly differ among different time points within the same cell type (p > 0.05). In contrast, the number of BNs in buccal epithelial cells significantly increased in all composite groups (p < 0.01, Transbond XT; p < 0.001, Kurasper F and GrenGloo). KL frequency significantly increased between the beginning and end of the study in the Kurasfer F (0.80 ± 0.79 to 1.90 ± 1.10; p < 0.05) and GrenGloo (1.30 ± 1.06 to 2.40 ± 1.08; p < 0.05) groups. Conclusions After 6 months of fixed orthodontic treatment with different light-cured composites, morphological signs of cytotoxicity were observed but genotoxic effects were absent. PMID:24892026
Zhou, Yang; Li, Zili; Wang, Xiaoxia; Zou, Bingshuang; Zhou, Yanheng
In this study, we aimed to compare treatment efficacy and postsurgical stability between minimal presurgical orthodontics and conventional presurgical orthodontics for patients with skeletal Class III malocclusion. Forty patients received minimal presurgical orthodontics (n = 20) or conventional presurgical orthodontics (n = 20). Lateral cephalograms were obtained before treatment, before orthognathic surgery, and at 1 week, 3 months, 6 months, and 12 months after surgery. Changes of overjet and mandibular incisal angle before surgery were greater in the conventional presurgical orthodontics group than in the minimal presurgical orthodontics group. Postsurgical horizontal changes in Points A and B, overjet, and mandibular incisal angle showed significant differences among the time points. Most of the horizontal and vertical relapses in the maxilla and the mandible occurred within the first 6 months in both groups. Minimal presurgical orthodontics and conventional presurgical orthodontics showed similar extents and directions of skeletal changes in patients with Class III malocclusion. However, orthodontists and surgeons should preoperatively consider the postsurgical counterclockwise rotation of the mandible when using minimal presurgical orthodontics. Close and frequent observations are recommended in the early postsurgical stages. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Sant'Anna, Eduardo Franzotti; Araújo, Mônica Tirre de Souza; Nojima, Lincoln Issamu; Cunha, Amanda Carneiro da; Silveira, Bruno Lopes da; Marquezan, Mariana
In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. The aim of this study is to discuss HILT applications in orthodontic treatment. This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.
Hägg, Urban; Wong, Ricky Wing Kit; Liao, Chongshan; Yang, Yanqi
The aim of this study was to evaluate the change in mandibular position during a two-phase orthodontic treatment of skeletal Class II malocclusion. Thirty consecutively treated Chinese male adolescents who had undergone two-phase treatment with Herbst appliance and fixed appliance and fulfilled the specific selection criteria were sampled. Cephalograms taken at T0 (before treatment), T1 (at the end of functional appliance treatment), and T2 (at the end of fixed appliance treatment) were analyzed. The change in sagittal positioning of the mandible was 6.8±3.44 mm in phase I (T0-T1), 0.4±2.79 mm in phase II (T1-T2), and 7.2±4.61 mm in total. The mandible came forward in 100% of the patients at T1. In phase II, it came forward in one-third (positive group) remained unchanged in one-third (stable group) and went backward in one-third (negative group) of the patients. At T2, it came forward twice as much in the positive group compared to the negative group. Mandibular length was significantly increased in 100% of the patients in both phases. In conclusion, during the treatment with functional appliance, the mandibular prognathism increases in all patients, whereas during the treatment with fixed appliance there is no significant change in mandibular prognathism. PMID:25695103
Kararia, Vandana; Jain, Pradeep; Chaudhary, Seema; Kararia, Nitin
Introduction: The biocompatibility of orthodontic dental alloys has been investigated over the past 20 years, but the results have been inconclusive. The study compares standard 3 M Unitek nickel-titanium (NiTi) and stainless steel archwires with locally available JJ orthodontics wires. Scanning electron microscope (SEM) study of surface changes and complexometric titration to study compositional change was performed. Materials and Methods: Ten archwires each of group 1–3 M 0.016” NiTi, group 2-JJ 0.016” NiTi, group 3–3 M 0.019” *0.025” SS and group 4-JJ SS contributed a 10 mm piece of wire for analysis prior to insertion in the patient and 6 weeks post insertion. SEM images were recorded at ×2000, ×4000 and ×6000 magnification. The same samples were subjected to complexiometric titration using ethylenediaminetetraacetic acid to gauge the actual change in the composition. Observations and Results: The SEM images of all the archwires showed marked changes with deep scratches and grooves and dark pitting corrosion areas post intraoral use. 3M wires showed an uniform criss-cross pattern in as received wires indicating a coating which was absent after intraoral use. There was a significant release of Nickel and Chromium from both group 3 and 4. Group 2 wires released ions significantly more than group 1 (P = 0.0). Conclusion: Extensive and stringent trials are required before certifying any product to be used in Orthodontics. PMID:25684911
Long, Hu; Wang, Yan; Jian, Fan; Liao, Li-Na; Yang, Xin; Lai, Wen-Li
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons: the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway—periaqueductal grey and dorsal raphe—has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti-inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviating orthodontic pain in the future. PMID:27341389
Ishii, Takenobu; Sakamoto, Teruo; Ishikawa, Munetada; Yasumura, Toshihiko; Miyazaki, Haruyo; Sueishi, Kenji
The present study targeted patients with unilateral cleft lip and palate (UCLP) undergoing either one - (Wardill technique) or two-stage palatoplasty (Perko technique). Correlations between Goslon Yardstick scores and orthodontic appliances used and whether an osteotomy was performed were investigated. No differences were observed between the two types of palatoplasty in terms of Goslon Yardstick scores. A palatal expander and protraction facemask were used in Phase I of orthodontic treatment. The palatal expander was selected for most patients with UCLP in Phase I, regardless of the surgical technique used. A protraction facemask was used in patients undergoing the Wardill procedure who had a Goslon Yardstick score placing them in Group 3 or 4. In contrast, a protraction facemask was used in patients undergoing the Perko procedure who had a Goslon Yardstick score placing them in Group 4. No significant differences were observed in the Goslon Yardstick scores yielded by either type of procedure. The Goslon Yardstick score in relation to whether an osteotomy was performed in Phase II as part of orthodontic treatment was determined, focusing on the relationship between that score and the palatoplasty method used. A protraction facemask was used in patients undergoing the Perko procedure, which eliminated the need for an osteotomy at a future date. However, a protraction facemask was also used in patients undergoing the Wardill option, and those patients were likely to require an osteotomy. In other words, the results suggest that the type of palatoplasty selected will determine the effectiveness of any orthodontic appliances used.
Al-Sarheed, M; Bedi, R; Hunt, N P
To determine the self-perception and need for orthodontic treatment in young sensory [visual (VI) and hearing (HI)] impaired children attending special schools in Riyadh, Saudi Arabia. Also, to determine if gender and social class background influence the rating and self-perception of malocclusion among the children. Riyadh, Saudi Arabia. A prospective study on orthodontic treatment need in sensory impaired children. Seventy-seven VI, 210 HI, and 494 control (C) children aged 11-16 years. The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was determined using the standard 10 pictures for the C group and HI with a modified version (tactile graphic) for VI. The dental health component (DHC) and AC of IOTN were used to allocate each child to no need, borderline need and definite need for treatment subgroups. Sixty-five per cent of VI, 21.8 per cent HI, and 18.7 per cent of the C were perceived to be in need of orthodontic treatment. However, 55.8 VI, 43 per cent HI and 34 per cent C were rated for treatment need based upon the AC. The difference between the examiner and the child's rating of treatment need was found to be statistically significant among the HI and control children (P < 0.001). The VI children who were scored for treatment by the examiner as having need for treatment had similar perceptions of their treatment need irrespective of their social background. Male VI children had a higher DHC score, but both VI and HI males had a higher normative and self-perceived need based on AC.
Rey, Diego; Aristizabal, Juan Fernando; Oberti, Giovanni; Angel, David
To show craniofacial and dental changes to the mandibular dentition with the use of cervical headgear as well as the mechanics used in the early management of Class III malocclusions. Clinical photos and cephalometric radiographs of 5 patients with different types of Class III malocclusion treated with mandibular cervical headgear are shown in this article. The use of the mandibular cervical headgear showed to be clinically effective in the treatment of different types of Class III malocclusions. The main effects of the appliance were posterior and anterior rotation of the mandible and distalization of the mandibular molars. The mandibular cervical headgear is a good alternative for the treatment of these cases and is well-accepted and tolerated by the patients.
Fornaini, Carlo; Brulat, Nathalie; Milia, Giulia; Rockl, Andrea; Rocca, Jean-Paul
This « in-vitro » study had two specific aims: the first, to test using a universal testing machine whether sub-ablative Er:YAG laser irradiation prior to acid etching is effective in orthodontic bracket bonding and secondly using micro-hardness measurements and Scanning Electron Microscopy (SEM) observations to investigate the effectiveness of de-mineralization reduction in enamel treated with sub-ablative Er:YAG laser irradiation followed by fluoride varnish application. One hundred and eighty bovine permanent maxillary incisors were selected for shear bond strength testing and microhardness measurements. Sub-ablative Er:YAG laser irradiation was set at a power density of 2.5 J/cm(2), a frequency of 7 Hz and air/water spray. Brackets were bonded with an auto-curing resin paste. The shear bond strength was measured comparing laser irradiated and non-irradiated enamel surface, followed by SEM observation of the bracket-resin-enamel interface. Microhardness measurements were made on enamel samples before treatment, after samples preparation, and after demineralization. While the adhesion of orthodontic brackets to bovine enamel after sub-ablative Er:YAG laser irradiation and acid etching is comparable to that obtained after conventional acid etching, the effect of laser irradiation associated with topical application of fluoride varnish increases the microhardness of enamel. Sub-ablative Er:YAG laser irradiation before the acid etching doesn't reduce the shear bond whereas when associated with fluoride application it may play a role in caries prevention. Further studies will be necessary to establish the mechanism by which the protective laser activated fluoride effect is achieved.
Bardinet, Etienne; Baron, Pascal; Bazert, Cédric; Boileau, Marie-José; Bougues, Roger; de Brondeau, François; Darqué, François; Faure, Jacques; Gardes, Christian; Garnier, Emmanuel; Milheau, Jean-François; Nakache, Carole; Pujol, André; Treil, Jacques
From an orthodontic point of view, asymmetries can be gathered in three great clinical entities: mandibular lateral deviations, dental asymmetries without skeletal involvement, skeletal asymmetries. Once the therapeutic aims and the principles of the orthodontic approach of these dysmorphoses have been recalled, the authors present the various orthodontic means implemented in this type of treatment. Four cases treated illustrate those types of treatment. Vertical non-surgical asymmetry may have an obvious local origin, for instance, a unilateral damage to a nerve. but usually, there is no evident origin. Frequently the occlusal slippage of a severe sagittal or a vertical malformation, which may evolve as a borderline surgery case, is suspected to be the real cause. In these cases, the diagnosis is always late, with the ending growth. The treatment needs peculiar strong asymmetric mechanics and, sometimes, unilateral mixed extractions. The post-treatment occlusion can be unstable; for this reason, the finishing steps must be carefully conducted. Four clinical case reports develop these points ov view. Multidisciplinary treatments prove very useful to solve three types of clinical situations. In the adult patient, facial esthetics are indicated in severe dentofacial asymmetries. Esthetic improvements of dental nature are still required in deviated smiles, or frontal tippings of the occlusal plane. In addition, asymmetrical intermaxillary relationships will lead to functional anomalies: TMJ disorders, dental wear or lingual dysfunctions. Finally, multidisciplinary treatments in the adult concern the occlusal transverse anomalies, the lateral crossbites, the Class II subdivisions, the deviations of the inter-incisor midlines or unilateral edentulousness. The various plans of treatment, as well as the orthodontic mechanics used, are illustrated in the following development by clinical cases.
Heidari, Somayeh; Torkan, Sepideh
A laser is a collimated single wavelength of light which delivers a concentrated source of energy. Soon after different types of lasers were invented, investigators began to examine the effects of different wavelengths of laser energy on oral tissues, routine dental procedures and experimental applications. Orthodontists, along with other specialist in different fields of dentistry, can now benefit from several different advantages that lasers provide during the treatment process, from the beginning of the treatment, when separators are placed, to the time of resin residues removal from the tooth surface at the end of orthodontic treatment. This article outlines some of the most common usages of laser beam in orthodontics and also provides a comparison between laser and other conventional method that were the standard of care prior to the advent of laser in this field. PMID:25606324
Beerens, Moniek W; Boekitwetan, Florence; van der Veen, Monique H; ten Cate, Jacob M
White spot lesions (WSL) are an important side-effect of orthodontic multi-bracket (MB) treatment. Standardized monitoring of such WSL may help in caries management. In this retrospective study the discriminatory power of caries assessment on routine digital oral photographs was compared to quantitative light-induced fluorescence (QLF) imaging in monitoring WSL development after debonding of orthodontic appliances. Oral and QLF photographs captured directly after debond (T1) and 1 year thereafter (T2) of 51 subjects, treated with full MB orthodontic appliances were used. Oral photographs were assessed by use of The International Caries Detection and Assessment System (ICDAS) at both time points independently and by side-by-side comparison to assess visual transition (VT). QLF photographs were categorized based on integrated fluorescence loss at T1 and T2. At T1 433 and 384 lesions on 918 buccal surfaces were detected using ICDAS and QLF, respectively. For both methods these numbers were reduced at T2. Changes within ICDAS scores were recorded by VT and showed mainly lesion improvement within ICDAS score 2. The oral and QLF photographs both showed regression of WSL after debonding of MB orthodontic appliances. The VT evaluation was found to have higher discriminatory power in comparison to ICDAS.
Mao, Jeremy J.
The profession of orthodontics is projected to face a multitude of challenges. Do cyclic forces accelerate the rate of tooth movement and hence the speed of orthodontic treatment? Would bioengineered cementum and dentine be a solution to root resorption? What would orthodontics be like when bioengineered periodontal ligament and alveolar bone become clinical practice, or one day, entire teeth are bioengineered? Would it be possible to selectively differentiate stem cells into osteoblasts or osteoclasts by either static or cyclic forces? What is the new demand on orthodontic expertise with increasingly automated appliances? What will be the impact of the next generation of dental implants or rapid prototyped crowns on orthodontics? A century ago, Edward Angle’s practice of fixed appliances, along with other seminal contributions, such as functional appliances, established the profession of orthodontics. Today, the biophysical principles of orthodontics remain largely unchanged from Angle’s era, despite incremental refinements of brackets and wires. The paucity of fundamental innovations in orthodontics for decades presents intrinsic risks for the profession. This review will identify challenges for contemporary orthodontics and delineate strategies for the profession to evolve in an era of unprecedented scientific and technological advances, and serve as a call to action for the orthodontic profession. PMID:25018618
Kettle, Jennifer; Marshman, Zoe; Benson, Philip E; McCarthy, Caroline; Pye, Gurpreet; Sandler, Jonathan; Winchester, Lindsay; Flett, Andrew
To explore the accessibility, usability and relevance of the British Orthodontic Society (BOS) online information resource (OIR), Your Jaw Surgery. Qualitative, cross-sectional study. 5 UK sites. Patients before, during and after treatment for non-cleft skeletal discrepancy. Patients were identified at joint clinics and recruited after having time to view the OIR. Semi-structured interviews were conducted with 17 patients (aged 16-46 years). The interviews were transcribed and thematic analysis was undertaken using a framework approach. The main themes identified were the overall usefulness, personal relevance and positive perceptions of the OIR. The OIR was seen to be useful for patients considering treatment, and potentially useful for patients undergoing treatment. Participants were looking for a personally relevant resource that would give them the best possible idea of how they would look and feel after surgery. The OIR was perceived as trusted, positive and reassuring. Patients at different stages of treatment found the OIR helpful and reassuring. Clinicians may find it useful to direct patients to the OIR to complement a professional consultation, but should be aware that patients may perceive it as presenting a positive image of the long-term benefits of orthognathic surgery.
Fleming, P S; Springate, S D; Chate, R A C
Comprehensive orthodontic treatment typically comprises an initial phase of alignment over a period of four to six months, followed by vertical, transverse and antero-posterior corrections, space closure, finishing and detailing to enhance dental and facial aesthetics and function. Each course of treatment involves a series of decisions and alternatives relating to objectives, appliance design and treatment mechanics. In recent years there has been increasing interest in short-term approaches to treatment with more limited objectives and the avoidance of phases traditionally considered integral to successful treatment. In this review the veracity of accepted truths in orthodontics are discussed; specifically, the importance of initial molar relationship, final incisor relationship, the merits of orthodontic extractions, anticipated treatment times, the value of modern fixed appliance systems, the importance of torque expression and the relative merits of bonded retainers and inter-proximal reduction are considered.
Santiago, José J; Martínez, Carlos J
The Objective Grading System (OGS) was introduced in 1999 by the American Board of Orthodontics (ABO) as an instrument to reduce subjectivity when evaluating cases submitted to the ABO for examination. The objectives of this study were (1) to employ the OGS to determine the percentage of treated and completed cases from the University of Puerto Rico's (UPR) Orthodontic Graduate Program Clinic that would have earned a passing OGS score (according to the ABO standards) and (2) to assess the contribution of various patient characteristics and factors to this score. A total of 64 cases completed during 2007 and 2008 met the inclusion criteria and were evaluated by a calibrated examiner using the OGS. Logistic regression and multiple regression analyses were performed to assess the association between the explanatory variables and the overall OGS score. Of the cases evaluated, 18.8% received a passing OGS score of <20, 34.4% received a borderline score of 20-30, and 46.9% received a failing score of >30. The mean OGS score was 32.17 +/- 13.03 points, similar to the mean OGS score of 34.36 +/- 10.39 reported in 2004 by a similar study. This study demonstrate that 53% of the completed cases at the university clinic obtained a potential passing score as per the ABO (OGS <30 points). Multiple and logistic regression analyses could neither explain the relationship between the explanatory variables and the OGS scores nor predict the probability of a particular case's passing when all variables were considered.
Kinzinger, Gero; Frye, Linda; Diedrich, Peter
It was the aim of this clinical study to compare the skeletal and dentoalveolar effects as well as those on the profile of three different treatment approaches in Class II patients (camouflage orthodontics, dentofacial orthopedics, and combined orthodontic and surgical treatment). Our study cohort consisted of 60 young adults presenting a skeletal Class II, Division 1 malocclusion: 20 patients whose overjet was reduced by camouflage following premolar extraction, 20 patients whose occlusions were corrected by placement of a fixed functional orthopedic appliance, and 20 who underwent orthognathic surgery (bilateral sagittal split osteotomy of the mandible without genioplasty). We documented the therapeutic progress using cephalometry. Each patient group achieved a reduction in overjet via their respective treatment. While no treatment-related changes in the maxillary area were assessable, the effects on the mandible differed. We observed advancement of the bony chin and an increase in mandibular length in the sagittal-diagonal dimension in the surgical and functional orthopedic groups. However, the extent of the treatment-related changes was significant only in the group of patients that had undergone orthognathic surgery. Only the surgical group presented changes in vertical relationships. Incisor repositioning as an outcome of the respective treatments differed fundamentally, with those in the surgical group revealing significant protrusion of the upper incisors. The maxillary incisors were retruded and mandibular incisors proclined in the functional orthopedic group, whereas the upper and lower incisors both retruded significantly in the extraction group. Soft-tissue remodeling bore no linear relationship to treatment-induced skeletal and dental effects. Still, orthognathic surgery led to the most marked profile changes. Treatment using fixed functional orthopedic appliances reduced the convexity of the soft-tissue profile at least moderately. Camouflage
Chen, Yi-Jane; Yao, Chung-Chen; Chang, Zwei-Chieng; Lai, Hsiang-Hua; Lu, Shao-Chun; Kok, Sang-Heng
Facial asymmetry is a common manifestation in patients with Class III malocclusion. The aims of this study were to classify mandibular asymmetry in Class III patients and to evaluate treatment outcomes according to different characteristics of asymmetry. Three dimensional cone-beam CT images of 38 patients were analyzed for menton deviation and discrepancies between bilateral structures of mandibular ramus and body. The patients were classified into 3 groups. Groups 1 and 2 exhibited a larger distance of ramus to midsagittal plane on menton-deviated side. In group 1, menton deviation was greater than ramus asymmetry and the condition was reversed for group 2. Group 3 had menton deviation contralateral to the side with larger transverse ramus distance. The features of asymmetry were delineated and the outcomes after surgical-orthodontic treatment were analyzed. Group 1 exhibited a roll rotation of mandibular structures. Mandibular deviation of group 2 patients was more of a horizontal shift nature rather than rotation. Group 3 patients displayed a yaw rotation of mandible to the side with lesser growth in body and ramus. After treatment, menton deviation and body asymmetry were significantly improved in all 3 groups, but the effect of therapy on ramus asymmetry was less predictable, especially for group 3. The classification system is simple and clinically useful and could form a base for future studies on facial asymmetry. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Yavnai, N; Aizenbud, D
ALS is considered a neurodegenerative disorder caused by progressive death of specific neuronal populations within the gray matter of the central nervous system. The cause of cell death is unknown and patients with ALS will live 3 to 5 years from disease onset. A common cause of death is neuromuscular respiratory failure or cardiac arrhythmias due to insufficient oxygen. The patients develop multiple symptoms and the focus of management is to maintain their quality of life. Orofacial manifestations in ALS are secondary to motor deficits, resulting in dysphagia, muscle spasticity, rigidity and tremor of the orofacial musculature, which can induce soft tissue trauma and sialorrhea. In this report the management of ALS oral symptoms, by means of an elastic silicone full coverage occlusal splint, often used as an orthodontic positioner, is discussed, as well as its advantages and alternatives. The positioner was easily tolerated by the patients who reported improvement in soft tissue trauma lesions due to accidental self biting, and improved control of the drooling due to excessive saliva and difficulty in swallowing.
Chan, A; Antoun, J S; Morgaine, K C; Farella, M
Social media offers an accessible resource for gaining valuable insights into the social culture of bullying. The purpose of this study was to qualitatively analyse Twitter posts for common themes relating to dentofacial features, braces and bullying. Twitter's database was searched from 2010 to 2014 using keywords relevant to bullying, teeth and orthodontics. Two investigators assessed the Twitter posts, and selected those that conveyed the experiences or opinions of bullying victims. The posts were qualitatively analysed using thematic analysis. Of the 548 posts screened, 321 were included in the final sample. Four primary categories relating to 'dental-related bullying' were identified: (i) morphological features, (ii) psychological and psychosocial impact, (iii) coping mechanisms and (iv) the role of family. Bullied individuals reported a diverse range of psychological impacts and coping mechanisms. Secondary categories were also identified. Family members, for example, were found to play both a contributory and mediatory role in bullying. In summary, social media can provide new and valuable information about the causal factors and social issues associated with oral health-related bullying. Importantly, some coping mechanisms may mitigate the negative effects of bullying. © 2017 John Wiley & Sons Ltd.
Whetten, Joshua L; Williamson, Philip C; Heo, Giseon; Varnhagen, Connie; Major, Paul W
Study models provide invaluable information in treatment planning. Digital models have proved to be an effective measurement tool, but their use in treatment planning has not been studied. Ten sets of records of Class II malocclusion subjects (dental study models, lateral cephalograms/tracings, panoramic radiographs, intraoral and extraoral photographs) were used for treatment planning by 20 orthodontists on 2 separate occasions. Digital models were used to evaluate the patients at 1 session and plaster models were used at the other session. Treatment recommendations were scored and compared for agreement. Eleven orthodontists served as the control group, looking at the records on 2 occasions with plaster models for agreement. Good agreement was noted for surgery (P = 1.00, kappa = 0.549), extractions (P = .360, kappa = 0.570), and auxiliary appliances (P = 1.00, kappa = 0.539) for the digital/plaster group. Agreement in the plaster/plaster group for surgery (P = 1.00, kappa = 0.671), extractions (P = 1.00, kappa = 0.626), and auxiliary appliances (P = .791, kappa = 0.672) was also good. Overall proportions of agreement ranged between 0.777 and 0.870 for digital/plaster and 0.818 and 0.873 for plaster/plaster. There was no statistical difference in intrarater treatment-planning agreement for Class II malocclusions based on the use of digital models in place of traditional plaster models. Digital orthodontic study models (e-models) are a valid alternative to traditional plaster study models in treatment planning for Class II malocclusion patients.
Smyth, Robert S D; Ryan, Fiona S
Data sourcesThe Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, Medline and the ClinicalTrials.gov databases.Study selectionRandomised controlled trials (RCTs) and controlled clinical trials (CCTs) of children aged 7-12 years with class III malocclusion undergoing fixed or removable orthodontic treatment for early correction were included.Data extraction and synthesisTwo reviewers independently selected studies, abstracted data and assessed risk of bias. The Cochrane risk of bias tool was used for RCTs and the Downs and Black and the Newcastle-Ottawa scales for CCTs. The primary outcome was correction of reverse overjet. Mean differences (MD) with 95% confidence intervals were calculated and a random effects meta-analysis conducted.ResultsFifteen studies (nine RCTs, six CCTs) were included. Only three of the RCTs were considered to be at low risk of bias, all six CCTs were at high risk of bias.Three RCTs (141 patients) compared protraction facemask and untreated control. The results for reverse overjet (MD = 2.5 mm; 95% CI, 1.21-3.79) and ANB angle (MD = 3.90˚; 95% CI, 3.54-4.25) were statistically significant favouring the facemask group. All CCTs demonstrated a statistically significant benefit in favour of the use of each appliance. However, the studies had high risk of bias.ConclusionsThere is a moderate amount of evidence to show that early treatment with a facemask results in positive improvement for both skeletal and dental effects in the short term. However, there was lack of evidence on long-term benefits. There is some evidence with regard to the chincup, tandem traction bow appliance and removable mandibular retractor, but the studies had a high risk of bias. Further high-quality, long-term studies are required to evaluate the early treatment effects for Class III malocclusion patients.
Patel, Mayara Paim; Henriques, José Fernando Castanha; de Almeida, Renato Rodrigues; Pinzan, Arnaldo; Janson, Guilherme; de Freitas, Marcos Roberto
The purpose of this study was to cephalometrically compare the skeletal and dentoalveolar effects in the treatment of Class II malocclusion with Pendulum and Jones jig appliances, followed by fixed corrective orthodontics, and to compare such effects to a control group. The sample was divided into three groups. Group 1: 18 patients treated with Pendulum, Group 2: 25 patients treated with Jones jig, and Group 3: 19 young subjects with untreated Class II malocclusions and initial mean age of 12.88 years. The chi-square test was applied to assess severity and gender distribution. Groups 1 and 2 were compared to the control group by means of the one-way ANOVA and Tukey tests in order to differentiate treatment changes from those occurred by craniofacial growth. There were no significant changes among the three groups with regard to the components of the maxilla and the mandible, maxillomandibular relationship, cephalometric and tegumental pattern. Buccal tipping of mandibular incisors was significantly greater in the experimental groups and increased mesial angulation of the maxillary second molars was found in the Jones jig group. In the experimental groups, dental relationship, overbite and overjet were corrected. It can be stated that the distalization achieved its purpose of correcting the Class II.
Bergstrand, Fredrik; Twetman, Svante
Objective: The aim of this paper was to update the evidence for primary and secondary prevention (treatment) of white spot lesions (WSL) adjacent to fixed orthodontic appliances. Material and methods: A search for relevant human clinical trials published in English between 2004 and March 2011 retrieved 25 publications that fulfilled the inclusion criteria. The papers were assessed for prevented fraction and/or absolute risk reduction when possible. Results and conclusions: The findings consolidated the use of topical fluorides in addition to fluoride toothpaste as the best evidence-based way to avoid WSL. The mean prevented fraction based on 6 trials was 42.5% with a range from -4% to 73%. The recent papers provided the strongest support for regular professional applications of fluoride varnish around the bracket base during the course of orthodontic treatment. For the treatment of post-orthodontic WSL, home-care applications of a remineralizing cream, based on casein phosphopeptide-stabilized amorphous calcium phosphate, as adjunct to fluoride toothpaste could be beneficial but the findings were equivocal. For emerging technologies such as sugar alcohols and probiotics, still only studies with surrogate endpoints are available. Thus, further well-designed studies with standardized regimes and endpoints are needed before guidelines on the non-fluoride technologies can be recommended. PMID:21966335
Kachoei, Mojgan; Rikhtegaran, Sahand; Fathalizadeh, Farzaneh; Navimipour, Elmira J.
Objectives: Satisfactory bonding of orthodontic attachments to amalgam is a challenge for orthodontists. The aim of this in vitro study was to compare the shear bond strength of stainless steel orthodontic brackets to silver amalgam treated with sandblasting and Er,Cr:YSGG laser. Study Design: Fifty-four amalgam discs were prepared, polished and divided into three groups: In group 1 (the control group) the premolar brackets were bonded using Panavia F resin cement without any surface treatment; in groups 2 and 3, the specimens were subjected to sandblasting and Er,Cr:YSGG laser respectively, before bracket bonding. After immersing in distilled water at 37°C for 24 hours, all the specimens were tested for shear bond strength. Bond failure sites were evaluated under a stereomicroscope. Data was analyzed using one-way ANOVA and a post hoc Tukey test. Results: The highest and lowest shear bond strength values were recorded in the laser and control groups, respectively. There were significant differences in mean shear bond strength values between the laser and the other two groups (p<0.05). However, there were no significant differences between the sandblast and control groups (p=0.5). Conclusions: Amalgam surface treatment with Er,Cr:YSGG laser increased shear bond strength of stainless steel orthodontic brackets. Key words: Amalgam, surface treatment, shear bond strength, sandblasting, Er,Cr:YSGG laser. PMID:22143706
Pithon, Matheus Melo; Oliveira, Márlio Vinícius de; Ruellas, Antonio Carlos de Oliveira; Bolognese, Ana Maria; Romano, Fábio Lourenço
The purpose of the present study was to evaluate the shear bond strength to enamel and the adhesive remnant index (ARI) of both metallic and polycarbonate brackets bonded under different conditions. Ninety bovine permanent mandibular incisors were embedded in acrylic resin using PVC rings as molds and assigned to 6 groups (n=15). In Groups 1 (control) and 3, metallic and polycarbonate orthodontic brackets were, respectively, bonded to the enamel surfaces using Transbond XT composite according to the manufacturer's recommendations. In Groups 2 and 4, both types of brackets were bonded to enamel with Transbond XT composite, but XT primer was replaced by the OrthoPrimer agent. In Groups 5 and 6, the polycarbonate bracket bases were sandblasted with 50-microm aluminum-oxide particle stream and bonded to the enamel surfaces prepared under the same conditions described in Groups 3 and 4, respectively. After bonding, the specimens were stored in distilled water at 37 degrees C for 24 hours and then submitted to shear bond strength test at a crosshead speed of 0.5 mm/min. The results (MPa) showed no statistically significant difference between Groups 4 and 6 (p>0.05). Likewise, no statistically significant differences (p>0.05) were found among Groups 1, 2, and 5, although their results were significantly lower than those of Groups 4 and 6 (p<0.05). Group 3 had statistically significant lower bond strength than Groups 2, 4, and 6, but no statistically significant differences were found on comparison to Groups 1 and 5. A larger number of fractures at the bracket/composite interface were evidenced by the ARI scores. OrthoPrimer bonding agent yielded higher bond strength in the groups using either conventional or sandblasted polycarbonate brackets, which was not observed in the groups using metallic brackets.
Pithon, Matheus Melo; de Oliveira, Márlio Vinícius; Ruellas, Antonio Carlos de Oliveira; Bolognese, Ana Maria; Romano, Fábio Lourenço
The purpose of the present study was to evaluate the shear bond strength to enamel and the adhesive remnant index (ARI) of both metallic and polycarbonate brackets bonded under different conditions. Ninety bovine permanent mandibular incisors were embedded in acrylic resin using PVC rings as molds and assigned to 6 groups (n=15). In Groups 1 (control) and 3, metallic and polycarbonate orthodontic brackets were, respectively, bonded to the enamel surfaces using Transbond XT composite according to the manufacturer's recommendations. In Groups 2 and 4, both types of brackets were bonded to enamel with Transbond XT composite, but XT primer was replaced by the OrthoPrimer agent. In Groups 5 and 6, the polycarbonate bracket bases were sandblasted with 50-μm aluminum-oxide particle stream and bonded to the enamel surfaces prepared under the same conditions described in Groups 3 and 4, respectively. After bonding, the specimens were stored in distilled water at 37°C for 24 hours and then submitted to shear bond strength test at a crosshead speed of 0.5 mm/min. The results (MPa) showed no statistically significant difference between Groups 4 and 6 (p>0.05). Likewise, no statistically significant differences (p>0.05) were found among Groups 1, 2, and 5, although their results were significantly lower than those of Groups 4 and 6 (p<0.05). Group 3 had statistically significant lower bond strength than Groups 2, 4, and 6, but no statistically significant differences were found on comparison to Groups 1 and 5. A larger number of fractures at the bracket/composite interface were evidenced by the ARI scores. OrthoPrimer bonding agent yielded higher bond strength in the groups using either conventional or sandblasted polycarbonate brackets, which was not observed in the groups using metallic brackets. PMID:19089115
Neeley, Wendell W; Kluemper, G Thomas; Hays, Lon R
Substance abuse by adolescents is a serious problem that will touch every orthodontic practice. Recent data show that 40% of tenth graders in the United States will use an illicit drug at some time, and 18% will do so in a 30-day period. These are significant figures that should impact orthodontic diagnosis and treatment planning. The nature of orthodontic treatment is unique in that the orthodontist will see relatively healthy adolescent patients on a monthly basis over a period of years. The orthodontist is in a prime position to recognize potential substance abuse problems and make referrals. This article discusses various types of substance abuse, diagnosis, options for referral, and orthodontic implications.
FREITAS, José Alberto de Souza; GARIB, Daniela Gamba; OLIVEIRA, Thais Marchini; LAURIS, Rita de Cássia Moura Carvalho; de ALMEIDA, Ana Lúcia Pompéia Fraga; NEVES, Lucimara Teixeira; TRINDADE-SUEDAM, Ivy Kiemle; YAEDÚ, Renato Yassutaka Faria; SOARES, Simone; PINTO, João Henrique Nogueira
The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies - University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics. PMID:22666849
Freitas, José Alberto de Souza; Garib, Daniela Gamba; Oliveira, Marchini; Lauris, Rita de Cássia Moura Carvalho; Almeida, Ana Lúcia Pompéia Fraga de; Neves, Lucimara Teixeira; Trindade-Suedam, Ivy Kiemle; Yaedú, Renato Yassutaka Faria; Soares, Simone; Pinto, João Henrique Nogueira
The aim of this article is to present the pediatric dentistry and orthodontic treatment protocol of rehabilitation of cleft lip and palate patients performed at the Hospital for Rehabilitation of Craniofacial Anomalies-University of São Paulo (HRAC-USP). Pediatric dentistry provides oral health information and should be able to follow the child with cleft lip and palate since the first months of life until establishment of the mixed dentition, craniofacial growth and dentition development. Orthodontic intervention starts in the mixed dentition, at 8-9 years of age, for preparing the maxillary arch for secondary bone graft procedure (SBGP). At this stage, rapid maxillary expansion is performed and a fixed palatal retainer is delivered before SBGP. When the permanent dentition is completed, comprehensive orthodontic treatment is initiated aiming tooth alignment and space closure. Maxillary permanent canines are commonly moved mesially in order to substitute absent maxillary lateral incisors. Patients with complete cleft lip and palate and poor midface growth will require orthognatic surgery for reaching adequate anteroposterior interarch relationship and good facial esthetics.
Karabekiroğlu, Said; Ünlü, Nimet; Küçükyilmaz, Ebru; Şener, Sevgi; Botsali, Murat Selim; Malkoç, Sıddık
To determine the efficacy of topical applications of 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste in reverting white spot lesions (WSLs) after fixed orthodontic treatment. Forty one participants were randomly assigned to either the test group (CPP-ACP) or the control group (only fluoride toothpaste). All patients used regular fluoride-containing toothpaste. CPPACP paste or fluoridated toothpaste was applied on to tooth surfaces with WSLs twice a day during 36-month after de-bonding. The labial/buccal surfaces of teeth were assessed by use of DIAGNOdent pen (DD), Gorelick Index and ICDAS II criteria at baseline (T1) and 36-month (T2) follow-up visits. The total counts of Streptococcus mutans and Lactobacillus were obtained at T1 and T2. DMFT, DMFS, stimulated flow rate and buffer capacity were calculated in two appointments. Daily usage of CPP-ACP paste was not better than normal care for improving the appearance of WSLs after 36 months.
Lima, Karina Jerônimo Rodrigues Santiago de; Henriques, José Fernando Castanha; Janson, Guilherme; Pereira, Suelen Cristina da Costa; Neves, Leniana Santos; Cançado, Rodrigo Hermont
The aim of this study was to compare the dentoskeletal changes of patients with Class II Division 1 malocclusion treated with either the Jasper jumper appliance or the activator-headgear combination, both associated with fixed appliances. The sample comprised 72 subjects with Class II Division 1 malocclusion divided into 3 groups: group 1 included 25 subjects treated with fixed appliances and the force modules of the Jasper jumper at an initial mean age of 12.72 years, group 2 included 25 subjects treated with the activator-headgear combination followed by fixed appliances at an initial mean age of 11.07 years, and group 3 included 22 untreated subjects at an initial mean age of 12.67 years. Initial cephalometric characteristics and dentoskeletal changes were compared with analysis of variance. Both experimental groups had similar dentoskeletal changes: restrictive effect on the maxilla, clockwise mandibular rotation and a slight increase in anterior face height, retrusion of the maxillary incisors, distalization of the maxillary molars, protrusion of the mandibular incisors, extrusion of the mandibular molars, and significant improvements of the maxillomandibular relationship, overjet, overbite, and the molar relationship. The effects of the Jasper jumper and the activator-headgear combination followed by fixed orthodontic appliances were similar in Class II malocclusion treatment. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Amini, Fariborz; Shariati, Mahsa; Sobouti, Farhad; Rakhshan, Vahid
Nickel and chromium might induce hypersensitivity. Therefore, they are of interest to orthodontists. Gingival crevicular fluid (GCF) is highly relevant to orthodontic treatments and might reflect systemic changes associated with the inflammatory response induced by orthodontic forces. Therefore, it might also be used to show metal ion changes. Nevertheless, baseline metal levels of GCF are unknown, and the effect of orthodontic treatment on GCF metal levels has not been investigated. The aim of this study was to assess the levels of nickel and chromium in GCF. Based on a pilot study, the sample size was predetermined as 24 × 3 measurements to obtain test powers above 90%. Nickel and chromium concentrations were measured before treatment and 1 month and 6 months later in 12 female and 12 male patients who had fixed orthodontic appliances using atomic absorption spectrophotometry. The gingival index was also evaluated in each session. The effects of treatment on GCF ions were analyzed using repeated-measures analysis of variance and Friedman tests (α = 0.05, β ≤0.01). The gingival index worsened over time (chi-square test, P <0.001). The mean nickel levels were 3.894 ± 1.442, 5.913 ± 2.735, and 19.810 ± 8.452 μg per gram, respectively, at baseline, month 1, and month 6. Chromium concentrations were 1.978 ± 0.721, 4.135 ± 1.591, and 13.760 ± 3.555 μg per gram, respectively. Compared with the baseline, nickel increased by 150% and 510%, respectively, in the first and sixth months (Friedman, P <0.0001), and chromium increased by 200% and 700%, respectively (analysis of variance, P <0.0001). Six months of fixed orthodontic treatment might intensify the levels of nickel and chromium in the GCF as well as gingival inflammation. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Khaneh Masjedi, Mashallah; Haghighat Jahromi, Nima; Niknam, Ozra; Hormozi, Elham; Rakhshan, Vahid
Although nickel and chromium are known as allergen and cytotoxic orthodontic metals, very few and controversial studies have assessed the effect of orthodontic treatment on their systemic levels especially those reflected by their best biomarker of exposure, hair. Additionally, metal injection moulding (MIM) brackets are not studied, and there is no study on systemic ion changes following their usage. In this double-blind randomized clinical trial, scalp hair samples of 24 female and 22 male fixed orthodontic patients [as two groups of conventional (two-piece) versus MIM brackets, n = 23×2] were collected before treatment and 6 months later. Randomization was carried out using a computer-generated random number table. The patients, laboratory expert, and author responsible for analyses were blinded of the bracket allocations. Hair nickel and chromium levels were measured using atomic absorption spectrophotometry. The effects of treatment, bracket types, gender, and age on hair ions were analysed statistically (α = 0.05, β ≤ 0.02). In both groups combined (n = 46), nickel increased from 0.1600±0.0890 µg/g dry hair mass (pre-treatment) to 0.3199±0.1706 (6th month). Chromium increased from 0.1657±0.0884 to 0.3066±0.1362 µg/g. Both of these increases were significant (paired t-test, P = 0.0000). Bracket types, age, and gender had no significant influence on ion levels (P > 0.05). ANCOVA indicated different patterns of chromium increases in different genders (P = 0.033) and ages (P = 0.056). Sample size determination should have accounted for the grouping as well. Hair nickel and chromium levels might increase about 185-200% after 6 months. They might not be affected by bracket types. Gender and age might not influence the baseline or 6th-month levels of both metals. Gender might however interact with orthodontic treatment, only in the case of chromium. The research is registered offline (thesis) and online (IR.AJUMS.REC.1394.516). The protocol was pre
Srivastava, Kamna; Tikku, Tripti; Khanna, Rohit; Sachan, Kiran
The formation of white spot lesions or enamel demineralization around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, which mars the result of a successfully completed case. This article is a contemporary review of the risk factors, preventive methods and fate of these orthodontics scars. The importance of excellent oral hygiene practice during fixed orthodontic treatment must be explained. Preventive programs must be emphasized to all orthodontic patients. Suggestions are offered in the literature for ways to prevent this condition from manifesting itself. PMID:24987641
Wang, Qingzhu; Jia, Peizeng; Anderson, Nina K; Wang, Lin; Lin, Jiuxiang
To test the hypothesis that the sagittal position of the anterior teeth has no effect on pharyngeal airway dimension or hyoid bone position and to investigate the influence of orthodontic retraction of the anterior teeth on each section of pharynx and hyoid position. Forty-four Class I bimaxillary protrusion adults, treated with preadjusted appliances and maximum anchorage after extraction of four premolars, were divided into two groups according to their vertical craniofacial skeletal patterns. Pretreatment and posttreatment variables were compared using paired t-test, and the relationship between pharyngeal airway size and dentofacial variables was analyzed using Pearson correlation coefficient. The changes of pharyngeal airway size and hyoid position after treatment were compared between two groups using independent t-test. Upon retraction of the incisors, the upper and lower lips were retracted by 2.60 mm and 3.87 mm, respectively. The tip of upper incisor was retracted by 6.84 mm and lower incisor retracted by 4.95 mm. There was significant decrease in SPP-SPPW, U-MPW, TB-TPPW, V-LPW, VAL, C3H, and SH (P < .05). No statistically significant different changes were observed in the dentofacial structures, pharyngeal airway, and hyoid position between the two groups after the treatment. There was a significant correlation between the retraction distance of lower incisor and the airway behind the soft palate, uvula, and tongue. The pharyngeal airway size became narrower after the treatment. Extraction of four premolars with retraction of incisors did affect velopharyngeal, glossopharyngeal, hypopharyngeal, and hyoid position in bimaxillary protrusive adult patients.
Root resorption can occur at any time during orthodontic treatment and lead to a compromise in the prognosis of the tooth and the stability of the treatment results. Recent research has focused more on the cause and effect relationship as well as preventive or treatment options to combat this unwelcome event. Investigations have highlighted the genetic as well as molecular aspects of the process and enabled clinicians to determine which patients might be susceptible. A proper medical history, an assessment of predisposing factors, a radiographic evaluation for alterations in root morphology and careful planning and execution of orthodontic mechanics may reduce the incidence of root resorption. The current review is aimed at providing clinicians and academics with an insight into the process of root resorption, the methods of identification during its early stages and intervention at the right time to reduce its severity. © 2017 Australian Dental Association.
Girme, Tejashree Suresh; Agrawal, Jiwanasha Manish; Agrawal, Manish Suresh; Fulari, Sangamesh Gurunath; Shetti, Shraddha Subhash; Kagi, Vishwal Ajith
Introduction Hand held mobile phones are presently the most popular means of communication worldwide and have transformed our lives in many aspects. The widespread use of such devices have resulted in growing concerns regarding harmful effects of radiations emitted by them. This study was designed to evaluate the effects of mobile phone usage on nickel ion release as well as pH of saliva in patients with fixed orthodontic appliances. Aim To assess the level of nickel ions in saliva and pH of saliva in mobile phone users undergoing fixed orthodontic treatment using inductively coupled plasma atomic emission spectrometry. Materials and Methods A total of 42 healthy patients with fixed orthodontic appliance in mouth for a duration of six to nine months were selected for the study. They were divided into experimental group (n=21) consisting of mobile phone users and control group (n=21) of non mobile phone users. Saliva samples were collected from both the groups and nickel ion levels were measured using inductively coupled plasma-mass spectroscopy. The pH values were also assessed for both groups using pH meter. Unpaired t-test was used for the data analysis. Results Statistical analysis revealed that though the pH levels were reduced and the nickel ion levels were higher in the experimental group compared to the control group, the results were non significant. Conclusion Mobile phone usage may affect the pH of saliva and result in increased release of nickel ions in saliva of patients with fixed orthodontic appliances in the oral cavity. PMID:29207841
Nanjannawar, Lalita Girish; Girme, Tejashree Suresh; Agrawal, Jiwanasha Manish; Agrawal, Manish Suresh; Fulari, Sangamesh Gurunath; Shetti, Shraddha Subhash; Kagi, Vishwal Ajith
Hand held mobile phones are presently the most popular means of communication worldwide and have transformed our lives in many aspects. The widespread use of such devices have resulted in growing concerns regarding harmful effects of radiations emitted by them. This study was designed to evaluate the effects of mobile phone usage on nickel ion release as well as pH of saliva in patients with fixed orthodontic appliances. To assess the level of nickel ions in saliva and pH of saliva in mobile phone users undergoing fixed orthodontic treatment using inductively coupled plasma atomic emission spectrometry. A total of 42 healthy patients with fixed orthodontic appliance in mouth for a duration of six to nine months were selected for the study. They were divided into experimental group (n=21) consisting of mobile phone users and control group (n=21) of non mobile phone users. Saliva samples were collected from both the groups and nickel ion levels were measured using inductively coupled plasma-mass spectroscopy. The pH values were also assessed for both groups using pH meter. Unpaired t-test was used for the data analysis. Statistical analysis revealed that though the pH levels were reduced and the nickel ion levels were higher in the experimental group compared to the control group, the results were non significant. Mobile phone usage may affect the pH of saliva and result in increased release of nickel ions in saliva of patients with fixed orthodontic appliances in the oral cavity.
Zetu, Irina; Ogodescu, Emilia; Zetu, L; Stratul, S I; Rusu, D; Talpoş, S; Ogodescu, A
Between orthodontics and periodontology there are many correlations, especially in the treatment of adults with already-damaged periodontal tissues and malocclusions. Aim of this paper was to emphasize that an interdisciplinary periodontal-orthodontic treatment could be beneficial even in a case that seemed hopelessly. A typical case of an adult patient with extensive bone loss due to periodontal disease, occlusal trauma caused by dental malpositions, spacing due to early loss of teeth in the lateral segments and pathologic tooth migration will be presented. The orthodontic treatment was initiated at 3 months after the stabilization of the periodontal therapy and was done with a fixed appliance. During the orthodontic stage periodontal maintenance visits continued at 2-month intervals. The therapy of"black triangles" occurred due to the loss of interdental gingiva was done by stripping followed by a space-closure procedure. A permanent retainer was applied. Benefits and problems of the comprehensive periodontal-orthodontic therapy and treatment protocols will be presented. In conclusion the interdisciplinary therapy of this patient, with a good compliance, was beneficial, improved esthetics, the periodontal status, the ability of the patient to clean the teeth and also led to best position of the abutments for optimal placement of prosthetic reconstructions.
Velİ, Ilknur; Akin, Mehmet; Baka, Zelİha Müge; Uysal, Tancan
To compare the effects of different treatment methods used for the enamel damage, on the shear bond strength (SBS) and fracture mode of orthodontic brackets. Freshly-extracted 140 premolars were randomly allocated to seven groups: Group I was considered as the control of other groups. The remaining groups were exposed to demineralization. In group II, brackets were directly bonded to the demineralized enamel surface. CPP-ACP paste (GC Tooth Mousse), fluoride varnish (Bifluorid 12), microabrasion with a mixture prepared with 18% hydrochloric acid and fine pumice powder, microabrasion with an agent (Opalustre) and resin infiltrant (Icon®) were applied in Groups III, IV, V, VI and VII, respectively. The specimens were tested for SBS and bond failures were scored according to the Adhesive Remnant Index (ARI). Analysis of variance and Tukey tests were used to compare the SBS of the groups. ARI scores were compared with G-test. The statistical significance was set at p < 0.05 level. Statistically significant differences were found among seven groups (F = 191.697; p < 0.001). The SBSs of groups I (mean = 18.8 ± 2.0 MPa) and VII (mean = 19.1 ± 1.4 MPa) were significantly higher than the other groups. No statistically significant difference was found between groups IV (mean = 11.5 ± 1.2 MPa) and V (mean = 12.6 ± 1.5 MPa). The differences in ARI scores of the groups were statistically significant (p < 0.01). All demineralization treatment methods improve bonding to demineralized enamel. Resin infiltrant application after demineralization showed similar bond strength values as intact enamel.
Holistic integrative medicine (HIM) is a new medical knowledge system, which is formed based on the theory of HIM. HIM treats people as a whole by combining the results of basic medical research, clinical practice and clinical research during the treatment process. The concept of HIM runs through the education and treatment of orthodontics. HIM is the trending norm of both modern medicine and orthodontics. This review is about the concept of HIM and the advantages and disadvantages of specialization. Moreover, this review also discusses the vital role of HIM in orthodontic treatment and development.
Kinzinger, G S M; Roth, A; Gülden, N; Bücker, A; Diedrich, P R
This study aimed to verify the effects that corrective treatment for skeletal Class II malocclusions with fixed functional orthopaedic appliances has on the relative positions of the articular disc and the mandibular condyle. Orthodontic treatment progress was monitored in 20 patients by magnetic resonance imaging (MRI) at four defined points in time. Visual inspection of the temporomandibular joints (TMJs) was performed on three slices each (lateral, central, medial) of closed-mouth and maximum-open parasagittal MRI. Metric analysis was performed on the central slices of the images obtained in the closed-mouth position. To assess the positional relationship in the sagittal dimension between the articular disc and the mandibular condyle, both methods were used. The comparison of pre-treatment and post-treatment findings revealed in none of the joints that the disc-condyle relationship had been adversely affected as a consequence of the treatment. Rather, the outcome was an improved relationship in a total of eight joints. After groups of joints had been defined by disc position, metric analysis revealed a significantly improved positional relationship in those joints in which an anterior disc displacement had been found initially. Orthodontic treatment with a rigid, fixed functional appliance to correct skeletal distoclusion results in the following side effects on the disc-condyle relationship in the TMJ: the treatment does not have adverse effects on initially physiological disc-condyle relationships; in TMJs with initial partial or total anterior disc displacement, improved disc position can be achieved.
Kassir, Chadi; Assi, Samar Bou
The treatment of open bite malocclusion is generally considered a challenge due to its multifactorial etiology. Many treatment modalities to correct open bites, including orthognathic surgery and dental compensation, have been proposed. Dental compensation (intruding the posterior teeth and uprighting and extruding the anterior teeth with elastics) is a treatment option for borderline patients and those who are reluctant to undergo surgery. This report documents the treatment of a patient with a severe skeletal open bite malocclusion whose treatment plan originally included fixed appliance therapy as well as orthognathic surgery. He was subsequently treated with only fixed appliances. The patient, a male 17 years, 7 months of age, presented with a Class II, Division 1 malocclusion, 5 mm anterior open bite, and an increased anterior facial height. He was treated with extraction of the maxillary and mandibular premolars, full fixed appliances, and anterior vertical elastics. After 30 months of active treatment, a Class I occlusion with improved overjet and overbite was achieved.
Al-Silwadi, Fadi M; Gill, Daljit S; Petrie, Aviva; Cunningham, Susan J
Research has shown that orthodontic patients are more likely to retain information presented in an audiovisual format. However, there has been little research on the effectiveness of audiovisual information provided through different routes such as the Internet. This parallel-group randomized controlled trial assessed whether provision of audiovisual information on the YouTube (Google, San Bruno, Calif) Web site to orthodontic patients undergoing fixed appliance treatment results in improved patient knowledge when compared with conventional methods of information provision. The effects of sex and ethnicity were also investigated. Participants were recruited from the Department of Orthodontics of the Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust, United Kingdom. The patients were 13 years of age and over, with no history of orthodontic treatment, and patient and parental (where appropriate) consent were obtained. The participants were randomized into control (n = 34) and intervention (n = 33) groups using a random number table; there was stratification based on age group, with permuted blocks of 10 patients. Both groups were given routine verbal and written patient information related to fixed appliances, and the participants in the intervention group were sent 3 e-mails over 6 weeks requesting that they view a 6-minute YouTube video containing similar information but in audiovisual format. Patient knowledge was measured using identical questionnaires answered on the day of recruitment (baseline) and again 6 to 8 weeks later. The researchers were unaware of group allocations when enrolling patients and scoring questionnaires. Sixty participants (89.55%) completed the study. Those who completed the trial in the intervention group (n = 30) demonstrated significantly greater improvements in knowledge than did those in the control group (n = 30), scoring, on average, almost 1 point more (95% CI for the difference, 0.305-1.602; P = 0
Park, Jae Hyun; Yu, Joseph; Bullen, Ryan
Nonextraction camouflage treatment along with Class III elastics was used to treat a 39-year-old woman with a skeletal Class III pattern and a low mandibular plane angle and short lower anterior facial height. The total active treatment time was 26 months. Her occlusion, smile esthetics, and soft tissue profile were significantly improved after treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Nichols, Grace A L; Antoun, Joseph S; Fowler, Peter V; Al-Ani, Azza H; Farella, Mauro
The aim of this study was to assess long-term changes and describe the trajectories of oral health-related quality of life (OHRQoL) in a cohort of cleft, surgery, and standard patients who received orthodontic treatment. Standard (n = 16), cleft (n = 19), and orthognathic surgery (n = 22) patients completed the short-form of the Oral Health Impact Profile (OHIP-14) before treatment, immediately posttreatment, and approximately 5 years posttreatment. An overall reduction in OHIP-14 scores (improvement in OHRQoL) occurred after orthodontic treatment; however, this was only significant for the surgery and standard groups (P <0.05). The total OHIP-14 score increased significantly from posttreatment to 5 years follow-up for all 3 study groups (P <0.05). Relative to pretreatment, however, there were significant reductions in total OHIP-14 scores at 5 years posttreatment in the surgery group (-57.4%; P <0.05), but not in the standard sample (-24.2%; P >0.05). By contrast, the OHIP-14 score in the cleft group increased but not significantly (40.2%; P >0.05). Using a mixed model analysis, a significant interaction was detected between patient group and time (ie, study time point) (F = 6.0; P <0.0001), after adjusting for age and sex. Distinct patient groups showed different OHRQoL trajectories after orthodontic treatment. Treatment-related improvements in OHRQoL are maintained over time for surgery patients, but not for those with standard malocclusions and orofacial clefts. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Nayak, Rabindra S; Khanna, Bharti; Pasha, Azam; Vinay, K; Narayan, Anjali; Chaitra, K
Fixed orthodontic appliances with the use of stainless steel brackets and archwires made of nitinol have a corrosive potential in the oral environment. Nickel and chromium ions released from these appliances act as allergens apart from being cytotoxic, mutagenic and carcinogenic in smaller quantities in the range of nanograms. This study was done to evaluate the release of nickel and chromium ions from orthodontic appliances in the oral cavity using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). Saliva samples from 30 orthodontic patients undergoing treatment with 0.022″ MBT mechanotherapy were collected prior to commencement of treatment, after initial aligning wires and after 10-12 months of treatment. Salivary nickel and chromium ion concentration was measured in parts per billion (ppb) using ICP-MS. Mean, standard deviation and range were computed for the concentrations of ions obtained. Results analyzed using ANOVA indicated a statistically significant increase of 10.35 ppb in nickel ion concentration and 33.53 ppb in chromium ion concentration after initial alignment. The ionic concentration at the end of 10-12 months of treatment showed a statistically significant increase in of 17.92 ppb for chromium and a statistically insignificant decrease in nickel ion concentration by 1.58 ppb. Pearson's correlation coefficient showed a positive correlation for an increase in nickel concentration after aligning, but not at the end of 10-12 months. A positive correlation was seen for an increase in chromium ion concentration at both time intervals. Nickel and chromium ion concentration in saliva even though below the recommended daily allowance should not be ignored in light of the new knowledge regarding effects of these ions at the molecular level and the allergic potential. Careful and detailed medical history of allergy is essential. Nickel free alternatives should form an essential part of an orthodontist's inventory.
Nienkemper, M; Wilmes, B; Pauls, A; Drescher, D
The goal of the study was to determine whether mini-implants inserted in the palate can be used to achieve more than one treatment goal consecutively or simultaneously in the same patient. The treatment results of 43 patients were retrospectively assessed. Two implant-supported mechanical systems per patient were applied either consecutively in 19 patients (group A) or simultaneously in 24 patients (group B). Both groups were analyzed and compared by calculating success rates for achievement of the treatment goals, survival of the mini-implants, and quality of anchorage. Durations of treatment were also analyzed for intergroup differences. Except for a single case in group A, the treatment goals were achieved in all patients (success rates 94.7% in group A versus 100% in group B). Anchorage loss was confined to one patient per group (success rates 94.7% in group A and 95.3% in group B). Mini-implant mobility, and hence implant failure, was observed in three implants in group A (survival rate 91.8%) and two implants in group B (survival rate 95.6%). While none of these intergroup differences were statistically significant, the treatment durations in both groups differed widely: those in group B were significantly shorter (10.0 ± 4.2 months) than those in group A (14.4 ± 3.5 months; p = 0.001). Mini-implants inserted in the palate for skeletal anchorage can be used to achieve more than one treatment goal in the same patient. Such multipurpose application can succeed consecutively and simultaneously. The latter option can significantly expedite treatments and should, therefore, be preferred when feasible, depending on the nature of coexisting therapeutic indications in a given patient.
Heath, Elizabeth M; English, Jeryl D; Johnson, Cleverick D; Swearingen, Elizabeth B; Akyalcin, Sercan
Our aims were to assess the perceptions of orthodontic case complexity among orthodontists, general dentists, orthodontic residents, and dental students and to compare their perceptions with the American Board of Orthodontics Discrepancy Index (DI). Orthodontists, general dentists, orthodontic residents, and dental students (n = 343) participated in a Web-based survey. Pretreatment orthodontic records of 29 cases with varying DI scores were obtained. Respondents were asked to evaluate case complexity on a 100-point visual analog scale. Additional information was collected on participants' orthodontic education and orthodontic treatment preferences. Pearson correlation coefficients were used to assess the relationship between the average complexity score and the DI score. Repeated measures analysis with linear mixed models was used to assess the association between the average complexity score and the DI score and whether the association between the 2 scores varied by level of difficulty or panel group. The level of significance for all analyses was set at P <0.05. The results showed that 71.6% of general dentists provided some orthodontic services, with 21.0% providing full fixed appliances and 38.3% providing clear aligners. DI score was significantly associated with complexity perceptions (P = 0.0168). Associations between average complexity and DI score varied significantly by provider group (P = 0.0033), with orthodontists and residents showing the strongest associations. When the DI score was greater than 15, orthodontists and residents perceived cases as more complex than did the other provider groups. Orthodontists and orthodontic residents had better judgments for evaluating orthodontic case complexity. The high correlation between orthodontic professionals' perceptions and DI scores suggested that additional orthodontic education and training have an influence on the ability to recognize case complexity. Copyright © 2017 American Association of
Yitschaky, O; Hofnung, T; Zini, A
Qualitative research is an umbrella term for an array of attitudes and strategies for conducting inquiries that are aimed at discerning how human beings understand, experience, and interpret the social world. It is employed in many different academic disciplines most particularly in the social sciences and humanities, however recently more and more qualitative research is being conducted under the medical sciences including dentistry and orthodontics. This is due to its nature of in-depth investigation, which can provide answers to questions that cannot be satisfactorily answered using quantitative methods alone. The aims of this article are to discuss the characteristics of qualitative research, to review the orthodontic English literature, and to highlight the advantages of qualitative research in orthodontics. The literature review yielded several important conclusions regarding qualitative research in orthodontics: 1. most of the qualitative research done in orthodontics chose to use semi structured in-depth interviews for data collection; 2. qualitative research highlights aspects that are very important, and sometimes crucial to everyday practice and long term treatment; 3. there is a lack of qualitative studies in the field of orthodontics. Taking into account the nature of the orthodontic treatment, which is a prolonged one, demanding of a good orthodontist-patient rapport, and a wide perspective on behalf of the clinician, filling the gap in the discipline through conducting more qualitative studies aimed at understanding the point of view of the patient, as well as that of the clinician, may be beneficial for the improvement of the treatment.
Ireland, A J; Willmot, D; Hunt, N P
Orthodontic treatment is not without risk. This article aims to look at some of the dento-legal issues surrounding orthodontic treatment, the risks to both the clinician and the patient, and how some of these risks can be mitigated.
Benson, Philip E; Parkin, Nicola; Dyer, Fiona; Millett, Declan T; Furness, Susan; Germain, Peter
Demineralised white lesions (DWLs) can appear on teeth during fixed brace treatment because of early decay around the brackets that attach the braces to the teeth. Fluoride is effective in reducing decay in susceptible individuals in the general population. Individuals receiving orthodontic treatment may be prescribed various forms of fluoride treatment. This review compares the effects of various forms of fluoride used during orthodontic treatment on the development of DWLs. This is an update of a Cochrane review first published in 2004. The primary objective of this review was to evaluate the effects of fluoride in reducing the incidence of DWLs on the teeth during orthodontic treatment.The secondary objectives were to examine the effectiveness of different modes of fluoride delivery in reducing the incidence of DWLs, as well as the size of lesions. Participant-assessed outcomes, such as perception of DWLs, and oral health-related quality of life data were to be included, as would reports of adverse effects. We searched the Cochrane Oral Health Group's Trials Register (to 31 January 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12); MEDLINE via OVID (1946 to 31 January 2013); and EMBASE via OVID (1980 to 31 January 2013). We included trials if they met the following criteria: (1) parallel-group randomised clinical trials comparing the use of a fluoride-containing product versus placebo, no treatment or a different type of fluoride treatment, in which (2) the outcome of enamel demineralisation was assessed at the start and at the end of orthodontic treatment. At least two review authors independently, in duplicate, conducted risk of bias assessments and extracted data. Authors of trials were contacted to obtain missing data or to ask for clarification of aspects of trial methodology. The Cochrane Collaboration's statistical guidelines were followed. For the 2013 update of this review, three changes were made
Kubota, T; Yagi, T; Tomonari, H; Ikemori, T; Miyawaki, S
Skeletal Class III patients exhibit malocclusion characterised by Angle Class III and anterior crossbite, and their occlusion shows total or partially lateral crossbite of the posterior teeth. Most patients exhibit lower bite force and muscle activity than non-affected subjects. While orthognathic surgery may help improve masticatory function in these patients, its effects have not been fully elucidated. The aims of the study were to evaluate jaw movement and the electromyographic (EMG) activity of masticatory muscles before and after orthognathic treatment in skeletal Class III patients in comparison with control subjects with normal occlusion. Jaw movement variables and EMG data were recorded in 14 female patients with skeletal Class III malocclusion and 15 female controls with good occlusion. Significant changes in jaw movement, from a chopping to a grinding pattern, were observed after orthognathic treatment (closing angle P < 0.01; cycle width P < 0.01), rendering jaw movement in the patient group similar to that of the control group. However, the grinding pattern in the patient group was not as broad as that of controls. The activity indexes, indicating the relative contributions of the masseter and temporalis muscles (where a negative value corresponds to relatively more temporalis activity and vice versa) changed from negative to positive after treatment (P < 0.05), becoming similar to those of control subjects. Our findings suggest that orthognathic treatment in skeletal Class III patients improves the masticatory chewing pattern and muscle activity. However, the chewing pattern remains incomplete compared with controls. © 2015 John Wiley & Sons Ltd.
Litsas, George; Acar, Ahu
Impaction of maxillary canines is a frequently encountered clinical problem the treatment of which usually requires an interdisciplinary approach. Surgical exposure of the impacted tooth and the complex orthodontic mechanisms that are applied to align the tooth into the arch may lead to varying amounts of damage to the supporting structures of the tooth, not to mention the long treatment duration and the financial burden to the patient. Hence, it seems worthwhile to focus on the means of early diagnosis and interception of this clinical situation. In the present article, theories related with the etiology of impacted canines and predictive variables of canine impaction in the mixed dentition are reviewed with an insight into current interceptive treatment modalities. PMID:21566691
Orthodontics came into being in 1728. Previously, practitioners were at a loss when confronted with crooked teeth. A Latin philosopher had an ingenious flash of orthodontic inspiration. Other authors were content to either extract the malposed teeth or to modify their shape. However, interest in an approach to preventive orthodontics had now begun. © EDP Sciences, SFODF, 2015.
Gencay, Koray; Tuna, Elif Bahar; Yaman, Duygu; Ozgen, Mehmet; Demirel, Korkud
Iatrogenic trauma can be defined as any adverse condition in a patient resulting from treatment by a physician or dentist. Orthodontic treatment carries with it the risks of tissue damage and treatment failure. The aim of this article is to present traumatic oral tissue lesions resulting from iatrogenic orthodontic origin with a 2-year follow-up period based on orthodontic intervention followed by periodontal surgery. The management of traumatic injuries is dependent on the severity of the involvement of the periodontal tissues. While, in most cases, the elimination of the offending agent and symptomatic therapy is sufficient, in severe cases, or when the injury resulted in permanent defects, periodontal/regenerative therapy may be necessary. The dentist must be aware of these risks in order to help the patient make a fully informed choice whether to proceed with orthodontic treatment. The skill, experience, and up-to-date knowledge of dentists are the main factors to prevent possible iatrogenic traumas.
Hamamci, Nihal; Başaran, Güvenç; Tümen, E Caner; Ozdemir, Eylem
Class III malocclusion is a difficult anomaly to understand. Because not all Class III patients are candidates for surgical correction, patient assessment and selection are especially important in diagnosis and treatment planning. In this article, we report the orthopedic treatment of a teenage girl with a severe skeletal Class III malocclusion. Her ANB angle was -4.5 degrees, and she had a 2-mm anterior crossbite, a 1-mm overbite, and a posterior asymmetric crossbite (greater on the left side). The patient refused surgery. We used a rapid palatal expansion appliance to expand the maxilla, standard edgewise brackets to align the teeth, and reverse headgear to bring the maxilla forward. We performed symmetric expansion, but, because of the asymmetric crossbite in the maxilla, we designed a modified apparatus that permitted greater relapse on 1 side. In this way, the posterior crossbite was ideally corrected by the end of treatment, and ideal overjet and overbite relationships, functional occlusion, and an esthetic facial appearance were all achieved.
Rinchuse, Daniel J; Rinchuse, Donald J
This article addresses issues in orthodontics such as timing of treatment, expansion in the absence of a posterior crossbite, serial ex-tractions, treatment of Class II and III malocclusions, treatment of open bites, extraction versus nonextraction, preservation of E-space to resolve crowding, orthodontics and temporomandibular disorders, orthognathic surgery, and current trends in orthodontics. Although much information is presented on these topics, many controversies still exist. When more data from evidence-based systematic reviews become available, more predictable and standardized orthodontic treatments may develop.
... Bar Home Current Issue Past Issues Special Section Kidney Disease: Early Detection and Treatment Past Issues / Winter ... called a "urine albumin-to-creatinine ratio." Treating Kidney Disease Kidney disease is usually a progressive disease, ...
Oh, Hee Soo; Korn, Edward L; Zhang, Xiaoyun; Liu, Yan; Xu, Tianmin; Boyd, Robert; Baumrind, Sheldon
Orthodontists rely on esthetic judgments from facial photographs. Concordance between estimates of facial attractiveness made from lateral cephalograms and those made from clinical photographs has not been determined. We conducted a preliminary examination to correlate clinicians' rankings of facial attractiveness from standardized end-of-treatment facial photographs (Photo Attractiveness Rank) with cephalometric measurements of facial attractiveness made for the same subjects at the same time. Forty-five Chinese and US orthodontic clinicians ranked end-of-treatment photographs of separate samples of 45 US and 48 Chinese adolescent patients for facial attractiveness. Separately for each sample, the photographic rankings were correlated with the values of 21 conventional hard- and soft-tissue measures from lateral cephalograms taken at the same visits as the photographs. Among US patients, higher rank for facial attractiveness on the photographs was strongly associated with higher values for profile angle, chin prominence, lower lip prominence, and Z-angle, and also with lower values for angle of convexity, H-angle, and ANB. Among Chinese patients, higher rank for facial attractiveness on the photographs was strongly associated with higher values for Z-angle and chin prominence, and also with lower values for angle of convexity, H-angle, B-line to upper lip, and mandibular plane angle. Chinese patients whose %lower face height values approximated the ethnic "ideal" (54%) tended to rank higher for facial attractiveness than patients with either higher or lower values for %lower face height. The absolute values of the correlations for the 7 US measures noted above ranged from 0.41 to 0.59; those of the 7 Chinese measures ranged from 0.39 to 0.49.The P value of the least statistically significant of these 14 correlations was 0.006, unadjusted for multiple comparisons. On the other hand, many cephalometric measures believed by clinicians to be indicators of facial
Heil, Alexander; Lazo Gonzalez, Eduardo; Hilgenfeld, Tim; Kickingereder, Philipp; Bendszus, Martin; Heiland, Sabine; Ozga, Ann-Kathrin; Sommer, Andreas; Lux, Christopher J; Zingler, Sebastian
The objective of this prospective study was to evaluate whether magnetic resonance imaging (MRI) is equivalent to lateral cephalometric radiographs (LCR, "gold standard") in cephalometric analysis. The applied MRI technique was optimized for short scanning time, high resolution, high contrast and geometric accuracy. Prior to orthodontic treatment, 20 patients (mean age ± SD, 13.95 years ± 5.34) received MRI and LCR. MRI datasets were postprocessed into lateral cephalograms. Cephalometric analysis was performed twice by two independent observers for both modalities with an interval of 4 weeks. Eight bilateral and 10 midsagittal landmarks were identified, and 24 widely used measurements (14 angles, 10 distances) were calculated. Statistical analysis was performed by using intraclass correlation coefficient (ICC), Bland-Altman analysis and two one-sided tests (TOST) within the predefined equivalence margin of ± 2°/mm. Geometric accuracy of the MRI technique was confirmed by phantom measurements. Mean intraobserver ICC were 0.977/0.975 for MRI and 0.975/0.961 for LCR. Average interobserver ICC were 0.980 for MRI and 0.929 for LCR. Bland-Altman analysis showed high levels of agreement between the two modalities, bias range (mean ± SD) was -0.66 to 0.61 mm (0.06 ± 0.44) for distances and -1.33 to 1.14° (0.06 ± 0.71) for angles. Except for the interincisal angle (p = 0.17) all measurements were statistically equivalent (p < 0.05). This study demonstrates feasibility of orthodontic treatment planning without radiation exposure based on MRI. High-resolution isotropic MRI datasets can be transformed into lateral cephalograms allowing reliable measurements as applied in orthodontic routine with high concordance to the corresponding measurements on LCR.
Kumar, R Vinoth; Rajvikram, N; Rajakumar, P; Saravanan, R; Deepak, V Arun; Vijaykumar, V
The aim of this study was to evaluate the release of nickel and chromium ions in human saliva during fixed orthodontic therapy. Ten patients with Angle's Class-I malocclusion with bimaxillary protrusion without any metal restorations or crowns and with all the permanent teeth were selected. Five male patients and five female patients in the age group range of 14 to 23 years were scheduled for orthodontic treatment with first premolar extraction. Saliva samples were collected in three stages: sample 1, before orthodontic treatment; sample 2, after 10 days of bonding sample; and sample 3, after 1 month of bonding. The samples were analyzed for the following metals nickel and chromium using inductively coupled plasma optical emission spectrometry (ICP-OES). The levels of nickel and chromium were statistically significant, while nickel showed a gradual increase in the first 10 days and a decline thereafter. Chromium showed a gradual increase and was statistically significant on the 30th day. There was greatest release of ions during the first 10 days and a gradual decline thereafter. Control group had traces of nickel and chromium. While comparing levels of nickel in saliva, there was a significant rise from baseline to 10th and 30th-day sample, which was statistically significant. While comparing 10th day to that of 30th day, there was no statistical significance. The levels of chromium ion in the saliva were more in 30th day, and when comparing 10th-day sample with 30th day, there was statistical significance. Nickel and chromium levels were well within the permissible levels. However, some hypersensitive individuals may be allergic to this minimal permissible level.
Antonarakis, G S; Kiliaridis, S
To evaluate, in Class II malocclusion children, vertical skeletal changes occurring with high- and low-pull headgear during non-extraction comprehensive orthodontic treatment, and retention. Two groups of thirty Class II malocclusion children (mean age 10.8 years) who had undergone non-extraction comprehensive orthodontic treatment with either high- or low-pull headgear and fixed appliances. Retrospective longitudinal study, where pre-treatment, post-treatment and at least 2 year post-retention lateral cephalometric radiographs were analyzed. Comparisons were made concerning changes during treatment and retention in high- or low-pull headgear-treated children. Correlation analyses were carried out investigating changes in vertical cephalometric parameters and pre-treatment vertical facial pattern or type of headgear used. During treatment, sagittal relationships improved in all children and remained stable during retention. Vertically, in both high- and low-pull headgear groups, the intermaxillary angle as well as the maxillary and mandibular plane angles did not show statistically significant changes during treatment or retention, and large variation was seen between patients. When pooling the whole patient sample, change in the vertical facial pattern was independent of the pre-treatment vertical facial pattern or type of headgear used. When treating Class II malocclusion children non-extraction with high- or low-pull headgear and fixed appliances, changes in vertical skeletal relationships demonstrate wide variation, both during treatment and retention. Dentoalveolar changes brought about by these appliances may not be able to make a predictable difference in vertical skeletal patterns of growing patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Zawawi, Khalid H
Objective To study patients’ acceptance of corticotomy-assisted orthodontics as a treatment option. Methods Adult patients seeking orthodontic treatment were asked to complete two sets of questionnaires; the first set included questions about age, sex, and level of education and general questions about orthodontic treatment; and the second set was related to the corticotomy-assisted orthodontics. Before answering the corticotomy questions, a brief description of the clinical procedure was explained and photographs of an actual procedure were shown. Results A total of 150 subjects were approached and 129 (86%) agreed to answer the questionnaires (72 male and 57 female patients). Of these, only 3.1% did hear about corticotomy and 7.8% selected corticotomy instead of extraction. Fear from the surgery (53.2%) was the most frequent reason for not selecting corticotomy followed by fear from pain (36.9%). The acceptance of corticotomy between males and females was similar. No relationship was found between the level of education and prior knowledge of the procedure, P=0.857. Prior knowledge about corticotomy was not a factor in selecting it as a treatment option (P=0.556) to reduce the treatment time (P=0.427). Conclusion The acceptance of corticotomy-assisted orthodontics as a treatment option was low. Fear from the surgery was the main reason for not selecting it. The acceptance of corticotomy-assisted orthodontics was not related to patient’s level of education or sex. PMID:26316719
Sander, Franz Martin; Sander, Christian; Sander, Franz Günter
The aim of this investigation was to employ a new in-vitro testing system for manual toothbrushes in order to distinguish the more effective from those less so for dental care during fixed appliance treatment. The testing apparatus consisted of a sliding carriage able to execute a horizontal brushing movement, and a row of artificial teeth upon which the various toothbrushes were manipulated. The artificial row of teeth was fixed on a sensor that recorded in all three dimensions the forces and moments caused by the toothbrushes on the toothbrush field. All the tests were executed with a weight of 110 g on a tooth field with a multibracket appliance. Tests were also carried out with five toothbrushes having weights of 200 g, 250 g and 300 g. Here, the decisive target values were 1) the degree of exertion necessary in the brushing direction to move a brush over the artificial teeth, and 2) the maximum force occurring in the brushing direction. High target values indicated high interaction between toothbrush bristles and the surfaces being brushed. From testing five toothbrushes with four different weights, we have established profiles confirming the beneficial and less beneficial properties of certain toothbrushes involving various high contact forces.
Bisphosphonates have been increasingly used not only to treat bone diseases as well as conditions such as osteopenia and osteoporosis, but also in oncotherapy. The use of bisphosphonates induces clinicians to fear and care. These reactions are associated with controversy resulting from lack of in-depth knowledge on the mechanisms of action as well as lack of a more accurate assessment of side effects. Scientific and clinical knowledge disclosure greatly contributes to professionals' discernment and inner balance, especially orthodontists. Fear does not lead to awareness. For these reasons, we present an article that focuses on that matter. This article was adapted from different journals of different dental specialties, as mentioned on footnote. There is no scientific evidence demonstrating that bisphosphonates are directly involved with etiopathogenic mechanisms of osteonecrosis and jaw osteomyelitis. Their use is contraindicated and limited in cases of dental treatment involving bone tissue. Nevertheless, such fact is based on professional opinion, case reports, and personal experience or trials with flaws in experimental methods. Additional studies will always be necessary; however, in-depth knowledge on bone biology is of paramount importance to offer an opinion about the clinical use of bisphosphonates and their further implications. Based on bone biopathology, this article aims at contributing to lay people the groundwork for this matter.
Bisphosphonates have been increasingly used not only to treat bone diseases as well as conditions such as osteopenia and osteoporosis, but also in oncotherapy. The use of bisphosphonates induces clinicians to fear and care. These reactions are associated with controversy resulting from lack of in-depth knowledge on the mechanisms of action as well as lack of a more accurate assessment of side effects. Scientific and clinical knowledge disclosure greatly contributes to professionals' discernment and inner balance, especially orthodontists. Fear does not lead to awareness. For these reasons, we present an article that focuses on that matter. This article was adapted from different journals of different dental specialties, as mentioned on footnote. There is no scientific evidence demonstrating that bisphosphonates are directly involved with etiopathogenic mechanisms of osteonecrosis and jaw osteomyelitis. Their use is contraindicated and limited in cases of dental treatment involving bone tissue. Nevertheless, such fact is based on professional opinion, case reports, and personal experience or experiment trials with failing methods. Additional studies will always be necessary; however, in-depth knowledge on bone biology is of paramount importance to offer an opinion about the clinical use of bisphosphonates and their further implications. Based on bone biopathology, this article aims at contributing to lay the groundwork for this matter. PMID:25279517
The demand for cosmetic dental treatments in the UK has grown dramatically in the last decade possibly due to increased public awareness of new techniques coupled with greater media attention for celebrities following smile enhancement treatments. In view of this, the aim of this article and the associated presentation at the 2013 British Dental Conference and Exhibition is to provide an overview of short-term cosmetic orthodontics for general dental practitioners. The presentation will cover the differences between short-term cosmetic orthodontics and comprehensive orthodontic treatment, and explain how using short-term orthodontics can be an effective tool to deliver minimally invasive cosmetic dentistry.
Alcañiz, M; Grau, V; Monserrat, C; Juan, C; Albalat, S
The detection and correction of malocclusions and other dental abnormalities is a significant area of work in orthodontic diagnosis. To assess the quality of occlusion between the teeth the orthodontist has to estimate distances between specific points located on the teeth of both arches. Distance measuring is based on the observation, by the orthodontist, of a plaster model of the mouth. Gathering of information required to make the diagnosis is a time consuming and costly operation. On the other hand, obtaining and manipulation of plaster casts constitute a huge problem in clinics, due to both the large space needed and high costs associated with plaster casts manufacturing. For this problem we present a new system for three-dimensional orthodontic treatment planning and movement of teeth. We describe a computer vision technique for the acquisition and processing of three-dimensional images of the profile of hydrocolloids dental imprints taken by mean of a own developed 3D laser scanner. Profile measurement is based on the triangulation method which detects deformation of the projection of a laser line on the dental imprints. The system is computer-controlled and designed to achieve depth and lateral resolutions of 0.1 mm and 0.2 mm, respectively, within a depth range of 40 mm. The developed diagnosis software system (named MAGALLANES) and the 3D laser scanner (named 3DENT) are both commercially available and have been designed to replace manual measurement methods, which use costly plaster models, with computer measurements methods and teeth movement simulation using cheap hydrocolloid dental wafers. This procedure will reduce the cost and acquisition time of orthodontic data and facilitate the conduct of epidemiological studies.
Nafziger, Y J
A dynamic analysis of the faces of patients seeking an aesthetic restoration of facial aberrations with orthognathic treatment requires (besides the routine static study, such as records, study models, photographs, and cephalometric tracings) the study of their facial expressions. To determine a classification method for the units of expressive facial behavior, the mobility of the face is studied with the aid of the facial action coding system (FACS) created by Ekman and Friesen. With video recordings of faces and photographic images taken from the video recordings, the authors have modified a technique of facial analysis structured on the visual observation of the anatomic basis of movement. The technique, itself, is based on the defining of individual facial expressions and then codifying such expressions through the use of minimal, anatomic action units. These action units actually combine to form facial expressions. With the help of FACS, the facial expressions of 18 patients before and after orthognathic surgery, and six control subjects without dentofacial deformation have been studied. I was able to register 6278 facial expressions and then further define 18,844 action units, from the 6278 facial expressions. A classification of the facial expressions made by subject groups and repeated in quantified time frames has allowed establishment of "rules" or "norms" relating to expression, thus further enabling the making of comparisons of facial expressiveness between patients and control subjects. This study indicates that the facial expressions of the patients were more similar to the facial expressions of the controls after orthognathic surgery. It was possible to distinguish changes in facial expressivity in patients after dentofacial surgery, the type and degree of change depended on the facial structure before surgery. Changes noted tended toward a functioning that is identical to that of subjects who do not suffer from dysmorphosis and toward greater lip
de Oliveira, José Norberto; Rodrigues de Almeida, Renato; Rodrigues de Almeida, Marcio; de Oliveira, José Norberto
INTRODUCTION The objective of this controlled clinical study was to compare the dentoskeletal effects of the Jasper jumper with those of cervical headgear, when both are used with edgewise appliances to correct Class II Division 1 malocclusion. Lateral cephalograms of 75 patients were divided into 3 groups of 25. The control group included untreated Class II children with an initial mean age of 11.82 years (range, 9.35-14.84 years); they were followed without treatment for a mean period of 1.95 years (range, 0.90-3.95 years). The Jasper jumper group had an initial mean age of 11.86 years (range, 9.45-14.94 years); they were treated for a mean period of 1.96 years (range, 0.93-3.98 years). The cervical headgear group had an initial mean age of 12.29 years (range, 9.95-15.24 years); they were treated for an average of 1.88 years (range, 0.95-3.95 years). Comparison of the initial measurements showed that the 3 groups were similar at pretreatment, thus allowing direct comparisons. Analysis of variance (ANOVA) and the Tukey test were applied for comparison of the groups. Different appliances yielded specific effects on several components (skeletal and dentoalveolar) evaluated. Anterior maxillary growth was significantly restricted by the cervical headgear. Mandibular growth was similar in all 3 groups, although it was slightly greater in the Jasper jumper group. The experimental groups had similar improvements in maxillomandibular relationshipd. The pattern of craniofacial growth was not significantly different between groups. The most significant effect on the maxillary dentoalveolar component was retrusion of the maxillary incisors by the cervical headgear. The effects observed for the Jasper jumper group were primarily related to the mandibular dentoalveolar component, including labial tipping and protrusion of the mandibular incisors, and mesial movement and extrusion of the mandibular molars compared with the control group. The headgear appliance corrected the
Kurt, Gökmen; Işeri, Haluk; Kişnişci, Reha
The purpose of this report is to describe the dentoalveolar distraction (DAD) technique and to present its effects on the surrounding structures by presenting a Class II case. A 15-year-old skeletal and dental Class II female patient with an overjet of 9 mm was treated by DAD osteogenesis. A custom-made, rigid, tooth-borne intraoral distraction device was used for rapid canine retraction. Osteotomies surrounding the canines were made to achieve rapid movement of the canines within the dentoalveolar segment, in compliance with distraction osteogenesis principles. The amount of canine retraction was 7.5 mm in 12 days at a rate of 0.625 mm per day, with no posterior anchorage loss. The canine teeth showed 1.6 mm extrusion and 11 degrees inclination change (distal tipping) during the same period. Orthodontic treatment continued for 6 months with no clinical and radiographic evidence of complications such as root fracture, root resorption, ankylosis, and soft tissue dehiscence. The DAD technique is an innovative method, because it reduces overall orthodontic treatment time by about 50%, with no unfavorable effects on periodontal tissues and surrounding structures and with no need to use any intraoral or extraoral anchorage appliances.
Ataç, Mustafa Sancar; Çakir, Merve; Yücel, Ergun; Gazioğlu, Çagri; Akkaya, Sevil
Ankylosis of temporomandibular joint is a condition in which partial or complete immobilization of mandible occurs because of fusion between mandibular condyle and skull base. This condition can be treated orthodontically, surgically, or therapeutically or by prosthodontic rehabilitation. A 10-year-old female patient presented to the Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, with limited mouth opening. She got injury in the face when she was 5 years old. Extraoral and intraoral examination findings were facial asymmetry on the left side, micrognathic mandible, and 19-mm mouth opening. After radiographic examination, ankylosis (Shawney type I) on the left side was revealed, and the patient was referred to Department of Orthodontics. After orthodontic clinical examination, we create following multidisciplinary treatment approach: (1) acrylic posterior bite block with spring application, (2) interpositional arthroplasty operation, and (3) physiotherapy (passive mouth-opening exercises). After the follow-up of 9 months, significant improvement (5 mm) was noticed in the opening of the mouth, and we decided to remove appliance and operate on the patient. Surgical procedure was performed under general anesthesia via blinded nasotracheal intubation. To prevent postoperative relapse, temporal fascia was interpositioned and sutured. Passive mouth-opening exercises were started 10 days after the surgery. Thirty-one-millimeter mouth opening was reached after the surgery and passive mouth-opening exercises. Patient's routine controls have been continued for 2 years.
Shivakumar, K M; Chandu, G N; Subba Reddy, V V; Shafiulla, M D
Malocclusion has large impact on individual and society in term of discomfort, Quality of Life [QoL]. To assess prevalence of malocclusion and orthodontic treatment needs among middle and high school children of Davangere city, India by using Dental Aesthetic Index [DAI]. A Descriptive cross sectional study was conducted among 1000, in the age group 12 to 15 year old school children studying in middle and high schools of Davangere city, India. 10 schools were selected by simple random sampling procedure and 100 study subjects were selected proportionately for males and females by using systematic random sampling procedures in each school. Data recorded using proforma consisted DAI components. The collected data was subjected to statistical analysis. The Chi-square test [x(2)] was used for comparison of severity of malocclusion. Analysis of Variance [ANOVA] test was used for comparison of mean DAI scores between the age groups and in DAI scores. 'Z' test was used for comparing the mean DAI scores between sex group. Of the 1000 children examined, 518[ 51.8%] were males and 482[ 48.2%] were females. 80.1% school children had < or = 25 DAI scores with no or minor malocclusion requiring no or little treatment, 15.7% had 26-30 DAI scores with definite malocclusion requiring elective treatment, 3.7% had 31-35 DAI scores with severe malocclusion requiring highly desirable treatment and 0.5% had > or = 36 DAI scores with handicapping malocclusion requiring mandatory treatment. 80.1% school children had no or minor malocclusion which required no or slight treatment, 19.9% had definite/handicapping malocclusion requiring definite/mandatory orthodontic treatment.
Marañón-Vásquez, Guido Artemio; Soldevilla Galarza, Luciano Carlos; Tolentino Solis, Freddy Antonio; Wilson, Cliff; Romano, Fábio Lourenço
Occasionally, orthodontists will be challenged to treat malocclusions and skeletal disharmonies, which by their complexity one might think that the only treatment alternative is the surgical-orthodontic approach. A male patient, aged 17 years old, was diagnosed with a skeletal Class III malocclusion, anterior open bite and negative overjet. An unpleasant profile was the patient's 'chief complaint' showing interest in facial aesthetics improvement. Nevertheless, the patient and his parents strongly preferred a non-surgical treatment approach. He was treated with a multiloop edgewise archwire to facilitate uprighting and distal en-masse movement of lower teeth, correct the Class III open bite malocclusion, change the inclination of the occlusal plane and obtain the consequent morphological-functional adaptation of the mandible. The Class III malocclusion was corrected and satisfactory changes in the patient's profile were obtained. Active treatment was completed in 2 years, and facial result remained stable at 2 years 6 months after debonding.
Oosterkamp, B C M; Kuijpers, M A R
In deze editie van het NTvT neemt het thema ‘Multidisciplinaire aanpak in de orthodontie’ de lezer mee in de mogelijkheden van multidisciplinaire zorg vanuit een orthodontisch oogpunt. Tandheelkunde is niet meer uitsluitend gericht op preventie en behandeling van cariës. De gebitstoestand van zowel kinderen als volwassenen is de afgelopen 30 jaar namelijk sterk verbeterd. De cariëservaring is duidelijk afgenomen en mensen behouden steeds langer hun natuurlijke gebit. Daarnaast is een fraai uitziend en goed functionerend gebit steeds vanzelfsprekender geworden en zijn patiënten gemotiveerd hun gebit te behouden. Deze ontwikkelingen vragen ook van (mond)zorgverleners een andere kijk op de zorg. De tandheelkundige zorg betreft steeds meer integrale zorg met een multidisciplinair karakter waarbij verschillende disciplines samenwerken om in samenspraak met de patiënt tot een optimaal resultaat te komen.
dos Santos, Isis Rodrigues Menezes; Moreira, Ana Cristina Azevedo; Costa, Myrela Galvão Cardoso; Barbosa, Marcelo de Castellucci e
Objective This study aimed at assessing, in vivo, whether the prior use of 0.12% chlorhexidine as mouthwash would decrease air contamination caused by aerosolized sodium bicarbonate during dental prophylaxis. The study was conducted with 23 patients aged between 10 and 40 years old who were randomly selected and undergoing fixed orthodontic treatment. Methods The study was divided into two phases (T1 and T2) with a 30-day interval in between. In both phases, dental prophylaxis was performed with aerosolized sodium bicarbonate jetted to the upper and lower arches for 4 minutes. In T1, 10 minutes before the prophylaxis procedure, the participants used distilled water as mouthwash for one minute; whereas in T2, mouthwash was performed with 0.12% chlorhexidine. Microbial samples were collected in BHI agar plates for microbiological analysis. Two dishes were positioned on the clinician (10 cm from the mouth) and a third one at 15 cm from the patient's mouth. The samples were incubated for 48 hours at 37°C. Results were expressed in colony-forming units (CFU). Results Statistical analysis carried out by means of Student's t test, as well as Wilconxon and Kruskal-Wallis tests revealed that the prior use of 0.12% chlorhexidine as mouthwash significantly reduced CFU in the three positions studied (P < 0.001). Conclusion The prior use of 0.12% chlorhexidine as mouthwash significantly reduced contamination caused by aerosolized sodium bicarbonate during dental prophylaxis in the orthodontic clinic. PMID:25162572
Goes, Paula; Dutra, Caio S; Lisboa, Mário R P; Gondim, Delane V; Leitão, Renata; Brito, Gerly A C; Rego, Rodrigo O
This pilot study evaluated the clinical efficacy of a mouthwash containing 1% Matricaria chamomilla L. (MTC) extract in reducing gingival inflammation and plaque formation in patients undergoing orthodontic treatment with fixed appliances. This randomized, double-blind, placebo-controlled study enrolled a total of 30 males and females (age, 10-40 years) with fixed orthodontic appliances and a minimum of 20 natural teeth. The participants were allocated to three groups (n = 10 each) and asked to rinse with 15 mL of a placebo, 0.12% chlorhexidine (CHX), or 1% MTC mouthwash, immediately after brushing for 1 min, in the morning and evening, for 15 days. Data (mean ± SD) on visible plaque index (VPI) and gingival bleeding index (GBI) were recorded on days 1 and 15. The placebo group exhibited increases in VPI and GBI (10.2% and 23.1%, respectively) from day 1 to day 15. As compared with placebo, VPI and GBI significantly decreased in the MTC group (-25.6% and -29.9%, respectively) and the CHX group (-39.9% and -32.0%, respectively). In summary, MTC reduced biofilm accumulation and gingival bleeding in patients with gingivitis, probably because of its antimicrobial and anti-inflammatory activities.(J Oral Sci 58, 569-574, 2016).
Monga, Nitika; Kharbanda, Om Prakash; Duggal, Ritu
Mesiodens is the most common type of supernumerary teeth found in the premaxilla between the two central incisors. Early and proper diagnosis and appropriate treatment plan is critical in eluding the extent of treatment needed. This case report presents the successful orthodontic and esthetic management of an unusual case of Indian origin with twin mesiodens in the maxillary arch causing torsiversion and attrition of mandibular incisors due to occlusal trauma. PMID:24963264
Monga, Nitika; Kharbanda, Om Prakash; Duggal, Ritu
Mesiodens is the most common type of supernumerary teeth found in the premaxilla between the two central incisors. Early and proper diagnosis and appropriate treatment plan is critical in eluding the extent of treatment needed. This case report presents the successful orthodontic and esthetic management of an unusual case of Indian origin with twin mesiodens in the maxillary arch causing torsiversion and attrition of mandibular incisors due to occlusal trauma.
Kim, Jae Hwan; Kim, Mi Ah; Kim, Jae Gon
The purpose of this study was to detect Streptococcus mutans by using monoclonal antibodies (mAbs) against S. mutans that cause dental caries and compare the levels of the bacterium between the saliva of adolescents undergoing orthodontic treatment (OT) and those not undergoing treatment (NT). Saliva samples, collected from 25 OT adolescents (with a mean age of 12.84 years) and 25 NT adolescents (mean age of 12.4 years), were analyzed by Dentocult-SM and enzyme-linked immunosorbent assay using mAbs against Ag I/II (ckAg I/II) and GTF B (ckGTF B), GTF C (ckGTF C), and GTF D (ckGTF D) of S. mutans. The DMFT index was slightly higher in the OT group (5.12 in OT and 4.96 in NT) and the level of S. mutans (≥10 5 CFU/mL) was higher in OT (72%) than in NT (56%). The detected levels of ckAg I/II, ckGTF B, ckGTF C, and ckGTF D were slightly higher in OT than in NT. The results of this study indicate that use of mAbs against S. mutans yields sensitive detection for the bacterium in saliva samples and shows that it has a reliable connection to the number of S. mutans and decayed, missing, filled teeth (DMFT), suggesting that the levels of S. mutans in saliva can be defined and compared by the application of the mAbs.
Sant’Anna, Eduardo Franzotti; Araújo, Mônica Tirre de Souza; Nojima, Lincoln Issamu; da Cunha, Amanda Carneiro; da Silveira, Bruno Lopes; Marquezan, Mariana
ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used. PMID:29364385
Elias, Carlos Nelson; de Oliveira Ruellas, Antônio Carlos; Fernandes, Daniel Jogaib
Orthodontic implants have become a reliable method in orthodontic practice for providing temporary additional anchorage. These devices are useful to control skeletal anchorage in less compliant patients or in cases where absolute anchorage is necessary. There are a great number of advantages in this new approach which include easy insertion, decreased patient discomfort, low price, immediate loading, reduced diameter, versatility in the forces to be used, ease of cleaning, and ease of removal. However, a proper management of the screws by the practitioner is necessary in order to increase the success rate of the technique. The purpose of this paper is to update practitioners on the current concepts of orthodontic implants and orthodontic mechanics. PMID:23209470
Zhao, Zhi-he; Bai, Ding
In recent years, new approaches to the diagnosis and treatment of malocclusion have emerged. The diagnostic and therapeutic techniques of orthodontics have evolved from two dimensions to five dimensions with the development of computer technology, auto-machining and imaging. Furthermore, interdisciplinary study has become the driving force for the advancement of fundamental research in orthodontics. The mechanisms of malocclusion and orthodontic tooth movement have been extensively studied to the details at the level of cells and molecules.
Miclotte, Annelie; Franco, Ademir; Guerrero, Maria Eugenia; Willems, Guy; Jacobs, Reinhilde
The present study aims to compare mandibular third molar position in relation to the mandibular ramus, mandibular third molar angulation, potential impaction and nerve involvement in orthodontic treated versus untreated subjects. The sample consisted of 300 panoramic radiographs 119 males (mean age 16.9 years); 181 females (mean age 16.8 years), contrasting an orthodontically treated (n = 150) to an untreated group (n = 150). Only patients with a full mandibular dentition were included. Pell and Gregory (Dent Digest 39: 330-338, 1933), Winter (Principles of exodontia as applied to the impacted third molars, 1926) and Félez-Gutierrez modified by Gomes (Study of nerve lesion following mandibular third molar surgery, 2011) classifications were used. Radiological information was used to predict eruption. Data was analyzed using frequency analysis and Chi-square testing. 220 lower wisdom teeth (73.3%) were impacted in the treated group, opposed to 236 impacted lower wisdom teeth (78.7%) in the untreated group. A close relation with the mandibular nerve was observed 125 times (41.7%) in the treated group, opposed to an incidence of 112 (37.3%) in the untreated group. The differences were not statistically significant. A partial eruption was predicted for 153 (51%) lower wisdom teeth in the treated group, opposed to 106 (35%) in the untreated group and an impossible eruption in 67 (22%) in the treated group, opposed to 130 (43%). These differences were statistically significant (p < 0.05). The significant outcomes indicate that orthodontically treated patients may develop a higher likeliness to partially erupted third molars, which potentially leads to local clinical morbidities, such as pericoronitis and caries on adjacent teeth. In this context, it may support third molar extractions at an earlier stage in particular cases.
Al Jabbari, Youssef S; Al Taweel, Sara M; Al Rifaiy, Mohammed; Alqahtani, Mohammed Q; Koutsoukis, Theodoros; Zinelis, Spiros
To evaluate the combined effects of material type, surface treatment, and thermocycling on the bond strength of orthodontic brackets to materials used for the fabrication of provisional crowns. Four materials were included in this study (ProTemp, Trim Plus, Trim II, and Superpont C+B). Sixty cylindrical specimens (1 × 3 cm) were prepared from each material and equally divided into three groups. The first group was ground with silica carbide paper, the second was polished with pumice, and the last group was sandblasted with 50-µm aluminum oxide particles. Stainless-steel maxillary central incisor brackets (Victory Series, 3M) were bonded to the provisional material specimens with Transbond XT light-cured composite resin, and half of the specimens from each group were thermocycled 500 times in 5°C and 55°C water baths. Then the brackets were debonded with shear testing, and the results were statistically analyzed by three-way analysis of variance and Tukey's multiple-comparison tests at α = 0.05. Adhesive Remnant Index (ARI) was also identified. Before and after thermocycling, ProTemp materials showed the highest shear bond strength with orthodontic brackets (10.3 and 13.1 MPa, respectively). The statistical analysis indicated an interaction among the three independent variables (P < .05) and statistically significant differences in bond strength among provisional materials (P < .001), surface treatments (P < .001), and thermocycling (P < .05). According to the ARI, most groups demonstrated adhesive failure. The provisional material type, surface treatment, and artificial aging have a significant effect on bond strength. Sandblasting treatment exerts a beneficial effect on shear bond strength.
Amini, Fariborz; Harandi, Saghar; Mollaei, Mobina; Rakhshan, Vahid
Despite the importance of nickel and chromium release from orthodontic brackets, there are no in vivo or in vitro studies on this issue in the case of metal-injection molding (MIM) brackets. Saliva samples were collected from 30 orthodontic patients divided randomly into two groups of conventional and MIM brackets, before treatment and 2 months later. Approved attendees with odd and even numbers were, respectively, assigned to the control and treatment groups. For blinding, the patients were not informed of their bracket types, and the saliva samples were coded. Nickel and chromium levels were determined using atomic absorption spectrophotometry. Data were analysed using repeated-measures two-way analysis of covariance, independent-samples t-test, chi-squared, Spearman and point-biserial correlation coefficients, Mann-Whitney, and Wilcoxon tests (α = 0.05). Mean nickel level increased from 7.87±8.14 (pre-treatment) to 12.57±9.96 (2nd month) in the control group, and from 8.62±9.85 (pre-treatment) to 8.86±6.42 µg/l in the MIM group. Both of these increases were significant (Wilcoxon P < 0.03). Average chromium level changed from 0.25±0.56 (pre-treatment) to 0.35±0.62 and from 0.42±0.48 to 0.26±0.57 µg/l in the MIM group. Only the reduction observed in the MIM group was significant (Wilcoxon P = 0.0438). Age and gender had no significant influence on ion levels (P > 0.1). The differences between both ions' levels measured in the 60th day in both bracket groups were not significant (Mann-Whitney P > 0.05). The extents of changes over time were not significantly different between the bracket types (Mann-Whitney P > 0.05). The sample size was not predetermined based on power calculations. The spectrophotometer was limited to detecting chromium concentrations above 0.25 µg/l. Ion discharge from brackets might continuously change. The current in vivo methods are unable to take such fluctuations into account. Nickel might increase in patients undergoing
The cure rates for early stage vocal cord cancer are excellent with primary radiotherapy. Voice quality remains as good or becomes better than prior to treatment. For the local failures that do occur, surgical salvage will yield ultimate cure rates of about 95% for T1 and 90% for T2 tumors.
Srivastava, Amitabh; Sharma, Ashish; Garg, Aarti; Kumar, Surubhi
The use of orthodontic treatment in adult patients is becoming more common and these patients have more specific objectives and concerns related to facial and dental aesthetics, specially regarding duration of treatment. Dentists are on the lookout for techniques for increased efficiency in orthodontic treatment. Alveolar Corticotomy-assisted orthodontic treatment is a recent orthodontic technique that is recently gaining wide acceptance and is recorded as effective means of accelerating orthodontic treatment. A 17-year-old female patient was undergoing orthodontic treatment for the past one year but during her space closure, a visual examination confirmed a buccal thickening that was encountered in the buccal plate between premolars and canine. Periodontal intervention involved elective alveolar decortication in the form of dots performed around the teeth that were to be moved. This was carried out to induce a state of increased tissue turnover and a transient osteopenia, which further helps in faster rate of orthodontic tooth movement. Its main advantages are reduction of treatment time and post-orthodontic stability. PMID:26894189
Doria, Andrea; Zen, Margherita; Canova, Mariagrazia; Bettio, Silvano; Bassi, Nicola; Nalotto, Linda; Rampudda, Mariaelisa; Ghirardello, Anna; Iaccarino, Luca
Around 1980 antinuclear antibody testing became widely used in routine laboratory practice leading to a tapering in the lag time between SLE onset and diagnosis. Since then nothing relevant has been introduced which could help us in making the diagnosis of SLE earlier than now. Notably, there is increasing evidence that early diagnosis and treatment could increase SLE remission rate and improve patient prognosis. Although it has been shown that autoantibodies appear before clinical manifestations in SLE patients, currently we cannot predict which autoantibody positive subjects will eventually develop the disease. Thus, great effort should be made in order to identify new biomarkers able to improve our diagnostic potential. B lymphocyte stimulator (BLyS), anti-ribosomal P protein and anti-C1q antibodies are among the most promising. In recent years, some therapeutic options have emerged as appropriate interventions for early SLE treatment, including antimalarials, vitamin D, statins and vaccination with self-derived peptides. All these immune modulators seem to be particularly useful when introduced in an early stage of the disease. Copyright © 2010 Elsevier B.V. All rights reserved.
Tsiouli, Kleopatra; Topouzelis, Nikolaos; Papadopoulos, Moschos A; Gkantidis, Nikolaos
The aim of this research was to investigate the perceived facial changes in Class II Division 1 patients with convex profiles after functional orthopedic treatment followed by fixed orthodontic appliances. Pretreatment and posttreatment profile photographs of 12 Class II Division 1 patients treated with activators, 12 Class II Division 1 patients treated with Twin-block appliances, and 12 controls with normal profiles treated without functional appliances were presented in pairs to 10 orthodontists, 10 patients, 10 parents, and 10 laypersons. The raters assessed changes in facial appearance on a visual analog scale. Two-way multivariate analysis of variance was used to evaluate differences among group ratings. Intrarater reliability was strong in most cases (intraclass correlation coefficients, >0.7). The internal consistency of the assessments was high (alpha, >0.87), both within and between groups. The raters consistently perceived more positive changes in the Class II Division 1 groups compared with the control group. However, this difference hardly exceeded 1/10th of the total visual analog scale length in its highest value and was mostly evident in the lower face and chin. No significant differences were found between the activator and the Twin-block groups. Although the raters perceived improvements of the facial profiles after functional orthopedic treatment followed by fixed orthodontic appliances, these were quite limited. Thus, orthodontists should be tentative when predicting significant improvement of a patient's profile with this treatment option. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Favero, L; Arreghini, A; Cocilovo, F; Favero, V
Obesity and allergic susceptibility are worsening problems in the most industrialised countries. With different mechanisms, they both lead to a deterioration of children's life quality because they affect the respiratory system, leading to asthma and respiratory disorders such as mouth breathing and obstructive sleep apnoea. The latter are related to specific types of malocclusions that require an early diagnosis and specific multidisciplinary treatment. The purpose of this work is to show the characteristic signs and symptoms of these disorders in children of the two phenotypes (allergic and slim, obese and dysmetabolic). Intercepting such issues allows both pediatricians and paediatric dentists to refer the child to a multidisciplinary team of specialists able to deal, in a holistic way, with both the physical and behavioural causes, and also with the consequences on systemic and craniofacial development in particular. The literature available on this topic in the years between 1997 and 2011 was reviewed, paying special attention to prevention, paediatric visits, diagnostic tools and treatment options for each of the two conditions. Dysmetabolic obese children and allergic slim children have specific respiratory problems during rest and exercise. Mouth breathing and obstructive sleep apnoea are due to an abnormal craniofacial development and can cause serious systemic problems in adulthood. Intercepting early signs of pathognomonic symptoms of sleep aponea and mouth breathing permits to treat children with an early multidisciplinary approach, and allows for proper physical and psychological development of the child.
Aesthetics in dentistry has of late become an awakening/actor among patients and often serves as a major reason for seeking dental treatment and care. Ever since the introduction of orthodontics as a separate specialty branch in dentistry, a variety of techniques have evolved, and methods developed both in the type of devices/instruments used and treatments planned. The discipline of orthodontic aesthetics involves micro and macro aesthetics, gingival, and facial aesthetics. This article helps focus on the artistic part of the orthodontic science. It brings out various important factors involved in customizing aesthetic orthodontic treatment planning according to the individual needs of the patient. Through this kind of treatment planning not only are the functional and biological needs of the patient met, they also provide a stable and durable results. Less invasive treatment planning makes it easier for the patient to select future treatment options as new technologies keep evolving. The review was selected by typing aesthetic orthodontics in the Google search engine, Pubmed, and Pubmed Central. Literature review of articles reflecting history, different analysis, factors responsible, and the latest technique was conducted.
Al Makhmari, Shamsa Abdullah; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E
Although powered toothbrushes have been reported to reduce gingivitis more than manual toothbrushes in the general population, the evidence regarding orthodontic patients has been inconclusive. Thus, we aimed to compare their effectiveness in relation to any available parameter regarding oral health in orthodontic patients with fixed appliances. Searches without restrictions for published and unpublished literature and hand searching took place up to August 2017. Oral-health relevant data from randomized controlled trials of at least 4-weeks duration comparing powered and manual tooth brushing without supervision were reviewed. Data were classified as short term (assessments at 1-3 months) and long term (assessments at >3 months), and the random-effects method was used to combine treatment effects. Individual study risk of bias was assessed using the Cochrane Risk of Bias Tool, and the quality of evidence was evaluated according to the Grades of Recommendation, Assessment, Development and Evaluation approach. The initially identified articles were finally reduced to 9 randomized controlled trials investigating the periodontal health in 434 patients. Eight studies followed patients up to 3 months, and 1 up to 12 months during treatment. One study was at low and the rest at unclear risk of bias. Overall, in the short term, there was low-quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual brushing with regard to the gingival index (weighted mean difference, -0.079; 95% confidence interval, -0.146 to -0.012; P = 0.021) and indexes assessing gingival bleeding (standardized mean difference, -0.637; 95% confidence interval, -1.092 to -0.183; P = 0.006). In the long term, only 1 available study showed a statistically significant benefit of powered over manual toothbrushes with regard to gingival index and bleeding. No differences were observed in probing pocket depth and relative attachment loss. For the
Turley, Patrick K
The importance of facial esthetics to the practice of orthodontics has its origins at the beginning of our specialty. In 1900, Edward H. Angle believed that an esthetic or a "harmonious" face required a full complement of teeth, but many who came after him questioned this notion. In the 1930s, the development of cephalometrics laid the foundation for studying growth and development, treatment effects, facial forms, and esthetics. By the 1950s, the importance of diagnosing and planning treatment for an esthetic result was established, but the measurement of soft tissue variables was lacking, and this became an important area of research. In the 1970s, researchers were looking at the stability of hard tissue changes over time, and they were also interested in how the soft tissues change with age. Although the early studies of esthetics in orthodontic treatment focused on how clinicians viewed their patients, changing demographics and cultural attitudes led researchers to look more seriously at consumer preferences and the public's attitudes. Their findings--that consumers preferred fuller lips--led to a swing back toward nonextraction treatment. Expansion appliances and molar distalization techniques became popular, and surgical procedures to obtain more ideal esthetic results became more common. Since the 1990s, advances in computers and technology have allowed us to study, predict, and produce esthetic results previously thought unattainable. Today, more so than at any other time in our specialty, we have the ability to provide esthetic results to our patients. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
Millett, Declan T; Glenny, Anne-Marie; Mattick, Rye Cr; Hickman, Joy; Mandall, Nicky A
Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachment