Despite the recent recommendation by the American Association of Orthodontists and Dentofacial Orthopedics that orthodontists begin screening patients by age 7, it is the author's experience that the majority of orthodontists do not treat children prior to the eruption of permanent teeth and do not use functional appliances. This leads many general dentists to provide orthodontic services to their younger patients because local orthodontists do not or will not treat them. This article seeks to encourage all general dentists, pediatric dentists, and orthodontists to learn how to use functional appliances to significantly improve the health and appearance of younger patients.
Tzemach, M; Aizenbud, D; Einy, S
The optimal timing for commencement of orthodontic treatment has been controversial. Initial early orthodontic treatment usually begins at the deciduous dentition or early mixed dentition stage and continues for 12-18 months. In most cases, a second treatment phase will be required in the permanent dentition stage to achieve the treatment goals and a stable occlusion. One of the main purposes of the early treatment phase is to affect the growth pattern of the jaw and consequently correct skeletal imbalance and prevent future severe malocclusion by means of growth modification. Some clinicians strongly believe that early intervention with functional appliances improves facial harmony and simplifies as well as shortens the second orthodontic treatment phase. In contrast others advocate that it is unnecessary as the early treatment results will be eliminated by future growth and a recurrent treatment phase is essential in the permanent dentition stage in any case. Thus it is merely a waste of time and resources, and all treatment goals could be reached by a comprehensive single continued treatment phase in the late mixed dentition stage. This article summarizes the scientific literature on the different concepts of early functional orthodontic treatment of Skeletal Class II malocclusion correction vs. a single comprehensive orthodontic treatment process in the late mixed dentition stage. The indications and benefits of each of the approaches are discussed in detail. In conclusion, most of the researchers recommend early orthodontic intervention in children suffering psychological and social problems associated with their malocclusion. Prevention of traumatic injury in cases of maxillary incisor protrusive inclination is also considered an indication for early orthodontic treatment.
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
Kuitert, R B
The number of adults undergoing orthodontic treatment has increased strongly and the average age that adult patients undergo orthodontic treatment increased steadily although 3/4 is still younger than 27 years. In adults the facial skeletal pattern can only be changed in a very confined way, consequently in case of an abnormal skeletal pattern one has to choose between a combined orthodontic-surgical approach (which is the case in 18% of the patients) and a compromised orthodontic treatment, if necessary combined with other disciplines. It is still controversial whether tooth movement in adults is slower and more difficult than in adolescents. The same holds true for the risk for loss of periodontal support, for root resorption, for gnathologic problems and for relapse. As related to these variables there appears to be a large individual variation. Many adults show one or more problems in their dentition that may influence their orthodontic treatment. About 60% of the adult patients need a multidisciplinary approach. The development of implantology and of bone regeneration and bone grafting has lead to more combined treatments. The risks of such complex treatment plans are generally larger than those for more simple kinds of treatment. A very careful treatment planning and good communication between the different specialists is essential. Moreover the treatment plan with all its (dis)advantages has to be extensively discussed with the patient.
Krausz, E; Einy, S; Aizenbud, D; Levin, L
Orthodontic treatment poses a significant challenge in patients suffering from periodontal disease. Providing orthodontic treatment to periodontal patients should be carefully planned and performed in a tight collaboration between the orthodontist and periodontist. Resolution and stabilization of the periodontal condition is a pre-requisite for orthodontic treatment initiation. Careful oral hygiene performance and highly frequent recall periodontal visits are also crucial. Pre- or post- orthodontic periodontal surgery might help providing better treatment outcomes.
Even the general dental practitioners consider the orthodontic therapeutical interventions carried out with removable appliances as a harmful procedure. It is much less known how the lack of adequate orthodontic treatment endangers the peridontium. Clinical data show a cause related correlation between the maxillary incisor protrusion, mandibular frontal jammed dentition, deep vertical overbite, openbite, crossbite early deciduous tooth extractions and the periodontal pathological happenings. So it is very important to start an early orthodontic treatment to avoid the periodontal consequences of malocclusion before it has become irreversible.
Suga, Uhana Seifert Guimarães; Terada, Raquel Sano Suga
Most supernumerary teeth are impacted and asymptomatic. Objective. The aim of this paper is to describe two cases of sequential development of supernumerary teeth in the mandibular premolar region, identified during orthodontic treatment. Reports. The first case describes the radiographic follow-up of a female patient that presented a supernumerary tooth at the age of 9 years and 10 months in the right mandibular premolar region, followed by a further supernumerary tooth in the left mandibular premolar region identified at the age of 11 years and 3 months. In the second case, the radiographic follow-up of a male patient demonstrated 3 supernumerary teeth in the premolar region at the age of 16 years. During orthognathic surgery planning at the age of 20 years and 5 months, a supplemental supernumerary tooth was found in the left mandibular region. Conclusion. Considering the late developing of supernumerary premolars, appropriate follow-up with panoramic radiographs of patients with previous experience of supernumerary teeth is essential for early diagnosis of supplemental premolars to prevent possible complications. PMID:27313911
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
OSAHS or snoring is an important condition within our community with the potential of being a significant health burden. Although the precise pathogenesis of upper airway obstruction during sleep remains uncertain in OSAHS and snoring patients, craniofacial risk factors are said to be associated with OSAHS and snoring. Since a high number of OSAHS and snoring patients consist of skeletal Class II malocclusion patients characterized by deficient mandible, then we can make the hypotheses that early orthodontic treatment of skeletal Class II malocclusion patients to improve such discrepancies during the growth period may be effective to prevent the potential for OSAHS and snoring.
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.
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?
Lawson, Robert B
Contemporary lingual orthodontic appliances offer an aesthetic and accurate means of treating malocclusion. Managing extraction-based treatments with lingual appliances presents a number of challenges. This article discusses the specific biomechanical considerations associated with extraction treatment and outlines clinical techniques that can optimize treatment outcome in these cases.
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.
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
Ngan, Peter; Moon, Won
Angle, Tweed, and Moyers classified Class III malocclusions into 3 types: pseudo, dentoalveolar, and skeletal. Clinicians have been trying to identify the best timing to intercept a Class III malocclusion that develops as early as the deciduous dentition. With microimplants as skeletal anchorage, orthopedic growth modification became more effective, and it also increased the scope of camouflage orthodontic treatment for patients who were not eligible for orthognathic surgery. However, orthodontic treatment combined with orthognathic surgery remains the only option for patients with a severe skeletal Class III malocclusion or a craniofacial anomaly. Distraction osteogenesis can now be performed intraorally at an earlier age. The surgery-first approach can minimize the length of time that the malocclusion needs to worsen before orthognathic surgery. Finally, the use of computed tomography scans for 3-dimensional diagnosis and treatment planning together with advances in imaging technology can improve the accuracy of surgical movements and the esthetic outcomes for these patients.
Abed Al Jawad, Feras; Cunningham, Susan J; Croft, Nick; Johal, Ama
The aim of this research was to assess the effects of fixed orthodontic treatment on dietary intake and behaviour. The study adopted a qualitative approach by conducting semi-structured one-to-one interviews, with 10 adolescent patients (four males; six females) undergoing fixed orthodontic treatment with a mean age of 13.21 (SD 0.71) years. The interviews were transcribed and analysed, by two independent investigators, using framework principles in which emerging themes and ideas were identified. These emerging themes were characterized and compared between patients until no new themes or ideas were identified. Framework analysis identified the following two main themes arising in adolescent patients undergoing fixed orthodontic treatment: pain experience and dietary change. All patients reported varying degrees of pain during the first few days of treatment, after which it was seen to reduce. All patients reported that their diet had changed in response to pain, inability to bite and chew, and in response to dietary instructions given to them by their orthodontist. Patients felt that their eating habits had become healthier during treatment. The study highlights the need to explore dietary changes in a larger population base.
Mituś-Kenig, Maria; Łoboda, Magdalena; Marcinkowska-Mituś, Agata; Durka-Zajac, Magdalena; Pawłowska, Elzbieta
The progress in oncological treatment has led to the current increase of childhood cancer survival rate to 80%. That is why orthodontists more and more frequently consult patients who had completed a successful anti-cancer therapy in childhood. Oncological treatments such as chemotherapy, radiotherapy or supportive immunosuppressive therapy cause numerous side effects in growing patients, connected i.a. with growth, the development of teeth or the viscerocranium. This is a special group of patients that needs an optimised plan of orthodontic treatment and often has to accept a compromise result. The purpose of the current work is to discuss the results of orthodontic treatment in patients after an anti-cancer therapy. Time of treatment was 12,5 months. In 6 patients (from 40 undergoing orthodontic therapy) we haven't reached a normocclusion, in 9 patients we should have stopped the therapy because of the recurrence. In 11 patients we found mucosa inflammation and in 1 patient the therapy stopped before the end because of very low oral hygiene level. Bearing in mind the limited number of original works on the above topic in Polish medical literature, the study has been carried out in order to make Polish orthodontists more acquainted with the topic and the standards of dealing with an oncological patient.
van Beek, H
The first part of this article is an edited Dutch summary of the paper "Oral-health-related benefits of orthodontic treatment" by Donald J. Burden in the special issue''Orthodontics: quality of care, quality of life'' in Seminars in Orthodontics (June 2007). Burden carried out a systematic review of the literature on some, historically claimed, beneficial influences of orthodontic treatment, such as reduced susceptibility to dental caries, periodontal disease, temporomandibular dysfunction, and traumatic injury. Based on the results of this review, Burden concludes that the oral health benefits of orthodontic intervention have not been demonstrated. The second part is a critical and balanced commentary on the content of the paper and on Burden's conclusions.
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.
Hemrend, Bernard; Altuna, Gurkan; Tompson, Bryan
The authors of this article offer an introduction to the field of orthodontics. They present the latest advances in orthodontic appliances and some of the possible consequences of orthodontic treatment. They discuss a number of cases and offer examples of some of the more common problems that the orthodontist is asked to treat. Such cases include severe Class II, division 1 malocclusion, surgical orthodontics, “long-face” syndrome, adult orthodontics-TMJ-periodontics, late adult growth, and post-retention changes. Practical information useful to the physician who encounters patient with these disorders is balanced with good research data to support the various claims. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:21249042
Maruchi, N; Miyajima, K; Iizuka, T; Inagaki, K; Noguchi, T; Sakai, M
Adults with untreated malocclusions suffer from more periodontal disease than if their malocclusion had been corrected orthodontically. What orthodontists can offer in the management of patients with periodontal disease, how they can help the periodontists and the patients, and how the periodontists can help the orthodontist make treatment safe and purposefully are widely discussed. The purpose of this study is, therefore, to discuss how orthodontic patients with severe periodontitis could be treated and what we should do for these patients during the treatment as well as at their initial visit. One case is presented as an example of treatment for malocclusion with sever periodontitis: The patient was a 23 years 8 months female with a chief complaint of protrusion of upper incisors. Since clinical examination revealed severe periodontitis, periodontal treatment was undertaken for one year prior to orthodontic treatment. From these observations, we are conviced of the importance again of the global approach and the team treatment method in treating malocclusions with periodontitis.
Salehi, P; Danaie, S Momene
This study assessed the effect of extraction and preservation of the 1st premolar on lower 3rd molar eruption. Orthodontic clinic records from 1993 to 1995 were evaluated before and after treatment and 8-9 years after treatment for 3 groups of patients: 32 with extraction of 1st premolars in both jaws, 32 with no extraction but orthodontic treatment and 48 controls with no extraction but orthodontic treatment in the upper jaws only. Successful eruption of 3rd molars was evaluated. There was a significant difference in the rates of successful eruptions in the extraction (42%), non-extraction (12%) and control (20%) groups. The findings indicate that 1st premolar extraction may increase the chance of 3rd molar eruption, leading to a lower incidence of health and economic complications.
Piyapattamin, Thosapol; Soma, Kunimichi; Hisano, Masataka
This report presents the case of a 25-year-old male patient who sought orthodontic treatment. Oral examination revealed an Angle Class I relation, with a bimaxillary dento-alveolar protrusion, evidence of anterior crowding, and a large overbite and overjet. Radiographic examination revealed a skeletal Class I occlusion. During the distal movement of the canines, occlusal interferences between the canines occurred and the commencement of a tongue thrust was observed. After correction of the applied forces, the canine movement was completed and the habit was no longer detectable. The incident indicates that an unusual oral habit suspiciously occurring during treatment should lead to an immediate reconsideration of the orthodontic treatment strategy.
Background The aim of this randomized clinical trial was to assess the effect of early orthodontic treatment for unilateral posterior cross bite in the late deciduous and early mixed dentition using orthopedic parameters. Methods Early orthodontic treatment was performed by initial maxillary expansion and subsequent activator therapy (Münster treatment concept). The patient sample was initially comprised of 80 patients with unilateral posterior cross bite (mean age 7.3 years, SD 2.1 years). After randomization, 77 children attended the initial examination appointment (therapy = 37, control = 40); 31 children in the therapy group and 35 children in the control group were monitored at the follow-up examination (T2). The mean interval between T1 and T2 was 1.1 years (SD 0.2 years). Rasterstereography was used for back shape analysis at T1 and T2. Using the profile, the kyphotic and lordotic angle, the surface rotation, the lateral deviation, pelvic tilt and pelvic torsion, statistical differences at T1 and T2 between the therapy and control groups were calculated (t-test). Our working hypothesis was, that early orthodontic treatment can induce negative therapeutic changes in body posture through thoracic and lumbar position changes in preadolescents with uniltaral cross bite. Results No clinically relevant differences between the control and the therapy groups at T1 and T2 were found for the parameters of kyphotic and lordotic angle, the surface rotation, lateral deviation, pelvic tilt, and pelvic torsion. Conclusions Our working hypothesis was tested to be not correct (within the limitations of this study). This randomized clinical trial demonstrates that in a juvenile population with unilateral posterior cross bite the selected early orthodontic treatment protocol does not affect negatively the postural parameters. Trial registration DRKS00003497 on DRKS PMID:22906114
Ikegami, Tomio; Wong, Ricky Wing-Kit; Hägg, Urban; Lee, Wilson; Hibino, Kyoko
This paper describes the Hybrid Orthodontic Treatment System (HOTS), an innovative method used in first premolar extraction cases. It comprises the following three components: (1) a miniscrew, (2) dual-dimension wires, and (3) multiloop edgewise archwires. HOTS consists of four clearly defined treatment steps: (1) setup, (2) leveling, (3) separate but simultaneous anterior and canine teeth retraction, and (4) final adjustment. HOTS achieves a predictable treatment outcome with a shorter treatment time.
Ispas, Dana Catrinel; Eftene, Oana Alexandra; Temelcea, Anca; Pădure, Hariclea
Orthodontic treatment as a help is the teeth movement made in order to facilitate the odontal,prosthetic and periodontal proceedures which are needed in the dentomaxilar and/or facial reabilitation. The aim of the study was to follow for 5 years which is the percentage of patients who asked for orthodontic treatment in the Orthodontic and Dentofacial Orthopedie Clinic from UMF 'Carol Davila'. We also followed the frequency related to the etiology of the loss of some teeth and also the relationship between the loss of the teeth and periodontal disease. In our country, the number of patients who ask for preprosthetic orthodontic treatment is lower comparing with Western and Northtern Europe, but the percentage is increasing due to the dentists calification. We can conclude by saying that the frequency of losing teeth by cavities is increased by age because all patients from the study group aged 35 and above lost their teeth from cavity etiology and the patients aged 18 and lower had genetic etiology in losing their teeth.
Yoshpe, Margarita; Kaufman, Arieh; Lin, Shaul; Gabay, Eran; Einy, Shmuel
Invasive cervical resorption (ICR), a destructive form of external root resorption, is characterized by invasion of the fibrovascular tissue. This phenomenon is very rare and appears in 0.02% of the general population where the leading factors are orthodontics in addition to trauma, restorations, and bleaching. Heavy orthodontic force may increase the incidence to 1%. One of the main concerns regarding ICR is that it is often misdiagnosed with conventional diagnostic tools. In recent decades, a cone beam computed tomography (CBCT) imaging technique has become more common and can lead to a more accurate diagnosis and treatment plan. This case report describes a possible association between orthodontic treatment and ICR of a 14-year-old male, 18 months post orthodontic treatment. ICR in the mandibular right canine was diagnosed and verified by CBCT, and underwent combined endodontic-periodontal treatment. However, after orthodontic forced eruption was performed on this tooth to improve the bone defect, ICR was diagnosed on the mandibular right second premolar. The possible association between orthodontic treatment and ICR is discussed, as ICR was noted following orthodontic treatment on both occasions. This case report stresses the importance of ICR early detection by close attention to periodic radiographic checkups during orthodontic treatment. The use of modern diagnostic tools is highly recommended in suspicious cases.
Aydoğan, Cihan; Alkan, Özer
Objective Patients' and parents' expectations are important in orthodontic treatment decision making. The literature generally demonstrates the perceived benefits of orthodontic treatment, but patients' and their parents' concerns about orthodontic treatment have not been investigated comprehensively. The aim of this study was to identify patients' and parents' concerns about orthodontic treatment and compare them according to sex, age, and treatment demand level. Methods One hundred and eighty-nine children and their parents were interviewed about concerns related to orthodontic treatment. Patients and parents were asked about orthodontic treatment decisions. Answers were recorded as "yes," "no," or "don't know." Chi-squared and Fisher's exact tests were used to compare concerns between age groups, sexes, and treatment demand levels. Kappa statistics were used to assess agreement between patients and their parents. Results Concerns about orthodontic treatment were gathered under 10 items as follows: "feeling pain," "the appearance of braces," "being teased," "avoiding smiling," "speech problems," "dietary changes," "problems with transportation," "economic problems," "long treatment duration," and "missing school." There was no statistically significant difference in concerns between the sexes or age groups. Some concern items and treatment demand were inversely related in patients. Conclusions The results of this study demonstrate patients' and parents' concerns about orthodontic treatment. Differences between the concerns of patients with different treatment demands imply that children might reject orthodontic treatment because of their concerns. Appropriate consultation of patients addressing their concerns may help reduce anxiety and improve the acceptance of treatment. PMID:26877979
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
Early in the last century, 3 events put Colorado in the orthodontic spotlight: the discovery-by an orthodontist-of the caries-preventive powers of fluoridated water, the formation of dentistry's first specialty board, and the founding of a supply company by and for orthodontists. Meanwhile, inventive practitioners were giving the profession more choices of treatment modalities, and stainless steel was making its feeble debut.
Simonnet Garcia, Marie-Hélène
Hypnosis is making a comeback in all of the medical disciplines. But in a world where everyone wants to control everything and manage everything, it's helpful to know that hypnosis is a dynamic process that cannot be forced on anyone, a psychic reality, clearly demonstrated today by brain imaging. Hypnosis does not take any power over the individual. It is just one more tool to help ease patient's discomfort. It is also useful to avoid professional burnout to provide care without depleting our energy and without wasting our valuable time. Medical hypnosis is a real asset for providing comfortable orthodontic treatment and creating a serene atmosphere. It can be done simply and rapidly to take high quality impressions, to place braces comfortably on a patient who is sitting quietly. Orthodontic treatment requires cooperation and motivation, so let's give our patients a new sense of confidence and a willingness to cooperate.
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.
Uzuner, F. Deniz; Darendeliler, Nilufer
Surgery on the dentoalveolar process combined with orthodontic treatment was emphasized as an alternative method for reducing the treatment time and improving the orthodontic treatment on post-adolescent and adult patients. This combined treatment facilitates and accelerates orthodontic tooth movement. This article reviews the clinical practice in surgery-assisted orthodontic treatment in relation to historical perspective, indications and biological principles, as well as limitations and risks of dento-osseous surgical techniques, including dento-osseous osteotomy and/or ostectomy, dento-osseous microfracture, dento-osseous corticotomy, and/or corticoectomy, and dental distraction. PMID:24883038
Pietilä, I; Pietilä, T; Svedström-Oristo, A-L; Varrela, J; Alanen, P
The objectives of the study were to compare the costs and outcome of orthodontic treatment in eight municipal health centres in Finland. A random sample of the age groups of 16- and 18-year-olds (n = 1109) living in these municipalities was clinically examined by two calibrated orthodontists. The acceptability of the morphology and function of the occlusion were assessed with the Occlusal Morphology and Function Index (OMFI). The data concerning previous orthodontic treatment were collected from the patient records of all subjects (n = 608) who reported previous or ongoing orthodontic treatment or who could not recall if they had received orthodontic treatment. The health centres were grouped into an early and a late timing group according to the mean age of starting the treatment. The mean age for starting orthodontic treatment was 8.0 years (SD 1.9) in the early group and 10.7 years (SD 2.3) in the late group. The visit costs and the costs of orthodontic appliances without overheads comprised the operating costs. The cost-effectiveness of orthodontic services was measured by estimating how much each health centre had to have paid for one per cent unit of acceptable morphology and acceptable function of occlusion. The mean appliance costs were higher in the late timing group and the mean visit costs higher in the early timing group. The mean operating costs per case were €720 in the early and €649 in the late timing group. However, there was a great variation within both groups. The cost of one per cent unit of acceptable morphology was the same in the two timing groups, while the cost of one per cent unit of acceptable function was lower in the early timing group. The low operating costs as such did not totally explain the better cost-effectiveness of orthodontic care. Furthermore, the cost-effectiveness was not directly connected with the timing of treatment.
Cross, David L; Short, Laura J
Clinical experience has shown that angular cheilitis can occur during orthodontic treatment and may persist into retention, but the incidence of the condition is unknown. The purpose of this paper is to increase the awareness among clinicians of angular cheilitis occurring during orthodontic treatment. It also proposes a treatment regime which may be used.
Alkhatib, Mhd Nour; Bedi, Raman; Foster, Claire; Jopanputra, Pooja; Allan, Sue
Background The study was carried out to determine the prevalence of orthodontic treatment need in children from minority ethnic groups and compare the need to the white population. The second objective was to explore variations in agreement between subjective and objective treatment need in a multiethnic context using the aesthetic component of Orthodontic Treatment Need Index (IOTN AC). Methods A cross-sectional study in North West London, 14 schools were randomly selected from the 27 schools in the two boroughs of Harrow and Hillingdon. Comparison between objective and subjective treatment need was carried out using IOTN AC index. Clinical orthodontic treatment need was also recorded using the dental health component of Orthodontic Treatment Need Index (IOTN DHC). Results 2,788 children were examined and completed the questionnaire. 16% of the study population were already wearing appliances or had finished orthodontic treatment. Of the remaining children; 15% had definite need for treatment using the dental health component of the IOTN. There was no significant variation in the need for orthodontic treatment between different ethnic backgrounds (P > 0.05) whether using the AC or DHC components of the IOTN index. However, poor agreement was detected between professional and subjective assessment of ethnic minority of orthodontic treatment need using IOTN AC index. Conclusion Orthodontic treatment need in children of ethnic minorities does not differ significantly from the vast majority of white children. However treatment need based on aesthetic index continues to vary in all ethnic groups from the professional aesthetic assessment PMID:16188024
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
Kuijpers-Jagtman, A M; Al Yami, E A; van 't Hof, M A
Aim of this study was to assess long-term stability of orthodontic treatment in a sample of 1016 patients until 10 years postretention. Treatment outcome was measured with the PAR-index at 6 different stages. The mean age of the patients was 12.0 +/- 3.1 year at the start of treatment to 26.3 +/- 2.9 year 10 years postretention. The results show that 67% of the orthodontic treatment result, as measured with the PAR-index, was maintained 10 years postretention. The PAR-scores for the midline and the open bite remained about the same over the years. However, the scores for the lateral occlusion, overjet, reversed overjet, overbite, and contact point displacement of the upper and lower front teeth increased gradually over time. Nearly 50% of the total relapse took place the first two years after retention. The largest change was found for the position of the lower incisors. Ten years postretention their position was even worse than at the start of treatment.
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
Dowsing, Paul; Murray, Alison; Sandler, Jonathan
In the second of two papers, management of orthodontic emergencies involving appliances other than Fixed appliances will be detailed. Problems relating to removable appliances, as well as other orthodontic adjuncts, will be discussed. Unfortunately, orthodontic appliance breakage does occur, despite the clinicians giving clear and concise instructions to the patients and their parents at fitting. If general dental practitioners have a practical knowledge of how to diagnose problems and to provide appropriate advice or timely 'emergency' treatment, this will significantly reduce the inconvenience for all parties concerned. It should also ensure that treatment progresses in the most efficient and comfortable manner for their patients. In specific situations the early, accurate identification of the problem and instigation of its appropriate management can avoid more serious consequences. Clinical Relevance: Appropriate handling of an orthodontic 'emergency' by the dentist can, on many occasions, provide immediate relief to the patient. This will, in turn, allow treatment to continue in the right direction, thus allowing more efficient and effective use of valuable resources.
Monini, André da Costa; Martins, Renato Parsekian; Martins, Isabela Parsekian; Martins, Lídia Parsekian
Paresthesia of the lower lip is uncommon during orthodontic treatment. In the present case, paresthesia occurred during orthodontic leveling of an extruded mandibular left second molar. It was decided to remove this tooth from the appliance and allow it to relapse. A reanatomization was then performed by grinding. The causes and treatment options of this rare disorder are reviewed and discussed. The main cause of paresthesia during orthodontic treatment may be associated with contact between the dental roots and inferior alveolar nerve, which may be well observed on tomography scans. Treatment usually involves tooth movement in the opposite direction of the cause of the disorder.
Gebeile-Chauty, Sarah; Robin, Olivier; Messaoudi, Yassine; Aknin, Jean-Jacques
While considered for years to play the primary role in the etiology of temporo-mandibular joint disturbances (TMD), occlusal discrepancies are now considered to be just one causative factor among many. Recent studies, literature reviews or meta-analyses, and longitudinal studies with follow-up of children treated for many years all conclude that there is no risk of orthodontic treatment giving rise to episodes of temporo-mandibular disorders. The signs of TMD appearing during the course of orthodontic treatment should be considered in the context of the epidemiology of the disorder, which is characterized by a strong increase in its occurrence during adolescence. In conclusion, it should be stated that if orthodontic treatment can no longer be considered as one of the etiopathogenic factors in the TMD complex, there are no scientific arguments to justify the converse, that there are indications for orthodontic treatment whose sole goal would be the treatment of TMD.
Lehman, J A; Tabbal, N; Haas, D G; Haas, A J
Patients with severe mandibular prognathism are best managed with a combined orthodontic-surgical approach. In our patients, the orthodontic treatment consisted of six to eighteen months of presurgical preparation, which in some patients may accentuate the dental deformity. This is done to provide two well-aligned dental arches that will fit accurately at surgery. The surgical procedure used was an oblique subcondylar osteotomy. This was followed by six to eight months of orthodontic treatment to complete dental alignment. Thirty patients were treated using this combined approach, with excellent results and few complications.
Boke, Fatma; Gazioglu, Cagri; Akkaya, Sevil; Akkaya, Murat
Objective: The aim of this retrospective study was to evaluate the relationship between orthodontic treatment and gingival health. Materials and Methods: A total of 251 patients among whom 177 were girls and 74 were boys, recruited from the records pool of the Department of Orthodontics, Faculty of Dentistry, University of Gazi, were included in the study. Patients’ treatments have been completed by postgraduate students during the period between 2006 and 2012. Patients’ folders were analyzed according to their age, treatment time, and the type of orthodontic treatment. Intra-oral photographs were analyzed, and the presence or absence of visible plaque, visible inflammation, and gingival recession were recorded, and incisor inclinations analyzed on lateral cephalometric films, before and after orthodontic treatment. Results: No statistically significant difference was found in patients treated with functional appliances before and after treatment. In patients treated with fixed orthodontic appliances, visible plaque, visible inflammation, and gingival recession showed significant increases after treatment, gingival biotype did not show any significant difference. Positive correlation was found between lower incisor position and gingival recession in patients treated with fixed appliance and extraction. And also cuspids were the teeth with the highest prevalence of gingival recession. Conclusion: Considering the relationship between orthodontic treatment and gingival health, cooperation among patients, orthodontists, and periodontists is important. PMID:25202219
Pizzo, G; Licata, M E; Guiglia, R; Giuliana, G
The aim of this paper was to provide a systematic review of the literature on the root resorption caused by orthodontic treatment. Original papers on this subject, published in English from January 2000 until December 2005, were located in the MEDLINE/PubMed database. Other sources were taken from the references of the selected papers. Root resorption is the most common sequela of the orthodontic treatment. It is an inflammatory process that leads to an ischemic necrosis localized in the periodontal ligament when the orthodontic force is applied. The onset and progression of root resorption are associated with risk factors related to the orthodontic treatment such as the duration of treatment, the magnitude of the force applied, the direction of the tooth movement, the method of force application (continuous versus intermittent), the orthodontic movement. Patient-related risk factors are the individual susceptibility on a genetic basis, some systemic diseases, anomalies in root morphology, dental trauma, and previous endodontic treatment. The prevention of root resorption during the orthodontic treatment may be performed controlling the risk factors. The periodic radiographic control during the treatment is necessary in order to detect the occurrence of root damages and quickly reassess the treatment goals.
A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient's severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient's sleep continuity and architecture with the elimination of obstructive apneas. PMID:27668098
Yip, Hilings H Y; Wong, Ricky W K; Hägg, Urban
Soft drink consumption has steadily increased in recent decades in both western and developing countries. The trend is most apparent among children and adolescents. This rise in soft drink consumption has raised concerns among health care professionals, including dental practitioners. Accordingly, the effects of soft drinks on dental health have been investigated. Several studies have shown that dental problems, such as caries, enamel erosion, and corrosion of dental materials, may be associated with soft drink consumption. Because orthodontic appliances restrict toothbrush access, patients undergoing orthodontic treatment need special oral care and advice. This article reviews the risks and implications of soft drink consumption for orthodontic patients.
Llewellyn, Stuart K; Hamdan, Ahmad M; Rock, William P
The aim of the present study was to develop an index specifically for the measurement of treatment complexity. Input factors were directly related to complexity, and the output was a score measuring the degree of treatment complexity. The sample comprised 120 sets of dental casts, 30 for each of the four main malocclusion classes. Sixteen orthodontists graded the study casts for perceived treatment complexity on a six-point scale and then listed, in order of importance, up to three occlusal features which they felt contributed to complexity from a pre-determined list. Multiple regression analysis was used to derive weightings for each occlusal feature, which would reflect the relevant treatment complexity. In order to obtain an overall treatment complexity score for each case, weightings were then multiplied by the corresponding occlusal feature scores and summed. The relationship between treatment complexity scores and perceived complexity was examined using Spearman's ranked correlation coefficient. The regression equation explained 49.5 per cent of the variance in treatment complexity of the whole sample. Regression analysis on the basis of malocclusion produced R (2) values of 90.7 per cent for Class I, 42.6 per cent for Class II division 1, 62.3 per cent for Class II division 2, and 79.5 per cent for Class III malocclusions. The index of orthodontic treatment complexity (IOTC) scores showed a moderate but highly significant association with the orthodontists' perceived complexity assessments (rho = 0.42, P = 0.000). The proposed IOTC shows sufficient promise to warrant further development.
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
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
Yu, Jian-Hong; Huang, Heng-Li; Liu, Chien-Feng; Wu, Jay; Li, Yu-Fen; Tsai, Ming-Tzu; Hsu, Jui-Ting
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 orthodontic treatment
Coyne, R; Woods, M; Abrams, R
A professionally managed telephone survey was undertaken to assess community-perceived need and demand for orthodontic treatment, and to determine the proportion of the community with a history of having some form of orthodontic treatment. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria in Australia. The sample distribution had a ninety-five per cent confidence limit with a five per cent margin of error, and closely matched the known population distributions for age, sex and geographical location. From the survey it can be concluded that apparently forty-four per cent of Victorian families include someone who has already received some form of orthodontic treatment. Twenty-five per cent of the survey respondents perceived some need for the treatment of a family member; only fifteen per cent of respondents, however, reported that someone in their family actually wanted treatment. This survey has established baseline values for community perceived need and demand for orthodontic treatment. Use of these values should assist in future resource management within both the public and private sectors.
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
Zawawi, Khalid H
Mandibular incisor extraction for orthodontic treatment is considered an unusual treatment option because of the limited number of patients that meet the criteria for such treatment. Accurate diagnosis and treatment planning is essential to achieve the desired results. Adult orthodontic patients are increasingly motivated by esthetic considerations and reject the idea of conventional fixed appliances. In recent years, Invisalign appliances have gained tremendous attention for orthodontic treatment of adult patients to meet their esthetic demands. In this case report, a case of Class I malocclusion was treated with mandibular incisor extraction using the Invisalign appliance system. Successful tooth alignment of both arches was achieved. The use of Invisalign appliance is an effective treatment option in adult patients with Class I malocclusion that requires incisor extraction due to moderate to severe mandibular anterior crowding.
Zawawi, Khalid H.
Mandibular incisor extraction for orthodontic treatment is considered an unusual treatment option because of the limited number of patients that meet the criteria for such treatment. Accurate diagnosis and treatment planning is essential to achieve the desired results. Adult orthodontic patients are increasingly motivated by esthetic considerations and reject the idea of conventional fixed appliances. In recent years, Invisalign appliances have gained tremendous attention for orthodontic treatment of adult patients to meet their esthetic demands. In this case report, a case of Class I malocclusion was treated with mandibular incisor extraction using the Invisalign appliance system. Successful tooth alignment of both arches was achieved. The use of Invisalign appliance is an effective treatment option in adult patients with Class I malocclusion that requires incisor extraction due to moderate to severe mandibular anterior crowding. PMID:25024852
Sadowsky, C; BeGole, E A
The periodontal health of a group of ninety-six patients who had received comprehensive fixed-appliance orthodontic treatment during adolescence between 12 and 35 years previously was evaluated. Comparisons were made with a group of 103 adults who were similar with regard to race, sex, age, socioeconomic status, dental awareness, and oral hygiene status but had malocclusions that had not been orthodontically treated. There were no statistically significant differences in the general prevalence of periodontal disease between the two groups. However, more detailed analysis revealed that the orthodontic group had a greater prevalence of mild to moderate periodontal disease in the maxillary posterior and mandibular anterior regions of the mouth, as compared to the control group. The results suggested that orthodontic treatment in adolescence is not a major factor in determining the long-term periodontal health status. No significant amount of either damage or benefit to the periodontal structures could be directly attributed to orthodontic therapy. Conversely, the lack of orthodontic therapy in adolescence does not appear to influence subsequent development or nondevelopment of periodontal disease in adults.
McNamara, J A; Seligman, D A; Okeson, J P
A review of the current literature regarding the interaction of morphologic and functional occlusal factors relative to TMD indicates that there is a relatively low association of occlusal factors in characterizing TMD. Skeletal anterior open bite, overjets greater than 6 to 7 mm, retruded cuspal position/intercuspal position slides greater than 4 mm, unilateral lingual crossbite, and five or more missing posterior teeth are the five occlusal features that have been associated with specific diagnostic groups of TMD conditions. The first three factors often are associated with TMJ arthropathies and may be the result of osseous or ligamentous changes within the temporomandibular articulation. With regard to the relationship of orthodontic treatment to TMD, the current literature indicates that orthodontic treatment performed during adolescence generally does not increase or decrease the odds of developing TMD later in life. There is no elevated risk of TMD associated with any particular type of orthodontic mechanics or with extraction protocols. Although a stable occlusion is a reasonable orthodontic treatment goal, not achieving a specific gnathologically ideal occlusion does not result in TMD signs and symptoms. Thus, according to the existing literature, the relationship of TMD to occlusion and orthodontic treatment is minor. Signs and symptoms of TMD occur in healthy individuals and increase with age, particularly during adolescence; thus, TM disorders that originate during various types of dental treatment may not be related to the treatment but may be a naturally occurring phenomenon.
Špalj, Stjepan; Šlaj, Martina; Athanasiou, Athanasios E; Žak, Irena; Šimunović, Martina; Šlaj, Mladen
The aim of this study was to explore the association between signs and symptoms of temporomandibular disorders (TMD) and orthodontic treatment need in orthodontically untreated children and adolescents. One thousand five hundred and ninety-seven subjects aged 11-19 years, without previous orthodontic history, from sixteen randomly selected public schools in Zagreb, Croatia, were examined. Malocclusion characteristics were assessed by using the criteria proposed by Bjork et al., the Dental Aesthetic Index, and the Aesthetic Component of Index of Orthodontic Treatment Need. Data on TMD signs/symptoms and parafunctional behaviour were obtained by means of questionnaire and clinical examination, respectively. Multiple logistic regression models were used for analysis. Twenty-two percent of children and young adolescents had one or more signs of TMD, ranging from 17% in age of 11 years up to 24% in age of 19. There was poor correlation between presence of TMD and orthodontic treatment need. Multiple logistic regression models showed that Class III, crowding and spacing were related to mandibular deflection on opening. Ectopic eruption was related to TMJ clicking, and severely tipped teeth with reduced mouth opening. Headaches presented a positive relationship with reverse overjet and severe rotations, and tooth wear with crowding, spacing and lateral openbite. Age, female gender and parafunctional habits were related to several TMD signs. Although logistic regression models were statistically significant (p < 0.05) malocclusions, parafunctional behaviours, age and gender accounted for less than 20% of the variability in TMD signs/symptoms. TMD signs and symptoms seemed to be poorly related to malocclusions or treatment needs.
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
Jamilian, Abdolreza; Darnahal, Alireza; Damani, Elnaz; Talaeipour, Maziar; Kamali, Zinat
Background. Widespread use of the IOTN along with detailed study of occlusal traits is suitable for planning community dental health resources. Objectives. The aim of current study was to assess the need for orthodontic treatment among school children of Tehran by means of the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) and also to evaluate the occlusal traits of the subjects. Methods. 684 (343 boys and 341 girls) school children, 15 to 17 years of age, were selected at random from 12 schools to represent the four main areas of Tehran. The final sample who met the inclusion criteria comprised 643 subjects (322 males and 321 females). Malocclusion was determined with the Index of Orthodontic Treatment Need. The IOTN grades were statistically compared in the two genders using chi-square test. Results. Orthodontic treatment need, using the DHC, was found in only 9.0 per cent of the children. The prevalence of Angle Class I malocclusion in this study was higher than other malocclusions (65.2 per cent), followed by crowding in 62.7 per cent of the subjects. Conclusion. Orthodontic treatment need for Tehran high school students was relatively lower than that reported in most recent studies in Europe.
Giuca, Maria Rita; Pasini, Marco; 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.
Christensen, L; Luther, F
The growth in adult orthodontics presents new challenges to both the general dental practitioner and the orthodontist. Although many of the main objectives of orthodontic treatment are similar for adults, young adults and children, adult patients frequently bring significant challenges in several areas not often seen in the younger patient group. In areas such as planning realistic treatment outcomes, it is paramount that the patient's expectations are identified, respected and managed where appropriate. The adult patient's dental health often dictates deviation from the ideal treatment plan and periodontal problems are a common example. Based on current evidence, this paper presents an overview of some of the difficulties in the management of these issues, as well as highlighting developments with regard to pain conditions and their relevance to orthodontic treatment and its effects on temporomandibular joint disorders (TMD) management.
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.
Spalj, Stjepan; Slaj, Martina; Athanasiou, Athanasios E; Govorko, Danijela Kalibović; Slaj, Mladen
The purpose of this study was to estimate unmet orthodontic treatment needs of adolescents in Zagreb, Croatia, compare normative and self-perceived need and investigate factors influencing the reason why untreated subjects with severe malocclusions have not been treated before. One thousand and forty-two non-orthodontically treated subjects in age groups of 12 and 18 years, from sixteen randomly selected public schools in Zagreb, Croatia were examined. The Dental Aesthetic Index, Aesthetic Component of Index of Orthodontic Treatment Need and a questionnaire concerning self-perceived orthodontic treatment need, perception of aesthetics, function, behaviors and socioeconomic status were used. Around one third of untreated adolescent population had an objective need, less than 20 percent had aesthetic need, and self-perceived need was reported in one third of population. Associations and agreements between objective, aesthetic and self-perceived need were weak (r = 0.27-0.48; p < 0.001 and κ in range from 0.05 (p > 0.05) to 0.32 (p < 0.05), respectively). Satisfaction with personal dental appearance and awareness of malocclusion were better related in persons with no treatment need or minor need (r = 0.53-0.59) than in those with major need (r = 0.31-0.40). Multiple logistic regression analyses confirmed that objective, aesthetic and self-perceived needs were better related between themselves than to socio-economic status of subjects, function, activities of daily living and oral health-related behaviors. It appears that self-perceived treatment need has low role in predicting objective need, but relation between satisfaction and awareness of malocclusion could be one of basic factors in process of making decision to go for treatment and maybe could serve in predicting patient's compliance.
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
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…
Tanaka, Eiji; Nishi-Sasaki, Akiko; Hasegawa, Takuro; Nishio, Clarice; Kawai, Nobuhiko; Tanne, Kazuo
The correction of a severe maxillary protrusion in an adult by distal movement of the maxillary molars has been one of the most difficult biomechanical problems in orthodontics. This article reports on the treatment of an adult case of severe maxillary protrusion and a large overjet treated with a skeletal anchorage system. A female patient, age 22 years and 3 months, complained of the difficulty of lip closure due to severe maxillary protrusion with a gummy smile. Overjet and overbite were +7.6 mm and -0.9 mm, respectively. She had a history of orthodontic treatment in which her maxillary first premolars were extracted. In order to conduct distal movement of the maxillary molars, anchor plates were placed in the zygomatic process. After achieving a Class I molar relationship, retraction and intrusion of the maxillary incisors were performed. After a 2-year treatment, an acceptable occlusion was achieved with a Class I molar relationship. Her convex facial profile with upper lip protrusion was considerably improved, and the lips showed less tension in lip closure. After a 2-year retention period, an acceptable occlusion was maintained without recurrence of maxillary protrusion, indicating a stability of the occlusion. The result of this treatment indicated that skeletal anchorage is of great importance as a remedy for achieving intrusion and retraction of the maxillary incisors in cases of severe maxillary protrusion with a patient who had previous orthodontic treatment.
Sabatoski, Claudio Vinicius; Bueno, Regis Claret; Reyes Pacheco, Ariel Adriano; Pithon, Matheus Melo; Tanaka, Orlando Motohiro
A 41-year-old man had a significant loss of bone and supporting tissues with pathologic migration of several teeth and several missing teeth. He was treated with an interdisciplinary therapeutic protocol that included nonsurgical periodontal therapy based on strict control of supragingival plaque, subgingival periodontal therapy, orthodontic and endodontic treatment, and replacement of restorations. The orthodontic therapy was performed in a severely reduced bone support and the presence of pathological tooth migration after periodontal disease control. The interdisciplinary treatment protocol was the key to achieve a significant improvement in his facial and dental esthetics, masticatory function, and quality of life. PMID:26587295
Orthodontic studies over several decades have found generally inconsistent agreement among dentists when evaluating orthodontic treatment need. There... Orthodontic Treatment Need (IOTN) is an occlusal index that has been found to be both reliable and valid in studies both in Europe and in the United...improve dental students’ ability to assess orthodontic treatment need. Fourth-year dental students were divided into three groups of twenty (control
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
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
Ribeiro, Gerson Luiz Ulema; Jacob, Helder B.
ABSTRACT Introduction: Space closure is one of the most challenging processes in Orthodontics and requires a solid comprehension of biomechanics in order to avoid undesirable side effects. Understanding the biomechanical basis of space closure better enables clinicians to determine anchorage and treatment options. In spite of the variety of appliance designs, space closure can be performed by means of friction or frictionless mechanics, and each technique has its advantages and disadvantages. Friction mechanics or sliding mechanics is attractive because of its simplicity; the space site is closed by means of elastics or coil springs to provide force, and the brackets slide on the orthodontic archwire. On the other hand, frictionless mechanics uses loop bends to generate force to close the space site, allowing differential moments in the active and reactive units, leading to a less or more anchorage control, depending on the situation. Objective: This article will discuss various theoretical aspects and methods of space closure based on biomechanical concepts. PMID:27275623
Benoist, H M; Ngom, P I; Seck-Diallo, A; Diallo, P D
Gingival enlargement is a condition that commonly develops during orthodontic treatment. Orthodontic appliances are irritation and retention plaque factors holding up oral hygiene and control of gingival inflammation. Two cases of gingival hypertrophy in young Senegalese females undergoing orthodontic treatment with fixed appliances are described and treated by gingivectomy. This surgical procedure have led to morphological conditions of gingiva allowing better plaque control and the orthodontic treatment going on. Periodical controls in child and adolescent are required for healthy periodontium during orthodontic therapy. Collaboration between orthodontist and periodontist is one of the most important keys to successful treatment.
Slade, Gary D.; Diatchenko, Luda; Ohrbach, Richard; Maixner, William
Traditionally, four groups of factors have been identified in the etiology of temporomandibular disorder (TMD): anatomical variation in the masticatory system; psychosocial characteristics; pain in other body regions; and demographics. Orthodontic treatment has been variously cited both as a protective and harmful factor in TMD etiology. Recently, a search has begun for a genetic influence on TMD etiology. Genetic markers can be of additional value in identifying gene-environment interactions, that is, isolating population sub-groups, defined by genotype in which environmental influences play a relatively greater or lesser etiological role. This paper reviews concepts and study design requirements for epidemiological investigations into TMD etiology. Findings are presented from a prospective cohort study of 186 females that illustrate an example of gene-environment interaction in TMD onset. Among people with a variant of the gene encoding catechol-O-methyl-transferase, an enzyme associated with pain responsiveness, risk of developing TMD was significantly greater for subjects who reported a history of orthodontic treatment compared with subjects who did not (P=0.04). While further studies are needed to investigate TMD etiology, this genetic variant potentially could help to identify patients whose risk of developing TMD is heightened following orthodontic treatment, hence serving as a risk marker useful in planning orthodontic care. PMID:18663384
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
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.
Lim, Won Hee; Chun, Youn Sic
This article describes the use of indirect skeletal anchorage and autotransplantation in a patient who had an ameloblastoma removed. The mandibular left second and third molars were also extracted. Autogenous bone was grafted after surgical removal of the ameloblastoma, and the mandibular right third permanent molar was transplanted into the extraction space. Orthodontic treatment included a miniscrew to bring the transplanted tooth into good occlusion. Four years after treatment, the patient continued to show good results, with no recurrence of the ameloblastoma.
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
Kerosuo, Heidi; Abdulkarim, Ebrahim; Kerosuo, Eero
The aims of this study were to explore orthodontic treatment experience, subjective need for treatment, and perceptions of teeth and dental appearance in relation to background factors such as funding system, area of living, age, gender, ethnicity, and socioeconomic status. The subjects were 1076 randomly selected second-year high school students from a rural (Jahra) and an urban (Capital) area of Kuwait, with a mean age of 15.1 years. Kuwaiti citizens constituted 79% of the sample, and the rest were of other Arab origins. The data were collected using a questionnaire. Orthodontic treatment rate was significantly higher for Kuwaitis (10%) than for non-Kuwaitis (2%). Among Kuwaiti subjects, urban area of living and female gender increased the odds of receiving orthodontic treatment. Subjective treatment need was 36%, with no difference between Kuwaiti and non-Kuwaiti subjects, but Kuwaitis in the rural area expressed subjective treatment need less often than those in the urban area. The results suggest that access to free-of-cost orthodontic treatment was likely to affect treatment rate, whereas it did not seem to influence the self-perceived need for treatment. Gender and area of living may be significant for the distribution of free-of-cost orthodontic treatment.
Yang-Powers, Linda C; Sadowsky, Cyril; Rosenstein, Sheldon; BeGole, Ellen A
Since 1999, the American Board of Orthodontics (ABO) has used the objective grading system (OGS) to grade clinical case reports; the ABO also encourages prospective candidates to use the system. Ninety-two cases that satisfied the specifications of 6 of the ABO's malocclusion categories were selected from the files of 500 consecutively completed patients in the graduate orthodontic clinic at the University of Illinois at Chicago; this was called the university group. A comparison group of 32 cases previously presented to the ABO was collected from 5 clinicians in the Chicago area who had passed the ABO examination and become board-certified between 1984 and 2000; this was called the ABO group. Fourteen of the 32 cases in the ABO group were presented to the ABO after implementation of the OGS; these were also analyzed separately. Overall, the ABO group lost fewer points (had lower OGS scores) than did the university group (P <.05); the ABO group comprised a highly selected sample. The university group had significantly (P <.05) better scores for root parallelism, whereas the ABO group had significantly better scores for occlusal contacts and overjet scores, possibly reflecting settling after appliance removal. Finishing in the anterior segment and the second molar region was better in the ABO group. Orthodontists are good at correcting spaces in the arch and are deficient in placing adequate torque in the buccal segments. No differences were found in OGS scores among the 6 malocclusion categories. This study suggests how university cases could be completed to a higher level of quality and how other samples could be evaluated to raise the level of orthodontic treatment outcome.
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.
Nimeri, Ghada; Kau, Chung H; Abou-Kheir, Nadia S; Corona, Rachel
Nowadays, there is an increased tendency for researches to focus on accelerating methods for tooth movement due to the huge demand for adults for a shorter orthodontic treatment time. Unfortunately, long orthodontic treatment time poses several disadvantages like higher predisposition to caries, gingival recession, and root resorption. This increases the demand to find the best method to increase tooth movement with the least possible disadvantages. The purpose of this study is to view the successful approaches in tooth movement and to highlight the newest technique in tooth movement. A total of 74 articles were reviewed in tooth movement and related discipline from 1959 to 2013. There is a high amount of researches done on the biological method for tooth movement; unfortunately, the majority of them were done on animals. Cytokine, PTH, vitamin D, and RANKL/RANK/OPG show promising results; on the other hand, relaxin does not accelerate tooth movement, but increases the tooth mobility. Low-level laser therapy has shown positive outcome, but further investigation should be done for the best energy and duration to achieve the highest success rate. Surgical approach has the most predictable outcomes but with limited application due to its aggressiveness. Piezocision technique is considered one of the best surgical approaches because it poses good periodontal tissue response and excellent aesthetic outcome. Due to the advantages and disadvantages of each approach, further investigations should be done to determine the best method to accelerate tooth movement.
Al-Bazi, Samar M; Abbassy, Mona A; Bakry, Ahmed S; Merdad, Leena A; Hassan, Ali H
The objectives of this study were to evaluate the effects of applying 0.50% chlorhexidine (CHX) gel using the dental drug delivery system (3DS) on salivary Streptococcus mutans (S. mutans) and on the surface topography of metal and ceramic orthodontic brackets. The study involved 20 orthodontic patients with high levels of salivary S. mutans. The patients were treated with professional mechanical tooth cleaning followed by application of 0.50% CHX using individual trays (3DS). Salivary S. mutans levels were repeatedly measured 1, 2, 4, and 8 weeks post-treatment. In vitro study utilized forty ceramic and metallic brackets that were immersed in 0.50% CHX gel for 10 min, whereas another untreated forty brackets served as controls. The frictional resistances of stainless steel wires to the brackets before and after CHX treatment were recorded using a universal testing machine. Scanning electron microscopy was used to compare changes in the surface topography of brackets. Statistical analyses were used to determine the effect of CHX on bacterial count and to evaluate the effect of CHX on frictional resistance. According to the results of this study, S. mutans levels were reduced significantly (P < 0.05). There were no significant changes in the frictional resistance and surface topography of brackets before or after application of CHX. (J Oral Sci 58, 35-42, 2016).
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
Chen, Weiting; Zhou, Yu
Objectives: The aim of this study was to assess the relationship between orthodontic and the development of dental caries in the same patients who received single jaw orthodontic treatment. Material and methods: A consecutive sample consisted of 60 subjects who required single upper jaw orthodontic were recruited consecutively from the Department of Orthodontic at the Stomatology Hospital of Wenzhou Medical University. The dental examinations were routinely carried out by one dentists at the following stages: pre-treatment (T1); post-treatment (T2); more than 7 years after T1 (T3). The DMFS count which reflect the caries experience was recorded. Results: There was no significant difference between the treated groups and untreated groups for the DMFS before received fixed orthodontic treatment. The same result was found after orthodontic treatment. However, the average number of DMFS in the treatment jaw after fixed orthodontic treatment was lower than in the without treatment jaw after long-term follow-up period. Conclusions: Fixed orthodontic appliances significant decrease the patients caries risk after orthodontic treatment. PMID:25932240
Monnet-Corti, Virginie; Barrin, Arnaud; Goubron, Cyril
The objective of this article is to review various unsightly periodontal defects and the treatments that have previously been used to eliminate them in order to establish guidelines for future therapy. The inter-relationship between orthodontic and periodontal disciplines is well established and needs no defense here. Periodontal tissues change throughout life and the same is true for the smile. The periodontium is an essential component of the appearance of the face as well as the lips. These are dynamic esthetic criteria while the gingiva and the static character of the dentition also contribute to the character of an individual's smile. In order to conduct orthodontic therapy most effectively it is essential that orthodontists and periodontists utilize a coordinated approach. From the beginning, they must establish an etiological diagnosis of any esthetic defects that will insure that their joint therapy is conducted appropriately and at the proper moment.
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.
Melsen, B; Klemt, B
A patient who originally only required gnathologic and prosthetic treatment received orthodontic treatment, which led to a technically less complicated treatment. The removal of teeth with a dubious prognosis improved the long-term prognosis of the dentition. The space closure resolved the anterior protrusion and crowding and was mainly performed through anterior retraction reducing the dentoalveolar protrusion. The buccolingual root control made it possible to generate a better periodontal status in relation to the maxillary canines. A flat splint used as a retainer assisted the prosthodontist in establishing the structural position of the mandible and the intercuspation. The importance of a close interdisciplinary collaboration is stressed.
Bagnenko, N M; Bagnenko, A S; Grebnev, G A; Madai, D Y
Epidemiology of dentoalveolar anomalies is undoubtedly important, but in terms of the organization of orthodontic care, greater interest are data on the needs in this type of treatment. In a situation of limited manpower and resources for the provision of orthodontic care information about needs in orthodontic treatment allows you to define a group of patients with the primary need for orthodontic treatment, and to identify priorities to optimize the organization of orthodontic care in the region. Such data can be obtained by using the Dental Aesthetics Index (DAI) and Index of Orthodontic Treatment Need (IOTN). The aim of the study was to analyze the epidemiology of various forms of dentoalveolar anomalies school-age children of Kirishi district of Leningrad region, as well as their needs in orthodontic treatment in accordance with objective evaluation indices. The study involved 734 pupils of Kirishi lyceum №1 of Leningrad region. Analysis of the prevalence of dentoalveolar anomalies, as well as needs in the orthodontic treatment was conducted in three age groups: I mixed dentition period (6-9 years), II mixed dentition period (10-13 years), and permanent dentition (14-17). To determine the needs in the orthodontic treatment were used two most common international index (DAI and IOTN). In Kirishi district of Leningrad region dentoalveolar anomalies were found in 88.8% of children of school age, which is in accordance with the indices and IOTN DAI needs in orthodontic treatment is 38.8% and 54.5%, respectively. In order to reduce unnecessarily high load volume medical institutions orthodontic profile, optimize utilization of financial resources, as well as reducing social tension it is recommended to introduce the practice of doctors-orthodontists methodology for determining the needs in orthodontic treatment by objective indices.
Pietilä, Ilpo; Pietilä, Terttu; Pirttiniemi, Pertti; Varrela, Juha; Alanen, Pentti
The aim of this study was to analyse the variation in the views of Finnish orthodontists on the indications for orthodontic treatment, timing of orthodontic assessment, and treatment methods used. The views were elicited by a questionnaire that was sent to all 146 specialist orthodontists under 65 years of age living in Finland in 2001. The response rate was 57 per cent. The association between an orthodontist's experience and timing of treatment was tested by Fisher's exact test. Stepwise logistic regression analysis was used to estimate the association between the demographic characteristics of orthodontists and the tendency to start Class II division I treatment early. Most orthodontists recommended that the first assessment of occlusion should be carried out before 7 years of age. A crossbite was mentioned as the most frequent indication for treatment in the primary and early mixed dentition, and a severe Class II division I malocclusion with an increased overjet as the most frequent indication in the late mixed dentition. Most respondents preferred early treatment, but there was a wide variation in the choice of appliances and in the timing of treatment of malocclusions other than crossbite and Class II malocclusions. A quadhelix, headgear, and the eruption guidance appliance were the most frequently used appliances in early treatment, with fixed appliances being most frequently used during the late mixed and permanent dentition phase. Orthodontists working full time in municipal health centres tended to prefer early treatment more often than those working part-time or outside health centres. There was no statistically significant association between an orthodontist's experience and timing of Class II division I and Class III treatment (P = 0.142 and P = 0.296, respectively). The preference for an early start in Class II division I treatment might be related to differing professional decisions, but no explaining factors could be found in the regression
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
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
Preoteasa, Cristina Teodora; NiŢoi, Dan Florin; Preoteasa, Elena
Orthodontic treatment has, as any other medical intervention, in addition to its benefits, side effects, some of them being perceived as unavoidable. The aim of this case series was to microscopically evaluate the changes of the tooth surface in relation to fixed orthodontic treatment. A case series study was implemented by the usage of four extracted first maxillary premolars, from patients with previous orthodontic treatment, of 12 and 23 months. Analysis was performed using the high precision stereomicroscope (Axiovert, Carl Zeiss, Germany), at magnifications from 10× to 50×. The tooth surface corresponding to the bracket bonding area registered numerous disorderly grooves and cracks, with various directions and depths, and was flattened, having lower convexity compared to teeth surfaces where brackets were not bonded. Root resorption lacunae were more frequently observed in teeth under orthodontic treatment, these having various depths, and sizes considerably larger than those observed in teeth without orthodontic treatment. Following orthodontic treatment, teeth exhibit changes that can be perceived as being directly linked to this medical intervention. These teeth changes usually have low or moderate severity, which can be influenced at some degree by the clinical conduct of the orthodontic treatment. The stereomicroscope proved to be a high sensitivity tool for the analysis of morphological changes of teeth in relation to the fixed orthodontic treatment.
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.
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. PMID:19466264
Brenkert, Dennis R
Orthodontic treatment for a patient who has had a displaced disk or disks and has been stabilized by anterior repositioning splint therapy presents the dentist with a difficult orthodontic problem. Frequently, there is a posterior open bite present, with the anterior teeth only occluding in the stabilized TMJ position upon removal of the splint. The current articles (Part I of II presented here) will present an organized TMJ/orthodontic diagnosis (Part I) and orthodontic treatment method (Part II, to be presented in the next journal) to properly treat these patients to a consistent stabilized occlusion compatible with the TMJ splint stabilized position.
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.
Canevello, Carola; Laffi, Nicola
Introduction. “Dens invaginatus” is a dental anomaly which originates from the invagination of the ameloblastic epithelium into the lingual surface of the dental crown during the odontogenesis. It can cause early pulpal necrosis, abscesses, retention or dislocation of contiguous elements, cysts, and internal resorptions. It normally affects the upper lateral incisors. In the following study the authors will discuss the etiology, the physiopathology, and the surgical-orthodontic management of a rare case of impacted canine associated with dens invaginatus and follicular cyst, with the aim of highlighting the importance of taking any therapeutic decision based on the data available in the literature. Case Report. The present study describes a combined surgical-orthodontic treatment of an impacted canine associated with a lateral incisor (2.2) suffering from type III dens invaginatus with radicular cyst, in a 15-year-old patient. Discussion. When treating a dens invaginatus there are different therapeutic solutions: they depend on the gravity of the anomaly and on the association with the retention of a permanent tooth. The aesthetic and functional restoration becomes extremely important when performing a surgical-orthodontic repositioning. PMID:24963421
Yi, Song; Zhang, Chuqin; Ni, Chulei; Qian, Ying; Zhang, Jun
Objective 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. Materials and methods 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). Results 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). Conclusion 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. PMID:27354773
The orthodontic situation in 2042 children in 4th to 8th schoolgrades was described by placing each child in one of five orthodontic categories (percentage refers to observed frequencies): I. No anomaly (25%), II. Malocclusion-under observation only (40%). III. Undergoing orthodontic treatment (20%). IV. Orthodontic treatment completed (12%) and V. Orthodontic treatment discontinued (3%). The socioeconomic status of the child's family, determined by the occupation of the father or mother, was described by one of the following five terms: A. Low, B lower middle, C. Middle, D. Upper middle and E. Upper socioeconomic group. The distribution of the orthodontic categories within the socioeconomic groups were found to be almost equal, but three trends could be noted: a slightly higher frequency of malocclusion in the low socioeconomic group; children from the middle socioeconomic group represented a relatively large part of the orthodontic treatment group and children in the two lowest socioeconomic groups showed a greater frequency of discontinued orthodontic treatment than the rest of the children.
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.
Omer, Yassir Talal; Bouserhal, Joseph; Hawas, Nuha; Abdel Moneim El Sayed, Ahmed
The aims of this study were to investigate the association between normative and perceived orthodontic treatment need in a Lebanese population and the effect of sociodemographic status on orthodontic treatment need. A prospective cross-sectional clinical study was designed using a sample of 150 subjects (81 males and 69 females) aged 11-18years seeking dental treatment at Beirut Arab University. Normative orthodontic treatment need was scored using the two components of the Index of Orthodontic Treatment Need (IOTN), the Dental Health Component (DHC) and the Aesthetic Component (AC). Perceived need for orthodontic treatment was evaluated by scoring the AC of the IOTN. A total of 31.3% of the sample were in great need of orthodontic treatment according to the DHC of the IOTN. On the other hand, only 9% of the sample perceived their need to be definite. A significant positive but weak correlation was found between the normative and perceived need for orthodontic treatment. There was also a significant association between age and normative treatment need.
Breistein, B; Burden, D J
This epidemiological study investigated the reasons why children in Northern Ireland who need orthodontic treatment do not receive treatment even when it is provided free by the state. A total of 1584 15- and 16-year-olds were examined in 23 high schools with the Index of Orthodontic Treatment Need. The characteristics of the adolescents who had received orthodontic treatment were compared with those who had a definite need for treatment and yet did not receive treatment or advice. One in 10 of the adolescents examined had an unmet need for orthodontic treatment. Logistic regression analysis was used to assess the influence of 11 variables including socioeconomic status, religion, and standard of dental health on the uptake of orthodontic care. This analysis revealed that the only significant predictors of whether an adolescent received orthodontic treatment was the dental attendance pattern of the adolescent, the adolescent's dental health, and the dental attendance pattern of the adolescent's mother. Those adolescents who had good dental health, who regularly attended a dentist, and whose mother regularly attended a dentist were more likely to receive orthodontic treatment.
The presence of a gingival recession prior to orthodontic treatment is a real problem. Patients are concerned about losing their teeth but may also complain of their unpleasant appearance or root sensitivity in the exposed area. The orthodontist is not sure whether orthodontic treatment can be performed or whether the tooth movement will not aggravate the recession and whether periodontal surgery needs to be done before or after orthodontic treatment. The aim of this paper is to present recent data from the literature and several clinical situations in adults in order to submit a treatment sequence and clarify the role of different periodontal plastic surgery root coverage procedures.
Polson, A M; Subtelny, J D; Meitner, S W; Polson, A P; Sommers, E W; Iker, H P; Reed, B E
This study evaluated the clinical periodontal status of persons who had completed orthodontic therapy at least 10 years previously (study) and compared the findings to those of adults with untreated malocclusions (control). Subjects in the study (n = 112; 63 female subjects, 49 male subjects; mean age 29.3 +/- 4.2 [SD] years) and control (n = 111; 62 female subjects, 49 male subjects; mean age 32.9 +/- 6.5 years) populations underwent a comprehensive periodontal examination that consisted of measurements taken at six points around the circumference of each tooth: (1) plaque, (2) visual inflammation, (3) bleeding after probing, (4) pocket depth, (5) gingival recession, and (6) loss of connective tissue attachment. Data from the individual measuring points were organized into 14 different combinations of either tooth types or surface locations; each was subjected to a four-way ANOVA partitioned on group (study vs. control), sex, socioeconomic status, and malocclusion type. The results showed that differences in age distribution within the groups were affecting the comparisons between the groups. Consequently, the groups were balanced for age and analyses were done to investigate group differences by means of multiple regression techniques. The comparisons showed no significant differences between the groups for any of the periodontal variables. It was concluded that orthodontic treatment during adolescence had no discernible effect upon later periodontal health.
Zhang, Jieni; Zhou, Shaonan; Zheng, Hui; Zhou, Yanheng; Chen, Feng; Lin, Jiuxiang
Orthodontic treatment induces various biological responses, including tooth movement and remodeling of alveolar bone. Although some studies have investigated the contribution of orthodontic procedures to changes in saliva conditions, little is known about the effects of different treatment durations on the saliva proteome. To identify the discriminating protein profiles in unstimulated whole saliva of orthodontic patients with different treatment durations, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with magnetic bead, and peptide mass fingerprints were created by scanning MS signals. Saliva samples from 40 patients (10 in each of four groups: the group without an appliance and groups under treatment for 2, 7, and 12 months) were analyzed. The results showed eight mass peaks with significant differences. Furthermore, mass peak intensities at proteins 1817.7, 2010.7, 2744 and 2710.2 Da represented a steady time-dependent increasing trend, whereas protein 4134 Da exhibited a decreasing tendency. Differential expression of the peptidome profile also occurred in the multiple comparisons, and we established a fitting model. Thus, the potential discriminating biomarkers investigated in this study reflected the complicated changes in periodontal tissues during orthodontic treatment and indicated dynamic interactions between orthodontic treatment and the saliva proteome. The results provide novel insights into alterations in salivary proteins due to different orthodontic treatment durations and may lead to the development of a therapeutic monitoring strategy for orthodontics.
Rana, Tarun Kumar; Sharma, Tarun; Prasad, Narayana; Singh, Shailendra
Many patients undergo orthodontic treatment for aesthetic improvement. It is well established that the patients who undergo orthodontic treatment have a high susceptibility to present plaque accumulation on their teeth because of the presence of brackets, wires and/or other orthodontic elements on the teeth surfaces with which the oral hygiene procedures might be more difficult. The orthodontic treatment is a double-action procedure regarding the periodontal tissues which may be very meaningful in increasing the periodontal health status and may be a harmful procedure which can be followed by several types of periodontal complications. There is a strong correlation between the severity and extent of gingival recessions and the orthodontic treatment suggesting that orthodontic tooth movement may lead to gingival recession. The principal objective in the treatment of gingival recession is to cover the exposed root surfaces to improve aesthetics and to reduce hypersensitivity. Different soft tissue grafting procedures have been proposed in the treatment of gingival recessions. Subepithelial connective tissue graft is a reliable method for treatment of gingival recession. The purpose of this case report was to illustrate the relationship between orthodontic therapy and gingival recession and to describe the management of this case. PMID:25177647
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
Tavares, Carlos Alberto Estevanell; Allgayer, Susiane; Calvete, Ernani da Silva; Polido, Waldemar Daudt
This case report demonstrates the interdisciplinary treatment of an adult patient with a Class II malocclusion, convex profile, incompetent lips, gummy smile, and advanced periodontal loss. Initial periodontal-endodontic treatment was followed by orthodontic and orthognathic surgical therapies. An esthetic facial profile, a pleasing smile, an appropriate occlusion, and overall good treatment outcomes, including the periodontal condition, remained stable 11 years after active orthodontic treatment.
Maeda, Sachiko; Maeda, Yoshinobu; Ono, Yoshihiro; Nakamura, Kimio; Matsui, Tokuo
Patients with a compromised periodontal condition and a breakdown in occlusal support may require periodontal and prosthodontic treatment in conjunction with orthodontic treatment. Orthodontic treatment of these patients is possible and would involve removal of inflammation and occlusal interference and provision of an environment for proper restorative rehabilitation. A different approach to the orthodontic treatment of these patients is required in terms of treatment manner, stabilizing anchorage systems, force systems, retention, and plaque control during treatment. This report describes the case of a 49-year-old woman with severely compromised periodontal tissues, multiple missing teeth, and malocclusion. Highly esthetic and functional results were achieved by treatment with orthodontics as well as periodontal therapy, including guided tissue regeneration and implant restoration with sinus lift.
Consolaro, Alberto; Consolaro, Renata Bianco; Francischone, Leda
With regard to the best moment for carrying out or recommending dental bleaching to orthodontic patients, some explanations and orientations are given in order to answers the following questions: 1) Why orthodontic treatment completion is considered the best opportunity for carrying out the procedure? 2) Why dental bleaching should not be performed immediately before orthodontic treatment? 3) If that would be possible at any special case, what would that be? 4) Why dental bleaching should not be performed during orthodontic treatment? 5) If that would be possible at any special case, what would that be? This article highlights why it is essential to protect both the mucosa and the cervical region, regardless of the moment when dental bleaching is performed, whether associated with orthodontic treatment or not. The "how", "why" and "if" it is or not convenient to perform dental bleaching before orthodontic treatment are still a matter of clinical suggestion, as it is a procedure that is under analysis, empirical knowledge waiting for scientific proof or disproof! Although tooth enamel has adamantine fluid flowing within it, providing a specific metabolism that is peculiar to its own and which could scientifically explain and base the option of carrying out teeth whitening before and during orthodontic treatment, we must still be very careful.
de Almeida, Anderson Barbosa; Leite, Isabel Cristina Gonçalves; Melgaço, Camilo Aquino; Marques, Leandro Silva
Objective This study aims at assessing the normative need for orthodontic treatment and the factors that determine the subjective impact of malocclusion on 12-year-old Brazilian school children. Methods A total of 451 subjects (215 males and 236 females) were randomly selected from private and public schools of Juiz de Fora, Brazil. The collected data included sociodemographic information and occlusal conditions. The esthetic subjective impact of malocclusion was assessed by means of the Orthodontic Aesthetic Subjective Impact Score - OASIS, whereas the malocclusion and the need for orthodontic treatment were assessed by means of the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need-Aesthetic Component (IOTN-AC). Results Prevalence of normative need for orthodontic treatment was 65.6% (n = 155), and prevalence of orthodontic esthetic subjective impact was 14.9%. The following variables showed significant association with esthetic subjective impact of malocclusion: female (p = 0.042; OR = 0.5; CI = 0.2-0.9), public school student (p = 0.002; OR = 6.8; CI = 1.9-23.8), maxillary overjet ≥ 4 mm (p = 0.037; OR = 1.7; CI = 1-3) and gingival smile ≥ 4 mm (p = 0.008; OR = 3.4; CI = 1.3-8.8). Conclusion The normative need for orthodontic treatment overestimated the perceived need. Occlusal and sociocultural factors influenced the dissatisfaction of schoolchildren with their dentofacial appearance. PMID:25162576
Kirschneck, Christian; Wolf, Michael; Reicheneder, Claudia; Wahlmann, Ulrich; Proff, Peter; Roemer, Piero
The anchorage mechanisms currently used in orthodontic treatment have various disadvantages. The objective of this study was to determine the applicability of the osteoporosis medication strontium ranelate in pharmacologically induced orthodontic tooth anchorage. In 48 male Wistar rats, a constant orthodontic force of 0.25 N was reciprocally applied to the upper first molar and the incisors by means of a Sentalloy(®) closed coil spring for two to four weeks. 50% of the animals received strontium ranelate at a daily oral dosage of 900 mg per kilogramme of body weight. Bioavailability was determined by blood analyses. The extent of tooth movement was measured both optometrically and cephalometrically (CBCT). Relative alveolar gene expression of osteoclastic markers and OPG-RANKL was assessed by qRT-PCR and root resorption area and osteoclastic activity were determined in TRAP-stained histologic sections of the alveolar process. Compared to controls, the animals treated with strontium ranelate showed up to 40% less tooth movement after four weeks of orthodontic treatment. Gene expression and histologic analyses showed significantly less osteoclastic activity and a significantly smaller root resorption area. Blood analyses confirmed sufficient bioavailability of strontium ranelate. Because of its pharmacologic effects on bone metabolism, strontium ranelate significantly reduced tooth movement and root resorption in orthodontic treatment of rats. Strontium ranelate may be a viable agent for inducing tooth anchorage and reducing undesired root resorption in orthodontic treatment. Patients under medication of strontium ranelate have to expect prolonged orthodontic treatment times.
SPUNTARELLI, M.; CECCHETTI, F.; ARCURI, L.; TESTI, D.; MELONE, P.; BIGELLI, E.; GERMANO, F.
SUMMARY Impaction of maxillary canine is a relatively frequent orthodontic anomaly which could represent fuctional and aesthetic problems for patients. Nowadays, the conventional technique to impacted canines consists of a combined orthodontic and surgical approach, aimed to guide cuspids at the center of the alveolar ridge in a stable position and surrounded by healthy hard and soft tissues. This article presents three cases studies with different combined surgical-orthodontic approaches for the treatment of infraosseous impacted canines. An impacted maxillary canine could be guided, after adequate space is created orthodontically, to the center of the ridge through an orthodontic traction directly applied to the crown of impacted cuspid. Several surgical techniques have been proposed to expose the crown of impacted tooth. Location (buccal or palatal side) of impactation and depth influence surgical approach in order to obtain best aesthetic and functional results. PMID:27555906
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
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.
Rusanen, Jaana; Pirttiniemi, Pertti; Tervonen, Osmo; Raustia, Aune
The aim of this study was to evaluate temporomandibular joints (TMJ) by magnetic resonance imaging (MRI) in patients who had undergone surgical/orthodontic or orthodontic treatment in a three-year follow-up study. Subjects consisted of 20 patients (40 TMJ), 16 females and four males (mean age 33.7 years, range 19-53 years), with severe temporomandibular disorders (TMD) referred to the Oral and Maxillofacial Department at Oulu University Hospital due to skeletal jaw discrepancy. All patients underwent extensive surgical/orthodontic or orthodontic treatment between 1996 and 2003. Clinical stomatognathic examination and MRI examinations were performed before the surgical/orthodontic or orthodontic treatment and one year after the completion of the treatment. The average treatment time was 23 months (range 12-34 months). MRI revealed a marked decrease, especially in the number of TMJ with joint effusion after the treatment. There were only a few changes in the number of diagnosed disk dislocations before and after the treatment. In five joints with anterior disk dislocation with reduction (r-ADD), a change to anterior disk dislocation without reduction (nr-ADD) was found. In 25 of the 40 condyles, the condylar configuration was normal on MRI before the treatment and in 19 condyles one year after the treatment. TMD signs and symptoms according to the Helkimo dysfunction index showed a statistically significant decrease after the treatment.
Patients can significantly affect the outcome of their orthodontic treatment. A practice committed to developing the right systems, scripts, and educational materials will experience a more satisfied patient, increased efficiencies, and higher profits. Educating and motivating patients to maintain their oral health and providing recommendations or dispensing of home care tools such as a power toothbrush increases patient compliance, positively impacts treatment outcomes, enhances customer service, and generates a new revenue stream for the practice. In a tight economy and a highly competitive orthodontic market, a power toothbrush can positively impact your marketing and case close rate. Treatment and fees being relatively equal, patients will tend to accept treatment from a practice that can demonstrate concern for the patients' overall oral health and greater value-added components to the orthodontic case. Power toothbrushes as part of a comprehensive orthodontic treatment provide a great differentiating marketing strategy.
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. PMID:27446262
Verma, Rashmi; Utreja, Ashok Kumar; Singh, Satinder Pal; Jena, Ashok Kumar
Objective: The aim of the study was to evaluate the effect of post- treatment critical evaluation on the quality of orthodontic care in a postgraduate orthodontic clinic. Materials and Methods: Orthodontic treatment outcome of 109 consecutively treated cases was evaluated in Phase-I evaluation. Following Phase-I evaluation, PTCE of each case was made mandatory. After 6-years of implementation of compulsory PTCE for each case, orthodontic treatment outcome of all consecutively treated cases (n = 126) was evaluated (Phase-II). The treatment outcome was evaluated by American Board of Orthodontics Model Grading System (ABO MGS) and Subjective evaluation (Visual Analogue Scale, VAS). Results: Based on the ABO scores, the cases were divided into three grades, that is, Grade-I, Grade-II, and Grade-III. The mean total ABO score was improved significantly in Phase-II evaluation (P < 0.01). The total number of cases in ABO Grade-II were increased significantly (P < 0.01) whereas cases in ABO Grade-I remained comparable. The VAS score was improved from 5.66 ± 0.77 at Phase-I to 6.02 ± 0.99 at Phase-II evaluation (P < 0.01). Conclusion: The implementation of PTCE significantly improved the quality of orthodontic care in a postgraduate orthodontic clinic. Clinical Significance: Grading one's own treatment improves the quality of future treatment. PMID:26392728
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
Feng, Yi-miao; Fang, Bing; Xia, Yun hui; Shu, Rong; Hans, Mark Guenther
In contemporary dental care, an increasing number of adult patients with periodontal disease are seeking orthodontic treatment. Achieving optimal results in such adult patients is difficult because decreased posterior tooth anchorage is risky. This case report demonstrates the use of miniscrew implant anchorage (MIA) in a Chinese male 21 years 5 months of age with maxillary and mandibular anterior dental spacing, bimaxillary protrusion, and severe bone loss caused by periodontal disease. Prior to orthodontic treatment, the patient underwent treatment to control his periodontitis. The patient was treated with 0.022-in straight-wire orthodontic appliances. After 17 months of active orthodontic treatment, the patient had healthier periodontal tissue with increased bone support, as well as improved facial esthetics and a functional occlusion. The results demonstrate that MIA is useful in enhancing anchorage in patients with bone loss associated with severe periodontal disease.
Kuroki, Hiroo; Miyagawa, Yukio; Shimomura-Kuroki, Junko; Endo, Toshiya; Shimomura, Hiromi
Orthodontic medical treatment is performed to move a tooth to the optimal position to obtain optimal occlusion. Orthodontic treatment is accompanied by mechanical stress due to orthodontic force and by psychological stress that is experienced as pain or displeasure. The purpose of this study was to identify stress marker proteins during orthodontic treatment. Levels of receptor activator of NFκB (RANKL) and heat shock protein 70 (HSP70) in the gingival crevicular fluid (GCF) were analyzed as markers of mechanical stress, and levels of chromogranin A (CgA) and amylase in whole saliva were analyzed as markers of psychological stress. GCF was collected from control and experimental teeth at initiation of treatment and 24 h after treatment. Whole saliva was collected before treatment, at initiation of treatment and 24 h after treatment. RANKL was expressed at 24 h after treatment in the experimental GCF, but not in the control GCF. HSP70 appeared to be constitutively expressed in GCF, and its levels showed no major change between the control and experimental groups from initiation of treatment to 24 h after treatment. Amylase activity in whole saliva was enhanced at 24 h after treatment compared to control, but CgA levels showed little change between the groups. These results indicated that RANKL and amylase may be the candidate markers for mechanical and psychological stress, respectively, during orthodontic treatment, even though the total protein concentration and amylase activity displayed a large standard deviation among subjects. Further studies are therefore required to establish these markers for clinical use.
Bezerra, Gisele Lima; Torres, Carlos Rocha Gomes; Tonetto, Mateus Rodrigues; Borges, Alvaro Henrique; Kuga, Milton Carlos; Bandeca, Matheus Coelho; Firoozmand, Leily Macedo
The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p < 0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance.
Bezerra, Gisele Lima; Torres, Carlos Rocha Gomes; Tonetto, Mateus Rodrigues; Borges, Alvaro Henrique; Kuga, Milton Carlos; Bandeca, Matheus Coelho; Firoozmand, Leily Macedo
The objective of this study is to assess, in vitro, the shear bond strength of orthodontic brackets fixed with remineralizing adhesive systems submitted to thermomechanical cycling, simulating one year of orthodontic treatment. Sixty-four bovine incisor teeth were randomly divided into 4 experimental groups (n = 16): XT: Transbond XT, QC: Quick Cure, OL: Ortholite Color, and SEP: Transbond Plus Self-Etching Primer. The samples were submitted to thermomechanical cycling simulating one year of orthodontic treatment. Shear bond strength tests were carried out using a universal testing machine with a load cell of 50 KgF at 0.5 mm/minute. The samples were examined with a stereomicroscope and a scanning electron microscope (SEM) in order to analyze enamel surface and Adhesive Remnant Index (ARI). Kruskal-Wallis and Mann-Whitney (with Bonferroni correction) tests showed a significant difference between the studied groups (p < 0.05). Groups XT, QC, and SEP presented the highest values of adhesive resistance and no statistical differences were found between them. The highest frequency of failures between enamel and adhesive was observed in groups XT, QC, and OL. Quick Cure (QC) remineralizing adhesive system presented average adhesive resistance values similar to conventional (XT) and self-etching (SEP) adhesives, while remineralizing system (OL) provided the lowest values of adhesive resistance. PMID:26380371
Rey, Diego; Smit, Rosana Martínez; Gamboa, Liliana
Multiple idiopathic external root resorption is a rare pathological condition usually detected as an incidental radiographic finding. External root resorption of permanent teeth is a multifactorial process related to several local and systemic factors. If an etiological factor cannot be identified for root resorption, the term "idiopathic" is applied. This report presents a case of multiple idiopathic apical root resorption. The condition was found in a young female patient seeking orthodontic treatment due to malocclusion. This kind of resorption starts apically and progresses coronally, causing a gradual shortening and rounding of the remaining root. Patients with this condition are not the ideal candidates for orthodontic treatment; however, the aim of this report is to describe an unusual case of idiopathic root resorption involving the entire dentition, and to present the orthodontic treatment of this patient. It describes the progress and completion of orthodontic therapy with satisfactory end results. PMID:25741832
Kuijpers-Jagtman, A M; Mink van der Molen, A B; Bierenbroodspot, F; Borstlap, W A
Cleft lip and palate is a common congenital malformation with a prevalence of 1:600 newborns. Children with orofacial clefts are treated by an interdisciplinary team of specialists while parents and child play a key role in their own care process. The orthodontic and facial orthopedic treatment of a child with a cleft takes many years. Children often get bored of the long treatment and this can cause problems with compliance and oral hygiene. Therefore it is advisable to distinguish 5 well-defined stages in the orthodontic treatment and to attempt to have some 'orthodontics free' time in between. The 3 orthodontic treatment phases between the age of 9 and 20 years consist of orthodontic treatment concerning the closing of the cleft with a bone transplant, the treatment of the permanent dentition and, finally, a possible combined orthodontic surgical treatment at the end of the period of growth. Good interdisciplinary collaboration among the different dental disciplines is essential in this regard.
Chu, Yong-Ming; Bergeron, Léonard; Chen, Yu-Ray
Bimaxillary protrusion is a commonly seen deformity in Asian populations. This condition is characterized by protrusive and proclined upper and lower incisors and an increased procumbency of the lips. It is usually combined with lip incompetence, gummy smile, mentalis strain, and anterior open bite. Facial aesthetics is the primary concern of these patients. Successful treatment depends on a thorough evaluation and understanding of this dentofacial deformity. Typical orthodontic treatment includes retraction and retroclination of maxillary and mandibular incisors after extraction of the four first premolars. Orthognathic surgery is required to correct significant skeletal problems. Anterior subapical osteotomies and extraction of premolars can correct sagittal excess of the jaw bones and relieve dental crowding. Segmental maxillary osteotomies are performed to treat patients with an associated exaggerated curve of Spee and vertical maxillary excess. Differential intrusion of anterior and posterior maxilla/maxillary segments with clockwise rotation of the occlusal plane is a useful technique for treatment of anterior open bite and creation of a consonant smile arc. Le Fort I osteotomy with setback sometimes provides an alternative to segmental maxillary osteotomies. Meticulous planning and execution of osteotomies in accordance with surgical planning are essential for aesthetic and functional outcome.
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.
Chin, Mervyn Y H; Busscher, Henk J; Evans, Robert; Noar, Joseph; Pratten, Jonathan
Decalcification is a commonly recognized complication of orthodontic treatment with fixed appliances. A technology, based on a parallel plate flow chamber, was developed to investigate early biofilm formation of a strain of Streptococcus sanguis on the surface of four orthodontic bonding materials: glass ionomer cement (Ketac Cem), resin-modified glass ionomer cement (Fuji Ortho LC), chemically-cured composite resin (Concise) and light-cured composite resin (Transbond XT). S. sanguis was used as it is one of the primary colonizers of dental hard surfaces. Artificial saliva was supplied as a source of nutrients for the biofilms. The effects of two commercially available mouthrinses (i.e. a fluoride containing rinse and chlorhexidine) were evaluated. Initial colonization of the bacterium was assessed after 6 hours of growth by the percentage surface coverage (PSC) of the biofilm on the disc surfaces. There were statistically significant differences in bacterial accumulation between different bonding materials (P < 0.05), Concise being the least colonized and Transbond XT being the most colonized by S. sanguis biofilms. All materials pre-treated with 0.05 per cent sodium fluoride mouthrinse showed more than 50 per cent reduction in biofilm formation. The 0.2 per cent chlorhexidine gluconate mouthrinse caused significant reduction of biofilm formation on all materials except Ketac Cem. This in vitro study showed that the use of a chemically-cured composite resin (Concise) reduced early S. sanguis biofilm formation. Also, fluoride had a greater effect in reducing the PSC by S. sanguis biofilms than chlorhexidine. Rinsing with 0.05 per cent sodium fluoride prior to placement of orthodontic appliances is effective in reducing early biofilm formation.
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.
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
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
Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal
Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy.
Gyawali, Rajesh; Bhattarai, Bhagabat
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.
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
Leiva Villagra, Noemí; Muñoz Domon, Miguel; Véliz Méndez, Sebastian
The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient. Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.
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
Leiva Villagra, Noemí; Muñoz Domon, Miguel; Véliz Méndez, Sebastian
The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient. Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable. PMID:25544903
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
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.
Rivera Circuns, A L; Tulloch, J F
Incomplete adaptation of supporting structures during orthodontic closure of extraction spaces may result in invagination of the gingiva in this area. This study was undertaken to determine the incidence and possible association of these structural changes with gingival health and stability of extraction-space closure. Three groups of twenty-four orthodontic patients who had first premolars removed were examined at different stages of treatment: space closure complete, in retention, and postretention. The location, and severity of invaginations were recorded. The overall and extraction area gingival health, width of attached gingiva, and tightness of contacts in that area were assessed. The canine inclination at the various stages of treatment was measured from panoramic radiographs. The data were analyzed via comparison of means, Pearson's correlation coefficient, and ANOVA. Results indicated a very high incidence of invaginations forming during extraction-space closure. Invaginations were more frequent, complex, and severe in the mandibular arch than in the maxillary arch (p less than 0.001). The width of attached gingiva, overall gingival health, and canine inclination were not consistently related to their formation. The general trend was toward some resolution of these defects with time, but many persisted years after retention was discontinued. There was no evidence of an association with reopening of extraction space (p greater than 0.05). The presence and severity of gingival invaginations were consistently related to a reduction in gingival health in that area (p less than 0.001), regardless of the phase of treatment.
Piassi, Eluza; Antunes, Leonardo Santos; Andrade, Marcia Rejane Thomas Canabarro
Anterior crossbite (AC) refers to a condition in which the maxillary anterior teeth are placed lingually in their relationship with the mandibular anterior teeth. This dental condition results in visible incisor differences that are associated with higher levels of dissatisfaction with appearance and have potential to negatively impact on oral health-related quality of life (OHRQoL) of the children. The aim of this paper was to report two cases of interceptive orthodontic treatment of twin children with anterior crossbite and its impact on OHRQoL of these children. Although AC affects negatively psychosocial aspects of OHRQoL of the children, the interceptive orthodontic treatment of children with AC was essential to improve their OHRQoL. PMID:27738533
Krey, Karl-Friedrich; Hirsch, Christian
Orthodontic treatment is a common dental procedure in developed countries. However, the frequency and factors associated with treatment demand are different between countries. The aim of this study was to examine the frequency of orthodontic treatment in German children and adolescents and to analyse the influence of age, gender, and socio-economic status (SES; education and region) on the frequency of treatment. Subjects in a random population sample of 1538 German children and adolescents, aged 11-14 years, were interviewed at home in the autumn of 2008 regarding current orthodontic treatment and associated factors. Approximately one-third (33.5 per cent) of the subjects interviewed were undergoing orthodontic treatment at that time. In a multivariable logistic regression model, the likelihood of receiving orthodontic treatment was higher for girls [odds ratio (OR) = 1.32, 95 per cent confidence interval (CI): 1.06-1.65], for high school pupils (OR = 1.19, 95 per cent CI: 1.06-1.34), and for children and adolescents living in the western part of Germany (OR = 1.45, 95 per cent CI: 1.00-2.08) and increased with age (OR = 1.13 per year, 95 per cent CI: 1.02-1.25). Subjects undergoing orthodontic treatment more often received prophylactic measures (OR = 2.06, 95 per cent CI: 1.63-2.59) compared with those not currently receiving orthodontic treatment. The frequency of orthodontic treatment in Germany largely depends on gender and SES.
Lenz, B E; Harris, E F
This study reports on evaluation of the occlusion in 16 young adults who had been treated orthodontically an average of 10 years previously. Cases were from among dental students who, we assume, have high dental "IQs" and greater than average concern for stability of their orthodontic correction. Relapse of the orthodontic correction was substantial; both dental and skeletal dimensions relapsed--returned toward pretreatment conditions--to statistically and clinically obvious extents. Relapse is greater here than some other studies because of our longer recall period. Results focus attention on the importance of prolonged posttreatment retention and greater awareness on the patient's part of the role of posttreatment facial growth on relapse from adolescence into adulthood.
Bernabé, Eduardo; Flores-Mir, Carlos
Background Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. Methods 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. Results An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4–5 was 29.9% whereas the percentage of students with AC grades 8–10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. Conclusion Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need. PMID:16884542
Qahtani, Nasser D Al
This review focused on airway dysfunctions and orthodontic treatment modalities. A systematic search of the dental literature was performed using PubMed and Web of Science library database. Different combinations of search terms related to airway and orthodontic treatment were used. Any Non-English articles were excluded. Among titles found, abstract and full articles were reviewed. References from all the relevant articles were hand-searched to include more articles. Forty articles which were found relevant were included in the review. Surgical, orthopedic and fixed appliance therapy has been advocated by clinicians to treat patients with airway dysfunctions. These treatment modalities differ from patient to patient and have to be considered based on lot of criterion. The reviewed studies were not convincing in providing information about the orthodontic treatment modalities; further research regarding the same could be encouraging.
Qahtani, Nasser D. Al
This review focused on airway dysfunctions and orthodontic treatment modalities. A systematic search of the dental literature was performed using PubMed and Web of Science library database. Different combinations of search terms related to airway and orthodontic treatment were used. Any Non-English articles were excluded. Among titles found, abstract and full articles were reviewed. References from all the relevant articles were hand-searched to include more articles. Forty articles which were found relevant were included in the review. Surgical, orthopedic and fixed appliance therapy has been advocated by clinicians to treat patients with airway dysfunctions. These treatment modalities differ from patient to patient and have to be considered based on lot of criterion. The reviewed studies were not convincing in providing information about the orthodontic treatment modalities; further research regarding the same could be encouraging. PMID:27022385
Jati, Ana Suzy; Furquim, Laurindo Zanco; Consolaro, Alberto
abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature. PMID:27409650
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.
Richardson, G; Russell, K A
Implant restorations have become a primary treatment option for the replacement of congenitally missing lateral incisors. The central incisor and canine often erupt in less than optimal positions adjacent to the edentulous lateral incisor space, and therefore preprosthetic orthodontic treatment is frequently required. Derotation of the central incisor and canine, space closure and correction of root proximities may be required to create appropriate space in which to place the implant and achieve an esthetic restoration. This paper discusses aspects of preprosthetic orthodontic diagnosis and treatment that need to be considered with implant restorations.
Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos
OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset. PMID:25741825
Eslamipour, Faezeh; Riahi, Farnaz Tajmir; Etemadi, Milad; Riahi, Alireza
Background: To determine patient orthodontic treatment need, appropriate self-perceived indices are required. The aim of this study was to assess the sensitivity and specificity of esthetic component (AC) of the index of orthodontic treatment need (IOTN), oral esthetic subjective index scale (OASIS), and visual analog scale (VAS) through dental health component (DHC) IOTN as a normative index to determine the more appropriate self-perceived index among young adults. Materials and Methods: In this cross-sectional study, a sample of 993 was randomly selected from freshman students of Isfahan University. Those with a history of orthodontic treatment or current treatment were excluded. DHC was evaluated by two inter- and intra-calibrated examiners. Data for AC, OASIS, and VAS were collected through a questionnaire completed by students. Descriptive statistics, Mann–Whitney U-test, and Spearman correlation test, were used for data analyses. Sensitivity, specificity, positive and negative predictive values of self-perceived indices were calculated through DHC. Results: Sensitivity of AC, OASIS, and VAS for evaluating definite orthodontic treatment need was calculated at 15.4%, 22.3%, and 44.6%, respectively. Specificity of these indices for evaluating definite orthodontic treatment need was calculated at 92.7%, 90.5%, and 76.2% percent, respectively. All self-perceived indices had a significant correlation with together and with DHC (P < 0.01). Among demographic factors, there was weak but significant correlation only between mother's educational level and VAS (P < 0.01). Conclusion: Due to the sensitivity and specificity of the three self-perceived indices, these indices are not recommended for population screening and should be used as adjuncts to a normative index for decision-making in orthodontic treatment planning. PMID:28348616
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
Sebaoun, Jean-David M; Surmenian, Jérôme; Dibart, Serge
An increasing number of adult patients are seeking orthodontic treatment and a short treatment time has become a recurring request. To meet their expectations, a number of surgical techniques have been developed to accelerate orthodontic tooth movement. However, these have been found to be quite invasive. We are introducing here a new, minimally invasive flapless procedure, combining micro incisions, piezoelectric incisions and selective tunneling that allows for hard- or soft-tissue grafting. Combined with a proper treatment planning and a good understanding of the biological events involved, this novel technique can locally manipulate alveolar bone metabolism in order to obtain rapid and stable orthodontic results. Piezocision allows for rapid correction of severe malocclusions without the drawbacks of traumatic conventional corticotomy procedures.
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
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
Livas, Christos; Delli, Konstantina
The aim of this work was to investigate the published evidence on the comparison of self-perception and diagnosis of orthodontic treatment need. A search of Cochrane Library, MEDLINE, Scopus databases, and archives of two orthodontic journals was carried out from January 1966 to August 2011 by the two authors using Medical Subject Heading terms. Studies that investigated solely either self-perception of orthodontic need by laypersons or assessment of orthodontic need by professionals were excluded from the data analysis. The methodological soundness of each study and the aggregate level of evidence were evaluated according to predetermined criteria. Moderate level of evidence, the relatively highest grade, was assigned to 9.1 per cent of the 22 studies, finally included in the data analysis. The overall evidence level provided by the evaluated publications was rated as limited. However, the existing body of evidence indicated a highly variable association between self-perception of orthodontic treatment need and orthodontist's assessment. Future controlled studies with well-defined samples and common assessment methodology will clarify further the relationship between perception of treatment need by laypersons and orthodontists and enhance international comparison and development of health care strategies.
Krooks, Laura; Pirttiniemi, Pertti; Kanavakis, Georgios; Lähdesmäki, Raija
Objective The aim of the study was to examine the prevalence of malocclusion traits and the extent of orthodontic treatment in a Finnish adult population. Materials and methods The study population comprised subjects (n = 1964) from the Northern Finland Birth Cohort 1966 living in the city of Oulu and within 100 km of it. A clinical oral and dental examination with registration of occlusion was carried out in 2012 in connection with a 46-year follow-up survey. Data on previous orthodontic treatment were collected based on a questionnaire. Results In the clinical examination, 39.5% of the subjects had at least one malocclusion trait. The most common malocclusion traits were lateral crossbite (17.9%), overbite ≥ 6 mm (11.7%) and overjet ≥ 6 mm (9.7%). Crossbite on the left premolars, negative overjet and increased overbite were found more frequently in men. The prevalence of malocclusion traits was at the same level in treated and untreated groups. Overall, 18.6% of the subjects had undergone orthodontic treatment. Women showed a significantly higher prevalence of orthodontic treatment. Conclusions The most common malocclusion trait in the present study was lateral crossbite. Significant male dominance in the prevalence of malocclusion was observed, which has not been reported earlier in Finland. Orthodontic treatment of malocclusion traits was more common among females in Northern Finland. This study indicates that orthodontic treatment provided in childhood was, on average, adequate in reducing malocclusion traits to the level observed in the general population.
de Avila, Érica Dorigatti; de Molon, Rafael Scaf; Cardoso, Mauricio de Almeida; Capelozza Filho, Leopoldino; Campos Velo, Marilia Mattar de Amoêdo; Mollo, Francisco de Assis; Borelli Barros, Luiz Antonio
The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary. PMID:24872900
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
Chung, Chooryung J; Choi, Yoon-Jeong; Kim, In-Sil; Huh, Jong-Ki; Kim, Hyung-Gon; Kim, Kyung-Ho
This case report describes the successful treatment of an adult patient with skeletal Class II open-bite malocclusion secondary to idiopathic condylar resorption. Total alloplastic joint reconstruction and counterclockwise rotation of the maxillomandibular complex combined with orthodontic treatment provided a satisfying outcome with maximum functional and esthetic improvement.
Chung, Chooryung J; Choi, Yoon-Jeong; Kim, In-Sil; Huh, Jong-Ki; Kim, Hyung-Gon; Kim, Kyung-Ho
This case report describes the successful treatment of an adult patient with skeletal Class II open-bite malocclusion secondary to idiopathic condylar resorption. Total alloplastic joint reconstruction and counterclockwise rotation of the maxillomandibular complex combined with orthodontic treatment provided a satisfying outcome with maximum functional and esthetic improvement.
Gorbunkova, Angelina; Pagni, Giorgio; Brizhak, Anna; Farronato, Giampietro; Rasperini, Giulio
The aim of this review is to describe the most commonly observed changes in periodontium caused by orthodontic treatment in order to facilitate specialists' collaboration and communication. An electronic database search was carried out using PubMed abstract and citation database and bibliographic material was then used in order to find other appropriate sources. Soft and hard periodontal tissues changes during orthodontic treatment and maintenance of the patients are discussed in order to provide an exhaustive picture of the possible interactions between these two interwoven disciplines. PMID:26904120
Park, Jae Hyun; Tai, Kiyoshi; Sato, Yasumori
A 15-year-old girl who had a unilateral condylar fracture with severe crowding in both arches was treated with 4 premolar extractions followed by orthodontic therapy with a temporary skeletal anchorage device in the maxillary arch. The total active treatment time was 21 months. Her occlusion was significantly improved by orthodontic treatment, and the range of condylar movement was also improved. Posttreatment records after 30 months showed excellent results with a good stable occlusion. The remodeling process of the condyle was confirmed with cone-beam computed tomography images.
Motta, Alexandre; Louro, Rafael Seabra; Medeiros, Paulo José D'Albuquerque; Capelli, Jonas
This article describes the surgical and orthodontic treatment of a girl with facial deformities and functional involvement. The left temporomandibular joint was ankylosed, and the lower third of the face was markedly deficient, with mandibular retrusion and severe laterognathism to the left side. Mouth-opening was limited, and the patient had problems speaking and chewing. Two surgical procedures had been performed previously at another institution. We treated the patient with condylar surgery while she was still growing, followed by orthodontic treatment and orthognathic surgery after growth was complete. Twelve-year follow-up records are presented.
The author gives an overview of orthodontic profession among the dental specialties. Educational problems of orthodontics in the new age are also discussed as well as treatment quality assurance possibilities and conditions. Future treatment possibilities of retrospectively rehabilitative adult orthodontics and interceptively prospective early treatment of children are referred. The article also cover the 3D imaging of the human face, animation of the craniofacial complex, and Cephalometric 3D analysis as areas of scientific research and realities. The need for restandardizing of orthodontic slot size to simplify and to minimize changeover problems in orthodontics basic hardware--the wires and brackets--are also addressed.
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
Purpose With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients’ periodontal health irrespective of orthodontic techniques. PMID:26734489
Background Although a great number of specific quality of life measures have been developed to analyze the impact of wearing fixed appliances, there is still a paucity of systematic appraisal of the consequences of orthodontics on quality of life. To assess the current evidence of the relationship between orthodontic treatment and quality of life. Methods Four electronic databases were searched for articles concerning the impact of orthodontic treatment on quality of life published between January 1960 and December 2013. Electronic searches were supplemented by manual searches and reference linkages. Eligible literature was reviewed and assessed by methodologic quality as well as by analytic results. Results From 204 reviewed articles, 11 met the inclusion criteria and used standardized health related quality of life and orthodontic assessment measures. The majority of studies (7/11) were conducted among child/adolescent populations. Eight of the papers were categorized as level 1 or 2 evidence based on the criteria of the Oxford Centre for Evidence-Based Medicine. An observed association between quality of life and orthodontic treatment was generally detected irrespective of how they were assessed. However, the strength of the association could be described as modest at best. Key findings and future research considerations are described in the review. Conclusions Findings of this review suggest that there is an association (albeit modest) between orthodontic treatment and quality of life. There is a need for further studies of their relationship, particularly studies that employ standardized assessment methods so that outcomes are uniform and thus amenable to meta-analysis. PMID:24913619
Steinmassl, Otto; Steinmassl, Patricia-Anca; Schwarz, Anna; Crismani, Adriano
Malocclusal traits can impair dental health and aesthetical appearance. The index of orthodontic treatment need (IOTN) identifies the patients who benefit the most from orthodontic treatment. The aim of this study was to assess the malocclusion frequencies and the orthodontic treatment need among Austrian children in the mixed dentition stage, since there is no pre-existing data from Austria. In the present study, 157 children aged between 8 and 10 years were examined. Following an anamnesis questionnaire, which included a question about the parents perceived treatment need, the children were examined clinically and dental impressions were taken. The sagittal molar relationship, overjet, overbite and the presence of cross- or scissor bite were registered. The treatment need was assessed using the dental health component (DHC) of the index of orthodontic treatment need (IOTN). 64.3% (95% CI [56.8, 71.8]) of the children showed Angle class I molar relation, 33.1% (95% CI [25.8, 40.5]) class II and 2.5% (95% CI [0.1, 5.0]) Angle class III relation. Crossbite was found in 36.3% (95% CI [28.8, 43.8]) of the participants. A treatment need for medical reasons (IOTN 4 or 5) was found in 30.6% (95% CI [23.4, 37.8]). There was no statistically significant relationship between objective treatment need and the parents perception. The malocclusion frequencies and the treatment need assessed in the present study appeared to be comparable to those assessed in other countries. The data supports the opinion that orthodontic screening is important and necessary at this stage of dental development, also due to the discordance between objective and perceived treatment need.
Rerhrhaye, W; Zaoui, F; Aalloula, E
In the mixed dentition, lower incisor crowding can exist. He may be transitory or increase with dental arch evolution because of reduction of arch length by loss of leeway space. Early diagnosis allows the instauration of interceptive therapy, to ovoid extractions. Preserve or loss leeway space will depend of orthodontic space management. The clinical case presented in this article shows the interest of early treatment of incisor crowding to preserve arch length and make the leeway space available to resolve the crowding.
Al-Balbeesi, Hana O.; Bin Huraib, Sahar M.; AlNahas, Nadia W.; AlKawari, Huda M.; Abu-Amara, Abdulrahman B.; Vellappally, Sajith; Anil, Sukumaran
Aims and Objectives: 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. Materials and Methods: 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. Results: 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. Conclusion: 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. PMID:28032047
McLaughlin, Richard P; Bennett, John C
Until the early 1970s, successful treatment with the Begg technique and the Tweed edgewise technique required tedious wire bending. The introduction of Andrews' straight wire appliance changed that, and it was one of the most significant contributions in the history of orthodontics. The straight wire appliance significantly reduced the amount of wire bending and also brought along other options in treatment mechanics. Retraction of the canines with elastic chains and ligature wires became more common. Sliding mechanics in place of closing loops became the method of space closure for a significant number of clinicians. Edgewise force levels were initially used to close spaces; however, it was soon observed that lighter forces were more effective with sliding mechanics. Along with these changes, it became apparent that compensation in the appliance was needed, depending on the type of malocclusion and particularly with varying extraction sequences. Various appliance designs were developed to accommodate changes in mechanics and force levels. These modifications improved tooth positions at the end of treatment as long as the brackets were properly placed. These major changes in appliances, force levels, and treatment mechanics can be traced back to the work of Dr Lawrence Andrews and the straight wire appliances.
Bronson, James M; Bronson, James Alexander
The aim of this study is to report five cases of children treated with an interceptive technique utilizing ALF (Advanced Light Force) functional orthodontic appliances in anterior and/or posterior cross bites in primary and early mixed dentition.
Hoseini, Mohammad; Mostafavi, Seyed Morteza Saadat; Rezaei, Navid; Boluri, Ehsan Javadzadeh
Today orthodontic treatment is in growing demand and is not limited to a specific age or social group. The nature of orthodontic treatment is such that the orthodontic wires and appliances, which are used to apply force and move the teeth, are exposed to the oral cavity. Shaping and replacing these wires in oral cavity are the major assignments of orthodontist on appointments. Therefore, we can say that orthodontic treatment requires working with dangerous tools in a sensitive place like oral cavity which is the entrance of respiratory and digestive systems. In this paper, a case of ingesting a broken orthodontic wire during eating is reported, and also necessary remedial measures at the time of encountering foreign body ingestion or aspiration are provided.
Hoseini, Mohammad; Mostafavi, Seyed Morteza Saadat; Rezaei, Navid; Boluri, Ehsan Javadzadeh
Today orthodontic treatment is in growing demand and is not limited to a specific age or social group. The nature of orthodontic treatment is such that the orthodontic wires and appliances, which are used to apply force and move the teeth, are exposed to the oral cavity. Shaping and replacing these wires in oral cavity are the major assignments of orthodontist on appointments. Therefore, we can say that orthodontic treatment requires working with dangerous tools in a sensitive place like oral cavity which is the entrance of respiratory and digestive systems. In this paper, a case of ingesting a broken orthodontic wire during eating is reported, and also necessary remedial measures at the time of encountering foreign body ingestion or aspiration are provided. PMID:23853727
There has been remarkable progress in the field of orthodontics with the advent of CAD/CAM technology since the beginning of the 21st century. In lingual orthodontics, brackets designed and manufactured with a CAD/CAM system  are now available to produce more efficient tooth movement with reduced frictional resistance. The use of implant anchors for absolute anchorage has eliminated the need for excessive tipping of the molars with anchorage bends, which compromises periodontal health, as well as the need for application of heavy extraoral forces, thus providing more reasonable treatment options for both the patient and orthodontist.
Alexander, R G; Sinclair, P M; Goates, L J
Increasing numbers of adult patients are seeking orthodontic care and some, despite significant skeletal malocclusions, elect not to have combined orthodontic-surgical treatment. The purpose of this article is to outline some of the diagnostic and therapeutic principles that can be used in the adult nonsurgical orthodontic patient. The importance of realistic goal setting in the face of compromised occlusions is emphasized. Diagnosis should include evaluation of all three dimensions and recognize the limitations of therapy in each dimension for the nongrowing patient. Periodontal considerations, extraction decisions, and retention regimens are of vital importance to the achievement and maintenance of an optimum result. Clinical records will demonstrate four commonly seen problems and their resolution.
Rakhshan, Hamid; Rakhshan, Vahid
Background and objectives As the most common complication of orthodontic treatment, pain can negatively impact quality of life and cause patients to discontinue treatment. However, few studies have evaluated pain during orthodontic treatment, with controversial findings. This study assessed the intensity and duration of pain and discomfort caused by active orthodontic treatment. Methods This descriptive cross-sectional study examined 67 patients (22 men, 45 females; age range: 18–32 years) undergoing fixed orthodontic treatment. Patients were interviewed after the active treatment stage to assess their perceived pain and discomfort at different sites during different activities by a visual analogue scale. Frequency and duration of pain in different areas were analyzed by the chi-squared and chi-squared goodness-of-fit tests (α = 0.05). Results Among the 67 patients, 65.7% experienced general dentogingival pain or discomfort and 34.3% had localized dentogingival pain or discomfort (p = 0.010, chi-squared goodness-of-fit test). Masticating soft foods reduced discomfort (p = 0.000, chi-squared) in the tongue, cheeks, and in or around the teeth and gingivae. Pain and discomfort were mostly moderate while masticating sticky, fibrous, and firm foods. Mild pains were mostly reported during tooth brushing and while consuming soft foods (p < 0.05, chi-squared). Pain and discomfort tended to last for more than 4 weeks, except in the tongue, where pain and discomfort lasted less than 4 weeks (p < 0.05, chi-squared goodness-of-fit test). Conclusions Pain and discomfort occur for more than 4 weeks after beginning fixed orthodontic treatment. Changing diets to incorporate softer foods is recommended to alleviate pain. PMID:26082574
Thomson, W M
The aim of this study was to use a health services research (HSR) approach to examine the longer-term outcomes of orthodontic treatment. Participants in a longstanding population-based New Zealand cohort study (the Dunedin Multidisciplinary Health and Development Study) were allocated to one of four malocclusion severity categories on the basis of orthodontic data collected at age 12. The outcome of that care by age 26 was evaluated using the key indicators of equity (was it fair?); efficacy (did it work?); effectiveness (did it work in the longer term?); and safety (was it associated with a greater subsequent experience of caries, periodontal disease, or tooth loss?). Data were available for 452 Study members, of whom 56.2% were in the minor/none category, 29.0% were in the definite category, 10.2% were in the severe category, and 4.6% were in the handicapping treatment-need category. No clear differences in treatment uptake by socioeconomic status were apparent, and the proportion treated increased across the malocclusion severity categories, as did the proportion that showed an improvement following treatment. By age 26 a difference between those who had and those who had not been treated was evident, with the percentage of those rating their dental appearance as above average increasing with increasing severity of the age-12 orthodontic treatment need. This was also true for the percentage that considered their orthodontic treatment to have been successful. There were no significant differences in caries experience, periodontal disease occurrence, or tooth loss between those who had and had not been treated by age 26. This study has found the equity, efficacy, effectiveness, and safety of orthodontic treatment in the Dunedin cohort to be acceptable.
Zyskind, K; Zyskind, D; Soskolne, W A; Harary, D
Subgingivally fractured incisors are still a challenge to treat. A case report is used as a basis for reviewing the different treatment options, which involve either extraction or preservation of the root. A multidisciplinary approach, using orthodontic forced eruption, is presented in detail.
Georgaklis, Clifton C
Even in the most stable types of orthodontic treatment, any relapse at all may be unacceptable cosmetically. Through the placement of a reinforced composite splint, the teeth can be held in position and more significantly recontoured, thus augmenting the final result. Subsequent splint removal can be done incrementally 3 to 5 years after placement as the patient desires.
Zanatta, Fabricio Batistin; Ardenghi, Thiago Machado; Antoniazzi, Raquel Pippi; Pinto, Tatiana Militz Perrone; Rösing, Cassiano Kuchenbecker
Objective The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. Methods A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. Results The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. Conclusion Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment. PMID:25162567
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
Sugawara, Yasuyo; Ishihara, Yoshihito; Takano-Yamamoto, Teruko; Yamashiro, Takashi; Kamioka, Hiroshi
The orofacial muscle is an important factor in the harmony of the occlusion, and its dysfunction significantly influences a patient's occlusion after craniofacial growth and development. In this case report, we describe the successful orthodontic treatment of a patient with unilateral orofacial muscle dysfunction. A boy, 10 years 0 months of age, with a chief complaint of anterior open bite, was diagnosed with a Class III malocclusion with facial musculoskeletal asymmetry. His maxillomandibular relationships were unstable, and he was unable to lift the right corner of his mouth upon smiling because of weak right orofacial muscles. A satisfactory occlusion and a balanced smile were achieved after orthodontic treatment combined with orofacial myofunctional therapy, including muscle exercises. An acceptable occlusion and facial proportion were maintained after a 2-year retention period. These results suggest that orthodontic treatment with orofacial myofunctional therapy is an effective option for a patient with orofacial muscle dysfunction.
Hohoff, Ariane; Joos, Ulrich; Meyer, Ulrich; Ehmer, Ulrike; Stamm, Thomas
In the PubMed accessible literature, information on the characteristics of interdisciplinary orthodontic and surgical treatment of patients with Apert syndrome is rare. The aim of the present article is threefold: (1) to show the spectrum of the phenotype, in order (2) to elucidate the scope of hindrances to orthodontic treatment, and (3) to demonstrate the problems of surgery and interdisciplinary approach. Children and adolescents who were born in 1985 or later, who were diagnosed with Apert syndrome, and who sought consultation or treatment at the Departments of Orthodontics or Craniomaxillofacial Surgery at the Dental School of the University Hospital of Münster (n = 22; 9 male, 13 female) were screened. Exemplarily, three of these patients (2 male, 1 female), seeking interdisciplinary (both orthodontic and surgical treatment) are presented. Orthodontic treatment before surgery was performed by one experienced orthodontist (AH), and orthognathic surgery was performed by one experienced surgeon (UJ), who diagnosed the syndrome according to the criteria listed in OMIM™. In the sagittal plane, the patients suffered from a mild to a very severe Angle Class III malocclusion, which was sometimes compensated by the inclination of the lower incisors; in the vertical dimension from an open bite; and transversally from a single tooth in crossbite to a circular crossbite. All patients showed dentitio tarda, some impaction, partial eruption, idopathic root resorption, transposition or other aberrations in the position of the tooth germs, and severe crowding, with sometimes parallel molar tooth buds in each quarter of the upper jaw. Because of the severity of malocclusion, orthodontic treatment needed to be performed with fixed appliances, and mainly with superelastic wires. The therapy was hampered with respect to positioning of bands and brackets because of incomplete tooth eruption, dense gingiva, and mucopolysaccharide ridges. Some teeth did not move, or moved
Conti, Ana; Freitas, Marcos; Conti, Paulo; Henriques, José; Janson, Guilherme
The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in individuals before and after orthodontic treatment. The sample comprised 200 individuals divided into four groups according to the type of malocclusion (class I or II) and the orthodontic treatment accomplished. An anamnestic questionnaire, comprising questions regarding the most frequent symptoms of TMD, was used to classify the sample according to the TMD presence and severity. A clinical examination, including TMJ and muscle palpation, mandibular range of motion, and joint noise analysis was performed. Based on the anamnestic questionnaire, 34% of the sample was considered as having mild TMD, whereas 3.5% had moderate TMD. A higher TMD prevalence was found in females. Joint noises (15.5%) followed by headache (13%) constituted the most frequent reported symptoms. The presence and severity of TMD have not shown any relationship with either the type of orthodontic mechanics or extraction protocols. On the other hand, a positive association was found between TMD and parafunctional habits and reported emotional tension. Orthodontic treatment is not associated with the presence of signs and symptoms of TMD.
Carvajal-Flórez, Alvaro; Barbosa-Lis, Diana María; Zapata-Noreña, Oscar Arturo; Marín-Velásquez, Julissa Andrea; Afanador-Bayona, Sergio Andrés
ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS) of the American Board of Orthodontics (ABO). Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG) consisted of 17 patients (19.88 ± 4.4 years old) treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old) selected by stratified randomization without finishing intervention (CG). Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048), respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8) (p = 0.009) and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6) (p = 0.007). Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8) (p = 0.62) and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9) (p = 0.65). Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system. PMID:27275620
Bahadure, Rakesh N; Thosar, Nilima; Khubchandani, Monika
Traumatic injury to a primary tooth can affect the underlying permanent tooth germ, and may result in a malformed, hypoplastic crown or root. The degree and nature of malformation depends on the injury. Most trauma cases can be diagnosed using conventional 2-dimensional radiographs, but some cases may benefit from more advanced 3-dimensional imaging such as cone-beam computed tomography (CBCT). This report describes the use of CBCT in the diagnosis and treatment planning of a case in which a 10-year-old girl reported with an impacted, recessed central incisor. The tooth was deformed due to trauma at an early age. Conventional 2-dimensional occlusal and periapical radiographs seemed to indicate that the root had almost completely resorbed. This implied that the optimal treatment plan would be the extraction of the central incisor and, later, the placement of an implant with a crown or bridge. However, a 3-dimensional CBCT radiographic examination showed that the tooth root was long and had enough of a crown-to-root ratio to anchor the tooth. The CBCT examination compelled the treating dentists to maintain the central incisor by orthodontically extruding the tooth and then rebuilding it with a bonded composite restoration.
Topouzelis, Nikolaos; Tsaousoglou, Phoebus
Miniscrews offer a reliable alternative for anchorage during orthodontic treatment, particularly for non-cooperative patients or periodontal patients with alveolar bone loss. The study aims at assessing the correlation of various clinical indicators with the success or failure of miniscrews used for anchorage during orthodontic treatment. Thirty-four consecutive patients with a cumulative total of 82 miniscrews implanted participated in the study. Generalized Estimating Equations were used to assess the correlation of various factors with success rates. The miniscrew was considered the unit of analysis clustered within site and within patient. The overall success rate of miniscrews was 90.2%. For every additional miniscrew used in a patient's oral cavity, the success rate was reduced by 67%. Retromandibular triangle and palatal placement and in movable mucosa resulted in lower success rate. The miniscrew length and diameter were found to correlate with success rates. Orthodontic force applied on miniscrews for uprighting purposes showed a lower success rate than that used for retraction. This study revealed that miniscrews present high success rates. The number of miniscrews used per patient, the miniscrew site placement, the soft tissue type of placement, the miniscrew length and diameter as well as the orthodontic force applied on the miniscrew showed significant correlation with success rates.
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.
Tecco, Simona; Marzo, Giuseppe; Crincoli, Vito; Di Bisceglie, Beatrice; Tetè, Stefano; Festa, Felice
Among treatments in the literature for myofascial pain syndrome (MPS), the most reliable therapies in dentistry are spray and stretch, and, although less frequently used, anesthetic injection. Adult MPS subjects are often treated using fixed orthodontic therapy for resolution of malocclusion. There is no clarity in the literature on the prognosis of MPS during orthodontic therapy. The purpose of this study was to analyze the prognosis of MPS during orthodontic treatment of subjects with malocclusion, initially diagnosed as having MPS. The analysis covered the medical records of 91 young adult Caucasians scheduled for orthodontic treatment for various malocclusions. Thirty-seven of the patients were initially diagnosed as also having MPS (T0). Thirty patients began the orthodontic treatment and were recalled for a re-evaluation of MPS after dental alignment and dental class correction was achieved (T1). A wait-and-see strategy was applied in seven subjects who were included as the control subjects. They received no treatment for MPS. At T1, a statistically significant decrease was observed in the study group in the presence of any clicking or creaking noises from the jaw joint, a significant jaw joint and jaw muscle pain reduction, and a quality of life improvement. Among patients who were depressed at the beginning of treatment, the majority felt better at the follow-up evaluation. On muscular palpation, a statistically significant decrease was found on the visual analogic scale value of the middle fibers of the temporalis muscle, temporalis tendon, clavicular and sternal division of the sternocleidomastoid muscle, masseter muscles, and posterior cervical muscles. The temporalis and the masseter muscles showed a significant decrease in the number of subjects with trigger points (TrPs) in all areas in the study group, after treatment. The digastric and sternocleidomastoid muscles also showed a significant reduction in the number of subjects with TrPs. Subjects with
Farret, Marcel M; Farret, Milton M B; da Luz Vieira, Gustavo; Assaf, Jamal Hassan; de Lima, Eduardo Martinelli S
This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results.
Osterne, Rafael Lima Verde; Moreira Neto, José Jeová Siebra; de Araújo Lima, Augusto Darwin Moreira; Nogueira, Renato Luiz Maia
Ameloblastoma treatment can lead to significant bone defects; consequently, oral rehabilitation can be challenging. We present the case of a 14-year-old girl diagnosed with a conventional ameloblastoma in the mandible who was treated using en bloc resection and rehabilitated with autotransplantation of the immature third molars and orthodontic treatment. The lesion was in the region of the lower left canine and premolars, and en bloc resection resulted in a significant alveolar bone defect. Autotransplantation of the lower third molars to the site of the lower left premolars was performed. After 2 years, the upper left third molar was transplanted to the site of the lower left canine. During the orthodontic treatment period, considerable alveolar bone formation was observed in the region of the transplanted teeth, and roots developed. To the best of our knowledge, this is the first reported case of alveolar bone formation induction caused by tooth transplantation after ameloblastoma treatment.
Closs, Luciane Quadrado; Gomes, Sabrina Carvalho; Oppermann, Rui Vicente; Bertoglio, Vivian
A combined periodontal and orthodontic treatment demands a detailed evaluation in both specialties, particularly when the periodontium is reduced. This is especially true for adult patients, but young patients can also suffer from advanced periodontitis. This article describes combined periodontal and orthodontic therapy in a young patient with severe localized and aggressive periodontitis, tooth crown abnormalities, and missing maxillary second premolars. Periodontal treatment was carried out. Once attachment gain and bone stability were confirmed, orthodontic therapy commenced. It lasted 32 months, during which segmented mechanics and only light forces were used. The result of this intervention was satisfactory, and long-term stability (9 years) with periodontal maintenance was achieved.
techniques to obtain adequate plaque removal. Failure to manage plaque removal during orthodontic treatment may lead to early loss of tooth support2 and an...demonstrating a technique of plaque removal that is effective before orthodontic treatment begins. This is fol- lowed by positive reinforcement...Zachrisson, B.U. and Zachrisson, S. Carie Incidence and Oral Hygiene During Orthodontic Treatment . Scand. J. Dent. Res. 79:394-401, 1971. 4. Alexander, C.M
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.
Carvalho Ferreira, Fernando Pedrin; de Paula, Eliana de Cássia Molina; Ferreira Conti, Ana Claudia de Castro; Valarelli, Danilo Pinelli; de Almeida-Pedrin, Renata Rodrigues
Improving facial and dental appearance and social interaction are the main factors for special needs (SN) patients to seek orthodontic treatment. The cooperation of SN patients and their parents is crucial for treatment success. Objective. To show through a case report the satisfactory results, both functional and esthetic, in patients with intellectual disability, congenital nystagmus, and severe scoliosis. Materials Used. Pendulum device with mini-implants as anchorage unit. Results. Improvement of facial and dental esthetics, correction of Class II malocclusion, and no root resorption shown in the radiographic follow-up. Conclusion. Knowing the limitations of SN patients, having a trained team, motivating and counting on the cooperation of parents and patients, and employing quick and low-cost orthodontic therapy have been shown to be the essential factors for treatment success. PMID:27847652
Shen, Y H; Chen, Y K; Chuang, S Y
A 28-year-old female underwent orthodontic treatment for approximately 22 months. During the later stages of this treatment, the patient reported right shoulder and neck-muscle pain. In addition, temporomandibular joint disorder (TMD) with a 'clicking' sound during mastication commenced 5 months prior to treatment completion. Specific medication to deal with these symptoms was suggested by medical specialists, as were some stress-relief methods, although the pain still progressed, and subsequent clinical and radiographical examinations were undertaken by another orthodontist. Right mandibular condylar resorption was observed from both the panorex and temporomandibular joint (TMJ) radiographs. No clinical signs of rheumatic disease were observed, although bruxism was noted. Following the termination of the orthodontic treatment by the second practitioner, the patient was treated with splint therapy 1 month subsequent to which, the previous symptoms of pain in the shoulder and neck, and the clicking sound during mastication had subsided. During the 14-month period of splint therapy and follow-up, new bone growth in the right condyle was observed from radiographs.
Kapila, S D; 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.
Li, Weihong; Wang, Shimei; Zhang, Yanzhen
Background Few research projects have looked at patient satisfaction with treatment outcome and factors contributing to satisfaction. The aim of this study was to examine treatment motivation and expectation associated with treatment-outcome satisfaction in a group of adolescent nonextraction orthodontic patients. We hypothesized that there would be significant correlations among treatment-outcome satisfaction, motivation, and expectations. Subjects and methods A sample of 120 patients who received orthodontic treatment at the Second Affiliated Hospital of Zhejiang University School of Medicine completed two questionnaires. Before treatment, questionnaire 1 was given to patients to assess treatment motivation and expectations. When treatment had been completed, questionnaire 2, concerning treatment satisfaction, was assessed. Spearman’s rank correlation and regression analyses were used to assess the relationships among treatment satisfaction, expectations, and motivation. Results A total of 110 patients completed the two questionnaires. There was a tendency toward significant correlations between treatment motivation and overall satisfaction with treatment (β-coefficient −0.264, 95% confidence interval −0.456 to 2.314; P<0.001). However, correlations among treatment motivation and satisfaction with changes made and satisfaction with one’s appearance posttreatment were more fragmented. No relationship between treatment expectation and satisfaction was found (β-coefficient −0.126; 95% confidence interval −0.024 to 0.524; P>0.05). Conclusion Motivation was correlated with satisfaction with treatment outcome. Patients’ expectations had no correlation with treatment satisfaction. PMID:27110100
Jamilian, Abdolreza; Kiaee, Bita; Sanayei, Shabnam; Khosravi, Saeed; Perillo, Letizia
Objectives: Malocclusion, though not life-threatening, has vast impact on individual’s social interactions and self-esteem. Therefore, the aim of the current study was to assess whether orthodontic treatment of adolescents with malocclusion had any association with their oral health-related quality of life (OHRQoL). Methods: The subjects for this study were recruited at a state-funded university clinic. Data were collected from 100 participants aged 17 to 21 with moderate to severe malocclusion. Experimental group comprised of 50 subjects who were in the retention phase of their orthodontic treatment and the control group comprised of 50 untreated subjects. The shortened version of the Oral Health Impacts Profile (OHIP-14) as used to assess the subjects’ oral health-related impact. T-test, Kruskal-Wallis, and Mann Whitney tests were used to analyze the data and p-value was set at P < 0.05. Results: In general, oral health-related quality of life of all subjects significantly improved after orthodontic treatment. (p<0.001) Subjects with moderate malocclusion showed better improvement than severe malocclusion subjects. (P<0.001) Conclusion: This study showed that oral health-related quality of life improves with the treatment of malocclusion. PMID:27386009
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.
Fernández-Ferrer, Laura; Montiel-Company, José-María; Candel-Martí, Eugenia; Almerich-Silla, José-Manuel; Peñarrocha-Diago, Miguel
Background One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects. Material and Methods A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed. Results All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term. Conclusions The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure. Key words:Corticotomy, orthodontics, adults, accelerated tooth movement, osteotomy. PMID:27475698
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.
COSTEA, CARMEN MARIA; BADEA, MÎNDRA EUGENIA; VASILACHE, SORIN; MESAROŞ, MICHAELA
Background and aims Nowadays centric relation is defined as a musculoskeletal stable position, with the condyles forward, as far upward as possible, centered transversely and with the articular disc properly interposed. On the other hand, centric occlusion or maximum intercuspidation is a dental determined position. The purpose of this pilot study is to evaluate the direction, frequency and magnitude of the discrepancy between centric occlusion and centric relation in all three axial directions, in a muscular non-deprogrammed population, before the beginning of orthodontic treatment. Methods The study group was represented by 40 symptomatic and asymptomatic patients seeking orthodontic treatment in a private dental office in Cluj-Napoca, Romania between 2014 and 2015. All patients had full records and articulator mounted models. All measurements were analyzed three-dimensionally. Results 85% of the patients had vertical and 87.5% had horizontal CO-CR discrepancy for both condyles. 87.5% of the cases have had a significant condylar displacement in at least one of the three planes. Conclusions We should be aware of the dental occlusion determined by the dental contacts and the occlusion dictated by the musculoskeletal stable position of the condyles. The bigger the discrepancy between these two positions at the level of the condyles, the greater the chances to have either a patient who will develop a form of TMD before/during or after the orthodontic or prosthetic treatment, or a patient suffering already, but poorly diagnosed. PMID:27152081
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.
Edman Tynelius, G; Bondemark, L; Lilja-Karlander, E
The aim of this study was to use a randomized controlled trial methodology to evaluate and compare three different retention methods. The capacity of the retention methods to retain orthodontic treatment results was in this first phase analysed on a short-term basis, i.e. after 1 year of retention. The subjects were recruited from adolescents undergoing fixed appliance treatment at an orthodontic clinic in the National Health Service (NHS) in Sweden between 2001 and 2007. Seventy-five patients (45 girls and 30 boys with a mean age of 14.4 years at the start of retention) were randomized into three retention systems; a vacuum-formed retainer in the maxilla and bonded canine-to-canine retainer in the mandible (group V-CTC), a vacuum-formed retainer in the maxilla combined with stripping of the 10 proximal surfaces of the lower mandibular anterior teeth (group V-S), and a prefabricated positioner covering the teeth in the maxilla and mandible (group P). The main outcome measures were: Little's irregularity index (LII), intercanine and intermolar width, arch length, overjet, and overbite. Registrations were made before orthodontic treatment, when the fixed orthodontic appliance was removed, and after 12 months in retention. Differences in means between groups were tested by one-way analysis of variance. After 1 year of retention, no clinically significant difference in retention capacity was found between the three retention methods. Small but significant differences (P < 0.05) were observed between the V-CTC and V-S groups regarding mandibular canine width, mandibular arch length, and overbite. In group P, two patients failed to co-operate.
Koprowski, Robert; Safranow, Krzysztof; Woźniak, Krzysztof
Despite the continuous development of materials and techniques of adhesive bonding, the basic procedure remains relatively constant. The technique is based on three components: etching substance, adhesive system, and composite material. The use of etchants during bonding orthodontic brackets carries the risk of damage to the enamel. Therefore, the article examines the effect of the manner of enamel etching on its thickness before and after orthodontic treatment. The study was carried out in vitro on a group of 80 teeth. It was divided into two subgroups of 40 teeth each. The procedure of enamel etching was performed under laboratory conditions. In the first subgroup, the classic method of enamel etching and the fifth-generation bonding system were used. In the second subgroup, the seventh-generation (self-etching) bonding system was used. In both groups, metal orthodontic brackets were fixed and the enamel was cleaned with a cutter fixed on the micromotor after their removal. Before and after the treatment, two-dimensional optical coherence tomography scans were performed. The enamel thickness was assessed on the two-dimensional scans. The average enamel thickness in both subgroups was not statistically significant. PMID:28243604
Wheeler, T T; McGorray, S P; Yurkiewicz, L; Keeling, S D; King, G J
There have been few reports worldwide addressing orthodontic need and demand in children and no recent reports in the United States. The purpose of this study was to examine the orthodontic need and demand in third and fourth grade children (n = 3696). Data including age, sex, race, orthodontic status, socioeconomic status, availability of specialist treatment services, as well as thorough occlusal data, were collected. Orthodontic demand was significantly higher in girls (9.5%) than boys (6.8%), whereas need had the inverse relationship (41.8%, 44.2%, respectively). There were no meaningful differences in age among the demand, need, and no need groups. Demand was greater in white than in black children (11.8% versus 1.2%); however, need was observed to be less in black (35.3%) than in white children (47.2%). Demand was greater in the urban schools (8.9%) than in the rural schools (6.3%), whereas need was found to be similar. There was more demand in the higher socioeconomic groups (11.7%) than in the lower groups (1.8%), whereas need was similar in all the groups. The demand group had a significantly greater number of orthodontists within a radius of up to 5 miles of the school than the need and no need groups. Logistic regression models to examine factors that distinguish the groups show that when demand versus need/no need groups are compared, those students with an increased "risk" of previous treatment are more likely to have more orthodontists nearby, to be in higher socioeconomic groups, and to be female students.
Bletsa, Athanasia; Berggreen, Ellen; Brudvik, Pongsri
Remodelling of the periodontium after application of mechanical forces constitutes the basis of clinical orthodontics and various immunoregulatory molecules are involved in this process. The aim of this study was to investigate the expression of the cytokines interleukin-1alpha (IL-1alpha) and tumor necrosis factor-alpha (TNF-alpha) in dental tissues during the early phases of orthodontic tooth movement. Eightteen male Wistar rats were used. All maxillary right first molars were moved orthodontically, with a force of 0.5 N, for 3 h, 1 d, and 3 d. The contralateral sides served as untreated controls. Parasagittal sections of the maxillary molars and the surrounding tissues were subjected to immunohistochemical staining for IL-1alpha or TNF-alpha, and were evaluated with light microscopy. IL-1alpha and TNF-alpha were expressed in the bone and periodontal ligament (PDL) along the roots of the orthodontically moved molars and in the gingiva. Increased expression of both cytokines was observed in the aforementioned areas after 1 and 3 d of tooth movement. The pulp tissue exhibited only minor changes in cytokine expression during tooth movement. The results suggest that mechanical stress results in almost immediate inflammatory reactions in various dental tissues.
Hong, Mihee; Kook, Yoon-Ah; Kim, Myeng-Ki; Lee, Jae-Il; Kim, Hong-Gee
Objective Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system―the Improvement and Completion of Outcome (ICO) index―to evaluate the outcome of orthodontic treatment. Methods Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process. PMID:27478797
Hosseinzadeh-Nik, Tahereh; Eftekhari, Armin; Shahroudi, Atefe Saffar; Kharrazifard, Mahammad Javad
Objectives: This study was designed to assess the changes of the mandible of patients who underwent orthodontic treatment with or without extraction of four premolars. Materials and Methods: Eighteen Class I bimaxillary protrusion patients treated with extraction of four first premolars and retraction of anterior teeth and 18 Class I non-extraction patients with a mean age of 16.38±0.4 years were selected. Cephalometric analysis was performed before and after treatment. Twenty-four variables for analyzing the hard and soft tissues of the mandible were compared between the two groups. Repeated measures ANOVA was used for the comparison of the two groups fallowed by paired t-test. The relationship between the soft and hard tissue variables was studied using the Pearson’s correlation coefficient. Results: In both groups, the mean value of angular measurements related to B point and Pogonion (Pog) decreased with treatment (P<0.05). Similarly, the symphysis depth of soft tissue decreased (P=0.008). The mean angular value of Y-axis increased in both groups after treatment (P=0.007). The mean changes in hard tissue symphysis depth after treatment were different in the two groups (P=0.021). Vertical, horizontal and rotational changes in soft tissue B point (B’) and Pogonion (pog’) followed their underlying hard tissue changes (P<0.05). Conclusions: Points B and Pog showed backward movement after orthodontic treatments in both extraction and non-extraction patients. Changes in B’ and Pog’ were directly influenced by the changes in the corresponding points of the underlying hard tissue. Orthodontic treatments with and without extraction of premolars produced insignificant changes in vertical facial dimension. PMID:28392817
Mencattelli, Margherita; Donati, Elisa; Spinelli, Pasqua; Cultrone, Massimo; Luzi, Cesare; Cantarella, Daniele; Stefanini, Cesare
The understanding of the phenomena at the base of tooth movement, due to orthodontic therapy, is an ambitious topic especially with regard to the "optimal forces" able to move teeth without causing irreversible tissue damages. To this aim, a measuring platform for detecting 3D orthodontic actions has been developed. It consists of customized load cells and dedicated acquisition electronics. The force sensors are able to detect, simultaneously and independently of each other, the six orthodontic components which a tooth is affected by. They have been calibrated and then applied on a clinical case that required NiTi closed coil springs and miniscrews for the treatment of upper post-extraction spaces closure. The tests have been conducted on teeth stumps belonging to a plaster cast of the patient's mouth. The load cells characteristics (sensor linearity and repeatability) have been analyzed (0.97 < R (2) < 1; 6.3*10 (-6) % < STD < 8.8 %) and, on the basis of calibration data, the actions exerted on teeth have been determined. The biomechanical behavior of the frontal group and clinical interpretation of the results are discussed.
Ma, Zhi-Gui; Yang, Chi; Fang, Bing; Xia, Yun-Hui; Mao, Li-Xia; Feng, Yi-Miao
Objectives: The objective of this study was to radiographically quantify bone height and bone density in patients with periodontitis after fixed orthodontic treatment using cone beam computed tomography (CBCT). Materials and methods: A total of 81 patients including 40 patients with chronic periodontitis (group 1) and 41 patients with normal periodontal tissues (group 2) were selected. CBCT scanning for anterior teeth were taken before and after orthodontic treatment. Measurements of bone height and bone density were performed using CBCT software. Results: The group 1 presented a statistically lesser bone density and bone height when compared to group 2 before treatment. There was a significant loss of bone density for both groups after orthodontic treatment, but bone density loss was significantly greater in the group 1. There was no statistically significant bone height change in two groups after treatment. Conclusions: This study demonstrated that orthodontic treatment can preserve bone height but not capable of maintaining bone density, especially for patients with periodontitis. It is indicated that the change of bone density may be more susceptible than that of bone height when radiographically evaluating bone status under this combined periodontal and orthodontic therapy. PMID:25932177
Bilgic, Fundagul; Gelgor, Ibrahim Erhan; Celebi, Ahmet Arif
Abstract Objective: To determine the prevalence of malocclusion and orthodontic treatment need in a large sample of Central Anatolian adolescents and compare them with European-other nations' adolescents. Methods: The sample included 1125 boys and 1204 girls aged between 12 and 16 years with no previous orthodontic treatment history. Occlusal variables examined were molar relationship, overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite. The dental health (DHC) and aesthetic components (AC) of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment for the total sample. Results: The results indicated a high prevalence of Class I (34.9%) and Class II, Division 1 malocclusions (40.0%). Moreover, increased (18%) and reduced bites (14.%), and increased (25.1%) and reversed overjet (10.%) were present in the sample. Conclusion: Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment need (grades 4 and 5) was 28.%. However, only 16.7% of individuals were in need (grades 8-10) of orthodontic treatment according to the AC. PMID:26691973
Thilander, B; Pena, L; Infante, C; Parada, S S; de Mayorga, C
The aim of the study was to assess the prevalence of malocclusion in a population of Bogotanian children and adolescents in terms of different degrees of severity in relation to sex and specific stages of dental development, in order to evaluate the need for orthodontic treatment in this part of Colombia. A sample of 4724 children (5-17 years of age) was randomly selected from a population that attended the Dental Health Service; none had been orthodontically treated. Based on their dental stages the subjects were grouped into deciduous, early mixed, late mixed and permanent dentition. The registrations were performed according to a method by Björk et al. (1964). The need for orthodontic treatment was evaluated according to an index used by the Swedish National Board of Health. The results showed that 88 per cent of the subjects had some type of anomaly, from mild to severe, half of them recorded as occlusal anomalies, one-third as space discrepancies, and one-fifth as dental anomalies. No clear sex differences were noted, except for maxillary overjet, spacing, tooth size (all more frequent in boys), and crowding (more frequent in girls). Occlusal anomalies and space discrepancies varied in the different dental developmental periods, as did tipped and rotated teeth. Little need for orthodontic treatment was found in 35 per cent and moderate need in 30 per cent. A great need was estimated in 20 per cent, comprising children with prenormal occlusion, maxillary overjet, or overbite (> 6 mm), posterior unilateral crossbite with midline deviation (> 2 mm), severe crowding or spacing, congenitally missing maxillary incisors, impacted maxillary canines or anterior open bite (> 3 mm in the permanent dentition). Urgent need for treatment was estimated to be 3 per cent, comprising subjects with extreme post- and pre-normal occlusion, impacted maxillary incisors or extensive aplasia.
Tecco, Simona; Teté, Stefano; Crincoli, Vito; Festa, Mario Armando; Festa, Felice
This study evaluated the use of a fixed orthodontic appliance in treatment of temporomandibular disorder (TMD) compared to the use of an intra-oral splint. Fifty (50) adult patients, with confirmed anterior disk displacement with reduction in at least one temporomandibular joint (TMJ), were divided into three groups: 20 patients treated with AR splint (Group I); 20 patients treated with a fixed orthodontic appliance (Group II) and 10 patients who underwent no treatment (Control Group). Joint pain, joint noise, muscle pain, and subjective relief were evaluated monthly before the treatment began (T0) and for six months thereafter. Subjects in Group I and Group II displayed a significant decrease in joint pain (p < 0.01) from T2 and in muscle pain from T1 (p < 0.01) to T6. Subjects in Group I showed a higher decrease in the frequency of joint noise (p < 0.05) from T1 to T6, compared with Group II. At T2 and T3, the patients in Group II reported a significantly lower discomfort level associated with the devices than subjects treated with the AR splint (p < 0.05). However, at T5 and T6, this observation was inverted. The use of a fixed orthodontic appliance seems to be as efficacious as the use of an AR maxillary splint in the treatment of joint pain and muscle pain, but not in the treatment of joint noise. These results are valid, at least for the short-term clinical results (first six months of treatment). Clinical implications for long-term use are not clarified by these results.
Salmerón-Valdés, Elías Nahúm; Lara-Carrillo, Edith; Medina-Solís, Carlo Eduardo; Robles-Bermeo, Norma Leticia; Scougall-Vilchis, Rogelio José; Casanova-Rosado, Juan Fernando; Pontigo-Loyola, América Patricia; Fernández Barrera, Miguel Ángel
Dental demineralization was determined in patients at three time points during fixed orthodontic treatment. A multiple cross-sectional study included 108 patients divided into three different groups: (1) beginning of orthodontic treatment; (2) one year into treatment; and (3) two years into treatment. Demineralization was estimated using a DIAGNOdent pen. We obtained data from multiple tooth-by-tooth demineralization readings combined with salivary pH and patients’ oral hygienic and dietary behaviors. A t-test for independent samples and Spearman´s correlation were performed. No demineralizations differences were found between the initial stage and one year into treatment. Between one and two years small differences were observed, but demineralization increased between the initial stage and second treatment year, predominating in upper right central incisors (p = 0.056), upper left lateral incisors (p = 0.040), both upper canines (p = 0.055 and p = 0.040, respectively) and first left premolars (p = 0.034 and p = 0.053, respectively). We did not find associations between oral hygiene and dietary behaviours or salivary pH. In conclusion, demineralization occurred in first year of treatment and increased during second year, predominating in the upper arch and the left side mainly in upper right central incisors, upper left lateral incisors, both upper canines, and first left premolars. PMID:27805027
Abrahamsson, C; Henrikson, T; Nilner, M; Sunzel, B; Bondemark, L; Ekberg, E C
The aims of the study were to investigate the alteration of temporomandibular disorders (TMD) after correction of dentofacial deformities by orthodontic treatment in conjunction with orthognathic surgery; and to compare the frequency of TMD in patients with dentofacial deformities with an age and gender matched control group. TMD were evaluated in 121 consecutive patients (treatment group), referred for orthognathic surgery, by a questionnaire and a clinical examination. 18 months after treatment, 81% of the patients completed a follow-up examination. The control group comprised 56 age and gender matched subjects, of whom 68% presented for follow-up examination. TMD were diagnosed according to research diagnostic criteria for TMD. At baseline examination, the treatment group had a higher frequency of myofascial pain (P=.035) and arthralgia (P=.040) than the control group. At follow-up, the frequencies of myofascial pain, arthralgia and disc displacement had decreased in the treatment group (P=.050, P=.004, P=.041, respectively). The frequency of TMD was comparable in the two groups at follow-up. Patients with dentofacial deformities, corrected by orthodontic treatment in conjunction with orthognathic surgery, seem to have a positive treatment outcome in respect of TMD pain.
da Silva Campos, Marcio José; de Albuquerque, Elisa Gomes; Pinto, Bernardo Caixeiro Hauck; Hungaro, Hélio Moreira; Gravina, Marco Abdo; Fraga, Marcelo Reis; Vitral, Robert Willer Farinazzo
Summary Background Orthodontic force application to the teeth is responsible for a series of biological responses in the bone and dentin, which lead to some alterations of the mineral density of the tissues. Our objective was determine, through cone-beam computed tomography (CBCT), the mineral density of the apical third of the roots of the upper central incisors and of the periapical bone portion surrounding these teeth, in patients submitted to orthodontic treated and untreated individuals. Material/Methods 30 untreated individuals and 15 treated ones (treatment cessation at least 1 year before the study) underwent CBCT. Mineral density was assessed in the apical third of the root of the upper central incisors and in the alveolar bone in the periapical region of these teeth. In order to reduce CBCT-related mineral density variability, we standardized the cone-beam tomography device, the image-acquisition settings and the field of view positioning and size. Student’s t test was used for the analyses. Results bone mineral density (BMD) and root mineral density (RMD), in Hounsfield Units, were 674.84 and 1282.26 for the untreated group and 630.28 and 1370.29 for the treated group, respectively. The differences between the group means were statistically significant for RMD (p<0.05). Conclusions untreated individuals had a significant lower mean RMD in comparison with those submitted to orthodontic treatment. PMID:23197239
Emerich, Katarzyna; Wojtaszek-Slominska, Anna
Primary preventive strategies for oral health are an essential public health priority. Paediatricians have frequent contact with families during routine preventive visits in the child's first few years of life and are in an ideal and unique position, to advise families about the prevention of oral diseases in their children. Primary prevention is always recommended in very young children, to promote positive outcomes during childhood and later adulthood. The knowledge paediatricians acquire about orofacial growth may enhance the implementation and eventual success of a preventive programme. In view of the widespread lack of any orthodontic knowledge amongst paediatricians, this paper describes most common and distinctive symptoms appearing frequently in the early stages of a child's development that are easily detectable by clinicians. It is difficult to define preventive strategies to prevent malocclusion owing to its multifactorial origin. There are some recognised behaviours, however, that should be discouraged to allow for ideal craniofacial development and some that require early referral to the orthodontist. The following disorders are easily diagnosed by the paediatrician or parents and represent conditions in which early intervention might be appropriate to prevent future possible orofacial dysfunction: different sucking habits persisting beyond 3 years of age, mouth breathing and significant deviations from established teeth eruption norms. It is suggested that early referral to a paediatric dentist or orthodontist is indicated when any of these conditions are observed. In general, measures to prevent malocclusion should be based on providing good incentives to promote normal growth and development of the face and the elimination of potential interferences that may harm these processes.
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 (R(2)=0.86, P<0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R(2)=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.
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
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
Amini, Fariborz; Mollaei, Mobina; Harandi, Saghar; 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 reflected by their best biomarker of exposure, hair. This prospective preliminary study was conducted to evaluate hair nickel and chromium levels in fixed orthodontic patients. Scalp hair nickel/chromium concentrations of 12 female and 12 male fixed orthodontic patients were measured before treatment and 6 months later, using atomic absorption spectrophotometry. The effects of treatment, gender, and age on hair ions were analyzed statistically (α = 0.05). The patients' mean age was 18.38 ± 3.98 years. The mean nickel levels were 0.1380 ± 0.0570 and 0.6715 ± 0.1785 μg/g dry hair mass, respectively, in the baseline and sixth month of treatment. Chromium concentrations were 0.1455 ± 0.0769 and 0.1683 ± 0.0707 μg/g dry hair mass, respectively. After 6 months, nickel increased for 387 % (paired t test P = 0.0000) and chromium increased for 16 % (P = 0.0002). No significant correlations were observed between any ion levels with age or gender (Spearman P > 0.2). Within the limitations of this preliminary study, it seems that 6 months of fixed orthodontic treatment might increase levels of hair nickel and chromium. Future larger studies are necessary to validate these results.
Kaneto, Maki; Namura, Yasuhiro; Tamura, Takahiko; Shimizu, Noriyoshi; Tsutsumi, Yusuke; Hanawa, Takao; Yoneyama, Takayuki
The purpose of this study was to examine the use of electrolytic treatment, which can improve the corrosion resistance of Ni-Ti orthodontic wires, to minimize adverse effects. Electrolytic treatment of Ni-Ti wires was performed in a solution composed of glycerol and lactic acid for 5, 15, or 30 min. The anodic polarization test, three-point bending test, and X-ray photoelectron spectroscopic analysis of the wire surface were performed to explore an optimal treatment condition. Breakdown potentials of treated wires increased with increasing treatment time and higher corrosion resistance was obtained by performing the electrolytic treatment for more than 5 min. The relative concentration of nickel in the layer was decreased in inverse proportion to the treatment time. The results suggest that the commercial Ni-Ti wire with low corrosion resistance can be improved by the electrolytic treatment for more than 5 min.
Brenkert, Dennis R
Orthodontic treatment for a patient who has had a displaced disk or disks and has been stabilized by anterior repositioning splint therapy presents the dentist with a difficult orthodontic problem. Frequently, there is a posterior open bite present, with the anterior teeth only occluding in the stabilized TMJ position upon removal of the splint. The current articles (Part II of II presented here) will present an organized TMJ/orthodontic diagnosis [Part I, J Craniomandib Pract2010; 28(3):193-199] and orthodontic treatment method (Part II) to properly treat these patients to a consistent stabilized occlusion compatible with the TMJ splint stabilized position.
Vinod, K; Reddy, Y Giridhar; Reddy, Vinay P; Nandan, Hemant; Sharma, Meenakshi
In this present era, when a significant number of patients seeking orthodontic treatment are adults, importance of multidisciplinary treatment approach cannot be overemphasized. Higher susceptibility of plaque accumulation in patients undergoing orthodontic treatment makes involvement of periodontist almost unavoidable. Also, orthodontic treatment frequently results in undesirable periodontal changes which require immediate attention. More recently, orthodontics has been used as an adjunct to periodontics to increase connective tissue support and alveolar bone height. The purpose of this article is to review the adverse effects of orthodontic treatment on the periodontal tissues and to discuss the mutually beneficial relationship shared between the two specialties.
Sundararaj, Dhinahar; Venkatachalapathy, Sudhakar; Tandon, Akshay; Pereira, Aaron
Objective: Development of dental caries, specifically, white spot lesions (WSLs), continues to be a well-recognized and troubling side effect of orthodontic fixed appliance therapy, despite vast improvement in preventive dental techniques and procedures. The aim of this meta-analysis is to evaluate, determine, and summarize the incidence and prevalence rates of WSLs during orthodontic treatment that have been published in the literature. Materials and Methods: According to predetermined criteria, databases were searched for appropriate studies. References of the selected articles and relevant reviews were searched for any missed publications. Results: In the 14 studies evaluated for WSLs, the incidence of new carious lesions formed during orthodontic treatment in patients was 45.8% and the prevalence of lesions in patients undergoing orthodontic treatment was 68.4%. Conclusion: The incidence and prevalence rates of WSLs in patients undergoing orthodontic treatment are quite high and significant. This widespread problem of WSL development is an alarming challenge and warrants significant attention from both patients and providers, which should result in greatly increased emphasis on effective caries prevention. PMID:26759794
Chesnokov, V A; Chesnokova, M G; Leontiev, V K; Mironov, A Yu; Lomiashvili, L M; Kriga, A S
The issues of pre-nosologic diagnostic and effectiveness of treatment of diseases of oral cavity is an actual issue in dentistry. The long- duration orthodontic treatment of patients with dentoalveolar anomalies using non-removable devices is followed by such negative consequences as development demineralization of enamel and caries registered during treatment and after remove ofdevices. The level of quantitative content of oral streptococci was analyzed and dental status in children with dentoalveolar anomalies was evaluated during treatment with non-removable devices was evaluated. The caries and inflammation of periodontium of oral cavity were most often detected in children with high level of content of streptococci. In different periods of study the firm tendency of increasing of concentration of Streptococcus mutans and S. sanguis of dental plaque of oral cavity is established. The established index indicators of dental status of patients testify intensity of caries damage, level of poor hygiene of oral cavity, development of average degree of severity of inflammation process of periodontium. The obtained results substantiate involvement ofstreptococci, associates of microbiota of dental plaque of oral cavity in children, in process of development of caries. The characteristics of micro-ecology of dental plaque to evaluate cariesgenic situation that can be used as a basis for constructing diagnostic algorithm under monitoring of patients with dentoalveolar anomalies with purpose of forthcoming planning and implementation of effective orthodontic treatment.
Moss, J P
The removal of economic barriers in Europe in 1992, began a new era in history and will have profound effects on orthodontics throughout Europe. In order to get an estimate of the orthodontic scene in each European country a questionnaire was sent to a well known orthodontist who was asked to fill in the form. The questionnaire consisted of enquiries into four areas of orthodontics. The first dealt with orthodontic specialization in the country and inquired into the numbers of orthodontists, where they practised, how they trained, and whether there was a specialist register. The second part dealt with the orthodontic societies, how many were there, how many members, and the frequency of the meetings. The third area asked about orthodontic practice, dealing with case load, types of appliances used, and the cost of treatment. The last section dealt with the future of orthodontics in their particular country. This related to the demand for orthodontics, the need for orthodontists and the changing patterns of orthodontic practice over the next decade. Twenty-three of the 26 countries in Europe when the questionnaire was sent out responded although some were unable to answer all the questions because orthodontics was not recognized in their country.
Scheibel, Paula Cabrini; Ramos, Adilson Luiz; Iwaki, Lilian Cristina Vessoni; Micheletti, Kelly Regina
OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction. PMID:25715722
Pandey, Vijayendra; Chandra, Subhash; Dilip Kumar, H. P.; Gupta, Ashish; Bhandari, Poonam Preet; Rathod, Pankaj
Objective: Maintenance of meticulous oral health practices is critical for patients who are under orthodontic treatment as failure to do so can result in deterioration of periodontal health. Thus, the present study was commenced to assess dental negligence and oral health status among patients undergoing orthodontic treatment using dental neglect scale (DNS) questionnaire. Materials and Methods: The present cross-sectional study was planned and carried out among the 40 patients undergoing fixed orthodontic treatment. The study comprised of two questionnaires, one was close-ended questionnaire which consisted of questions regarding patient practice in maintenance of oral health and other questionnaire comprised of DNS followed by examination of oral hygiene status using Oral Hygiene Index Simplified. Data so obtained were subjected to analysis using SPSS version 20 and Chi-square test was used to statistically analyze data with P < 0.05 regarded as a statistically significant value. Results: The present study revealed that 63% among the studied orthodontic patients brushed once daily, 26% brushed twice daily, and 11% brushed thrice. About one-fourth was using brush with soft bristles and only 9% among the respondents used interdental aids. Data revealed positive correlation between DNS and oral hygiene index-simplified score with P < 0.05. Conclusion: The present study found that less frequency of brushing, rinsing mouth, and eating sticky and hard food can be attributed to self-neglect of the orthodontic patients. PMID:27114950
Rizzuti, N; Scotti, S
A 10.1-year-old boy showed no permanent teeth, with the exception of the lower central incisors. An x-ray examination revealed that eruption of the permanent dentition was obstructed by 1 deciduous supernumerary and 22 permanent supernumeraries ectopically. Treatment consisted of the following steps: (1) extracting all deciduous and supernumerary teeth; (2) waiting for the roots of the permanent teeth to develop and fitting two temporary partial prostheses; (3) assisting eruption of the permanent teeth by removing the bone that covers the remaining teeth and applying crowns to stimulate the eruption; and (4) bringing the permanent teeth into occlusion with orthodontic treatment. The problem of limiting treatment time was made more difficult by the amount of repositioning needed to bring the teeth into occlusion and by delayed root formation. Therefore the orthodontist decided to use extreme caution in applying forces; as a result, treatment time was lengthened. Success was due to good teamwork between the surgeon with an orthodontic background and the orthodontist, who was familiar with surgical procedures.
Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji
This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function.
Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji
This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. PMID:27556023
Chibinski, Ana Cláudia; Coelho, Ulisses; Wambier, Letícia Stadler; Zedebski, Rosário de Arruda Moura; de Moraes, Mari Eli Leonelli; de Moraes, Luiz Cesar
Purpose This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. Materials and Methods A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. Results The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. Conclusion A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment. PMID:27051635
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.
Bandeca, Matheus Coelho; Porto, Alessandra Nogueira; Valieri, Sidnei; Valieri, Matheus; Borges, Alvaro H; Mattos, Fernanda Zanol
The aim of this study was to report a clinical case of treatment of Class II division I malocclusion with facial aesthetic impairment, whose therapeutic approach comprised the association of orthodontic treatment with orthognathic surgery. The treatment for the present case consisted of decompensation oflower incisors and extraction oftwo lower premolars, in order to obtain horizontal discrepancy allowing the surgery for mandibular advancement. At the end of treatment, we could clinically observe a Class I molar/canine relationship, normal overbite and overjet, presence of lip seal, type I facial profile with considerable aesthetic improvement. We can conclude that the ortho-surgical treatment is a therapeutic alternative providing the best prognosis in terms of aesthetic correction in patients with unpleasant facial profile.
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.
Imai, T; Okamoto, T; Kaneko, T; Umeda, K; Yamamoto, T; Nakamura, S
Fifty-eight patients (mean age 18.4 years) who had received splint therapy for internal derangement of the temporomandibular joint (TMJ) were examined retrospectively to investigate the efficacy of occlusal reconstruction by orthodontic treatment. The subjects were divided into three groups: 18 patients (mean age 18.6 years) who underwent orthodontic treatment combined with the use of splints (ST group); 27 patients (mean age 18.2 years) who underwent orthodontic treatment without the use of splints (NST group); and 13 patients (mean age 17.9 years) who received only splint therapy for temporomandibular joint disorders (TMD; control group). TMJ sound, pain on movement and restriction of mandibular movement were examined at the initial examination (T1), at the end of the splint therapy for TMD or beginning of orthodontic treatment (T2), at the end of orthodontic treatment (T3), and at recall or 1 year after orthodontic treatment (T4). The following results were found. (1) The percentage of patients with no joint sound at T2 was 20-30 per cent. The percentage of such patients in both the ST and NST groups increased to over 50 per cent at T3, but slightly decreased to 39-50 per cent at T4. There were no significant inter-group differences at any time point. (2) The number of patients who had no pain on movement at T2 was 60-80 per cent. The percentage of such patients in both the ST and NST groups increased to over 90 per cent at T3, but then slightly decreased to 80 per cent at T4. There were no significant inter-group differences at any time point. (3) None of the patients showed restriction of movement of the TMJ at T2 or T4. One patient in the ST group was found to have restriction at T3. There were no significant inter-group differences at any time point. (4) The most frequent type of malocclusion in both ST and NST groups was anterior open bite. These results suggest that TMD symptoms that have been eliminated by splint therapy are not likely to recur due to
Crossman, Jacqueline; Hassan, Ali H; Saleem, Ali; Felemban, Nayef; Aldaghreer, Saleh; Fawzi, Elham; Farid, Mamdouh; Abdel-Ghaffar, Khaled; Gargoum, Ausama; El-Bialy, Tarek
Objectives: To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Materials and Methods: Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. Results: There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness (P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness (P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. Conclusion: OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities. PMID:28197400
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.
Gingival crevicular fluid (GCF) is a biological exudate and quantification of its constituents is a current method to identify specific biomarkers with reasonable sensitivity for several biological events. Studies are being performed to evaluate whether the GCF biomarkers in growing subjects reflect both the stages of individual skeletal maturation and the local tissue remodeling triggered by orthodontic force. Present evidence is still little regarding whether and which GCF biomarkers are correlated with the growth phase (mainly pubertal growth spurt), while huge investigations have been reported on several GCF biomarkers (for inflammation, tissue damage, bone deposition and resorption, and other biological processes) in relation to the orthodontic tooth movement. In spite of these investigations, the clinical applicability of the method is still limited with further data needed to reach a full diagnostic utility of specific GCF biomarkers in orthodontics. Future studies are warranted to elucidate the role of main GCF biomarkers and how they can be used to enhance functional treatment, optimize orthodontic force intensity, or prevent major tissue damage consequent to orthodontic treatment. PMID:28232938
de Aguiar, Mariana Caires Sobral; Perinetti, Giuseppe; Capelli, Jonas
Gingival crevicular fluid (GCF) is a biological exudate and quantification of its constituents is a current method to identify specific biomarkers with reasonable sensitivity for several biological events. Studies are being performed to evaluate whether the GCF biomarkers in growing subjects reflect both the stages of individual skeletal maturation and the local tissue remodeling triggered by orthodontic force. Present evidence is still little regarding whether and which GCF biomarkers are correlated with the growth phase (mainly pubertal growth spurt), while huge investigations have been reported on several GCF biomarkers (for inflammation, tissue damage, bone deposition and resorption, and other biological processes) in relation to the orthodontic tooth movement. In spite of these investigations, the clinical applicability of the method is still limited with further data needed to reach a full diagnostic utility of specific GCF biomarkers in orthodontics. Future studies are warranted to elucidate the role of main GCF biomarkers and how they can be used to enhance functional treatment, optimize orthodontic force intensity, or prevent major tissue damage consequent to orthodontic treatment.
van Beek, H
Late in the last decade of the previous century, an orthodontic-surgical treatment was elected for a 31-years-old woman, who had severe malocclusion and temporomandibular complaints. The skeletal pattern (high angled mandibula) and degenerating joints were considered risk factors for relapse and condylar lysis. Nevertheless, the severity of the malocclusion justified the treatment. The goal was a stable occlusion and the creation ofa smooth articulation to eliminate dysfunction and facilitate later temporomandibular joint treatment with splints if necessary. In the 1990s this was considered state of the art treatment. Eliminating the scissors bite of 27 seemed instrumental in the elimination of the symptoms. Surgery brought the face and the occlusion further in harmony. The final occlusion features only one lower incisor.
Introduction Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. Materials and methods The sample comprised 100 patients (17–75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. Results All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. Conclusions The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length
Belli, Evaristo; Matteini, Claudio; Incisivo, Veronica
A posttraumatic open bite associated with a bird face is reported. Condylectomy was indicated in relation to the plurifragmentary fracture of the condyles with limitation of mandibular movement. Condylectomies were mandatory as a result of delayed maxillofacial surgical treatment, which was related to the poor general condition of the patient after trauma. Functional disorder recovery and aesthetic deformity correction were planned by a team approach between orthodontists and maxillofacial surgeons with the support of a logopedist for the postural-related muscle problems. The main practical and theoretical problems presented by the clinical case were a result of the need to restore the occlusal relations and to avoid recurrence of open bite in this patient. The patient presented a wide alteration of muscular function and a strength fibrotic retraction with alteration in the relationship between upper and lower jaws and retrusion of the mandible associated to open bite. Orthodontic treatment was carried with no impact on the upper and lower axis, avoiding orthodontic correction of the open bite. Surgery corrected both the open bite and the bird face by means of bilateral sagittal split osteotomies. Wiring of the mandibular osteotomies and intermaxillary fixation allowed positioning of the mandibular ramus bilaterally because of the fibrosis and muscular action-related forces without resulting in a similar rotation of the mandible with the risk of recurrence. Myotherapy and logopedic support minimized the risk of recurrence, improved reduction of muscular tension with the resolution of the lip incompetence, and allowed functional recovery of mandibular movements.
The incorporation of technological advances in the field of clinical orthodontics to increase treatment efficiency has led to the development of customized appliances (Insignia®), archwires (Suresmile®), and the production of devices to enhance tooth movement (Acceledent®). This review presents a comprehensive study of the literature concerning these products, and analyzes the available evidence of their efficiency. To date, one pilot study has evaluated the efficiency of the Insignia® system, three retrospective studies have assessed the efficiency of the Suresmile® system, and a few Acceledent® reports have described its effect on treatment time. Critical appraisal of the reviewed papers revealed that the efficiency of the Insignia® system cannot be confirmed based on the available evidence, while the use of Suresmile® can reduce overall treatment time in simple cases. The acceleration of tooth movement by Acceledent® devices has not yet been confirmed. PMID:27226964
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.
Seeliger, Julia; Lipski, Mariusz; Wójcicka, Anna; Gedrange, Tomasz; Woźniak, Krzysztof
Braces as foreign bodies in the mouth carry a risk of side effects and toxicity to the human body. This article presents the results indicating the possible toxic effects of tools used for cleaning the enamel after the completion of orthodontic treatment. The studies were carried out in vitro. The procedure of enamel etching, bonding orthodontic metal brackets, and enamel cleaning after their removal was performed under laboratory conditions. The enamel microstructure and elements present on its surface were evaluated using the scanning electron microscope (SEM). Silicon and aluminium were found in addition to the tooth building elements. PMID:27766265
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
Liu, J K; Tsai, M Y
The purpose of this study was to investigate the role of functional malocclusion in temporomandibular disorders (TMD) in untreated orthodontic patients. A total of 508 orthodontic patients were enrolled. All patients were evaluated for the presence of various types of functional malocclusion and clinical signs of TMD before treatment. The chi-square test was used to evaluate the association of functional malocclusion and TMD. The frequencies of TMD were 44.2% in patients with retruded position (RP) interference and 38.1% in those without such interference (p > 0.05). The frequency of TMD in patients with protrusive interference was greater than those without (32.2% vs. 18.4%; p < 0.005). Patients with balancing interference had a significantly higher frequency of TMD than those without (49.2% vs. 23.9%; p < 0.0001). We thus conclude that patients with functional malocclusion of balancing or protrusive interference type have an increased risk for developing TMD.
Henrikson, T; Nilner, M; Kurol, J
The aim of this investigation was to prospectively and longitudinally study signs of temporomandibular disorders (TMD) and occlusal changes in girls with Class II malocclusion receiving orthodontic treatment and to compare them with subjects with untreated Class II malocclusions and with normal occlusion subjects. Three groups of age-matched adolescent girls were examined for clinical signs of TMD and re-examined 2 years later. Sixty-five Class II subjects received orthodontic fixed straight-wire appliance treatment (Orthodontic group), 58 subjects were orthodontically untreated (Class II group), and 60 subjects had a normal occlusion (Normal group). In the Orthodontic group, the prevalence of muscular signs of TMD was significantly less common post-treatment. The Class II and the Normal groups showed minor changes during the 2-year period. 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 signs of TMD than the Orthodontic and the Class II groups at both registrations. Functional occlusal interferences decreased in the Orthodontic group, but remained the same in the other groups over the 2 years. In conclusion, orthodontic treatment did not increase the risk for or worsen pretreatment signs of TMD. On the contrary, subjects with Class II malocclusions and signs of TMD of muscular origin seemed to benefit functionally from orthodontic treatment in a 2-year perspective. The Normal group had a lower prevalence of signs of TMD than the Orthodontic and the untreated Class II groups.
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.
Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption? PMID:25992982
Deciduous teeth exfoliate as a result of apoptosis induced by cementoblasts, a process that reveals the mineralized portion of the root while attracting clasts. Root resorption in deciduous teeth is slow due to lack of mediators necessary to speed it up; however, it accelerates and spreads in one single direction whenever a permanent tooth pericoronal follicle, rich in epithelial growth factor (EGF), or other bone resorption mediators come near. The latter are responsible for bone resorption during eruption, and deciduous teeth root resorption and exfoliation. Should deciduous teeth be subjected to orthodontic movement or anchorage, mediators local levels will increase. Thus, one should be fully aware that root resorption in deciduous teeth will speed up and exfoliation will early occur. Treatment planning involving deciduous teeth orthodontic movement and/or anchorage should consider: Are clinical benefits relevant enough as to be worth the risk of undergoing early inconvenient root resorption?
The condylar position was stabilized with a gnathologic splint designed to achieve a mutually protected occlusion in a patient with internally deranged joints whose symptoms had not been resolved with an anterior repositioning splint. A diagnosis was made in the stable condylar position from which hinge axis movement of the mandible could be performed. After preoperative orthodontic treatment, the mandibular position was restabilized with splint therapy; then, a sagittal split ramus osteotomy was performed, by using an overcorrection splint. As a result, the stable position of the condyles was in line with the centric occlusion of the teeth. Changes in the joint status are illustrated with magnetic resonance images. The occlusion was stable 2 years after active treatment without recurrence of joint symptoms.
Sato, Shuichi; Nomura, Naoyuki; Kawashima, Hideyuki; Ito, Koichi
This case report describes the nonsurgical creation of an interdental papilla in orthodontic therapy of a patient with severe periodontal disease. A large diastema between the maxillary incisors was closed completely, and the lost interdental papilla was re-created by orthodontic therapy after nonsurgical periodontal therapy. Radiographs showed improvement of the bone defect. Periodontal/orthodontic soft tissue manipulation is a nonsurgical technique that can lead to reformation of the interdental papilla, provided that periodontal health is maintained.
Gómez, Elena; Otero, Marta; Berraquero, Rosario; Wucherpfennig, Begona; Hernández-Godoy, Juan; Guiñales, Jorge; Vincent, Germán; Burgueño, Miguel
Introduction Conventional treatments are sometimes not possible in certain alveolar cleft cases due to the severity of the gap which separates the fragments. Various management strategies have been proposed, including sequential surgical interventions or delaying treatment until adulthood to then carry out maxillary osteotomies. A further alternative approach has also been proposed, involving the application of bone transport techniques to mobilise the osseous fragments and thereby reduce the gap between lateral fragments and the premaxilla. Case Report We introduce the case of a 10-year-old patient who presented with a bilateral alveolar cleft and a severe gap. Stable occlusion between the premaxilla and the mandible was achieved following orthodontic treatment, making it inadvisable to perform a retrusive osteotomy of the premaxilla in order to close the alveolar clefts. Faced with this situation, it was decided we would employ a bone transport technique under orthodontic guidance using a dental splint. This would enable an osseous disc to be displaced towards the medial area and reduce the interfragmentary distance. During a second surgical intervention, closure of the soft tissues was performed and the gap was filled in using autogenous bone. Conclusions The use of bone transport techniques in selected cases allows closure of the osseous defect, whilst also preserving soft tissues and reducing the amount of bone autograft required. In our case, we were able to respect the position of the premaxilla and, at the same time, generate new tissues at both an alveolar bone and soft tissue level with results which have remained stable over the course of time. Key words:Alveolar cleft, bone transport, graft. PMID:26855699
Lenza, Marcos Augusto; de Carvalho, Adilson Alves; Lenza, Eduardo Beaton; Lenza, Mauricio Guilherme; de Torres, Hianne Miranda; de Souza, João Batista
INTRODUCTION: Despite discussion on the merit of various cephalometric superimposition methods, there remains a need to assess which one can be used in daily practice with reasonably accuracy and less working time. OBJECTIVE: The aim of this study was to investigate four methods of cephalometric superimposition by means of assessing the longitudinal changes in craniofacial morphology caused by growth and response of adolescents with Class I malocclusion to orthodontic treatment involving first premolar extraction. METHODS: Pretreatment (T1) and post-treatment (T2) standardized lateral cephalometric radiographs of 31 adolescents (20 females and 11 males), with Angle Class I malocclusion and indication of premolar extraction, participated in this study. Radiographs were digitized, traced and had structures identified by means of a cephalometric software. Four superimposition methods were used: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point. Positional changes were quantified by horizontal and vertical linear changes in the following cephalometric landmarks: anterior/posterior nasal spine (ANS and PNS), gnathion (Gn), Gonion (Go), Pogonion (Pog), A-point and B-point. Differences between T1 and T2 in horizontal and vertical positional changes for all superimposition methods were assessed by one-way analysis of variance (ANOVA) and Bonferroni correction (p < 0.05). RESULTS: There were no statistically significant differences among the cephalometric superimposition methods or when patients' sex was considered. CONCLUSION: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point methods were reliable and presented similar precision when the overall facial changes due to active growth and/or orthodontic treatment were examined. PMID:26154453
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
Castroflorio, Tommaso; Titolo, Cristina; Deregibus, Andrea; Debernardi, Cesare; Bracco, Pietro
The aim of this work was to test the effects of the Function Generator Bite (FGB) on the masticatory muscles of temporomandibular joint dysfunction (TMD) subjects. Two groups were selected for the study. A group of 20 TMD patients (group F) requiring orthodontic treatment and treated with FGB and a group of 10 healthy subjects (group H) were considered. Both groups were evaluated before the therapy began (TO) and then after 18 months of therapy (T1). An electromyographic analysis of the masseter and temporalis anterior muscles and a clinical evaluation according to the Research Diagnostic Criteria for TMD (RDC/TMD) were performed. A statistical difference between the two groups was observed at TO with respect to the activity index. TMD subjects showed a lower value of the index. Further studies are necessary to fully understand the utility of this EMG index as a diagnostic indicator.
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
Yassaei, Soghra; Aghili, Hossein Agha; Davari, Abdolrahim
Objectives: Providing reliable attachment between bracket base and zirconia surface is a prerequisite for exertion of orthodontic force. The purpose of the present study was to evaluate the effect of four zirconium surface treatment methods on shear bond strength (SBS) of orthodontic brackets. Materials and Methods: One block of zirconium was trimmed into four zirconium surfaces, which served as our four study groups and each had 18 metal brackets bonded to them. Once the glazed layer was removed, the first group was etched with 9.6% hydrofluoric acid (HF), and the remaining three groups were prepared by means of sandblasting and 1W, and 2W Er: YAG laser, respectively. After application of silane, central incisor brackets were bonded to the zirconium surfaces. The SBS values were measured by a Dartec testing machine with a crosshead speed of 1 mm/min. Data were analyzed using one-way ANOVA and Tukey’s HSD for multiple comparisons. Results: The highest SBS was achieved in the sandblasted group (7.81±1.02 MPa) followed in a descending order by 2W laser group (6.95±0.87 MPa), 1W laser group (6.87±0.92 MPa) and HF acid etched group (5.84±0.78 MPa). The differences between the study groups were statistically significant except between the laser groups (P<0.05). Conclusion: In terms of higher bond strength and safety, sandblasting and Er: YAG laser irradiation with power output of 1W and 2W can be considered more appropriate alternatives to HF acid etching for zirconium surface treatment prior to bracket bonding. PMID:26622283
Vahid Dastjerdi, Elahe; Khaloo, Negar; Mojahedi, Seyed Masoud; Azarsina, Mohadese
Background: Bleaching treatments decrease shear bond strength between orthodontic brackets and teeth; although definite results have not been reported in this regard. Objectives: This study determined the effects of different bleaching protocols on the shear bond strength of orthodontic brackets to teeth. Materials and Methods: This experimental study was performed in Iran. Forty-eight extracted human premolars were randomly assigned into four groups. In the control group, no bleaching treatment was performed. In groups 2 - 4, the bleaching procedures were performed using carbamide peroxide 45%, carbamide peroxide 20% and diode laser, respectively. Two weeks later, brackets were bonded to teeth and thermocycled. The shear bond strengths of the brackets to the teeth were measured. Data was analyzed by one-way ANOVA and Dunnett post-hoc test. Results: Shear bond strength of the brackets to the teeth were 10.54 ± 1.51, 6.37 ± 0.92, 7.67 ± 1.01 and 7.49 ± 1.19 MPa, in groups 1 - 4, respectively. Significant differences were found between control group and all other groups (P < 0.001); and also between groups 2 and 3 (P < 0.05). No significant differences were found between the other groups. Conclusions: The bleaching procedures using 20% carbamide peroxide and 45% carbamide peroxide and diode laser significantly decreased shear bond strength of brackets to the teeth. 45% carbamide peroxide had a more significant effect on bond strength compared to 20% carbamide peroxide. The difference in bond strength was not significant between laser group and either carbamide peroxide groups. PMID:26734481
Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco J.
Introduction: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. Methodology: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student’s t-test, chi-square test and logistic regression analysis were used to determine statistical significance. Results: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. Conclusions: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps. Key words:Endodontics, orthodontics, root canal treatment, root resorption. PMID:22143731
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
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
Dmitrenko, M I
The results of investigation showed that it is necessary to use complex methods of orthodontic treatment in patients with malocclusion complicated by dental crowding. Orthodontic appliance therapy should be accompanied by differentiated massage and mioymnastics to improve functional state of masseter and temporal muscles. It was found that after the treatment electromyographic potential amplitude of temporal muscles is on the average in 1.5 times lower as compared with pretreatment records (P < 0.05). It was observed increase on the average in 1.5 times in electromyographic potential oscillation amplitude of masseter muscles during clenching after the treatment of maxillary and mandibular dental crowding (P < 0.05). Treatment of dental crowding resulted in restoration of masseter muscles functional symmetry. During clenching index MASI(MM) significantly decreased in all groups in comparison with pretreatment indices (P < 0.05).
Xue, Dai Juan and Feng
In this report we describe a combined orthodontic and surgical treatment for a 14-year-old boy with severe skeletal class III deformity and dental problem. His upper posterior primary teeth in the left side were over-retained and 6 maxillary teeth (bilateral central incisors and canines, left first and second premolars) were impacted, together with 5 supernumerary teeth in both arches. The treatment protocol involved extraction of all the supernumerary and deciduous teeth, surgical exposure and orthodontic traction of the impacted teeth, a bimaxillary orthognathic approach including Lefort I osteotomy. Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty was performed to correct skeletal problem. After treatment, all of the impacted teeth were brought to proper alignment in the maxillary arch. A satisfied profile and good posterior occlusion was achieved. Treatment mechanics and consideration during different stages are discussed. PMID:24893948
Egermark, Inger; Carlsson, Gunnar E; Magnusson, Tomas
This investigation analyzed the influence of orthodontic treatment performed in childhood on the long-term development of signs and symptoms of temporomandibular disorders (TMDs). The original sample consisted of 50 consecutive patients (27 girls and 23 boys) with different morphological malocclusions, who were to receive orthodontic treatment. Their mean age at start of treatment was 12.9 years. Seventeen (range 15-18) years after completion of orthodontic treatment, 40 former patients (89% of the traced subjects) completed and returned a questionnaire, and 31 subjects (69% of the traced subjects) were also examined clinically. A great majority of the participants were pleased with the result of the orthodontic treatment. Relapses of morphological malocclusions were very uncommon. The prevalence of signs and symptoms of TMD was low both before and after the active phase of orthodontic treatment, as well as at the long-term follow-up after 15 to 18 years. The incidence per year of manifest TMD requiring treatment was approximately 1%. The result of the present investigation supports the opinion that orthodontic treatment in childhood does not entail an increased risk to develop either signs or symptoms of TMD later in life.
Katzhendler, E; Steigman, S
This study evaluated the response of treated teeth to renewed orthodontic force. Thirty female rats (201 +/- 2.7 g) were divided into groups A and B. Linguointrusive loads (20.58 +/- 1.88 g) generated by springs were applied to the lower left incisor for 2 weeks and then removed to allow recovery during 27 weeks (group A). Identical loading was then repeated in group A and applied as primary treatment in group B. Five animals from each group were killed with the springs in situ (A-1 and B-1), while the remaining 20 animals were killed after a 3-month recovery (A-2, B-2). The decalcified incisors were cross-sectioned serially (2 microm), and the distance of each section from the apex was computed. Dental and periodontal injuries were evaluated by light microscopy and plotted according to their location on the tooth axis. The intrusion of the teeth in group A-1 was significantly greater, whereas recovery of the normal eruption rate in group A-2 was significantly slower compared with groups B-1 and B-2. The histopathologic lesions in groups A-1 and B-1 did not differ. However, group A-2 showed a higher frequency of injured enamel organ, tissue infiltration by inflammatory cells, necrotic areas, and dentin resorption than group B-2. Initial orthodontic loading had a detrimental effect on the ability of the periodontal and dental tissues to cope with, and to recover from, repeated stress, probably because of a decrease in the number of periodontal fibroblasts and damage to the dentin-protecting cementoblastic layer.
de Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Guilherme; Pinzan, Arnaldo; Henriques, José Fernando Castanha
Objective: The present study was designed to retrospectively evaluate Class I malocclusion cases treated with extraction of the four first premolars, aiming to establish the relationship between the quality of orthodontic treatment outcomes and the long-term occlusal stability. Material and methods: The sample comprised 94 patients of both genders, presenting Class I malocclusion, treated with extractions of the four first premolars and Edgewise mechanics. All the patients selected were whites, being 50 males and 44 females. The mean pretreatment age was 13.46 years (s.d. 1.8). The mean treatment time was 2.09 years (s.d. 0.58), the mean retention time was 1.63 years (s.d. 0.73) and the mean time of postretention evaluation was 5.31 years (s.d. 1.61). The dental casts were measured at pretreatment (T1), posttreatment (T2) and postretention (T3), by the PAR index and by the Little irregularity index, and the correction due to treatment (T1-2) and the change at the postretention period (T3-2) were calculated. The descriptive statistics was performed and the Pearson correlation coefficient was applied for the PAR and the Little indices in the total sample, among the times evaluated. Results: The mean PAR reduction due to treatment was 78.54%, and 66.6%, at the postretention stage related to pretreatment stage. Significant correlations were found for the PAR index at the times evaluated, except between T1 and T2 and between T1-2 and T3. In other words, the higher the treatment correction (T1-2), the lower the posttreatment PAR index (PAR T2) will be, and the higher will be the PAR change at the postretention period (PAR T3-2). Also, the higher the posttreatment PAR score (PAR T2), the higher will be the postretention PAR score (PAR T3). Conclusion: It was concluded that the quality of orthodontic treatment outcomes is not related to the long-term occlusal stability. PMID:19089052
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
Kwak, Yoon-Young; Jang, Insan; Choi, Dong-Soon
An 8-years old boy with facial asymmetry and unilateral posterior crossbite on the left side received orthopedic and orthodontic treatment. During the first phase of treatment, the narrow maxillary arch was expanded using an acrylic plate. Then, the acrylic plate was used as a bite block with occlusal indentations from the construction bite that was obtained with the incisors in a coincident dental midline. After the position of the mandible was stabilized, the second phase of orthodontic treatment was initiated using fixed appliances for detailing of the occlusion. Skeletal symmetry, ideal occlusion, and coincident dental midlines were thus achieved. Functionally, occlusal force balance and masticatory muscle activity were improved, and the chewing patterns were normalized. PMID:24892028
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.
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.
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.
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 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.
dipeptide , and arginine have shown efficacy. (3,4) Studies with crocetin have also shown efficacy (5), but this agent is not available in a form which...in humans, while alanine-glutamine dipeptide is not approved in the United States. Crocetin is still in early Phase I studies, and will be...4. Alanine-glutamine dipeptide (AGD) studies are presented here. It should be noted that AGD is used widely in the clinical situation (in Europe
Aristizábal, Juan Fernando; Smit, Rosana Martínez
Turner syndrome is caused by complete or partial absence of one X chromosome. These patients usually have a delay in growth and altered body proportions, causing sexual infantilism, short stature, delayed bone maturation, and variations in craniofacial morphology, among other systemic complications. The skeletal features associated with this syndrome include maxillary growth reduction with midface hypoplasia; mandibular micrognathia; high, narrow palate; V-shaped maxillary arch; and open bite. This case report shows a two-phase orthodontic treatment in a patient with Turner syndrome with a Class II malocclusion and severe deep bite, which is an unusual feature in patients with this disease. A conventional orthodontic treatment was performed, and after 20 months in retention the patient remains stable.
Krieger, Elena; Wegener, Joachim; Wagner, Wilfried; Hornikel, Sandra; Wehrbein, Heinrich
Functional and esthetic results can improve significantly when a combined prosthodontic-orthodontic treatment approach is employed in cases requiring extensive oral rehabilitation. The patient presented in this case report was treated in his late teens with dental implants as a replacement for his maxillary incisors. Ten years later, the entire maxillary anterior segment was in infraocclusion compared to the rest of the dentition and lip line. Since prosthodontic follow-up treatment alone could not achieve an optimal functional and esthetic outcome, the patient was treated orthodontically prior to renewing the restoration. A fixed appliance was used to intrude the mandibular anterior teeth as well as vertically align the infrapositioned maxillary lateral incisors.
Proffit, William R.; Jackson, Tate H.; Turvey, Timothy A.
Introduction The characteristics of patients who seek and accept orthognathic surgery appear to be changing over time but have not been well documented in the 21st century. Methods Records for patients who had orthognathic surgery at the University of North Carolina from 1996 to 2000 and from 2006 to 2010 were reviewed to collect data for changes in the prevalence of patients with mandibular deficiency (Class II), maxillary deficiency or mandibular prognathism (Class III), long face, and asymmetry problems. The changes were compared with those in previous time periods and at other locations. Results Between 1996 and 2000 and between 2006 and 2010, the percentage of Class III patients increased from 35% to 54%, and the percentage of Class II patients decreased from 59% to 41%, while the percentages for long face and asymmetry showed little change. The decrease in Class II patients was accentuation of a long-term trend; the increase in Class III patients occurred only after the turn of the century. Conclusions A similar but less-marked change has been noted at some but not all other locations in the United States. It appears to be related primarily to an increase in the numbers of African Americans, Native Americans, Hispanics, and Asians who now are seeking surgical treatment, but it also has been affected by changes in where orthognathic surgery is performed, decisions by third-party payers (insurance and Medicaid) about coverage for treatment, and the availability of nonsurgical orthodontic treatment options for Class II patients. PMID:23726329
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.
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 cm(3) at 6 months compared to 0.59 ± 0.22 cm(3); p < 0.05) and less residual alveolar bone defect (0.31 ± 0.08 cm(3) at 6 months compared to s 0.55 ± 0.14 cm(3); 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.
0.3, were found between morphological malocclusions and the presence of frequent headaches, bruxism , symptoms or clinical signs of TMD (Egermark...clenching during the day, and frequent stress (Locker and Slade, 1988). History of trauma and orthodontic treatment were not found to be associated...of this study in terms of the differences found between men and women may be attributable to the greater stress in an urban lifestyle. A cross
Tomita, Yuko; Kuroda, Shingo; Takahashi, Takumi; Ohura, Ritsuko; Tanaka, Eiji
Conservative treatment of an ameloblastoma often requires an occlusal reconstruction. In this article, we report the successful interdisciplinary treatment of a 14-year-old girl with a unicystic ameloblastoma in the mandible. One year after the marsupialization, enucleation with bone curettage was performed with extraction of the impacted third molar, but the proximal second molar could be maintained. The conservative treatment required long-term use of an obturator, and it caused a total open bite. Additionally, the patient genetically had a Class II malocclusion with severe crowding. Consequently, orthodontic treatment was performed after 4 premolar extractions. There was no recurrence of the ameloblastoma 10 years after the enucleation.
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.
Background 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. Methods 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. Results 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. Conclusions Among parents of disabled children undergoing OT, the perceived level of overall satisfaction was very high and expectations were often exceeded. PMID:25096027
Abreu, Lucas Guimarães; Melgaço, Camilo Aquino; Abreu, Mauro Henrique Nogueira Guimaraes; Lages, Elizabeth Maria Bastos; Paiva, Saul Martins
Objective: To assess parents' and caregivers' view of the first twelve months of adolescents' orthodontic treatment with fixed appliances and to assess the evaluative properties of the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) in the orthodontic setting. Methods: Data from a sample of 96 parents and caregivers of adolescents undergoing orthodontic treatment with fixed appliances were collected by means of P-CPQ. Assessments were performed before banding and bracket bonding (T1) and 12 months after placement of fixed appliances (T2). Statistical analysis included Wilcoxon signed-rank test for the overall P-CPQ score and Bonferroni correction for P-CPQ subscales. The evaluative properties of the P-CPQ were assessed through responsiveness calculation and the minimally clinical important difference (MCID). Results: Among the 96 participants, 76 were mothers of patients, 16 were fathers, and four were other family members. Adolescents' mean age was 11.49 ± 0.50 years. Most families earned equal to or less than three times the Brazilian monthly minimum wage. There was significant improvement in the emotional and social well-being subscales (p < 0.001), which contributed to improve patient's overall quality of life (p< 0.001). Reductions in scores were associated with clinically meaningful moderate changes in the overall score as well as in the emotional and social well-being subscales. The MCID was 6.16 for the P-CPQ overall score. Conclusion: Parents and caregivers reported significant improvement in the quality of life of adolescents undergoing orthodontic treatment with fixed appliances. PMID:26560827
Chesnokov, V A; Chesnokova, M G; Mironov, A Iu; Turchaninov, D V; Kriga, A S
The application of Bayes theorem in medical diagnostic includes such important step as derivation for every symptom and diagnosis data values of finite or a posteriori probability of presence of germ, for instance S. sanguis, in patients receiving orthodontic treatment. This value expresses importance of the given symptoms for detection of germ presence. In the implemented studies the Bayes theorem was applied to evaluate probability of presence of particular germ in particular concentration (degree of semination, CO) under concrete symptom group. The rates were used to calculate probability of presence of cariesgenic streptococcus S. mutans and S. sanguis in prospect patient. The rates were calculated for the group with fixed orthodontic apparatuses. The high degree of risk of development of caries in children under orthodontic treatment is conditioned by a whole complex of existing unfavorable factors present in oral cavity. Hence, a powerful negative potential to develop expressed cariesgenic situation in oral cavity is present. The analysis of medical data of patients with distal occlusion was applied using Bayes theorem from the point of view their diagnostic value. The study established 36 symptoms, factors, risk factors and background diseases common in case of distal occlusion in children. The probability to detect the mentioned characteristics and likelihood ratio under different degree of concentration of cariesgenic Streptococcus mutans and Streptococcus sanguis in dental plaque of children was considered. The establishment of character of likelihood ratio for different qualitative content of streptococcus in case of isolation from biotope of dental plaque permitted to determine the informative characteristics. The Bayesian model can be applied in clinics as a computer program to process incoming information about patients with distal occlusion under active orthodontic treatment. The developed diagnostic algorithm in a fast and simple mode of clinical
de Jesus Tavarez, Rudys Rodolfo; Lima Bezerra, Gisele; de Souza Penha, Karla Janilee; Torres, Carlos Rocha Gomes; Firoozmand, Leily Macedo
Objective The aim of this study was to evaluate in vitro bond strength of metal brackets bonded with: total etch, total etch with erbium: yttrium aluminum garnet laser (Er:YAG) and self-etching adhesive systems, submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment. Materials and methods For the study, 80 bovine incisors were randomly divided into 3 experimental groups (n=16 each): XT- acid etching + Transbond XT, XT/Er:YAG- Transbond XT associated with Er:YAG laser irradiation (λ=2.94 μm, 60 mJ, 10 Hz) and SEP- Transbond Plus Self Etching Primer. Samples were submitted to thermal-mechanical cycling, simulating 1 year of orthodontic treatment. Afterward, the shear bond strength test was performed in a universal test machine at a speed of 0.5mm/min. Samples were evaluated under a stereomicroscope and by scanning electron microscopy for analysis of enamel surface and adhesive remnant index. Data were analyzed using Kruskal–Wallis and Mann–Whitney (with Bonferroni correction) statistical tests. Results Statistically significant difference was observed between the groups studied (p<0.05). Groups XT and SEP showed the highest bond strength values, without statistical difference between them, while group XT/Er:YAG showed reduction in bond strength values. Higher frequency of adhesive failures between enamel and adhesive system was verified for groups XT and XT/Er:YAG. Conclusion The conventional (XT) and self-etching (SEP) adhesive systems showed mean bond strength values, similar between them, whereas the previous application of Er:YAG laser promoted the lowest bond strength values. PMID:28392716
Cardoso, Mauricio de Almeida; Saraiva, Patrícia Pinto; Maltagliati, Liliana Ávila; Rhoden, Fernando Kleinübing; Costa, Carla Cristina Alvarenga; Normando, David; Capelozza, Leopoldino
OBJECTIVE: The aim of the present study was to evaluate, comparatively, the periodontal response during orthodontic treatment performed with self-ligating and conventional brackets. METHODS: Sixteen Caucasian individuals of both sexes, aged between 12 and 16 years old and in permanent dentition were selected. Eight individuals were treated with conventional brackets installed on the lower dental arch and self-ligating brackets on the upper arch. Another eight individuals received self-ligating brackets in the lower arch and conventional brackets in the upper arch. The subjects received material and instructions for oral hygiene. Visible plaque index (VPI), gingival bleeding index (GBI) and clinical attachment level (CAL) were evaluated just after installation of orthodontic appliances, and 30, 60 and 180 days later. Mann-Whitney test was used to compare differences between groups (self-ligating and conventional), two-way ANOVA followed by Tukey's test was used to assess CAL at each site of each tooth. Significance level was set at 5%. RESULTS: No significant changes were found with regard to the assessed parameters (VPI, GBI and CAL) in either one of the systems. CONCLUSION: No significant changes were found with regard to the periodontal response to orthodontic treatment for the variables assessed and between subjects receiving passive self-ligating and conventional brackets. All individuals had received oral hygiene instructions and had their periodontal conditions monitored. PMID:25992985
Krupińska-Nanys, Magdalena; Zarzecka, Joanna
Backround: The study is focused on increased risk of dental plaque accumulation among the children undergoing orthodontic treatment in consideration of individual hygiene and dietary habits. Materials and Methods: The study was conducted among 91 children aged 7-14 including 47 girls and 44 boys. The main objectives of the study were: API index, plaque pH, DMF index, proper hygiene and dietary habits. Statistical analysis was provided in Microsoft Office Exel spreadsheet and STATISTICA statistical software. Results: The average API index among the children wearing removable appliance was 9 (SD = 13), and among children without appliances was 16 (SD = 21). DMF index for patients using appliances was 5 (SD = 3) and for those without appliances was 4 (SD = 2). The average plaque pH was 6 for children with appliances (SD = 0.9) and 6.2 without ones (SD = 0.3). Conclusion: In patients in whom there is a higher risk of dental plaque accumulating, correct oral hygiene supported with regular visits to the dentist is one of the best ways to control dental caries. In the fight against caries the most effective and only approach is to promote awareness of the problem, foster proper hygiene and nutritional habits, as well as educate children from a very young age in how to maintain proper oral hygiene. PMID:25709359
Mao, Li-Xia; Shen, Guo-Fang; Fang, Bing; Xia, Yun-Hui; Ma, Xu-Hui; Wang, Bo
Objective : A multimodal therapy was applied to solve a set of related problems including collapse of the posterior segment, high level gingival margin of canine, and resorption of grafted bone in a cohort of Chinese youngsters with cleft lip and palate. This study aimed to evaluate the benefits of this treatment procedure. Methods : Thirty patients with unilateral cleft lip and palate were included in this prospective study. All patients had previously undergone only cleft lip and palate repair and presented with alveolar cleft and an obvious step in the gingival margin between the canine tooth and the teeth beside it. A multimodal therapy that included bone grafting, corticotomy, and orthodontics was applied to solve these problems. Grafted bone volume, parallelism of the roots, root resorption, gingival margin, and mobility of the canine on the cleft side were established before surgery, 1 week after surgery, and after straightening of the canine. Results : Less than 25% of the grafted bone was reabsorbed in 25 of the 30 patients, while less than 50% was resorbed in the remaining five. The roots of the canines on the cleft side were mostly parallel to the adjacent teeth. Root resorption and mobility of the canines were slight. The difference in the gingival margin between the canines on the cleft side and the other side was small. Conclusions : Canines moved into the grafted bone safely and effectively, thus achieving a normal gingival margin and retaining grafted bone volume in one operation.
Sandeep, K. Sai; Singaraju, Gowri Sankar; Reddy, V. Karunakar; Mandava, Prasad; Bhavikati, Venkata N.; Reddy, Rohit
Aim: The aim of this study was to evaluate and compare the changes in body weight, body mass index (BMI), and body fat percentage (BFP) during the initial stages of fixed orthodontic treatment. Materials and Methods: The sample for this observational prospective study included 68 individuals with fixed orthodontic appliance in the age group of 18–25 years of both the sexes (25 males and 43 females). The control group consisted of 60 individuals (24 males and 36 females). The weight, BMI, and BFP were measured using a Body Composition Monitor at three points of time “T1” initial; “T2” after 1 month; and “T2” after 3 months. The results were tabulated and analyzed with the Statistical Package for the Social Sciences software. The mean changes between different parameters in both the study and control groups and between males and females in the study group was compared by using two-tailed unpaired student's t-test. The statistical significance is set atP ≤ 0.05. Results: There was an overall decrease in the body weight, BMI, and BFP after 1 month in the study cohort, which was statistically significant compared to the control group (P < 0.0001). This was followed by an increase in the parameters after the end of the 3rd month. Comparison of the parameters between the study and control group at the start of the treatment and at the end of the 3rd month had no statistical significance. There was a marked variation in the changes of these parameters between males and females of the study group, which is statistically significant (<0.0001). Conclusion: There is a definite reduction in the weight, BMP, and BMI at the end of the first month followed by a gain of weight, but not at the initial point by the end of the 3rd month. PMID:27583224
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.
Seifi, Massoud; Vahid-Dastjerdi, Elahe; Ameli, Nazila; Badiee, Mohammad-Reza; Younessian, Farnaz; Amdjadi, Parisa
Introduction: Failure of teeth to erupt from gingival tissues at usual developmental time is called delayed tooth eruption (DTE). Delayed tooth eruption lead to prolonged fixed orthodontic treatment and its eventual complications. The purpose of the present study was to evaluate the effect of laser-assisted (808 nm) surgical uncovering, on the tooth emergence and orthodontic treatment of DTE. Methods: A total of 16 orthodontic patients were included in this study and were equally assigned to an experimental and a control group. Subjects for experiment consisted of eight patients (6 girls and 2 boys) with a mean age of 14±0.9 years. All patients exhibited delayed second premolar eruption. The laser wavelength was 810 nm and it was set in a continuous wave mode at a power output of 1.6 watt with a 0.3-mm diameter fiber tip. When the target tissue was sufficiently anesthetized, the tip was directed at an angle of 10 to 20 degrees to the tissue (light contact mode); and was applied continuously for approximately 12 Seconds until an acceptable tooth exposure area was visible. The facial axis of the clinical crown (FACC) line represents the most prominent portion of the facial central lobe for premolars. All orthodontic brackets are aligned along this reference and are located on FA (Facial Axis) point. The standard for adequate tooth eruption was the accessibility of facial axis of the clinical crown (FACC) for bonding the brackets. Data gathered from the patients were statistically surveyed and compared by means of Tukey’s Test and Analysis of Variance (ANOVA). Results: All patients showed good gingival status, no significant bleeding during or immediately after the surgery, and acceptable level of healing after laser surgery. The biologic width of the teeth was preserved and no violation of this important periodontal parameter was observed. The average time for accessing the FA point in experimental group was 11±1.1 weeks and the mentioned period was increased to
Zahed Zahedani, SM; Oshagh, M; Momeni Danaei, Sh; Roeinpeikar, SMM
Statement of Problem: One of the major outcomes of orthodontic treatment is the apical root resorption of teeth moved during the treatment. Identifying the possible risk factors, are necessary for every orthodontist. Purpose: The aim of this study was to compare the rate of apical root resorption after fixed orthodontic treatment with standard edgewise and straight wire (MBT) method, and also to evaluate other factors effecting the rate of root resorption in orthodontic treatments. Materials and Method: In this study, parallel periapical radiographs of 127 patients imaging a total of 737 individual teeth, were collected. A total of 76 patients were treated by standard edgewise and 51 patients by straight wire method. The periapical radiographs were scanned and then the percentage of root resorption was calculated by Photoshop software. The data were analyzed by Paired-Samples t-test and the Generalized Linear Model adopting the SPSS 15.0. Results: In patients treated with straight wire method (MBT), mean root resorption was 18.26% compared to 14.82% in patients treated with standard edgewise technique (p< .05). Male patients had higher rate of root resorption,statistically significant (p< .05). Age at onset of treatment, duration of treatment, type of dental occlusion, premolar extractions and the use of intermaxillary elastics had no significant effect on the root resorption in this study. Conclusion: Having more root resorption in the straight wire method and less in the standard edgewise technique can be attributed to more root movement in pre-adjusted MBT technique due to the brackets employed in this method. PMID:24724131
Sodipo, Ibukunoluwa; Birdsall, Joanne
Orthodontic emergencies occasionally arise and although they can cause discomfort to the patient, they can usually be stabilized by a general dentist and then followed up by the orthodontist. CPD/Clinical Relevance: Patients undergoing orthodontic treatment may initially present to their general dental practitioner with an orthodontic emergency as opposed to their orthodontist. It is therefore important that general dental practitioners are aware of common orthodontic emergencies and their management.
Background The aim of this investigation was to assess the effects of different treatments of demineralised enamel on microleakage under orthodontic brackets. Methods Seventy-five intact premolars were randomly assigned to five groups. The teeth in groups 2 through 5 were immersed in a demineralising solution for 16 weeks. In groups 1 (control) and 2 (demineralised/control), conventional acid etching was used. In group 3, sodium hypochlorite (NaOCl) was applied on the enamel surface for 1 min after acid etching, and in group 4, Transbond Plus (3M Unitek, Monrovia, CA, USA) self-etching primer (SEP) was used. The teeth in group 5 were treated with 2% sodium fluoride (NaF) for 4 min before etching. After bracket bonding, the specimens were thermocycled, sealed with nail varnish, immersed in 0.5% basic fuchsine solution for 24 h and sectioned. Microleakage was measured under a stereomicroscope for the enamel-adhesive and adhesive-bracket interfaces of both occlusal and gingival sides. Results Demineralised teeth showed more microleakage at the enamel-adhesive interface on both occlusal and gingival sides compared to sound teeth, but the difference was not significant (P > 0.005). Treating the demineralised enamel with 5% NaOCl or Transbond Plus SEP was not effective in reducing microleakage. NaF treatment followed by acid etching of demineralised enamel resulted in significantly lower microleakage in most comparisons (P < 0.005). Conclusions The use of 2% NaF on hypomineralised enamel before the bracket bonding procedure is an effective way to decrease microleakage. PMID:24325863
Azuma, Shiori; Kohzuki, Masahiro; Saeki, Shuichi; Tajima, Mayumi; Igarashi, Kaoru; Sugawara, Junji
Patients with malocclusion, especially those in need of surgical correction, have lower health related quality of life (HRQOL) and higher anxiety. We investigated the changes of HRQOL and psychological status following jaw surgery in the patients with facial deformities. Thirty-one adult orthodontic patients admitted to Tohoku University Hospital and diagnosed as malocclusion requiring jaw surgery were recruited for the study. The severity of malocclusion was assessed by Severity Score (SS) which is based on their cephalometric radiographs. They were divided into three groups according to the severity of malocclusion, i.e. Low-SS, Moderate-SS and High-SS. The subjects also completed a generic HRQOL (entire body health) instrument, and three disease-specific oral HRQOL instruments. HRQOL and psychological status of the patients were assessed before (T1) and at debonding of multibracketed appliances after surgery (T2). SS in each group significantly decreased to normal occlusion level (SS = approximately 0-1). Oral function significantly improved from 11.8 +/- 5.4 to 5.9 +/- 4.3 in the Low-SS (p < 0.01), from 13.7 +/- 6.5 to 8.8 +/- 5.1 in the Moderate-SS (p < 0.05), and from 14.7 +/- 6.7 to 7.8 +/- 5.7 in the High-SS (p < 0.01). The patients after the surgical correction had improved disease-specific HRQOL and state anxiety irrespective of the severity before surgery, although the generic HRQOL, trait anxiety and depression were equal to that before the surgery. Furthermore, both postoperative anxiety and HRQOL were estimated by the preoperative anxiety and HRQOL. These results indicated that jaw surgery markedly improved the disease-specific HRQOL and psychological status in the present patients. We therefore suggest that assessments of the HRQOL and psychological status before treatment might predict the HRQOL and psychological status after the treatment to a certain extent.
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.
Remmelink, H J
The mentally handicapped exhibit a 3 times higher incidence of malocclusions and related functional problems than the general population. In contrast there is little available literature relating to the orthodontic treatment of handicapped patients. Based on published articles on orthodontic treatment of disabled patients the following recommendations can be given. First of all for each patient a 'problem list' should be drawn up, based on the diagnosis. In this list the orthodontic problems are formulated. Additionally, the list makes clear who is responsible for providing services related to orthodontic care, such as oral hygiene and transportation of the patient to the orthodontist. When deciding whether or not orthodontic treatment should be administered to a patient with a mental handicap the same functional and aesthetic considerations as with any other orthodontic case must be taken into account. Furthermore, the severity of the handicap and possible associated psychosocial and medical limitations as well as the extent to which it will be possible to treat the patient have to be considered. Contraindications are a severe mental handicap, inability to remain still in the dental chair, insufficient co-operation of parents/carers, open bite resulting from abnormal oral function, and a mild malocclusion. The orthodontic treatment should aim for an acceptable result, and not for orthodontic perfection.
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.
Bonetti, Stefano; Dalessandri, Domenico; Mandelli, Gualtiero; Paganelli, Corrado
Background Root resorption shall be taken into consideration during every orthodontic treatment, and it can be effected by the use of different techniques, such as the application of low friction mechanics. However, its routinely assessment on orthopantomography has limitations related to distortions and changes in dental inclination. Aim The aim of this investigation was to evaluate the severity of apical root resorption of maxillary and mandibular incisors after low-friction orthodontic treatment, using the combination of panoramic and lateral radiographs, and applying a trigonometric correction. Settings and Design A hospital based Retrospective study at the orthodontic Department (Dental School, University of Brescia, Spedali Civili di Brescia, Brescia, Italy). Materials and Methods Ninety-three subjects (53 females and 40 males; mean age, 14 years) with mild teeth crowding were treated without extractions by the same operator using a low-friction fixed appliance following an integrated straight wire (ISW) protocol. The pre- and post-treatment tooth lengths of the maxillary and mandibular incisors were measured on panoramic radiographs. A trigonometric factor of correction for the pre-treatment length was calculated based on the difference between the pre and post-treatment incisal inclination on lateral cephalograms. Statistical Analysis The changes in lengths were investigated using the Student’s t-test for paired values (p<0.05). Results Maxillary central incisors showed no changes (0.3%, 0.6%), maxillary lateral incisors showed a small increase (1.4%, 1.8%) that was attributed to the completion of root development in younger patients, mandibular central and lateral incisors underwent slight resorption (-3.1%, -3.4%). A statistically significant difference was found for the mandibular incisors but not for the maxillary ones. Conclusion In patients with mild crowding and consequent low amount of root movement, a low-friction orthodontic treatment can lead
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
Taner, Tülin Ugur; Ciger, Semra; El, Hakan; Germeç, Derya; Es, Alphan
The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained.
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
Wey, Mang Chek; Othman, Siti Adibah
Objective This randomized controlled trial aimed to compare the stability of mandibular arch orthodontic treatment outcomes between passive self-ligating and conventional systems during 6 months of retention. Methods Fortyseven orthodontic patients with mild to moderate crowding malocclusions not requiring extraction were recruited based on inclusion criteria. Patients (mean age 21.58 ± 2.94 years) were randomized into two groups to receive either passive self-ligating (Damon® 3MX, n = 23) or conventional system (Gemini MBT, n = 24) orthodontic treatment. Direct measurements of the final sample comprising 20 study models per group were performed using a digital caliper at the debonding stage, and 1 month, 3 months, and 6 months after debonding. Paired t-test, independent t-test, and non-parametric test were used for statistical analysis. Results A significant increase (p < 0.01) in incisor irregularity was observed in both self-ligating and conventional system groups. A significant reduction (p < 0.01) in second interpremolar width was observed in both groups. Mandibular arch length decreased significantly (p = 0.001) in the conventional system group but not in the self-ligating system group. A similar pattern of stability was observed for intercanine width, first interpremolar width, intermolar width, and arch depth throughout the 6-month retention period after debonding. Comparison of incisor irregularity and arch dimension changes between self-ligating system and conventional system groups during the 6 months were non-significant. Conclusions The stability of treatment outcomes for mild to moderate crowding malocclusions was similar between the self-ligating system and conventional system during the first 6 months of retention. PMID:28127535
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.
Johnston, C D; Littlewood, S J
Retention is necessary following orthodontic treatment to prevent relapse of the final occlusal outcome. Relapse can occur as a result of forces from the periodontal fibres around the teeth which tend to pull the teeth back towards their pre-treatment positions, and also from deflecting occlusal contacts if the final occlusion is less than ideal. Age changes, in the form of ongoing dentofacial growth, as well as changes in the surrounding soft tissues, can also affect the stability of the orthodontic outcome. It is therefore essential that orthodontists, patients and their general dental practitioners understand the importance of wearing retainers after orthodontic treatment. This article will update the reader on the different types of removable and fixed retainers, including their indications, duration of wear, and how they should be managed in order to minimise any unwanted effects on oral health and orthodontic outcomes. The key roles that the general dental practitioner can play in supporting their patients wearing orthodontic retainers are also emphasised.
Sakar, Olcay; Beyli, Mehmet; Marsan, Gulnaz
This clinical report describes a multidisciplinary approach for the treatment of a patient with Angle Class III skeletal malocclusion and decreased occlusal vertical dimension. An overlay removable partial denture (ORPD) was used to reestablish the occlusal vertical dimension (OVD). After the trial and adjustment period, the reduced lower anterior dentofacial height was orthodontically increased and the negative horizontal overlap was corrected. A maxillary precision attachment RPD and a mandibular fixed partial denture and metal ceramic crowns were fabricated to satisfy esthetic and functional requirements.
Amato, Francesco; Mirabella, A Davide; Borlizzi, Diego
This article presents a clinical case of bilateral partial edentulism in the posterior mandible with severe horizontal and moderate vertical bone atrophy. A new technique using rapid orthodontics after ridge splitting is presented. The split-crest technique was carried out using piezosurgical instruments in the first molar and second premolar areas to widen the bone crest and open a channel for tooth movement. Immediately after, orthodontic appliances were used to move the first premolars distally and the second molars mesially into the surgical site. The rationale was to facilitate and accelerate orthodontic movement of the teeth, which is otherwise difficult in a cortical knife-edged ridge. The bone defect was filled with the alveolar bone of the adjacent teeth that were moved into the surgically opened path. Adequate bone volume for implant placement was generated in the first premolar area. Implants were then inserted, and the patient was rehabilitated.
Renkema, A M; Padmos, J A D; de Quincey, G de
Gingival recessions represent the most visible periodontal disease. The prevalence of gingival recessions is high. The root surface is literally exposed to negative influences such as erosion, abrasion, discoloration and decay. Moreover, gingival recessions can affect the quality of life by increased thermal sensitivity and reduced dento-gingival aesthetics. The aetiology of gingival recessions is complex and considered to be multifactorial. In order to prevent the development of gingival recessions during and after orthodontic treatment, several factors should be taken into account, among which maintenance of optimal oral hygiene and respect for the 'biological envelope' are decisive. Once gingival recessions have developed, orthodontic therapy can play a positive role in their treatment.
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
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.
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
Mikulewicz, Marcin; Kachniarz, Krzysztof; Chojnacka, Katarzyna
The Objective The aim of the study was evaluation of metal ions (nickel and chromium) released from orthodontic appliances in cleft lip and palate patients and the usefulness of non-invasive matrices (saliva and hair). Materials and Methods The material studied consisted of 100 individuals, including 59 females and 41 males of 5 to 16 years of age, which were divided into 3 groups: experimental–patients with cleft lip and palate (36 individuals, the average treatment time 5.74 years); control group–patients without cleft lip and palate, during orthodontic treatment (32 individuals, the average treatment time 1.78 years) and the control group patients without cleft lip and palate, without any orthodontic appliances (32 individuals). Samples (saliva, hair) were collected and subjects underwent a survey by questionnaire. Multi-elemental analyses of the composition of non-invasive matrices was conducted in an accredited laboratory by inductively coupled plasma spectrometry technique ICP-OES. The results were reported as mean contents of particular elements (Cd, Cr, Cu, Fe, Mn, Mo, Ni, Si) in hair and in saliva. Results The concentration of Cr, Ni, Fe and Cu ions in saliva of cleft lip and palate patients were several times higher as compared with not treated orthodontically control groups and higher than in the group with orthodontic appliances. Among the assessed matrices, hair of cleft lip and palate patients seem to be not a meaningful biomarker. Conclusion It was found that orthodontic appliances used in long-term treatment of cleft lip and palate patients do not release toxic levels of Cr and Ni ions. PMID:26544176
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.
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.
Gracco, Antonio; Siviero, Laura; Perri, Alessandro; Favero, Lorenzo; Stellini, Edoardo
A 12-year-old girl was referred to our clinic for evaluation of an unaesthetic dental appearance. All permanent teeth were erupted, while the deciduous maxillary right canine was retained. Cone-beam computed tomography revealed a complete transposition of the maxillary left canine and first premolar involving both the crowns and the roots. Initial cephalometric analysis showed a skeletal Class III pattern, with a slight maxillary retrusion and a compensated proclination of the upper incisors. The patient's teeth were considered to be in the correct position; therefore, we decided to attempt treatment by correcting the transposition and using only orthodontic compensation of the skeletal Class III malocclusion. After 25 months of active orthodontic treatment, the patient had a Class I molar and canine relationship on both sides, with ideal overbite and overjet values. Her profile was improved, her lips were competent, and cephalometric evaluation showed acceptable maxillary and mandibular incisor inclinations. The final panoramic radiograph showed that good root parallelism was achieved. Two-year follow-up intraoral photography showed stable results.
Sasaguri, Kenichi; Ishizaki-Takeuchi, Rika; Kuramae, Sakurako; Tanaka, Eliana Midori; Sakurai, Takashi; Sato, Sadao
A 32-year-old Japanese female patient consulted the authors' dental clinic with a 4.5-year history of rheumatoid arthritis (RA). She complained of pain during mouth opening and difficulty in eating due to masticatory dysfunction caused by an anterior open bite. Imaging showed severe erosion and flattening of both condyles. RA stabilized after pharmacological therapy and became inactive during the orthodontic therapy aimed at reconstructing an optimal occlusion capable of promoting functional repositioning of the mandible. At present, 4 years and 2 months postretention, the reconstructed occlusion remains stable, and both condyles continue to be remodeled. The distance from reference position to intercuspal position has gradually decreased throughout the 4-year posttreatment and postretention periods. Orthodontic therapy that comprehensively reconstructs occlusion and enhances the functioning of the mandible can induce remodeling of eroded condyles, even those with a history of rheumatoid arthritis.
Satake, H; Yamada, T; Kitamura, N; Yoshimura, T; Sasabe, E; Yamamoto, T
A case of prolonged unilateral temporomandibular joint (TMJ) dislocation, which was treated by open surgical reduction and post-surgical orthodontic therapy, is presented. A 58-year-old woman presented complaining of facial asymmetry and malocclusion. She had received surgery for a malignant tumour in the right retromolar region 7 years previously. It was considered that contraction of the pterygoid muscle by surgical injury caused anterior meniscal displacement and TMJ dislocation. Since manual manipulation failed, direct open reduction was performed after separation of the lateral pterygoid muscle from the condylar head and removal of the intra-articular scar tissues. Although the condylar head was returned to the glenoid fossa, optimal occlusion was not obtained because of compensatory tooth movement and inclination. Satisfactory occlusion and symmetric facial appearance were brought about by post-surgical orthodontic therapy.
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.
Talking about periodontic-orthodontic interrelationships is related primarily to the 1960s, where a generalized increase in salivary bacterial counts, especially Lactobacillus, had been shown after orthodontic band placement. The purpose of this article is to provide the dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics by means of representing classical studies, and, to give an update on this topic by demonstrating the most recent opinions concerning periodontic-orthodontic interrelationships. Specific areas reviewed are the ability of orthodontic treatment to afford some degree of protection against periodontal breakdown, short-term and long-term effects of orthodontic treatment on the periodontium, and some mucogingival considerations. Topics considering orthodontic treatment in periodontally compromised patients were not included in this review. While past studies have shown that orthodontic treatment can positively affect the periodontal health, recent reviews indicate an absence of reliable evidence for the positive effects of orthodontic therapy on patients’ periodontal status. Periodontic-orthodontic interrelationships are still controversial issues. However, a standard language between the periodontist and the orthodontist must always be established to eliminate the existing communications barrier, and to improve the outcomes of the whole treatment. PMID:20922083
Zhang, Jingjing; Chen, Gui; Li, Weiran; Xu, Tianmin; Gao, Xuemei
Objective Whether the orthodontic treatment with premolar extraction and maximum anchorage in adults will lead to a narrowed upper airway remains under debated. The study aims to investigate the airway changes after orthodontic extraction treatment in adult patients with Class II and hyperdivergent skeletal malocclusion. Materials and Methods This retrospective study enrolled 18 adults with Class II and hyperdivergent skeletal malocclusion (5 males and 13 females, 24.1 ± 3.8 years of age, BMI 20.33 ± 1.77 kg/m2). And 18 untreated controls were matched 1:1 with the treated patients for age, sex, BMI, and skeletal pattern. CBCT images before and after treatment were obtained. DOLPHIN 11.7 software was used to reconstruct and measure the airway size, hyoid position, and craniofacial structures. Changes in the airway and craniofacial parameters from pre to post treatment were assessed by Wilcoxon signed rank test. Mann-Whitney U test was used in comparisons of the airway parameters between the treated patients and the untreated controls. Significant level was set at 0.05. Results The upper and lower incisors retracted 7.87 mm and 6.10 mm based on the measurement of U1-VRL and L1-VRL (P < 0.01), while the positions of the upper and lower molars (U6-VRL, and L6-VRL) remained stable. Volume, height, and cross-sectional area of the airway were not significantly changed after treatment, while the sagittal dimensions of SPP-SPPW, U-MPW, PAS, and V-LPW were significantly decreased (P < 0.05), and the morphology of the cross sections passing through SPP-SPPW, U-MPW, PAS, and V-LPW became anteroposteriorly compressed (P <0.001). No significant differences in the airway volume, height, and cross-sectional area were found between the treated patients and untreated controls. Conclusions The airway changes after orthodontic treatment with premolar extraction and maximum anchorage in adults are mainly morphological changes with anteroposterior dimension compressed in airway cross
Introduction This study determined the amount and severity of EARR (external apical root resorption) after orthodontic treatment with self-ligating (SL) and conventional (Non-SL) brackets. Differences regarding rate of extraction cases, appointments and treatment time were evaluated. Material and methods 213 patients with a mean age of 12.4 ± 2.2 years were evaluated retrospectively. The treatments were performed with SL brackets (n = 139, Smartclip, 3 M Unitek, USA) or Non-SL brackets (n = 74, Victory Series, 3 M Unitek, USA). Measurements of the crown and root length of the incisors were taken using panoramic radiographs. Three-factor analysis of variance (ANOVA) was performed for an appliance effect. Results There was no difference between patients treated with Non-SL or SL brackets regarding the amount (in percentage) of EARR (Non-SL: 4.5 ± 6.6 vs. SL: 3.0 ± 5.6). Occurrence of severe EARR (sEARR) did also not differ between the two groups (Non-SL 0.5 vs. SL: 0.3). The percentage of patients with need of tooth extraction for treatment (Non SL: 8.1 vs. SL: 6.9) and the number of appointments (Non-SL: 12.4 ± 3.4 vs. SL: 13.9 ± 3.3) did not show any differences. The treatment time was shorter with Non-SL brackets (Non-SL: 18.1 ± 5.3 vs. SL: 20.7 ± 4.9 months). Conclusions This is the largest study showing that there is no difference in the amount of EARR, number of appointments and extraction rate between conventional and self-ligating brackets. For the first time we could demonstrate that occurrence of sEARR does not differ between the two types of brackets. PMID:24456620
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.
Teitelbaum, Valérie; Balon-Perin, Alain; De Maertelaer, Viviane; Daelemans, Philippe; Glineur, Régine
The impact of dental and skeletal movements on the soft tissues during orthodontic and surgical treatments is widely known. Most studies are limited to examining the repercussions of a dental or skeletal movement on a given soft tissue point. The uniqueness of the present study, carried out on 95 patients, lies in the examination of the impact of movements of various landmarks--2 dental points (incision superius and incision inferius) and 4 skeletal points (anterior nasal spine, point A, point B, andpogonion)--on 7 soft tissue landmarks (from the tip of the nose to soft tissue pogonion). The study was carried out with the purpose of providing a simple, practical, and accurate tool for clinical use to assist in treatment planning. This article outlines the main aspects of the tool while specifying its limitations and error margins.
Chaqués Asensi, José
The extraction of a lower incisor has been a therapeutic approach considered controversial in orthodontics over the last decades and, therefore, supported by some authors and questioned by others. In recent years, different publications have attempted to provide with substantial and structured information that could help to perform this atypical form of therapy in selected cases with a prospective good result. The purpose of this article is to summarise the available information, providing an order and structure to the diagnostic features that could support the indication and use of this treatment alternative, including the quantification of those parameters that can be measured in the decision-making process. Finally, to set up a clear and meaningful clinical frame that could be used by the orthodontist as a reference line in daily practice. Four case reports will be used in order to illustrate the indication of this treatment modality in different malocclusions.
Thind, Bikram S; Stirrups, David R; Forgie, Andrew H; Larmour, Colin J; Mossey, Peter A
Patients with congenitally missing teeth (hypodontia) present with complex problems. Meeting their treatment needs requires a joint effort between the disciplines of orthodontics and restorative dentistry. There are a number of options available to restore space generated by missing teeth. In the majority of patients orthodontic treatment will be required before this space can be restored satisfactorily. The second part of this series reviews the orthodontic considerations for various options.
Introduction Fixed orthodontic appliances, despite years of research and development, still raise a lot of controversy because of its potentially destructive influence on enamel. Therefore, it is necessary to quantitatively assess the condition and therein the thickness of tooth enamel in order to select the appropriate orthodontic bonding and debonding methodology as well as to assess the quality of enamel after treatment and clean-up procedure in order to choose the most advantageous course of treatment. One of the assessment methods is computed tomography where the measurement of enamel thickness and the 3D reconstruction of image sequences can be performed fully automatically. Material and method OCT images of 180 teeth were obtained from the Topcon 3D OCT-2000 camera. The images were obtained in vitro by performing sequentially 7 stages of treatment on all the teeth: before any interference into enamel, polishing with orthodontic paste, etching and application of a bonding system, orthodontic bracket bonding, orthodontic bracket removal, cleaning off adhesive residue. A dedicated method for the analysis and processing of images involving median filtering, mathematical morphology, binarization, polynomial approximation and the active contour method has been proposed. Results The obtained results enable automatic measurement of tooth enamel thickness in 5 seconds using the Core i5 CPU M460 @ 2.5GHz 4GB RAM. For one patient, the proposed method of analysis confirms enamel thickness loss of 80 μm (from 730 ± 165 μm to 650 ± 129 μm) after polishing with paste, enamel thickness loss of 435 μm (from 730 ± 165 μm to 295 ± 55 μm) after etching and bonding resin application, growth of a layer having a thickness of 265 μm (from 295 ± 55 μm to 560 ± 98 μm after etching) which is the adhesive system. After removing an orthodontic bracket, the adhesive residue was 105 μm and after cleaning it off, the enamel thickness was
Noverraz, R R; van Spronsen, P H
Content and background of the Capacity report 2001 for orthodontics in the Netherlands are discussed. The final conclusion of this report is that there is a yearly need of an input of 12 to 15 residents into postgraduate orthodontic programs. At the moment capacity of postgraduate training programs in the Netherlands is 4.5 resident yearly. Discussion is focussed on the advantages and disadvantages of the model used for the calculated estimations. More research on certain aspects of treatment need and demand is necessary. Implementation of the outcome will be a complex process for every party in the orthodontic field.
Lin, Feiou; Yao, Linjie; Bhikoo, Chandradev; Guo, Jing
Objective To assess the impact of wearing fixed orthodontic appliance (FOA) or clear-aligner, on daily performance in adult patients. Methods The Oral Impacts on Daily Performance (OIDP) index was assessed in 152 adults aged 25–35 years at baseline (T0), 6 months after bonding (T1), and 12 months after bonding (T2). Participants were randomly divided into two groups: CA group (participants treated with clear-aligner) and a control group (FOA group; participants treated with FOA). Baseline malocclusion severity was assessed using the Index of Orthodontic Treatment Need. Results There were no significant differences in sociodemographic variables and OIDP scores at baseline between the two groups. Significant changes in OIDP total and subscale scores were observed while wearing FOA: OIDP total score and subscale scores of eating, cleaning teeth, smiling, and social relation at T1 and T2 were significantly higher than at baseline (P<0.05 or P<0.01). However, only OIDP total score was significantly increased at T1 compared to the baseline in the CA group. OIDP total score and subscale scores of eating, cleaning teeth, smiling, and social relation were significantly higher in patients wearing FOA than in patients wearing clear-aligner at T1 and T2 (P<0.05 or P<0.01). Conclusion Patients wearing clear-aligner have fewer impacts on daily life than those wearing FOA during treatment, and have no significant changes in OIPD subscale scores at 12 months. FOA therapy significantly impacts daily performance in adult patients during treatment. PMID:27616881
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
Cheung, Rhonda Nga Yi; 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.
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
Bolendeŕ, C J
In orthodontics, incisor overbite has always been considered as an anomaly difficult to correct but also as the one most hindering the solving of the problems resulting from other associated malpositions. The recent concept of unlocking, introduced by the bioprogressive School, proves that the profession has become aware of its importance in any orthodontic treatment plan. Due to the fact that overbite also hinders the setting up of inferior brackets or forces the practitioner to bond them in a position liable to burden the parodontal health of the lower incisors has therefore induced the author to put in place, at the beginning of the treatment with the Tip-Edge technique, an anterior bite raiser thus generating space in the lateral sectors. Considering how fast the anterior problem is solved once the occlusion is lifted, the bite raiser can be suppressed within three months. Another advantage resides in the possible adjunction of an expansion screw also aimed at unlocking the occlusion in transverse direction. The question then raised in to know whether that approach which ought to be compared to the one of the functional appliances is not the ideal solution to unlock the occlusion in the three dimensions of space when the use of fixed appliances alone might be unsuitable or too slow, regarding current therapeutic aims. Attributing that spectacular therapeutic result to an incisor intrusion or a molar extrusion is of little interest as far as those alterations do not lead to an increase of the vertical dimension of the lower portion of the face. A cephalometric study, published concomitantly, has evidenced that the use of an anterior bite raiser together with the Tip-Edge technique only leads to perfectly similar alterations to those observed with the Ricketts bioprogressive technique or the Schudy edgewise technique, without the help of a bite raiser. From now on, integrating the bite raiser in our therapeutic armamentarium in conjunction with fixed techniques
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
Oh, Eun-Ju; Nguyen, Thuy-Duong T.; Lee, Seung-Youp; Jeon, Young-Mi; Bae, Tae-Sung
Objective To evaluate the bioactivity, and the biomechanical and bone-regenerative properties of Ti6Al4V miniscrews subjected to anodization, cyclic precalcification, and heat treatment (APH treatment) and their potential clinical use. Methods The surfaces of Ti6Al4V alloys were modified by APH treatment. Bioactivity was assessed after immersion in simulated body fluid for 3 days. The hydrophilicity and the roughness of APH-treated surfaces were compared with those of untreated (UT) and anodized and heat-treated (AH) samples. For in vivo tests, 32 miniscrews (16 UT and 16 APH) were inserted into 16 Wistar rats, one UT and one APH-treated miniscrew in either tibia. The miniscrews were extracted after 3 and 6 weeks and their osseointegration (n = 8 for each time point and group) was investigated by surface and histological analyses and removal torque measurements. Results APH treatment formed a dense surface array of nanotubular TiO2 layer covered with a compact apatite-like film. APH-treated samples showed better bioactivity and biocompatibility compared with UT and AH samples. In vivo, APH-treated miniscrews showed higher removal torque and bone-to-implant contact than did UT miniscrews, after both 3 and 6 weeks (p < 0.05). Also, early deposition of densely mineralized bone around APH-treated miniscrews was observed, implying good bonding to the treated surface. Conclusions APH treatment enhanced the bioactivity, and the biomechanical and bone regenerative properties of the Ti6Al4V alloy miniscrews. The enhanced initial stability afforded should be valuable in orthodontic applications. PMID:25309864
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
Brulat, Nathalie; Milia, Giulia; Rockl, Andrea; Rocca, Jean-Paul
Purpose: 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. Materials and Methods: 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/cm2, 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. Results: 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. Conclusion: 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. PMID:25368443
Josefsson, Eva; Bjerklin, Krister; Lindsten, Rune
Orthodontic treatment need and demand in 19-year-olds in Sweden has not previously been analysed in relation to geographic origin. The aim of this follow-up study was to examine the prevalence of self-perceived treatment need, malocclusion, earlier orthodontic treatment, self-perceived dental aesthetics and prevalence of symptoms indicative oftemporomandibular disorders in 18-19 year-olds and to analyze any differences between native born and immigrants. Body esteem and psychological wellbeing were also evaluated. The subjects, n=316, were grouped according to family origin: Group A: both parents born in Sweden (98 girls, 80 boys); Group B:the subject or at least one parent born in Eastern /South Eastern Europe (24 girls, 26 boys) and Group C: Asia (44 girls, 44 boys). Two hundered and sixty-eight participants presented for clinical examination and answered the full questionnaire, and 48 who rejected clinical examination,were interviewed by telephone using selected questions from a questionnaire. The results show that adolescents of Asian origin had a higher self-perceived treatment need than adolescents of Swedish origin. There were negligible inter-group differences with respect to frequency of malocclusion. Forty-four per cent of all participants had previously undergone orthodontic treatment, significantly more Swedish than Asian subjects. Dissatisfaction with dental aesthetics was attributed primarily to tooth colour (38 per cent) and irregular anterior teeth (34 per cent). Adolescents of Asian origin had a higher frequency of headache than those of Eastern/South Eastern European origin. Compared to boys, girls had a higher self-perceived treatment need, a higher frequency of headache and TMD and were more concerned about body appearance. Psychological wellbeing was reduced in nearly one quarter of the participants, predominantly girls: girls of Asian origin had the highest frequency. No association was found between self-perceived orthodontic treatment need
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
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.
Aim: The study aims to know whether modern orthodontic treatment procedure do actually cause permanent bone loss at the alveolar bone crest or improve alveolar bone morphology on labial aspect of permanent incisors which are to be moved lingually. Settings and Design: Manual tracings of pre and post treatment lateral cephalometric radiographs were used. Material and Method: The cephalometric radiographs of 34 adult bengali subjects whose orthodontic treatment involved lingual positioning of procumbent mandibular central incisors were examined to determine the morphologic changes (bone height) in the labial alveolar bone that resulted from orthodontic treatment. Result: Comparison of tracings of radiographs taken before and after treatment indicated that 57.6% shows an increase in labial alveolar bone height, 30.3% shows decreased value and 12.1% shows no change with the decrease in the angulation between long axis of lower incisor and mandibular plane (GoGn). In the increase group there is a significant increase in the distance ‘incisal edge to D point’ whereas this dimension decreased significantly in the rest of the cases. In addition, a significant positive correlation (r = 0.56) was found between the changes in the distance from the incisal edge to the ‘D’ point and the alveolar bone height. But no significant relation was found between alveolar bone height and decrease in angulation of lower incisor either in the ‘increase group’ (r = 0.13, p > 0.05) or in the ‘decrease group’ (r = 0.37, p > 0.05). Conclusion: These findings indicate that during orthodontic treatment that involves lingual positioning of procumbent teeth but no intrusion, an increase in the amount of buccal alveolar bone may take place. PMID:25684908
Vaughan, O B
Periodontal disease during orthodontic therapy is preventable and is controllable and in continuous studies after orthodontic therapy has been completed, it has been shown that under the properly controlled regimen of treatment the destruction to the periodontal tissues of the teeth is not accentuated to a statistically significant degree as greater than that which occurs during the same interim without orthodontic therapy. This encourages us; however, the difficulties cited in the paper above challenges us and our finest professional skills in the proper care of the orthodontic patients with periodontal complications.
Pithon, Matheus Melo
The aim of this article is to report the clinical case of non-surgical treatment of a Class II malocclusion with anterior open bite, associated with absence of a maxillary central incisor avulsed due to trauma. Treatment proceeded with the use of orthodontic mini-implants as an anchorage device for intrusion of the maxillary molars and for mesial movement of the lateral incisor to replace the central incisor. Treatment resulted in good occlusion, with anterior and lateral guides, enhancement of the facial profile, and good dental esthetic appearance without the need for prosthetic treatment. The treatment outcome was satisfactory but needs long-term or permanent retention.
Whitehouse, Joseph A
Adults are now much more in favor of receiving orthodontic treatment than in the past. The baby boomer generation has a deep desire to keep their "youngness" and is willing to invest in such. Along with this attitude has come the ability to treat malocclusions and other clinical deficiencies with new products that decrease the treatment time. Nickel titanium wire has revolutionized the mechanics of treatment, so that often only one wire need be used throughout treatment, and the time of care has been reduced. Invisalign has resulted in higher acceptance rates for treatment that was passed up before. Although Invisalign has its limitations, for most basic alignment, it can provide a nice result. Patients who might come to an office for Invisalign can be open to braces if Invisalign will not correct their problem. In this article, several uses of adult orthodontics have been shown. It behooves the general practitioner to refer those cases that can benefit from the multiple uses of orthodontics. Should the GP desire to learn to perform any or all of the tooth movements necessary to create a more desired outcome, there are several marketed orthodontic courses that will provide the knowledge necessary. Finally, I encourage those who would enjoy treating patients with orthodontic needs. I have found it to be very rewarding to work toward a shared outcome that is often a less invasive treatment. Patients really enjoy the results.
Momeni Danaei, Shahla; Salehi, Parisa
Self-perception of dental attractiveness is an important factor affecting orthodontic treatment need. The purpose of this study was to investigate the association between normative and self-perceived orthodontic treatment need and to evaluate the influence of gender and socioeconomic background such as family size, parental education and father's employment. The subjects were 900 male and female junior high school students (450 males, 450 females) aged 12-15 years, from four districts in the city of Shiraz, Iran. The participants were asked to complete a questionnaire and then underwent a dental examination. Normative treatment need was assessed clinically using the Dental Aesthetic Index (DAI) according to the World Health Organization guidelines. Statistical analysis was undertaken using t- and chi-squared tests. There was no statistically significant correlation between DAI scores and demographics. The results showed a significant correlation between DAI scores and a subject's awareness of malocclusion and their satisfaction with dental appearance. There were no differences between genders concerning the questionnaire data. The results suggest that the DAI score might reflect a self-perceived need for orthodontic treatment.
Baherimoghaddam, T; Tabrizi, R; Naseri, N; Pouzesh, A; Oshagh, M; Torkan, S
The aim of this longitudinal study was to assess and compare the oral health-related quality of life (OHRQoL) of patients with class II and III deformities during and after orthodontic-surgical treatment. Thirty class III and 28 class II patients were evaluated at baseline (T0), just prior to surgery (T1), at 6 months after surgery (T2), and at 12 months after debonding (T3). OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14). Friedman two-way analysis of variance and the Wilcoxon signed-rank test were performed to compare the relative changes in OHRQoL during treatment. Significant changes in the overall OHIP-14 scores were observed during and after orthodontic-surgical treatment in both groups. During the pre-surgical stage, psychological discomfort and psychological disability decreased in class III patients, and class II patients experienced a significant deterioration in psychological discomfort during the same period. Six months after surgery, patients in both groups showed improvements in psychological discomfort, social disability, and handicap. Physical disability and functional limitation showed further improvement at 12 months after debonding in class II patients. This study reaffirms that orthodontic-surgical treatment has a significant effect on the OHRQoL of class III and class II patients.
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.
Nagalakshmi, S.; Sathish, R.; Priya, K.; Dhayanithi, D.
Aim: The aim of our study is to evaluate the changes in quality of life among patients treated for maxillary midline diastema by fixed orthodontic appliances. Materials and Methods: This prospective longitudinal study consists of 40 patients of age group 20-30 years who underwent orthodontic correction of midline diastema. The patient's quality of life is evaluated using 22-item orthognathic quality of life questionnaire. They were evaluated prior to appliance therapy, 1 month after appliance fixation, 4th and 8th month during treatment and 1 month after treatment. Results: Our results showed moderate improvement in quality of life as early as at the start of orthodontic therapy. The response was equal among both sexes. The quality of life experience improved only mildly during the orthodontic treatment. However, the condition specific quality of life at the end of appliance therapy improved by nearly 50% when compared with prior to treatment. Conclusion: Our study has concluded that the correction of midline diastema has improved the quality of life among young people by nearly 50%. The acceptance to orthodontic therapy and patient perception toward fixed appliance has demonstrated remarkable improvement in quality of life during the treatment. Our study calls for additional patient counseling and motivation during the course of fixed appliance therapy. PMID:25210363
Cobo Plana, J; de Carlos Villafranca, F; Macías Escalada, E
One of the general aims of orthodontic treatment and of the combination of orthodontics and orthognathic surgery is to achieve good occlusion and aesthetic improvement, especially in cases of severe dentoskeletal deformities. However, on many occasions, the parameters of the upper airways are not taken into account when the aims of conventional treatment are fulfilled. Patients with obstructive alterations during sleep represent for the orthodontist a type of patient who differs from the normal; for them, treatment should include the objective of improving oxygen saturation. Here, functional considerations should outweigh purely aesthetic ones. It is important, when making an orthodontic, surgical or combined diagnosis for a patient, to bear in mind the impact that treatment may have on the upper airways. Good aesthetics should never be achieved for some of our patients at the expense of diminishing the capacity of their upper airways.
Chang, Hong-Po; Tseng, Yu-Chuan
The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality) obtained by preoperative diagnostic computed tomography (CT) or by cone-beam computed tomography (CBCT) prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.
Espinel, Jesús; Pinedo, Eugenia; Ojeda, Vanesa; del Rio, Maria Guerra
Different treatment modalities have been proposed in the treatment of early gastric cancer (EGC). Endoscopic resection (ER) is an established treatment that allows curative treatment, in selected cases. In addition, ER allows for an accurate histological staging, which is crucial when deciding on the best treatment option for EGC. Recently, endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have become alternatives to surgery in early gastric cancer, mainly in Asian countries. Patients with “standard” criteria can be successfully treated by EMR techniques. Those who meet “expanded” criteria may benefit from treatment by ESD, reducing the need for surgery. Standardized ESD training system is imperative to promulgate effective and safe ESD technique to practices with limited expertise. Although endoscopic resection is an option in patients with EGC, surgical treatment continues to be a widespread therapeutic option worldwide. In this review we tried to point out the treatment modalities for early gastric cancer. PMID:26380052
Altalibi, Mostafa; Saltaji, Humam; Roduta Roberts, Mary; Major, Michael P; MacLean, Joanna; Major, Paul W
Introduction Sleep disordered breathing in the paediatric population can manifest as an array of different systemic symptoms; among them is a distinct malocclusion and craniofacial phenotype. Emerging research suggests that the treatment of this malocclusion and/or craniofacial phenotype through orthodontic intervention may help with the symptoms of these patients. Selecting the patients who would benefit from orthodontic treatment can be a difficult task for the physician with minimal dental training. Therefore the aim of this study is to develop a simple index to be used by medical professionals to identify those paediatric patients with orthodontic treatment needs who may benefit their obstructive sleep apnoea (OSA) symptoms. Methods and analysis The methodology in this project has been devised through the WHO's recommendations on developing an index, with modifications based on the specific needs of this study. Based on the available literature, a draft index will be produced and subjected to multiple iterative revisions based on the feedback from: the Index Development Group, a group of multidisciplinary and internationally acclaimed experts in the field; the External Review Group, a group of potential end users and interested parties and the Steering Committee. Once the index has been formalised, it will be subjected to a pair of reliability tests using physicians and orthodontists scored 2 weeks apart. Subsequently, the index will be validated using dichotomous responses from orthodontists on whether they would treat a patient for OSA symptoms, and comparing the responses to the score of the index on the same patient. Ethics and dissemination The index will be translated into French and will be presented in orthodontic and medical conferences, workshops, seminars, round table discussions, and free copies for download will be made available on the website of the University of Alberta Interdisciplinary Airway Research Clinic (iarc.ualberta.ca). Furthermore
Bonnick, Andrea M; Nalbandian, Mark; Siewe, Marianne S
New technological advances have helped the orthodontic profession progress in traditional and surgical methods of treatment. The profession has seen transitions from traditional braces to self-ligating brackets, lingual braces, removable aligners, and more advanced technology, which have helped to address concerns that include but are not limited to better diagnostics, anchorage control, length of treatment, and esthetics. An increase in the number of adult patients seeking orthodontic treatment and the need for a timely efficient care will continue to drive technology and the use of cone beam computed tomography, miniscrews, piezocision, distraction osteogenesis, and bioengineering.
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
Zawawi, Khalid H; Malki, Ghadah A
Objective: The aim of this study was to compare the amount of root resorption after orthodontic treatment between the bidimensional and the Roth straight-wire techniques. Another objective was to compare the amount of root resorption in the whole sample studied and record the prevalence of root resorption. Materials and Methods: The sample consisted of 40 patients (age ranged between 11 and 18 years) with Angle Class II division 1 malocclusions, treated nonextraction. Twenty patients were treated with bidimensional technique and 20 with a 0.018-inch Roth straight-wire technique. Root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs. Results: The results demonstrated that the bidimensional and Roth straight-wire groups showed significant root resorption after treatment, 1.11 (0.17) and 0.86 (0.05), respectively, P < 0.001. When comparing the amount of root shortening between the bidimensional and Roth straight-wire groups, there was no significant difference between the mean change from pre- to post-treatment between bidimensional group (mean = 1.00 ± 1.34) and Roth straight-wire group (mean = 0.88 ± 0.86), P = 0.63. Considering the whole sample, there was no root resoprtion in 32.5% of the analysed teeth. There was only mild resorption in 56.2%, moderate in 8.8% and severe in only 2.5% of the teeth. Conclusions: Treatment with the bidimensional technique did not produce an increase in the amount of root resorption. The prevalence and amount of root resorption was similar between bidimensional and Roth straight-wire techniques. PMID:25426453
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.
Singh, Harpreet; Srivastava, Dhirendra; Kapoor, Pranav; Sharma, Poonam
This case report describes the successful treatment of a patient with mandibular laterognathism and associated facial asymmetry with combined surgical orthodontic approach. After 7 months of presurgical orthodontic treatment, intraoral vertical ramus osteotomy, and straightening genioplasty were performed as two step surgeries to reposition the deviated mandible and chin, respectively. The total active treatment period was 14 months. After surgical orthodontic treatment, significant improvement in occlusion, masticatory function, and facial appearance was discernible. Posttreatment records at 3 years showed stable results with good occlusion. PMID:27127755
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.
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
Tanimoto, Yuko; Miyawaki, Shouichi; Imai, Mikako; Takeda, Ryoko; Takano-Yamamoto, Teruko
An eight-year-, four-month-old girl was brought to the orthodontic clinic of Okayama University Medical and Dental Hospital. The patient had an impacted upper left second premolar because of an odontogenic keratocyst and showed a skeletal Class II jaw base relationship. At the age of six years four months, marsupialization of a cyst was performed at the Okayama University Medical and Dental Hospital because the patient had shown a swelling of the left cheek because of the cyst. The upper left second premolar was located in the roof of the maxillary sinus. The cyst was histopathologically diagnosed as an odontogenic keratocyst. At the age of nine years 10 months and after regaining the space for eruption of the premolar, the impacted premolar erupted without traction. At the age of 12 years five months, edgewise treatment was initiated, which continued for three years. After removing the edgewise appliance, an optimum occlusion was achieved. The occlusion was maintained without recurrence of the keratocyst after a retention period of five years.
Michelotti, A; Iodice, G
Temporomandibular Disorder (TMD) is the main cause of pain of non-dental origin in the oro-facial region including head, face and related structures. The aetiology and the pathophysiology of TMD is poorly understood. It is generally accepted that the aetiology is multifactorial, involving a large number of direct and indirect causal factors. Among such factors, occlusion is frequently cited as one of the major aetiological factors causing TMD. It is well known from epidemiologic studies that TMD-related signs and symptoms, particularly temporomandibular joint (TMJ) sounds, are frequently found in children and adolescents and show increased prevalence among subjects between 15 and 45 years old. Aesthetic awareness, the development of new aesthetic orthodontic techniques and the possibility of improving prosthetic rehabilitation has increased the number of adults seeking orthodontic treatment. The shift in patient age also has increased the likelihood of patients presenting with signs and symptoms of TMD. Because orthodontic treatment lasts around 2 years, orthodontic patients may complain about TMD during or after treatment and orthodontists may be blamed for causing TMD by unsatisfied patients. This hypothesis of causality has led to legal problems for dentists and orthodontists. For these reasons, the interest in the relationship between occlusal factors, orthodontic treatment and TMD has grown and many studies have been conducted. Indeed, claims that orthodontic treatment may cause or cure TMD should be supported by good evidence. Hence, the aim of this article is to critically review evidence for a possible association between malocclusion, orthodontic treatment and TMD.
... 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, ...
Rhee, Chang-Hoon; Choi, Youn-Kyung; Kim, Seong-Sik; Park, Soo-Byung; Son, Woo-Sung
Objective To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods A retrospective study of 34 patients (23 men, 11 women; mean age, 26.2 ± 6.6 years) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results The significant T0 to T1 mandibular changes occurred -9.24 ± 3.97 mm horizontally. From T1 to T2, the mandible tended to move forward 1.22 ± 2.02 mm, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment. PMID:25798411
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.
An early diagnosis of strabismus is important in order to rule out treatable organic causes and in children, if indicated, to start as early as possible with an amblyopia treatment. Early detection will also decrease the risk for accidents secondary to diplopia, to the loss of binocular vision and to the restriction of the binocular visual field in case of esodeviations. The following therapeutic options exist: in some cases the prescription of the correct refraction will be sufficient, for small deviations a prismatic correction may allow a longstanding treatment, for larger or incomitant deviations strabismus surgery will be necessary, which nowadays can be performed using minimal-invasive technique on an outpatient base.
Seyyed Aghamiri, S M; Ahmadabadi, M Nili; Raygan, Sh
The shape memory nickel-titanium alloy has been applied in many fields due to its unique thermal and mechanical performance. One of the successful applications of NiTi wires is in orthodontics because of its good characteristics such as low stiffness, high spring back, high stored energy, biocompatibility, superelasticity and shape memory effect. The mechanical properties of wires are paid special attention which results in achieving continuous optimal forces and eventually causing rapid tooth movement without any damage. The behavior of the alloy can be controlled by chemical composition and thermo-mechanical treatment during the manufacturing process. In this study two kinds of commercial superelastic NiTi archwires of 0.41 mm diameter were investigated: Copper NiTi and Highland Metal. The chemical analysis of both wires was estimated by energy dispersive spectroscopy (EDS). It was showed that Copper NiTi wire contained copper and chromium. The two types of wires were exposed to different heat treatment conditions at 400 and 500 °C for 10 and 60 min to compare the behavior of the wires at aged and as-received conditions. Phase transformation temperatures clarified by differential scanning calorimetry (DSC) showed B2 <--> R <--> B19 transformation in Highland Metal wire and B2 <--> B19(') transformation in Copper NiTi wire. Three point bending (TPB) tests in the certain designed fixture were performed at 37 °C to evaluate the mechanical behavior of the wires. The experimental results revealed the superelastic behavior of the Highland Metal wire after 60 min ageing at 400 and 500 °C and the plastic deformation of the Copper NiTi wire after annealing due to the effect of copper in the alloy composition.
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.
McCarthy, Eileen; Cobb, Alistair R M
A case is presented of a 14-year-old female undergoing orthodontic fixed appliance treatment who presented with right facial swelling in the parotid region. An initial diagnosis of acute infective parotitis was made by her primary care clinician. However, after clinical examination and ultrasonographic imaging, a diagnosis of salivary stasis secondary to inflammatory occlusion of Stensen's ductal orifice was made. The ductal orifice had been traumatized by the adjacent orthodontic appliance. This has not been described before in the literature. The differential diagnosis of parotid enlargement in children is discussed.
Klein, C; Howaldt, H P
The sole orthodontic treatment of severe dysgnathias in childhood often leads to unsatisfactory results. On the other hand, standard surgical procedures are very difficult and due to their high risks not practicable in early childhood. The distraction osteogenesis enables us to correct hypoplastic mandibles, so that secondary malformations of the midfacial complex can be avoided. During the operation the hypoplastic site of the mandible is osteotomized behind the last visible tooth bud and a bidirectional distractor is inserted. Following the principles of Ilizarov the new callus is lengthened gradually until the required length of the mandible has been achieved. Out of a total sample of 27 patients 3 case reports of young children are presented. The new surgical concept describes new treatment perspectives.
Nayak, Rabindra S; Khanna, Bharti; Pasha, Azam; Vinay, K; Narayan, Anjali; Chaitra, K
Background: 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). Materials and Methods: 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. Results: 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. Conclusion: 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
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.
Kuijpers, M A R; Kuijpers-Jagtman, A M
With regard to the optimal treatment timing for children with an Angle Class II division 1 malocclusion, there is an ongoing controversy on the effectiveness of a two-phase or a one-phase therapy. Two-phase treatment involves a first phase to correct the jaw relationship starting at the age of 7 to 9 years, and, when all permanent teeth are present, a second phase of treatment by fixed appliances. A one-phase treatment involves treatment of the jaw relationship and the dental malocclusion simultaneously or consecutively, starting during the early adolescence period. In recent years, several randomized controlled clinical trials have been performed on this topic. More recently, a Cochrane meta-analysis of these trials has been published. The results show that early treatment of an Angle Class II division 1 malocclusion followed by a second phase of treatment does not have any advantages over treatment that is started later and finished in one phase. One-phase treatment is as effective as two-phase treatment, while the time needed for treatment is shorter and, as a consequence, total costs are lower. Dentists should take into account this information, when treating children with an Angle Class II division 1 malocclusion or referring them to an orthodontist.
Nakajima, Kan; Yamaguchi, Tetsutaro; Maki, Koutaro
We report here the case of a woman with Class III malocclusion and advanced periodontal disease who was treated with surgical orthodontic correction. Functional recovery after orthodontic treatment is often monitored by serial electromyography of the masticatory muscles, whereas 3-dimensional cone-beam computed tomography can provide detailed structural information about, for example, periodontal bone defects. However, it is unclear whether the information obtained via these methods is sufficient to determine the treatment goal. It might be useful to address this issue for patients with advanced periodontal disease because of much variability between patients in the determination of treatment goals. We used detailed information obtained by 3-dimensional cone-beam computed tomography to identify periodontal bone defects and set appropriate treatment goals for inclination of the incisors and mandibular surgery. Results for this patient included stable occlusion and improved facial esthetics. This case report illustrates the benefits of establishing treatment goals acceptable to the patient, based on precise 3-dimensional assessment of dentoalveolar bone, and by using masticatory muscle activity to monitor the stability of occlusion.
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.
Zorich, M E; Iatskevich, O S; Ivanov, S Iu; Muraev, A A
Class II malocclusions are of interest to the practicing orthodontists since they constitute a significant percentage of the cases they treat. The process of establishing a treatment plan requires an assessment of therapeutic modifiability. The purpose of this article is to provide a perspective on the characteristics, development, etiology and broad treatment consideration in Class II malocclusions.
Egermark, Inger; Magnusson, Tomas; Carlsson, Gunnar E
This investigation analyzes the influence of orthodontic treatment on signs and symptoms of temporomandibular disorders (TMDs) and different malocclusions during a 20-year period. Originally, 402 randomly selected 7-, 11-, and 15-year-old subjects were examined clinically and by means of a questionnaire for signs and symptoms of TMDs. The examination was repeated after five and ten years. After 20 years, 320 subjects (85% of the traced subjects) completed the questionnaire. The oldest age group,now 35 years of age, was invited to a clinical examination, and 100 subjects (81% of the traced subjects) were examined. The correlations between signs and symptoms of TMD and different malocclusions were mainly weak, although sometimes statistically significant. Lateral forced bite and unilateral crossbite were correlated with TMD signs and symptoms at the 10- and 20-year follow-ups (r = 0.38, P < .05 and r = 0.34, P < .01, respectively). Subjects with malocclusion over a long period of time tended to report more symptoms of TMD and to show a higher dysfunction index, compared with subjects with no malocclusion at all. There were no statistically significant differences in the prevalence of TMD signs and symptoms between subjects with or without previous experience of orthodontic treatment. This 20-year follow-up supports the opinion that no single occlusal factor is of major importance for the development of TMD, but a lateral forced bite between retruded contact position (RCP) and intercuspal position (ICP), as well as unilateral crossbite, may be a potential risk factor in this respect. Furthermore, subjects with a history of orthodontic treatment do not run a higher risk of developing TMD later in life, compared with subjects with no such experience.
Pagani, Renato; Signorino, Fabrizio; Poli, Pier Paolo; Manzini, Pietro; Panisi, Irene
The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time.
The approach to skeletal dysmorphisms in the maxillofacial area usually requires an orthodontic treatment by means of fixed appliances, both before and after the surgical phase. Since its introduction, Invisalign system has become a popular treatment choice for the clinicians because of the aesthetics and comfort of the removable clear aligners compared with the traditional appliances. Therefore, the aim of the present report was to illustrate the management of a malocclusion by means of Invisalign system associated with the traditional surgical technique. The present paper shows a case of a 23-year-old male patient characterized by a Class III malocclusion with lateral deviation of the mandible to the left side and cross-bite on teeth 2.2, 2.3, and 2.4. Invisalign system was used during the pre- and postsurgical phases rather than fixed appliances. The posttreatment cephalometric analysis emphasized the stability of the dental and skeletal symmetry corrections, occlusion and functional balance, over a 6-year follow-up. The results achieved at the end of the treatment showed how Invisalign can be effective in the management of the orthodontic phases in orthognathic surgery. The follow-up after 6 years emphasizes the stability of the treatment over time. PMID:27429811
Nervina, J M
Cone beam computed tomography (CBCT) is widely used by orthodontists to obtain three-dimensional (3-D) images of their patients. This is of value as malocclusion results from discrepancies in three planes of space. This review tracks the use of CBCT in orthodontics, from its validation as an accurate and reliable tool, to its use in diagnosing and treatment planning, and in assessing treatment outcomes in orthodontics.
Lazo Gonzalez, Eduardo; Hilgenfeld, Tim; Kickingereder, Philipp; Bendszus, Martin; Heiland, Sabine; Ozga, Ann-Kathrin; Sommer, Andreas; Lux, Christopher J.; Zingler, Sebastian
Objective 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. Methods 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. Results 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). Conclusions 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. PMID:28334054
Motamedi, Alimohammad K.; Dadgar, Sepideh; Teimouri, Fatemeh; Aslani, Farzin
Background: The aim of this study was to determine the pattern and amount of change exhibited in mandibular intercanine and intermolar width during treatment and assessing its stability1-3 years post-retention. Materials and Methods: The material consisted of 70 cases of which 20 cases were treated without extraction and 30 cases were treated with extraction, which were compared with 20 untreated cases which served as a control group. A series of three measurements were made for each case of the treated group: At the beginning of treatment, end of active treatment and 1-3 years post-retention; and for the control group: At 12, 15 and 18 years of age. The Wilcoxon signed ranks test was used to evaluate treatment changes in each group. The Kruskal-Wallis H test was used to compare the treatment changes between the 3 groups (α = 0.05). SPSS 16 software (SPSS Inc., Chicago, IL, USA) was used to evaluate the data. Results: Mean changes of intercanine width for three groups was −0.5 mm for control group, −0.26 mm for non-extraction group and +0.18 mm for extraction group. Intermolar width of the extraction group decreased significantly during treatment. In contrast to the extraction group, the control and non-extraction groups both demonstrated an increase in mean intermolar width which was 0.66 mm and 0.91 mm respectively. Conclusion: It was concluded that although mean changes of intercanine and intermolar width were statistically significant but they were not perceptible clinically. PMID:25709678
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.
Mattick, C R
There are potential religious, cultural and ethical dilemmas facing patients who are undergoing orthodontic treatment. Opinions were collected from religious and cultural leaders, as well as from non-religious groups who take an ethical standpoint on certain medical or dental treatment. Factors relating to ingredients in orthodontic products, timing of orthodontic appointments, and the effects of religious fasting are all discussed. It is important to recognize all patients' opinions and beliefs when planning and undertaking orthodontic treatment.
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.
Sapir, S; Shapira, J
Dentinogenesis imperfecta (DI) type 2 is a disease inherited in a simple autosomal dominant mode. As soon as the teeth erupt the parents may notice the problem and look for a pediatric dentist's advice and treatment. Early diagnosis and treatment of DI is recommended, as it may prevent or intercept deterioration of the teeth and occlusion and improve esthetics. The purpose of this article is to present the objectives, treatment options, and problems encountered in the treatment of DI in the early primary dentition. A two-stage treatment of a toddler under general anesthesia is described and discussed. This paper recommends for severe cases of DI two treatment stages performed under general anesthesia. Stage 1 is early (around age 18-20 months) and is directed to covering the incisors with composite restorations and the first primary molars with preformed crowns. Stage 2 (around age 28-30 months) seeks to protect the second primary molars with preformed crowns and cover the canines with composite restorations.
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.
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.
Hocevar, R A
Conventional Begg technique is efficacious for alignment, overbite reduction, and anchorage conservation, but it has a number of deficiencies. Biomechanical systems should be determined by the characteristics of each individual malocclusion, not by habitual application of the same recipe to every patient. Check elastics can increase the bite-opening potency of the appliance, thus permitting control of root movement at any stage. Ribbon arch wires can provide torque control for either bolstering or expending anchorage. Extraoral traction can provide anchorage, control of orientation of the dentition within the face, and simplify and/or shorten treatment in some cases.
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.
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
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.
Mukherjee, P M; Almas, K
Gingivitis is caused by several known systemic and local factors. Among systemic factors, the role of hormonal changes during pregnancy is well established. While presence of fixed orthodontic appliances alone may not cause gingivitis, factors such as pregnancy and poor oral hygiene combined together could precipitate acute gingival inflammation that may progress to a periodontal condition in a patient receiving orthodontic therapy. There has been an increase in the number of adult patients who are receiving orthodontic treatment. Orthodontic appliances could act as a potential plaque retentive source and aggravate inflammatory reactions that are seen during pregnancy. There is a lack of awareness regarding oral healthcare issues among patients who are pregnant and choose to seek orthodontic treatment. In addition, there is a need in the literature to outline management guidelines for patients who want to receive orthodontic treatment during pregnancy, with or without pre-existing gingival conditions. This review focuses on the aetiology of pregnancy gingivitis and the management of orthodontic patients during pregnancy. Our emphasis is on patient education, oral hygiene maintenance, preventive and treatment strategies for the management of gingival health in orthodontic patients during pregnancy. We also highlight some of the possible complications of initiating orthodontic treatment during pregnancy.
The story of orthodontics during the first 100 years of Journal publication can be told through the people who lived it. As part of the American Journal of Orthodontics and Dentofacial Orthopedics' Centennial Celebration, we present 100 people who most influenced the specialty during the last 100 years. Part 1 describes the orthodontic pioneers who were born in the 1800 s. They were broadly educated in the sciences, and most studied orthodontics with Angle, Dewey, or Lischer. They were innovators and inventors, and they laid the foundation of the specialty during the early years of the 20th century.
The introduction of modern quality thinking to orthodontic care should be a continuing effort on the part of the orthodontic profession. The strategy for the development of a European quality management system in orthodontic care was developed from 1993 to 2000 during the EURO-QUAL project. During the project's first stage, the basic prerequisites were identified for a general model of quality management in orthodontic care. A supra-national agreement was reached on policy statements for orthodontic care in Europe. The essential components of an orthodontic quality management system are: linking orthodontic care to population need, patient partnership, clinical accountability, and containing costs.Value-based health care and "TQM", the philosophy of total quality management, are basic principles applied in accordance with the recommendations of the European Health Committee of September 1997 and the "Health-for-All" policy framework of the World Health Organization.
Shivakumar, KM; Chandu, GN; Shafiulla, MD
Objectives: To assess the severity of malocclusion and orthodontic treatment needs among 12- to 15-year-old school children of Davangere District, India, by using the Dental Aesthetic Index (DAI). Methods: A descriptive cross-sectional study was conducted among 1800 12- to 15-year-old school children of Davangere District, Karnataka, India. Talukas (administrative units in some states in India) were considered clusters. Schools were selected using simple random sampling procedures. The 300 study subjects were selected using systematic random sampling procedures. Data consisting of DAI components were recorded pro forma. The collected data were subjected to statistical analysis. The Chi-square test (χ2) was used to compare malocclusion severity. The analysis of variance (ANOVA) test was used to compare the changes in DAI scores and the mean DAI scores between age groups. The Z test was used to compare mean DAI scores between the 2 sexes and between children residing in urban and rural areas. Results: Of the 1800 school children examined, 899 (49.9%) were boys and 901 (50.1%) were girls. Most of the children (79.9%) had DAI scores ≤ 25 with no or minor malocclusion requiring no or little treatment, 15.4% had DAI scores of 26–30 with definite malocclusion requiring elective treatment, 4.2% had DAI scores of 31–35 with severe malocclusion requiring highly desirable treatment, and 0.5% had DAI scores ≥ 36 with handicapping malocclusion requiring mandatory treatment. Conclusions: The majority of the children in our study (79.9%) required no or little treatment; 20.1% had definite malocclusion requiring definite orthodontic treatment. PMID:20613919
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
Teittinen, Marjut; Tuovinen, Veikko; Tammela, Leena; Schätzle, Marc; Peltomäki, Timo
In adults, superior repositioning of posterior maxilla with or without mandibular surgery has become the treatment method of choice to close anterior open bite. Study aim was to examine the long-term stability of anterior open bite closure by superior repositioning of maxilla or by combining maxillary impaction with mandibular surgery. The sample comprised 24 patients who underwent anterior open bite closure by superior repositioning of maxilla (maxillary group, n = 12, mean age 29.3 years) or by maxillary impaction and mandibular osteotomy (bimaxillary group, n = 12, mean age 30.8 years). Lateral cephalograms were studied prior to surgery (T1), the first post-operative day (T2) and in the long term (T3, maxillary group mean 3.5 years; bimaxillary group mean 2.0 years). Paired and two-sample t-tests were used to assess differences within and between the groups. The vertical incisal bite relations were -2.6 and -2.2 mm at T1; 1.23 and 0.98 mm at T2; and 1.85 and 0.73 mm at T3 in the maxillary and bimaxillary groups. At T3, all subjects had positive overbite in the maxillary group, but open bite recurred in three subjects with bimaxillary surgery. For both groups, the maxilla relapsed vertically. Significant changes in sagittal and vertical positions of the mandible occurred in both groups. In the bimaxillary group, the changes were larger and statistically significant. In general, the maxilla seems to relapse moderately vertically and the mandible both vertically and sagittally, particularly when both jaws were operated on. Overbite seems to be more stable when only the maxilla has been operated on.
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.
This case report presents a patient who is undergoing orthodontic treatment with upper and lower fixed appliance. An interesting point on this case is that the patient only uses Miswak as her oral hygiene tool due to her religious belief. The oral hygiene protocol was allowed and her oral health was closely monitored throughout her orthodontic treatment. PMID:27994891
This case report presents a patient who is undergoing orthodontic treatment with upper and lower fixed appliance. An interesting point on this case is that the patient only uses Miswak as her oral hygiene tool due to her religious belief. The oral hygiene protocol was allowed and her oral health was closely monitored throughout her orthodontic treatment.
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).
Machado, Genevive L
The application of innovative technologies in dentistry and orthodontics has been very interesting to observe. The development of cone-beam computed tomography (CBCT) as a preferred imaging procedure for comprehensive orthodontic treatment is of particular interest. The information obtained from CBCT imaging provides several substantial advantages. For example, CBCT imaging provides accurate measurements, improves localization of impacted teeth, provides visualization of airway abnormalities, it identifies and quantifies asymmetry, it can be used to assess periodontal structures, to identify endodontic problems, to plan placement sites for temporary skeletal anchorage devices, and to view condylar positions and temporomandibular joint (TMJ) bony structures according to the practitioner's knowledge at the time of orthodontic diagnosis. Moreover, CBCT imaging involves only a minimal increase in radiation dose relative to combined diagnostic modern digital panoramic and cephalometric imaging. The aim of this article is to provide a comprehensive overview of CBCT imaging, including its technique, advantages, and applications in orthodontics.
Machado, Genevive L.
The application of innovative technologies in dentistry and orthodontics has been very interesting to observe. The development of cone-beam computed tomography (CBCT) as a preferred imaging procedure for comprehensive orthodontic treatment is of particular interest. The information obtained from CBCT imaging provides several substantial advantages. For example, CBCT imaging provides accurate measurements, improves localization of impacted teeth, provides visualization of airway abnormalities, it identifies and quantifies asymmetry, it can be used to assess periodontal structures, to identify endodontic problems, to plan placement sites for temporary skeletal anchorage devices, and to view condylar positions and temporomandibular joint (TMJ) bony structures according to the practitioner’s knowledge at the time of orthodontic diagnosis. Moreover, CBCT imaging involves only a minimal increase in radiation dose relative to combined diagnostic modern digital panoramic and cephalometric imaging. The aim of this article is to provide a comprehensive overview of CBCT imaging, including its technique, advantages, and applications in orthodontics. PMID:25544810
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.
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
Early-onset scoliosis, which appears before the age of 10, can be due to congenital vertebral anomalies, neuromuscular diseases, scoliosis-associated syndromes, or idiopathic causes. It can have serious consequences for lung development and significantly reduce the life expectancy compared to adolescent scoliosis. Extended posterior fusion must be avoided to prevent the crankshaft phenomenon, uneven growth of the trunk and especially restrictive lung disease. Conservative (non-surgical) treatment is used first. If this fails, fusionless surgery can be performed to delay the final fusion procedure until the patient is older. The gold standard delaying surgical treatment is the implantation of growing rods as described by Moe and colleagues in the mid-1980s. These rods, which are lengthened during short surgical procedures at regular intervals, curb the scoliosis progression until the patient reaches an age where fusion can be performed. Knowledge of this technique and its complications has led to several mechanical improvements being made, namely use of rods that can be distracted magnetically on an outpatient basis, without the need for anesthesia. Devices based on the same principle have been designed that preferentially attach to the ribs to specifically address chest wall and spine dysplasia. The second category of surgical devices consists of rods used to guide spinal growth that do not require repeated surgical procedures. The third type of fusionless surgical treatment involves slowing the growth of the scoliosis convexity to help reduce the Cobb angle. The indications are constantly changing. Improvements in surgical techniques and greater surgeon experience may help to reduce the number of complications and make this lengthy treatment acceptable to patients and their family. Long-term effects of surgery on the Cobb angle have not been compared to those involving conservative "delaying" treatments. Because the latter has fewer complications associated with
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.
[How to push the limits in the transverse dimension? Facial asymmetry, palatal volume and tongue posture in children with unilateral posterior cross bite: a three-dimensional evaluation of early treatment].
Ovsenik, Maja; Primožič, Jasmina
Unilateral posterior crossbites have been reported to be one of the most prevalent malocclusions of the primary dentition in Caucasian children. Facial asymmetry due to lateral mandibular displacement in unilateral posterior crossbite, if not treated in the primary dentition period, may lead to an undesirable growth modification which results in facial asymmetry of skeletal origin. Irregular tongue function and posture have also been diagnosed as important etiological factors. Early orthodontic treatment seems to be profitable and desirable to create conditions for normal dental, functional and skeletal development of the orofacial region. Treatment success after correction of unilateral posterior crossbite in the primary dentition is highly questionable, as it is very difficult to objectively assess correction of facial asymmetry and irregular tongue function and posture in small, growing children. Although facial photography is an important diagnostic tool in orthodontics, its main disadvantage is that it represents a three dimensional subject in two dimensions. Tongue posture and function during clinical examination are difficult to assess and is therefore unreliable. Contemporary 3D diagnostics in unilateral posterior crossbite enables uninvasive, valid and objective assessment of facial morphology, palatal volume, tongue function and posture. It can, therefore, become in the future an important part of morphological and functional diagnostics in orthodontics and dentofacial orthopedics before, during and after orthodontic treatment.
Janson, Marcos; Janson, Guilherme; Murillo-Goizueta, Oscar Edwin Francisco
An interdisciplinary approach is often the best option for achieving a predictable outcome for an adult patient with complex clinical problems. This case report demonstrates the combined periodontal/orthodontic treatment for a 49-year-old woman presenting with a Class II Division 1 malocclusion with moderate maxillary anterior crowding, a 9-mm overjet, and moderate to severe bone loss as the main characteristics of the periodontal disease. The orthodontic treatment included 2 maxillary first premolar extractions through forced extrusion. Active orthodontic treatment was completed in 30 months. The treatment outcomes, including the periodontal condition, were stable 17 months after active orthodontic treatment. The advantages of this interdisciplinary approach are discussed. Periodontally compromised orthodontic patients can be satisfactorily treated, achieving most of the conventional orthodontic goals, if a combined orthodontic/periodontic approach is used.
Okeson, Jeffrey P
Occlusion has been an important consideration in orthodontics since the beginning of the discipline. Early emphasis was placed on the alignment of the teeth, the stability of the intercuspal position, and the esthetic value of proper tooth positioning. These factors remain important to orthodontists, but orthopedic principles associated with masticatory functions must also be considered. Orthopedic stability in the masticatory structures should be a routine treatment goal to help reduce risk factors associated with developing temporomandibular disorders.
Noar, J H; Sharma, S; Roberts-Harry, D; Qureshi, T
There is currently considerable interest from general dental practitioners (GDPs) in the use of simple orthodontics to treat adult malocclusions. There is controversy in this, particularly in relation to 'quick fixes', simple orthodontics and 'straight teeth in six months' as opposed to more conventional treatment where the whole malocclusion is treated. This article will present a case for the use of simple aesthetic adult orthodontics in a measured and planned way. It will discuss the processes, planning and the importance of consent. It will also highlight how digital technology is used to preview, consent and execute an aesthetic result. Many of the recent systems emerging, have been as a result of the demand and supply of cosmetic dentistry. This, to a degree, has not helped since the implication of a 'quick-fix' is associated with this field. There has also been discussion on what the limits of GDP orthodontics should be. There is variability in how GDPs approach orthodontics, their experience, skill and ability to treat to an acceptable standard. Short courses may be one way of delivering orthodontic training but some of these courses are not regulated and the amount of internal mentoring is variable. This article highlights some of the systems in use, and potential upsides and downsides of this approach.
Kumar, A Anand; Saravanan, K; Kohila, K; Kumar, S Sathesh
Tooth movement by orthodontic treatment is characterized by remodeling changes in the periodontal ligament, alveolar bone, and gingiva. A reflection of these phenomenons can be found in the gingival crevicular fluid (GCF) of moving teeth, with significant elevations in the concentrations of its components like, cytokines, neurotransmitters, growth Factors, and a arachidonic acid metabolites. GCF arises at the gingival margin and can be described as a transudate or an exudate. Several studies have focused on the composition of GCF and the changes that occur during orthodontic tooth movement (OTM). GCF component analysis is a non-invasive method for studying the cellular response of the underlying periodontium. Clinically, GCF can be easily collected using platinum loops, filter paper strips, gingival washings, and micropipettes. A number of GCF biomarkers involve in bone remodeling during OTM. The data suggest that knowledge of all the biomarkers present in the GCF that can be used to mark the changes in tooth that is undergoing orthodontic treatment may be of clinical usefulness leading to proper choice of mechanical stress to improve and to shorten treatment time and avoid side effects.
Ireland, A J
Orthodontic treatment appears to be in ever-increasing demand, but the number of specialists is insufficient to meet the current need. This article considers the role of the extended practitioner training scheme in the present climate of uncertainty surrounding orthodontics in the general dental services in the UK, particularly for the general dental practitioner.
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Orthodontic appliance and accessories. 872.5410 Section 872.5410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... orthodontic treatment. The device is affixed to a tooth so that pressure can be exerted on the teeth....
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Orthodontic appliance and accessories. 872.5410 Section 872.5410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... orthodontic treatment. The device is affixed to a tooth so that pressure can be exerted on the teeth....
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Orthodontic appliance and accessories. 872.5410 Section 872.5410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... orthodontic treatment. The device is affixed to a tooth so that pressure can be exerted on the teeth....
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Orthodontic appliance and accessories. 872.5410 Section 872.5410 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... orthodontic treatment. The device is affixed to a tooth so that pressure can be exerted on the teeth....
Manasse, Robert J.; Dooley, Raynard J.
A study undertaken to determine the extent of orthodontic referrals and treatment performed by general dentists is discussed. Results indicate that general practitioners who graduated after 1945 tend to make more referrals, and general practitioners who had treated patients orthodontically in their predoctoral training tend to continue in…
Lawrence, A J; Wright, F A; D'Adamo, S P
Information regarding orthodontic service provision by general dental practitioners in Australia is limited. The aim of this survey was to determine the amount and variety of orthodontic services provided by general dental practitioners in the Melbourne Statistical Division, Victoria, Australia. A random sample of 307 dentists drawn from the Victorian Dentists Register was surveyed by mailed questionnaire: 218 (71%) replied. Data were collected using a fortnight log. During this time 59 per cent of the dentists saw at least one orthodontic patient; one dentist saw 66 orthodontic patients. Removable orthodontic appliances were used by 35 per cent of the dentists and fixed orthodontic appliances by 18 per cent. Twenty-six per cent provided comprehensive orthodontic treatment, 22 per cent aligned incisors, and 21 per cent corrected anterior crossbites. The general dental practitioners surveyed provided a wide range of preventive and interceptive orthodontic services to generally a small percentage of their patients.
higher incidence of car- ies in patients undergoing orthodontic treatment . Areas of ena- mel demineralization are often observed after removal of...producing latic acid play a major role in enamel decalcification during orthodontic treatment . The scoring method used for visual observation was partly... orthodontic treatment . Am J. Ortho 75: 416-420 4. Tillery, T.J., Hembree,J.H., and Weber, F.N. 1976, Preventing enamel decalcification during orthodontic
Chu, L W
With ageing of populations, the worldwide population of persons with dementia will reach over 81 million by 2040, of which the most common cause is Alzheimer's disease. In recent years, there have been major advances in the understanding of its pathogenesis, methods to diagnose it, and treatment. Magnetic resonance brain imaging, cerebrospinal fluid biomarkers, and Pittsburgh compound B and fluorodeoxyglucose positron emission tomography of the brain can facilitate an accurate diagnosis of Alzheimer's disease in its early stage, and diagnose the mild cognitive impairment stage of Alzheimer's disease. At present, only symptomatic but not disease-modifying drug treatments are available. Donepezil, rivastigmine and galantamine are the currently approved cholinesterase inhibitors for the treatment of mild, moderate, and severe Alzheimer's disease. Overall, cholinesterase inhibitors show beneficial effects on cognition, activity of daily living, behaviour, and overall clinical rating. Memantine is another symptomatic treatment for moderate-to-severe Alzheimer's disease patients. It has a small beneficial effect on cognition, activity of daily living, behaviour, and overall clinical rating. Vitamin E has antioxidant properties, and may be used in some Alzheimer's disease patients without vascular risk factors. Concurrent non-pharmacological and psychosocial management of patients and their caregivers have a very important role. Disease-modifying therapies are still under development, whilst immunotherapy may be a viable option in the near future.
Klang, Elisabeth; Helms, Hans-Joachim; Wiechmann, Dirk
Summary Background: Using lingual enamel surfaces for bracket placement not only has esthetic advantages, but may also be suitable in terms of reducing frequencies of enamel decalcifications. Objective: To test the null-hypothesis that there is no significant difference in enamel decalcification or cavitation incidence adjacent to and beneath bracket bases between two lingual multi-bracket (MB) appliances that are different in terms of design, material composition, and manufacturing technology (group A: WIN, DW-LingualSystems; group B: Incognito, 3M-Unitek), taking into account patient- and treatment-related variables on white spot lesion (WSL) formation. Methods: Standardized, digital, top-view photographs of 630 consecutive subjects (16214 teeth; n Incognito = 237/6076 teeth; n WIN = 393/10138 teeth; mean age: 17.47±7.8; m/f 43.2/56.8%) with completed lingual MB treatment of the upper and lower permanent teeth 1–7 were screened for decalcification or cavitation adjacent to and beneath the bracket bases before and after treatment, scored from 0 to 7. Non-parametric ANOVA was used for main effects ‘appliance type’, ‘gender’, ‘treatment complexity’, ‘grouped age’ (≤16/>16 years), and ‘treatment duration’ as covariable, at an α-level of 5%. Results: About 2.57% [5.94%] of all teeth in group A [B] developed decalcifications. Subject-related incidence was 9.59% [16.17%] for upper incisors in group A [B], and 12.98% [25.74%] for all teeth 16–46. There were significant effects by gender, age, and treatment duration. Conclusion: The null-hypothesis was rejected: sub-bracket lesions were significantly less frequent in group A, while frequencies of WSL adjacent to brackets were not significantly affected by appliance type. In view of the overall low incidences of lingual post-orthodontic white-spot lesions, the use of lingual appliances is advocated as a valid strategy for a reduction of enamel decalcifications during orthodontic treatment. PMID
Pepe, S.; Pepe, W. D.; Strauss, A. M.
A general theory of orthodontic motion is developed that can be applied to determine the forces necessary to induce a given tooth to move to the predetermined desirable position. It is assumed that the natural (nonorthodontic) forces may be represented by a periodic function and the orthodontic forces may be superimposed upon the natural forces. A simple expression is derived for the applied stress.
Grauer, Dan; Cevidanes, Lucia H.; Tyndall, Donald; Styner, Martin A.; Flood, Patrick M.; Proffit, William R.
Current methods to assess outcomes and change in orthodontics are comparison of photographs, cephalometric measurements and superimpositions, and comparisons/measurements on dental casts. Digital models are a relatively new records modality in orthodontics. They offer numerous advantages in terms of storage space, spatial registration and superimposition. The purpose of this chapter is to determine the reproducibility of: 1) establishing occlusion of independently scanned digital models; and 2) registering digital models obtained after treatment on their homologous digital model setups produced before treatment. Reliability of both procedures was assessed with two random samples of five patient’s models. In both experiments, three replicate positionings of the models per patient were created and variability in position was evaluated by the maximum surface difference between replicates, and the standard deviation of the surface distances between replicates respectively. Based on the data obtained, we concluded that it is reliable to register independently scanned models to a scanned surface of the models in occlusion. Surface-to-surface registration of final orthodontic digital models to planned setup models also is reproducible. PMID:26549917
Bethea, Terrence C.; Sikich, Linmarie
Autism is a dynamic neurodevelopmental syndrome in which disabilities emerge during the first three postnatal years and continue to evolve with ongoing development. We briefly review research in autism describing subtle changes in molecules important in brain development and neurotransmission, in morphology of specific neurons, brain connections and in brain size. We then provide a general schema of how these processes may interact with particular emphasis on neurotransmission. In this context, we present a rationale for utilizing pharmacologic treatments aimed at modifying key neurodevelopmental processes in young children with autism. Early treatment with selective serotonin reuptake inhibitors (SSRIs) is presented as a model for pharmacologic interventions because there is evidence in autistic children for reduced brain serotonin synthesis during periods of peak synaptogenesis; serotonin is known to enhance synapse refinement; and exploratory studies with these agents in autistic children exist. Additional hypothetical developmental interventions and relevant published clinical data are described. Finally, we discuss the importance of exploring early pharmacologic interventions within multiple experimental settings in order to develop effective treatments as quickly as possible while minimizing risks. PMID:17276749
This paper is an attempt to individuate some principles and guidelines apt to regulate the relationship between orthodontists and financing third parties, applicable to most western European Countries. The concepts of orthodontic treatment need, orthodontic treatment request and orthodontic screening are discussed, alongside with a short overview of some of the most common indexes to assess the severity of the malocclusion and/or the treatment priority. The screening method introduced by the Danish Ministry of Health is presented; its importance lies in the fact that for the first time a direct correlation between health risk and individual malocclusions is recognized and assessed. In the discussion, it is stressed how the screening system tightly depends on the chosen general model for orthodontic care. Different models of orthodontic care organization as presently used in many European countries are presented and shortly discussed; among these, the Norwegian model is described more in details, because of its simplicity. Eventually, some guidelines considered necessary in order to achieve satisfactory standards of quality and efficiency are presented and discussed.
Cassetta, M; Giansanti, M; Di Mambro, A; Calasso, S; Barbato, E
The aim of this prospective study was to evaluate the effectiveness of an innovative, minimally invasive, flapless corticotomy procedure in orthodontics. The STROBE guidelines were followed. Ten patients with severe dental crowding and a class I molar relationship were selected to receive orthodontic treatment with clear aligners and corticotomy-facilitated orthodontics. The mean age of these patients was 21 years (range 17-28, standard deviation 6.08 years); the male to female ratio was 2:1. The main outcome was a reduction in the total treatment time to correct dental crowding. The secondary outcomes were periodontal index changes, the degree of root resorption, and patient perceptions of the method used, assessed using the short-form Oral Health Impact Profile (OHIP-14). The occurrence of early surgical complications or unexpected events was also recorded. All patients completed the treatment to correct dental crowding. The average treatment time was reduced by two-thirds. The procedure did not significantly modify the periodontal indices or oral health-related quality of life. No early surgical complications or unexpected events were observed. In short, the results indicate that this new procedure is safe and accelerates tooth movement without periodontal complications or discomfort. However, the efficacy of this procedure must be confirmed in controlled clinical trials.
Abdel-Kader, Hussam M
The term "psychosomatic norm" is not commonly used directly or indirectly in orthodontic discussions. However, at times, this may be the most important factor affecting patient satisfaction with treatment outcome. Psychosomatic norm is a norm based on a subjective psychosocial assessment of what is the patient's norm. A norm that significantly differs from the clinician's somatic norm, which is based on objective anatomic assessment, may end in a dilemma of unexplainable and unpredictable dissatisfaction with the orthodontic treatment outcome if not properly handled by the orthodontist. This review article attempts to approach and solve this clinically problematic situation.
Ghafari, Joseph G
The American Journal of Orthodontics and Dentofacial Orthopedics celebrates its centennial, safeguarded by the nearly 115-year-old American Association of Orthodontists. This journey witnessed the rise and demise of various developments, concepts, and procedures, while basic knowledge is still needed. Various periods can be defined in the past century, but the goals remain to obtain more accurate diagnosis through precise anatomic imaging, more controlled and faster tooth movement, more discreet appliances, and the balance of esthetics, function, and stability. The most recent technologic advances have buttressed these goals. Cone-beam computed tomography has brought 3-dimensional assessment to daily usage, albeit the original enthusiasm is tempered by the risk of additional radiation. Temporary anchorage devices or miniscrews have revolutionized orthodontic practice and loom as a solid cornerstone of orthodontic science. Decortication and microperforation promise to speed up tooth displacement by stimulating vascularization. The concept of the regional acceleratory phenomenon has touched upon even the timing of orthognathic surgery. The burden of esthetic appliances remains, with the demand for "cosmetic" appliances and clear aligners. Have these developments changed the face of orthodontics? Have we engaged in another turn wherein certain treatment modalities may fade, while others join mainstream applications? These questions are addressed in this essay on the challenges, promises, and limitations of current orthodontic technology, enhancement of biologic response, and personalized treatment approaches.
The intention of this study was to determine whether toothbrushing pressures varied significantly between groups of orthodontic patients who were good toothbrushers and those who were poor toothbrushers. Seventy-two patients undergoing full-banded orthodontic treatment were selected from the author's practice and were subjectively paired by him according to their habitual oral hygiene. One group of thirty-six patients who habitually displayed poor oral hygiene was compared to a group of thirty-six patients who habitually displayed good oral hygiene. A specially designed strain gauge with a force-averaging feedback mechanism was attached to each patient's manual toothbrush, and the force with which that patient brushed was averaged and recorded in pounds. The poor brushers averaged 0.20 pound, whereas the average pressure of the good brushers was 0.89 pound. The statistical evidence indicates that the difference between the two groups is highly significant and is unlikely to be due to chance alone. This study has shown that toothbrush pressures can be easily and accurately measured. The attempt to objectify a single characteristic of toothbrushing behavior in an orthodontic population is an effort to avoid the medical model explanation of behavior vis-a-vis the nonspecific and subjective word attitude. Future studies will determine whether poor toothbrushers can be changed into good toothbrushers through the progressive acquisition of greater toothbrushing forces.
Vollmer, D; Ehmer, U; Bourauel, C; Linss, G
Treatment of maxillofacial dysgnathia using a combined surgical/orthodontic approach requires careful orthodontic and orthognathic diagnosis and treatment planning. In the present study, a system enabling on-line presentation of the necessary displacements of the jaw during surgery, while improving the accuracy of the planning, is described. Using the hexapod principle, it is possible to plan operations with six degrees of freedom and to measure the three-dimensional movements of jaws and jaw segments within the planning stage. Routinely prepared casts are employed for simulation of the operation. The displacements of the jaw are presented in a manner familiar to the orthodontic surgeon, namely in a surgical record. The accuracy achieved with the hexapod is superior to that achievable intra-operatively.
Hodge, T; Parkin, N
The contraction of the economy in the United Kingdom and constraints on the National Health Service (NHS) together with new opportunities for the delivery of orthodontic treatment has resulted in an increasing number of dental personnel across the different registrant groups. This article focuses on the changes that have taken place in the orthodontic workforce over the past decade. Although others help deliver orthodontic services such as material suppliers, treatment coordinators and those involved in marketing, this article will restrict itself to informing the reader specifically about which dental registrants are doing what at the clinical interface. How health professionals have developed their skills to undertake the role they play within the team and possible threats arising because of these changes are also discussed.
King, G J; Latta, L; Rutenberg, J; Ossi, A; Keeling, S D
The purpose of this study was to acquire tooth movement, histomorphometric and biochemical data on oral tissues that had previously been loaded with calibrated orthodontic forces. One hundred and forty-four male Sprague-Dawley rats were randomly divided into two groups: Group I, orthodontic appliances placed for 16 days to mesially move maxillary first molars with an initial force of 40 gm, and group II, sham orthodontic treatment. Seven to twelve rats were killed at each of six times after removal of appliance. Tooth movement was measured cephalometrically, alveolar bone turnover by histomorphometry, and tissue phosphatase levels biochemically. Treated molars moved distally more rapidly than the shams (13.9 vs 5.0 microns/day). The appliance removal group had a persistent 10-fold elevation in root resorption on the mesial (p < 0.0001), as well as early elevations in osteoclasts on the mesial and osteoblasts on the distal (p < 0.001) that returned to control by 3 to 5 days. Acid, alkaline phosphatase, and tartrate-resistant acid phosphatase (TRAP) remained elevated in the tissues until 10 days (p < 0.0001). Changes in the dynamic measures of bone formation were characterized by low rates at days 1 and 3 (p < 0.01), elevating thereafter on the mesial and the converse on the distal. Orthodontic tooth movement relapses, and bone remodeling continues for several days after removal of appliance consistent with the direction of loading, orthodontic treatment stimulates root resorption at sites that were loaded in pressure without detectable recovery, and root resorption does not increase at the tension sites.
DiBiase, A T; Sandler, P J
With the increasing provision of orthodontic care in this country, certain practitioners have raised concerns regarding the use of elective extractions and retraction mechanics, especially the effects on the facial profile and the TMJ. The non-extraction versus extraction debate spans the history of orthodontics, and the concepts of facial attractiveness are subject to change as fashions change. Within the realms of evidence-based practice, there is little or no evidence to suggest that the philosophies and mechanics of contemporary orthodontics, in the vast majority of cases, cause damage to the profile or are directly linked to the development of TMJ dysfunction.
Chaturvedi, T P; Upadhayay, S N
Various types of metallic orthodontic appliances are used in the management of malocclusion. These appliances are placed in oral environment under many stresses and variations such as masticatory forces, appliance loading, temperature fluctuations, varieties of ingested food and saliva. These metals undergo electrochemical reactions with the oral environment resulting in dissolution or formation of chemical compounds. Various microorganisms and many aggressive ions containing oral environment can cause material degradation (corrosion) and its associated problems during long time exposure. Orthodontic alloys must have excellent corrosion resistance to the oral environment, which is highly important for biocompatibility as well as for orthodontic appliance durability. This article reviews various aspects of corrosion (surface degradation) of orthodontic alloys. It explores the emerging research strategies for probing the biocompatibility of materials. During orthodontic treatment, use of nickel free, better corrosion resistance alloys and less use of fluoride containing toothpaste or gel is expected.
Objective The aims of our study were to verify the validity of the T-Scan III system (Tekscan) as an objective occlusal evaluation tool, and to assess the differences between two occlusal indexes-the peer assessment rating (PAR) index and the American Board of Orthodontics objective grading system (OGS)-by comparing the scores derived from the T-Scan III system with the two occlusal indexes and analyzing the correlations between them. Methods The final study sample included 48 adult volunteers (39 men and 9 women, mean age 24.14 ± 3.16 years), after excluding 29 volunteers whose occlusion could not be evaluated by the T-Scan III system due to severe skeletal or occlusal problems. PAR index and OGS scores were assessed using dental study models, and measurements of centric occlusion, protrusive movement, and lateral excursion movement were obtained via the T-Scan III system. The results were analyzed to determine correlations. Results Occlusal analysis by the T-Scan III system was clinically reliable (p < 0.05), and the PAR index and OGS scores were significantly correlated with several measurements obtained with the T-Scan III system (p < 0.05). Conclusions The T-Scan III system is a quantitative and reliable method for occlusal evaluation, and represents a potential substitute for occlusal indexes. Compared to the PAR index, the OGS scores of more variables were significantly correlated with the T-Scan measurements. PMID:26877980
Ann, Hye-Rim; Jung, Young-Soo; Lee, Kee-Joon
Objective The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). Methods This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12). CBCT images acquired preoperatively, 1 month after surgery, and 1 year after surgery were analyzed to compare the intergroup differences in postoperative three-dimensional movements of the maxillary and mandibular landmarks and the changes in lateral cephalometric variables. Results Baseline demographics (sex and age) were similar between the two groups (6 men and 6 women in each group). During the postsurgical period, the POGS group showed more significant upward movement of the mandible (p < 0.05) than did the CS group. Neither group showed significant transverse movement of any of the skeletal landmarks. Moreover, none of the dental and skeletal variables showed significant intergroup differences 1 year after surgery. Conclusions Compared with CS, POGS with IVRO resulted in significantly different postsurgical skeletal movement in the mandible. Although both groups showed similar skeletal and dental outcomes at 1 year after surgery, upward movement of the mandible during the postsurgical period should be considered to ensure a more reliable outcome after POGS. PMID:27668193
... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Therapeutic Devices § 872.5410 Orthodontic appliance and... device includes the preformed orthodontic band, orthodontic band material, orthodontic elastic...
8217 monophosphate (cyclic AMP, cGMP) in the periodontal tissue response to orthodontic treatment and concluded that mechanical forces might not be the most...currents to periodontal tissues during orthodontic treatment will potentiate the effect of mechanical forces and lead to an enhanced rate of cell...left sides of the arch. Specimens underwent orthodontic treatment for 49 days under control- : led conditions. 22~ 4.. . ., b-A TALT.OTOOTCVOT OEET
Heravi, Farzin; Shafaee, Hooman; Forouzanfar, Ali; Zarch, Seyed Hossein Hoseini; Merati, Mohsen
ABSTRACT Objective: The aim of this study was to evaluate the movement of impacted canines away from the roots of neighboring teeth before full-mouth bracket placement, performed by means of TADs to decrease undesired side effects on adjacent teeth. Methods: The study sample consisted of 34 palatally impacted canines, being 19 in the experimental group and 15 in the control group. In the experimental group, before placement of brackets, the impacted canine was erupted by means of miniscrews. In the control group, after initiation of comprehensive orthodontics, canine disimpaction was performed by means of a cantilever spring soldered to a palatal bar. At the end of treatment, volume of lateral incisors and canine root resorption were measured and compared by means of a CBCT-derived tridimensional model. Visual Analogue Scale (VAS) score, bleeding on probing (BOP) and gingival index (GI) were recorded. Clinical success rate was also calculated. Results: The volume of root resorption of lateral teeth in the control group was significantly greater than in the experimental group (p < 0.001). At the end of treatment, VAS score, GI and BOP were not significantly different between the two groups. Conclusion: Based on our results, it seems that disimpaction of canines and moving them to the arch can be done successfully carried out with minimal side effects by means of skeletal anchorage. PMID:27275617
Ryzhkova, Anastasia V.; Lebedeva, Nina G.; Sedykh, Alexey V.; Ulyanov, Sergey S.; Lepilin, Alexander V.; Kharish, Natalia A.
The results of statistical analysis of Doppler spectra of intensity fluctuations of light, scattered from mucose membrane of oral cavity of healthy volunteers and patients, abused by the orthodontic diseases, are presented. Analysis of Doppler spectra, obtained from tooth pulp of patients, is carried out. New approach to monitoring of blood microcirculation in orthodontics is suggested. Influence of own noise of measuring system on formation of the speckle-interferometric signal is studied.
Almpani, Konstantinia; Kolokitha, Olga-Elpis
The role of third molars in the oral cavity has been extensively studied over the years. Literature includes numerous diagnostic and treatment alternatives regarding the third molars. However, an issue that has not been discussed at the same level is their involvement in orthodontic therapy. The aim of this study is to present a review of the contemporary literature regarding the most broadly discussed aspects of the multifactorial role of third molars in orthodontics and which are of general dental interest too. PMID:25685759
Barreto, Gustavo Mattos; Feitosa, Henrique Oliveira
ABSTRACT Introduction: Orthodontics has gone through remarkable advances for those who practice it with dignity and clinical quality, such as the unprecedented number of patients treated of some type of iatrogenic problems (post-treatment root resorptions; occlusal plane changes; midline discrepancies, asymmetries, etc). Several questions may raise useful reflections about the constant increase of iatrogenics. What is causing it? Does it occur when dentists are properly trained? In legal terms, how can dentists accept these patients? How should they be orthodontically treated? What are the most common problems? Objective: This study analyzed and discussed relevant aspects to understand patients with iatrogenic problems and describe a simple and efficient approach to treat complex cases associated with orthodontic iatrogenics. PMID:27901237
Uysal, Tancan; Yagci, Ahmet; Kara, Sadik; Okkesim, Sukru
The aim of this follow-up study was to evaluate the effects of Pre-Orthodontic Trainer (POT) appliance on the anterior temporal, mental, orbicularis oris, and masseter muscles through electromyography (EMG) evaluations in subjects with Class II division 1 malocclusion and incompetent lips. Twenty patients (mean age: 9.8 ± 2.2 years) with a Class II division 1 malocclusion were treated with POT (Myofunctional Research Co., Queensland, Australia). A group of 15 subjects (mean age: 9.2 ± 0.9 years) with untreated Class II division 1 malocclusions was used as a control. EMG recordings of treatment group were taken at the beginning and at the end of the POT therapy (mean treatment period: 7.43 ± 1.06 months). Follow-up records of the control group were taken after 8 months of the first records. Recordings were taken during different oral functions: clenching, sucking, and swallowing. Statistical analyses were undertaken with Wilcoxon and Mann-Whitney U-tests. During the POT treatment, activity of anterior temporal, mental, and masseter muscles was decreased and orbicularis oris activity was increased during clenching and these differences were found statistically significant when compared to control. Orbicularis oris activity during sucking was increased in the treatment group (P < 0.05). In the control group, significant changes were determined for anterior temporal (P < 0.05) and masseter (P < 0.01) muscle at clenching and orbicularis oris (P < 0.05) muscle at swallowing during observation period. Present findings indicated that treatment with POT appliance showed a positive influence on the masticatory and perioral musculature.
Grollemund, Bruno; Rinkenbach, Renaud
When patients older than 60 decide to undergo orthodontic treatment, their motivation is not merely for esthetic purposes; it is also intended to preserve their biological capital. Their treatment is often complicated. The orthodontist has to take into account any particularities related to their past dental or even orthodontic history. Their treatment are freed, sometimes due to necessary compromises, from constraints that are determined by the occlusion, the periodontium or by prosthetic devices which are sometimes implant borne. For some patients, the original shape of their teeth that make up their smile are an integral part of their personality. By preserving the integrity of these teeth with an orthodontic treatment they avoid the sudden and jarring transformation of their smile and maintain their identity. Therapeutic choices that combine orthodontics and prosthetics and sometimes surgery can preserve the senescence of a face.
Wehrbein, H; Wriedt, S; Jung, B A
Long-term prophylaxis achievements, demographic changes, scientific progress, patient requirements, and political regulations through social legislation will fundamentally change the future of orthodontics, i.e., a reduction in children and adolescent therapy as well as an increase in interdisciplinary complex treatments for adult patients mostly outside the social security system. Health care research at a high evidence level needs to be intensified due to social-political reasons. In addition to well-proven appliances, modern sometimes even invisible appliances (CAD-CAM) will be used in future orthodontic therapy. Three-dimensional diagnostics could improve treatment planning. Whether improved prenatal diagnosis will alter the number of newborns with dentofacial malformations (cleft lip and palate) or syndromes (e.g., Down syndrome), thus, changing treatment needs in the future, cannot be predicted today, due to the multiple influencing factors. A well-structured 4-year specialist training according to European guidelines will also be necessary in the future to comply with complex treatment needs be it within or outside the social security system (quality assurance).
D ' Attilio, M; De Angelis, F; Vadini, M; Rodolfino, D; Trubiani, O; Di Nardo Di Maio, F; D' Arcangelo, C
Inflamed human pulp tissue presents an increase in the level of nitric oxide synthase (NOS). The aim of this study is to verify the presence of NOS in human pulp of teeth that are subject to orthodontic force. 20 healthy subjects, wearers of fixed braces on the upper arch, were selected. An open coil-spring in NiTi was applied on the upper premolar test tooth (TT); the controlateral control tooth (CCT) was subjected to orthodontic treatment but not to the further force of the open coil-spring; the antagonist control tooth (ACT) did not undergo any orthodontic treatment. Pulps were taken from test, contralateral control and antagonist control teeth immediately after the extractions which were done at 15 and 30 days from the start of application of the orthodontic force. The pulp tissue was analyzed through immunohistochemical and molecular biology examinations. The results showed tooth pulps subject to orthodontic treatment were very inflamed in the first 15 days with high levels of iNOS and low levels of eNOS; after 30 days a decrease of the inflammation and an increase of the pulp vascularization were observed together with a reduction of iNOS and an increase of eNOS respectively.
Kasa, Ilda; Di Blasio, Marco; Gandolfini, Mauro
The authors report a combined orthodontic-surgical correction of an adult patient's malocclusion affected by Moebius Syndrome (MS). The treatment was conducted at the Dentistry Unit and the Maxillofacial Surgery Unit of the University Hospital of Parma. Treatment of malocclusion was performed after the correction of facial mimic mobility with smile surgery. The postoperative stability and orthodontic results were good and the correction of the morphological problems related to the syndrome was very satisfactory.
Zhang, Ronghe; Zhang, Weiwei; Bai, Xueyan; Song, Xiaotong; Wang, Chunyan; Gao, Xinxin; Tian, Xubiao; Liu, Fengzhen
This paper aims to explore the antibacterial property of nano Ag/TiO2 coating bracket for the common bacteria in oral cavity, and discuss its biocompatibility. Micro morphology in the surface of nano Ag/TiO2 coating bracket was detected by scanning electron microscope (SEM), and surface roughness of ordinary mental bracket, nano TiO2 coating bracket and nano Ag/TiO2 coating bracket were measured. First, antibacterial property of nano Ag/TiO2 coating bracket on the common bacteria in oral cavity was studied by sticking membrane method. Secondly, bonding strength of nano TiO2 coating and nano Ag/TiO2 coating bracket in groups were detected by scratching test. The result showed that, the synthetic nano Ag/TiO2 coating was nanogranular films with rigorous organizational structure, presenting as smooth and clean surface, and antibacterial rate of nano Ag/TiO2 coating for the common bacteria in oral cavity for 20 min was more than 79% in the dark. All the findings suggested that, nano Ag/TiO2 coating bracket not only has antibacterial effect but also has good biocompatibility, therefore, it can satisfy the clinical request of orthodontic treatment.
Peres, Fernando Gianzanti; Padovan, Luis Eduardo Marques; Kluppel, Leandro Eduardo; Albuquerque, Gustavo Calvalcanti; de Souza, Paulo Cesar Ulson; Claudino, Marcela
ABSTRACT Introduction: Temporary anchorage devices (TADs) have been developed to be used as direct adjuncts in orthodontic treatment and have facilitated treatment of more complex orthodontic cases, including patients with dental impaction. Objectives: This clinical case reports the applicability of TADs in the orthodontic treatment of a patient with impacted mandibular second molars. Surgical and orthodontic procedures related to the use of miniplates were also discussed in this study. Conclusions: The use of temporary anchorage devices, such as miniplates, can be suggested as an alternative to treat patients with impacted mandibular second molars. PMID:27901235
Köseoğlu, Serhat; Fidancıoğlu, Ahmet; Sağlam, Mehmet; Savran, Levent
Purpose. As documented in the literature, bony defects can be managed by an orthodontic approach. Methods. This case report describes the treatment of a bony defect caused by orthodontic malposition through phase I periodontal therapy and a simple removable orthodontic appliance used for the first time in a 20-year-old girl. Results. The periodontal pocket was reduced from 8 mm to 3 mm shortly after treatment. Conclusion. This case report concludes that orthodontic therapy can be used successfully in treatment of bony defects caused by mesially tilted molars. PMID:26421197
Nosouhian, Saeid; Rismanchian, Mansour; Sabzian, Roya; Shadmehr, Elham; Badrian, Hamid; Davoudi, Amin
The purpose of this literature review was to screen the valuable published articles regarding to the impacts of mini-implants on orthodontic science, briefly. The searching category was performed on the Pubmed using MeSH words such as “dental (mini) implants, orthodontic anchorage procedures, and orthodontic appliances.” After preliminary sketch, they were grouped as follow: Those evaluating (a) common appliances for providing orthodontic anchorage, (b) biomechanical details of mini-implants and their insertion, (c) clinical application of mini-implants for orthognathic treatments, (d) limitations and possible complications. In conclusion, mini-implant evolved the orthodontic treatment plans and compromised the required orthognathic surgery. Malocclusion treatment and pure orthodontic or orthopedic movements in the three-dimensions have become recently possible by using mini-implant to provide skeletal anchorage. PMID:26225113
Mamatha, J; Chaitra, K R; Paul, Renji K; George, Merin; Anitha, J; Khanna, Bharti
Today, we are in a world of innovations, and there are various diagnostics aids that help to take a decision regarding treatment in a well-planned way. Cone beam computed tomography (CBCT) has been a vital tool for imaging diagnostic tool in orthodontics. This article reviews case reports during orthodontic treatment and importance of CBCT during the treatment evaluation.
Mamatha, J; Chaitra, K R; Paul, Renji K; George, Merin; Anitha, J; Khanna, Bharti
Today, we are in a world of innovations, and there are various diagnostics aids that help to take a decision regarding treatment in a well-planned way. Cone beam computed tomography (CBCT) has been a vital tool for imaging diagnostic tool in orthodontics. This article reviews case reports during orthodontic treatment and importance of CBCT during the treatment evaluation. PMID:26225116
Wise, G.E.; King, G.J.
Teeth move through alveolar bone, whether through the normal process of tooth eruption or by strains generated by orthodontic appliances. Both eruption and orthodontics accomplish this feat through similar fundamental biological processes, osteoclastogenesis and osteogenesis, but there are differences that make their mechanisms unique. A better appreciation of the molecular and cellular events that regulate osteoclastogenesis and osteogenesis in eruption and orthodontics is not only central to our understanding of how these processes occur, but also is needed for ultimate development of the means to control them. Possible future studies in these areas are also discussed, with particular emphasis on translation of fundamental knowledge to improve dental treatments. PMID:18434571
Sangani, Indiya; Watt, Eileen; Cross, David
Necrotizing ulcerative gingivitis (NUG) can be a painful periodontal disease that can lead to loss of the interdental papillae. It is usually accompanied by systemic signs of fever, malaise and cervical and submandibular lymphadenopathy. It is caused by the profileration of anaerobic bacteria and has been linked to smoking and immunosuppression. This case series reports the occurrence of NUG in orthodontic patients and demonstrates that there is a varying scale of severity of the condition. Orthodontists should be aware of the clinical signs of NUG to ensure early detection and treatment of their patients in order to prevent irreversible loss of the interdental papillae and reduce the likelihood of recurrence. A treatment regime is suggested.
The professional distinction of "surgeon-dentist," created in France in the 18th century, stimulated dentistry's early advance as a learned profession. By 1841, Pierre-Joachim Lefoulon coined the term "orthodontosie," which was the root of "orthodontics and dentofacial orthopedics" as a distinct academic field and a specialty. In 1907, the American Orthodontist became the first scientific journal in the world completely devoted to orthodontics. Its failure after 5 years of publication prompted former editor Martin Dewey to find a new publisher for an orthodontic specialty journal. In 1915, the International Journal of Orthodontia was created with Dewey as editor. After some years, its name was changed to the American Journal of Orthodontics, which later became the American Journal of Orthodontics and Dentofacial Orthopedics, or AJO-DO. Today, the AJO-DO at 100 years is a mainstay of scientific advancement in orthodontics.
Naragond, Appasaheb; Kenganal, Smitha; Sagarkar, Roshan; Sugaradday
Since so many decades, various treatment modalities have been presented for the treatment for the class II, div 1 malocclusions. In recent times, we have seen enormously increasing numbers of young adults who desire the shortest, cost effective and a non surgical correction of Class II malocclusions and they accept dental camouflage as a treatment option to mask the skeletal discrepancy. This case report presents one such case of a 22 year old non-growing female who had a skeletal Class II, division 1 malocclusion with an orthognathic maxilla, a retrognathic mandible, a negative VTO and an overjet of 12mm, who did not want a surgical treatment. We considered the camouflage treatment by extracting the upper first premolars. Following the treatment, a satisfactory result was achieved with an ideal, static and a functional occlusion, facial profile, smile and lip competence and stability of the treatment results. PMID:23543878
Bittencourt, Marcos Alan Vieira
Abstract Class III skeletal pattern is characterized by disharmony between maxillary and mandibular basal bones anteroposteriorly, and might or might not be associated with dental changes. In general, facial esthetics is hindered significantly, which most of times is the reason why patients or patient's guardians seek treatment. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for Diplomate recertification and revalidation. PMID:26691976
Finkelstein, Tamar; Kadry, Rana; Schonberger, Shirley; Shpack, Nir
Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch. PMID:28119788
This paper describes the orthodontic treatment of two cases that were successfully entered for the 2005 American Orthodontics MOrth Cases Prize. The first case is that of a patient presenting with a Class II division 2 malocclusion treated with upper and lower fixed appliances plus headgear. The second case demonstrates the use of a twin-block appliance, followed by fixed appliances to correct a moderate Class II division 1 malocclusion.
Mycosis fungoides is a candidate for skin-directed therapies in its initial stages. In recent years, therapeutic options outside of the normal treatment recommendations such as topical imiquimod, topical tazarotene, topical methotrexate, excimer light sources, and photodynamic therapy have been published with variable results. These alternatives have been useful in cases of localized mycosis fungoides that do not respond to routine treatments; nevertheless, more studies on these methods are still needed. This article summarizes the literature and data that are known so far about these treatments. PMID:23450851
Norman W. Kingsley (1829- 1913) of New York City was one of the great contributors to the early development of orthodontics and cleft palate therapy. His biographical chronology is presented, based largely on a little-known autobiography published in 1907 when he was 77 years old. Also presented is a Kingsley bibliography with key publications by and about this remarkable pioneer in orthodontics.
Xu, Xiaomei; Zhao, Qing; Yang, Siwei; Fu, Guangxin; Chen, Yangxi
Tooth movement occurs as a consequence of periodontal tissue remodeling. The goal of every orthodontist is to investigate better approaches to accelerate tooth movement. Estrogen, by binding with its receptors in periodontal tissue, regulates the remodeling of alveolar bones, promotes bone formation, and inhibits bone resorption. Estrogen secretion in vivo is characterized by a nearly lunar rhythm. The estrogen expression level is low during menstruation and the luteal phase, and reaches the highest at 1-2days before ovulation. Estrogen physiological fluctuations can cause physiological fluctuations in the serum markers of bone turnover. Therefore, orthodontic therapy should be planned according to the menstrual cycle since tooth movement, under the application of force, is faster during low estrogen levels. In this paper, we propose a hypothesis that application of orthodontic force after each ovulation may promote tooth movement, thereby shortening the course of orthodontic treatment.
Hans, Mark G; Palomo, J Martin; Valiathan, Manish
The history of imaging and orthodontics is a story of technology informing biology. Advances in imaging changed our thinking as our understanding of craniofacial growth and the impact of orthodontic treatment deepened. This article traces the history of imaging in orthodontics from the invention of the cephalometer by B. Holly Broadbent in 1930 to the introduction of low-cost, low-radiation-dose cone-beam computed tomography imaging in 2015.
Danz, J C; Greuter, C; Sifakakis, I; Fayed, M; Pandis, N; Katsaros, C
The purpose of this long-term follow-up study was twofold-firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relapse.
Purpose The aim of this study was to evaluate alterations of papilla dimensions after orthodontic closure of the diastema between maxillary central incisors. Methods Sixty patients who had a visible diastema between maxillary central incisors that had been closed by orthodontic approximation were selected for this study. Various papilla dimensions were assessed on clinical photographs and study models before the orthodontic treatment and at the follow-up examination after closure of the diastema. Influences of the variables assessed before orthodontic treatment on the alterations of papilla height (PH) and papilla base thickness (PBT) were evaluated by univariate regression analysis. To analyze potential influences of the 3-dimensional papilla dimensions before orthodontic treatment on the alterations of PH and PBT, a multiple regression model was formulated including the 3-dimensional papilla dimensions as predictor variables. Results On average, PH decreased by 0.80 mm and PBT increased after orthodontic closure of the diastema (P<0.01). Univariate regression analysis revealed that the PH (P=0.002) and PBT (P=0.047) before orthodontic treatment influenced the alteration of PH. With respect to the alteration of PBT, the diastema width (P=0.045) and PBT (P=0.000) were found to be influential factors. PBT before the orthodontic treatment significantly influenced the alteration of PBT in the multiple regression model. Conclusions PH decreased but PBT increased after orthodontic closure of the diastema. The papilla dimensions before orthodontic treatment influenced the alterations of PH and PBT after closure of the diastema. The PBT increased more when the diastema width before the orthodontic treatment was larger. PMID:27382507
Many patients seek orthodontic treatment for esthetic improvement. These patients mostly present with mal-alignment of the anterior teeth. The positive effects of orthodontic treatment on their appearance and self-esteem are easy to envision. However, does orthodontic treatment provide dental health benefits in addition to the esthetic benefits? Do malocclusions harm the periodontium? Is correcting malocclusions with orthodontic treatment beneficial for periodontal health? The purpose of this study is to present evidence available on this topic. Two systematic reviews were conducted to address these questions: does a malocclusion affect periodontal health, and does orthodontic treatment affect periodontal health? Inclusion and exclusion criteria were established for both reviews, and an electronic search and a hand search were conducted. Several papers were included in both reviews, but the overall quality of the studies was weak. The first review found a correlation between the presence of a malocclusion and periodontal disease. Subjects with greater malocclusion have more severe periodontal disease. This may be dependent on oral health status. One should keep in mind that an association does not necessarily mean causation. The second review identified an absence of reliable evidence on the effects of orthodontic treatment on periodontal health. The existing low-quality evidence suggests that orthodontic therapy results in small detrimental effects to the periodontium. The results of both reviews do not warrant recommendation for orthodontic treatment to prevent future periodontal problems, except for specific unusual malocclusions.
Baek, Seung-Hak; Ahn, Hyo-Won; Kwon, Yoon-Hee; Choi, Jin-Young
The purpose of this study was to evaluate the surgical movement and postoperative orthodontic treatment (POT) of the surgery-first approach for the correction of skeletal class III malocclusion. The samples consisted of 11 patients with skeletal class III malocclusion who underwent nonextraction treatment and 2-jaw surgery (Le Fort I osteotomy impaction of the posterior maxilla, IPM; bilateral sagittal split ramus osteotomy setback of the mandible). The wafer was removed 4 weeks after surgery. Mean (SD) durations of POT and total treatment were 8.91 (3.14) and 12.18 (3.57) months, respectively. Lateral cephalograms were obtained during the initial examination (T0), immediately after surgery (T1), and after debonding (T2). Sixteen variables were measured. Paired t-test was performed for statistical analysis. The maxilla rotated clockwise, and the nasolabial angle increased by IPM (FH-palatal plane angle, FH-occlusal plane angle, P < 0.01; nasolabial angle, P < 0.05) and well maintained during POT. The mandible was repositioned backward by bilateral sagittal split ramus osteotomy setback of the mandible (SNB, Pog-N perp, P < 0.001) and relapsed forward during POT (SNB, P < 0.01; Pog-N perp, P < 0.05). U1-SN decreased by IPM (P < 0.001) and relapsed labially owing to class III mechanics during POT (P < 0.01); eventually, no significant difference was found between T0 and T2 stages. Although IMPA increased by POT, there was no significant difference between T0 and T2 stages. The mandible seems to relapse forward immediately after wafer removal and before labioversion of the lower incisors. Accurate prediction of POT is crucial in controlling dental alignment, incisor dec