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The Angle Orthodontist Nov 2023To evaluate whether the quality of orthodontic finishing influences long-term stability of anterior tooth alignment.
OBJECTIVES
To evaluate whether the quality of orthodontic finishing influences long-term stability of anterior tooth alignment.
MATERIALS AND METHODS
This retrospective study evaluated 38 patients. Data were obtained at the beginning of treatment (T0), at the end (T1), and at least 5 years after T1 (T2). At this point, the individuals were no longer wearing retainers. Anterior tooth alignment was measured using Little's index (LI). Effect on alignment stability was tested with multiple linear regression using LI-T0, LI-T1, intercanine width difference T1-T0, overbite (T1), overjet (T1), age, gender, time without retention, and presence of third molars as predictor variables. Well-aligned (LI < 1.5 mm) and misaligned (LI > 1.5 mm) cases were compared at T2.
RESULTS
At T2, the alignment stability in the upper arch was inversely associated with the alignment quality (R2 = 0.378, P < .001) and directly associated with overbite (R2 = 0.113, P = .008) at T1. Posttreatment changes caused cases finished with poor alignment to become similar to those finished with excellent alignment (P = .917). In the mandible, posttreatment changes were directly associated only with overjet (R2 = 0.152, P = .015) and well-finished cases displayed better alignment than poorly finished cases (P = .011). Other variables showed no significant association.
CONCLUSIONS
In arches without retention, better quality of orthodontic finishing does not guarantee the stability of anterior alignment. In the maxilla, long-term changes were more significant the greater the overbite and the better the quality of alignment at end of treatment. In the mandible, changes were not dependent on the quality of finishing but were associated with greater overbite at T2.
Topics: Humans; Overbite; Retrospective Studies; Malocclusion, Angle Class II; Mandible; Molar, Third; Orthodontic Retainers
PubMed: 37200475
DOI: 10.2319/101722-722.1 -
International Journal of Paediatric... Nov 2022To evaluate the clinical effectiveness of the eruption guidance appliances (EGAs) in treating malocclusion in the early mixed dentition. (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the clinical effectiveness of the eruption guidance appliances (EGAs) in treating malocclusion in the early mixed dentition.
DESIGN
Electronic databases were comprehensively searched for the eligibility literature of the EGA treatment for a period spanning from the earliest available date in each database up to July 2021. Randomized controlled trials, controlled clinical trials, and prospective and retrospective cohort studies were included in the present review. The quality of clinical trials was assessed according to the Cochrane Collaboration's tools (RoB2.0 and ROBINS-I), whereas cohort studies were based on the Newcastle-Ottawa Scale (NOS). The data were gathered and synthesized with the Stata software (version 12).
RESULTS
The screen yielded 436 articles, of which 17 papers were potentially eligible, and 7 articles from 3 studies (1 RCT, 1 CCT, and 1 PCS) were qualified for the final review and analysis. The meta-analysis showed both favorable dentoalveolar and skeletal changes in short term. Both overjet and overbite had a significant decrease after treatment (MD = -2.38 mm, 95% CI: -2.82 to -1.94, p < .001, and MD = -2.43 mm, 95% CI: -3.52 to -1.35, p < .001, respectively), and SNB increased significantly by 0.73 degrees (95% CI: 0.17-1.28, p = .01). After the retention period, however, overbite had a significant increase of 0.88mm, which indicated the occurrence of a relapse (95% CI: 0.60-1.16, p < .001).
CONCLUSIONS
According to the existing evidence, the EGA treatment is effectively correcting overjet and overbite in the early mixed dentition in short term; furthermore, high-quality and long-term studies are warranted to determine its long-term effectiveness.
Topics: Dentition, Mixed; Humans; Malocclusion; Malocclusion, Angle Class II; Overbite; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 35191109
DOI: 10.1111/ipd.12961 -
Operative Dentistry 2017Amelogenesis imperfecta (AI) refers to a group of rare genetic disorders that involve tooth development and that are passed down through families as a dominant trait....
Amelogenesis imperfecta (AI) refers to a group of rare genetic disorders that involve tooth development and that are passed down through families as a dominant trait. This condition is characterized by abnormal enamel formation caused by gene mutations that alter the quality and/or quantity of enamel. This dental problem can impact both primary and permanent dentition, varies among affected individuals, and results in esthetic and functional problems. This condition caused the patient in the current case report to have a lack of confidence when speaking. The treatment for amelogenesis imperfecta depends on the severity of the problem and age of the patient. It is crucial to plan a proper remedy, which requires collaboration among dental specialties to execute comprehensive dental treatment in order to provide a long-term solution with adequate esthetics. The current clinical study presents a patient affected by AI that was diagnosed when the patient was a child. The interdisciplinary treatment continued throughout his childhood and into adult life. The initial treatment consisted of resin composite veneers and stainless-steel crowns to restore the defective tooth structure. The malocclusion of the patient was corrected using a fixed orthodontic appliance that was placed when he had an entire permanent dentition. The treatment plan was eventually intended to include all ceramic crowns and veneers.
Topics: Amelogenesis Imperfecta; Child; Dental Veneers; Humans; Male; Malocclusion; Orthodontic Appliances; Overbite; Palatal Expansion Technique; Tooth Movement Techniques
PubMed: 28829932
DOI: 10.2341/13-256-S -
BMC Oral Health Mar 2024Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over...
BACKGROUND
Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth.
METHODS
This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant.
RESULTS
The mean accuracy of overbite correction was 37.63% after 1 set, followed by 11.19%, 6.32%, and 13.80% (2-4 sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1 and 2 sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1 set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque.
CONCLUSIONS
The most overbite correction occurs during the 1 set of aligners, and refinement treatment does not significantly improve the deep bite correction.
Topics: Humans; Young Adult; Adult; Overbite; Retrospective Studies; Tooth Movement Techniques; Malocclusion, Angle Class II; Orthodontic Appliances, Removable
PubMed: 38491450
DOI: 10.1186/s12903-024-04099-8 -
Equine Veterinary Journal Sep 2016There are limited reports on the efficacy of functional orthodontic correction of overjet or overbite in foals.
REASONS FOR PERFORMING STUDY
There are limited reports on the efficacy of functional orthodontic correction of overjet or overbite in foals.
OBJECTIVES
To report the outcome of using orthodontic tension bands in combination with an inclined plane biteplate in the treatment of overjet, with or without concurrent overbite, rates of correction of these 2 malocclusions and associated complications. And to examine factors associated with outcomes.
STUDY DESIGN
Retrospective case series.
METHODS
Clinical records for 73 foals treated at a single clinic, by the same surgeon were analysed. Overall change and rates of change in overjet and overbite were calculated. Associations between potential explanatory variables including age, severity of initial malocclusion and surgeon experience were examined using linear regression.
RESULTS
Records for 73 foals (43 colts, 30 fillies) were evaluated. The median number of implant placements per animal was 2 (range 1-4). Of 61 cases with complete records, reduction in overjet and overbite dimensions were achieved in 95% and 90% of foals, respectively, with mean reductions in malocclusions of 9.9 and 8.4 mm, respectively. Complete reduction in overjet was achieved in 25% (15/61) and reduction of malocclusion dimensions to ≤5 mm (i.e. functionally corrected) was achieved in 51% (31/61). Increasing animal age was significantly associated with decreased total reduction in overjet and decreased rate of reduction in overbite. Increased original severity of overbite was significantly associated with increased rate of its correction. Short-term complications included intraoperative haemorrhage, transient facial nerve neuropraxia and irritation of the mare's udder by the brace. Longer-term complications included cheek teeth diastema formation and incisor discoloration and maleruption.
CONCLUSIONS
Using this technique, correction or improvement of these malocclusions is rapid, with minimal complications. Often more than one implant is required. Animal age at the start of treatment is associated with rate and amount of correction achievable, so initiating treatment at an early age is recommended.
Topics: Animals; Female; Horse Diseases; Horses; Male; Orthodontics, Corrective; Overbite; Retrospective Studies
PubMed: 26582741
DOI: 10.1111/evj.12540 -
European Journal of Orthodontics Jun 2016To systematically investigate review in literature the effects of the Herbst appliance for patients with Class II malocclusion patients. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically investigate review in literature the effects of the Herbst appliance for patients with Class II malocclusion patients.
METHOD
We performed a comprehensive literature survey on PubMed, Web of Science, Embase, CENTRAL, SIGLE, and ClinicalTrial.gov up to December 2014. The selection criteria: randomized controlled trials or clinical controlled trials; using any kind of Herbst appliances to correct Class II division 1 malocclusions; skeletal and/or dental changes evaluated through lateral cephalograms. And the exclusion criteria: syndromic patients; individual case reports and series of cases; surgical interventions. Article screening, data extraction, assessment of risk of bias, and evaluation of evidence quality through GRADE were conducted independently by two well-trained orthodontic doctors. Consensus was made via group discussion of all authors when there is inconsistent information from the two. After that, sensitivity analysis and subgroup analysis were performed to evaluate the robustness of the meta-analysis.
RESULTS
Twelve clinical controlled trials meet the above-mentioned criteria, and were included in this analysis. All included studies have eleven measures taken during both active treatment effect and long term effect periods, including four angular ones (i.e., SNA, SNB, ANB, mandibular plane angle) and seven linear ones (i.e. Co-Go, Co-Gn, overjet, overbite, molar relationship, A point-OLp, Pg-OLp) during active treatment effect period were statistically pooled. Meta-analysis and sensitivity analysis demonstrated that all these measures showed consistent results except for SNA, ANB, and overbite. Subgroup analysis showed significant changes in SNA, overbite, and Pg-OLp. Publication bias was detected in SNB, mandibular plane angle, and A point-OLp.
CONCLUSION
The Herbst appliance is effective for patients with Class II malocclusion in active treatment period. Especially, there are obvious changes on dental discrepancy and skeletal changes on Co-Gn. As to its long-term effects, more evidence is needed to draw conclusions.
Topics: Cephalometry; Evidence-Based Medicine; Humans; Malocclusion, Angle Class II; Mandible; Orthodontic Appliances, Functional; Orthodontics, Corrective; Overbite; Radiography, Dental
PubMed: 26306822
DOI: 10.1093/ejo/cjv057 -
American Journal of Orthodontics and... Jan 2019The aim of this study was to explore the association of soft tissue profile and severity of overbite and overjet in a large adult population.
INTRODUCTION
The aim of this study was to explore the association of soft tissue profile and severity of overbite and overjet in a large adult population.
METHODS
The study population consisted of 1630 adults (age, 46 years; 712 men, 919 women), all part of the Northern Finland Birth Cohort 1966. A clinical examination was performed on all subjects, including recording of overjet and overbite, and digital facial (frontal and profile) photographs were obtained. A multivariate regression model was developed to study the correlation of soft tissue measurements with overjet and overbite, considering the effect of sex.
RESULTS
The regression model explained approximately 30% of the variability in overjet in our sample and approximately 22% of the variability in overbite. Overjet was related more significantly to upper and lower anteroposterior lip position, and upper and lower facial height (P <0.05). Overbite showed a stronger association with anteroposterior position of the lower lip, pogonion, and soft tissue B-point (P <0.05).
CONCLUSIONS
Soft tissue profile was weakly to moderately correlated with severity of overjet and overbite in the entire sample. However, in subjects with negative overjet (mandibular prognathism), this association was highly significant.
Topics: Cross-Sectional Studies; Face; Female; Humans; Male; Middle Aged; Overbite
PubMed: 30591167
DOI: 10.1016/j.ajodo.2018.02.015 -
Indian Journal of Dental Research :... 2020The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to estimate the prevalence of traumatic dental injuries (TDI) in India. The secondary objective was to evaluate the prevalence rate according to the differences in gender, age, regions, type of TDI and risk factors associated with TDI.
METHODS
The PubMed, LILACS, Web of Science, Cochrane, CINHAL, and Scopus databases, along with the Public Health Electronic Library, TRoPHI and DoPHER were searched from 1 March to 15April 2019 without any restriction of language and year of publication. The qualitative synthesis was done regarding the demographics, study methods, cause of trauma, geographic location, increased overjet and inadequate lip coverage. The meta-analysis was undertaken with STATA-14 software (USA). The pooled prevalence of TDI was calculated using data extracted from 48 studies included in qualitative synthesis and meta-analysis. A sub-group meta-analysis was done by extraction of the data for age groups of 6 years and >6 years.
RESULTS
The pooled prevalence of TDI in Indian population was 13 cases in 100 individuals. The prevalence of TDI for age groups of ≤6 was 15% (males, 15%; females, 16%) and for >6 years was 12% (males, 13%; females, 8%). The most common cause of TDI was falls, and most frequent location was home. The odds ratio for occurrence of TDI and inadequate lip-coverage was 3.35 and overjet greater than 3 mm was 3.53.
CONCLUSIONS
The pooled prevalence of TDI was 13% and slightly higher in children less than 6 years of age. Inadequate lip coverage and increased overjet are the risk factors associated with TDI. Heterogeneity was observed among the studies in terms of design, variables recorded, sampling, study methods and statistical methods. Majority of them also suffered from moderate to high risk of bias.
Topics: Accidental Falls; Child; Female; Humans; India; Male; Overbite; Prevalence; Tooth Injuries
PubMed: 33107464
DOI: 10.4103/ijdr.IJDR_953_19 -
Orthodontics & Craniofacial Research Nov 2022This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation...
OBJECTIVES
This study aimed to analyse the relationship between adverse pregnancy outcomes (APO) and occlusal traits in the primary dentition, checking for different mediation paths.
SETTING AND SAMPLE POPULATION
Children evaluated at birth (T1), between 12 and 24 months (T2), and between 24 and 36 months (T3) were included. Two hundred and seventeen children who participated in T1 and T2 were randomly selected to perform the occlusion examination.
MATERIALS AND METHODS
This is a prospective cohort study (BRISA). The theoretical model was tested by structural equation modelling (SEM), estimating standardized coefficients (Coeff.) (α = 0.05). The primary exposure was APO-a latent variable manifested from three health problems at birth: low birthweight (LBW), pre-term birth (PTB) and intrauterine growth restriction (IUGR), evaluated in T1. The outcomes were four different occlusal traits assessed in T3: overjet, anterior and posterior crossbite, and crowding. Each outcome's direct and indirect effects were tested, mediated by growth, breathing, breastfeeding, and pacifier use.
RESULTS
There was no direct association between APO and any of the outcomes: overjet (Coeff. = -0.163, P = .241), anterior crossbite (Coeff. = -0.696, P = .065), posterior crossbite (Coeff. = -0.087, P = .589) and crowding (Coeff. = 0.400, P = .423). The indirect (total and specifics) effects tested also showed no association (P > .05). However, APO was associated with lower child growth in all models; breastfeeding was associated with higher child growth in all models, and pacifier use was associated with overjet (Coeff. = 0.184, P < .001) and posterior crossbite (Coeff. = 0.373, P = .011).
CONCLUSION
APO was not a risk factor for overjet, crossbite and crowding in an early stage of the primary dentition by direct and indirect pathways. However, growth has been lower in children with APO and higher in children breastfed. Also, the harmful effects of using a pacifier in dental occlusion are highlighted.
Topics: Apolipoproteins A; Child; Cohort Studies; Female; Humans; Infant, Newborn; Malocclusion; Overbite; Pregnancy; Pregnancy Outcome; Prospective Studies; Tooth, Deciduous
PubMed: 34982513
DOI: 10.1111/ocr.12563 -
Progress in Orthodontics Apr 2022To produce a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (dental health component DHC 3) and to compare views of... (Observational Study)
Observational Study
OBJECTIVE
To produce a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (dental health component DHC 3) and to compare views of different panels of judges on treatment need.
MATERIALS AND METHODS
Prospective, observational study. Photographs of one hundred subjects displaying borderline occlusal traits (DHC3) were collected. Three panels of judges consisting of 25 orthodontists, 25 dentists and 25 lay persons assessed photographs based on orthodontic treatment need on aesthetic grounds.
RESULTS
Spearman's correlation coefficient showed no statistical difference between the panels of judges (p < 0.001). The judges identified a 'high need' for treatment on aesthetic grounds for those with anterior open bites and reverse overjets. Kappa analysis showed moderate intra-rater agreement for the orthodontic and dental panels of judges (k = 0.47 and 0.45, respectively) and fair agreement (k = 0.26) for the lay panel, highlighting the intrinsic difficulty of assessing borderline malocclusions.
CONCLUSION
There was no statistical difference in the way the orthodontic, dental and lay panels of judges perceived treatment need for DHC 3 cases. Anterior open bites and reverse overjets were predominantly found to be in high need of treatment by all panels of judges. A 'Guide to Borderline Orthodontic Need' (GBON) is proposed consisting of 8 photographs of subjects with borderline occlusal traits (DHC3) determined unambiguously by lay, dental and orthodontic panels as either 'needing' or 'not needing' orthodontic treatment on aesthetic grounds. It is anticipated that this will assist users to make judgments on aesthetic grounds on the need for treatment in borderline cases.
Topics: Esthetics, Dental; Humans; Malocclusion; Open Bite; Orthodontics, Corrective; Overbite; Prospective Studies
PubMed: 35434773
DOI: 10.1186/s40510-022-00407-6