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Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.The Angle Orthodontist Nov 2023To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion.
MATERIALS AND METHODS
Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis.
RESULTS
After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05).
CONCLUSIONS
Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
Topics: Adult; Humans; Root Resorption; Overbite; Open Bite; Malocclusion, Angle Class II; Molar; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliances, Removable; Maxilla
PubMed: 37922387
DOI: 10.2319/010723-14.1 -
The Angle Orthodontist Jan 2024To introduce and validate newly designed computer software to aid in the diagnosis of anterior open bite (AOB).
OBJECTIVES
To introduce and validate newly designed computer software to aid in the diagnosis of anterior open bite (AOB).
MATERIALS AND METHODS
The software was constructed based on the algorithm of a standardized open bite checklist, which considered skeletal, dental, and soft tissue components, as well as smile characteristics. Feeding the software with this input yielded a digital form output (DFO) in the guise of a diagnostic report characterizing the AOB phenotype, contributing components, severity, associated problems, and functional factors. For validation, DFO was compared to a conventional form output (CFO), created in a standardized manner according to expert opinions. Agreement between the DFO and CFO in terms of AOB phenotype was the primary outcome, while the secondary outcome was the number of missing diagnostic components in either method.
RESULTS
Percentage of agreement between CFO and DFO was 82.2%, with a kappa coefficient of 0.78, which is considered a good level of agreement. There was a statistically significant relationship between the number of missing diagnostic components in CFO and level of disagreement, which rendered the DFO more reliable.
CONCLUSIONS
Newly constructed software represents an efficient and valid diagnostic tool for AOB and its contributing components. There was good agreement between CFO and DFO, with the latter being more comprehensive and reliable. The algorithm built in the software can be used as the basis for a future artificial intelligence model to aid in the diagnosis of AOB.
Topics: Humans; Open Bite; Artificial Intelligence; Checklist; Forecasting
PubMed: 37650552
DOI: 10.2319/032923-225.1 -
Journal of Dental Research, Dental... 2023Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the... (Review)
Review
BACKGROUND
Posterior intrusion with skeletal anchorage is one of the effective methods in the treatment of anterior open bite. Knowing the effects of posterior intrusion, the amount of possible molar intrusion using skeletal anchorage, and its impact on clinical and cephalometric indicators can help the clinician choose the optimal treatment method, especially in borderline surgical cases.
METHODS
In this systematic review, a series of articles were collected through a systematic search in databases, and the titles and summaries of all these articles were reviewed. After removing the irrelevant articles, the full texts of the related articles were read carefully, and their validity was evaluated. Only RCTs and observational studies that complied with PICO questions were included. The Cochrane Risk of Bias 2.0 (RoB 2), ROBINS-I, and GRADE were used to assess the risk of bias in the included studies. The relevant information on selected articles was extracted, and a meta-analysis was performed with Review Manager 5.4 software.
RESULTS
The meta-analysis revealed a significant average molar intrusion of 2.89 mm using temporary anchorage devices (TADs). A subgroup analysis showed that miniplates achieved greater intrusion (3.29 mm) compared to miniscrews (2.25 mm) (=0.03). The level of applied force did not significantly affect the degree of intrusion. Dental parameters such as overbite and overjet were notably altered, with overbite increasing by 4.81 mm and overjet decreasing by 2.06 mm on average. As for the skeletal cephalometric characteristics, SNB, ANB, and SN-Pog increased while mandibular plane angle and lower anterior facial height (LAFH) decreased, and these changes were significant. Meanwhile, SNA and palatal angle changes were not significant.
CONCLUSION
TADs have proved effective in achieving significant intrusion of maxillary molars, leading to marked improvements in dental and skeletal characteristics in patients with open bite malocclusion. Miniplates proved more effective in achieving greater intrusion.
PubMed: 38584993
DOI: 10.34172/joddd.2023.40754 -
JAMA Network Open Jan 2024Tick-borne diseases (TBDs) other than Lyme disease, such as spotted fever group rickettsiosis, ehrlichiosis, and galactose-α-1,3-galactose (α-gal) syndrome, are an...
IMPORTANCE
Tick-borne diseases (TBDs) other than Lyme disease, such as spotted fever group rickettsiosis, ehrlichiosis, and galactose-α-1,3-galactose (α-gal) syndrome, are an emerging public health issue. Long-term sequelae secondary to Ehrlichia or Rickettsia infection are uncommon; however, musculoskeletal symptoms are often attributed to prior tick exposure.
OBJECTIVE
To evaluate the potential associations between prior exposure to TBDs and musculoskeletal symptoms, including radiographic osteoarthritis.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study analyzed serum samples from the fourth visit (2017-2018) of the Johnston County Osteoarthritis (JoCo OA) project, an ongoing longitudinal, population-based study in Johnston County, North Carolina. Biospecimen testing and analysis were performed between May 2022 and November 2023. Participants in the JoCo OA project are noninstitutionalized White and Black Johnston County residents 45 years or older.
MAIN OUTCOME AND MEASURES
The primary outcome was seropositivity with Ehrlichia IgG, Rickettsia IgG, and/or α-gal IgE and musculoskeletal symptoms. Secondary outcomes included risk factors associated with elevated α-gal IgE and weighted population point prevalence rates. Participants completed questionnaires, underwent physical assessments, and provided biospecimens for serological testing. Multivariable models were used to estimate associations of interest.
RESULTS
Of the 605 participants who completed the fourth visit of the JoCo OA project, 488 (80.7%) had serum samples available for testing. The 488 participants had a median (IQR) age of 72 (68-78) years and included 336 females (68.9%) and 161 Black (33.0%) and 327 White (67.0%) individuals. The overall weighted point prevalence was 8.6% (95% CI, 5.9%-11.3%) for Ehrlichia IgG, 17.1% (95% CI, 12.6%-21.5%) for Rickettsia IgG, and 19.6% (95% CI, 15.3%-23.8%) for α-gal IgE level greater than 0.1 IU/mL. Only α-gal IgE was associated with knee pain, aching or stiffness (mean ratio, 1.30; 95% CI, 1.09-1.56). Antibodies to Rickettsia, Ehrlichia, and α-gal were not associated with symptomatic radiographic knee osteoarthritis. Male sex (odds ratio [OR], 2.63; 95% CI, 1.55-4.47), current smoker status (OR, 3.55; 95% CI, 1.38-9.18), and an attached tick bite in the past 5 years (OR, 3.99; 95% CI, 2.22-7.15) were all risk factors that were associated with α-gal IgE level greater than 0.1 IU/mL. Despite only 84 individuals (17.2%) recalling a tick bite in the past 5 years, 178 (36.5%) had evidence of prior tick-borne exposure, suggesting frequent human-tick interactions.
CONCLUSIONS AND RELEVANCE
Results of this cross-sectional study indicate no association between Ehrlichia or Rickettsia seropositivity and chronic musculoskeletal symptoms or osteoarthritis. Further investigation is needed into the pathogenesis of α-gal syndrome and interventions to reduce human-tick interactions.
Topics: Female; Male; Humans; Aged; Musculoskeletal Pain; Tick Bites; Cross-Sectional Studies; Galactose; Tick-Borne Diseases; Immunoglobulin G; Osteoarthritis; Immunoglobulin E
PubMed: 38206624
DOI: 10.1001/jamanetworkopen.2023.51418 -
International Journal of Oral and... May 2024The purpose of this study was to investigate the scientific evidence on the short- and long-term effects of orthodontic correction of anterior open bite (AOB) using... (Meta-Analysis)
Meta-Analysis Review
The purpose of this study was to investigate the scientific evidence on the short- and long-term effects of orthodontic correction of anterior open bite (AOB) using skeletal anchorage (SA). Clinical studies on the use of SA for AOB in patients with permanent dentition, or at least 12 years of age, were searched. Short- and long-term (≥2 years) outcomes were collected. Mean differences were calculated from pooled data. Twenty-four eligible articles with a total of 362 subjects were selected for inclusion in the meta-analysis. There was a significant increase in overbite (3.88 mm, P < 0.001) and maxillary molar intrusion (-2.15 mm, P < 0.001). The mandible showed counterclockwise rotation with anterosuperior chin movement (all P < 0.001). Long term, the decrease in overbite was 19.9% and decrease in molar intrusion was 22.9%. The decrease in the mandibular projection was 14.6% for ANB (A-point-nasion-B-point angle) and 46.2% for mandibular anteroposterior position. The overall risk of bias in the included studies was rated as moderate to high, and publication bias existed for several key variables. SA for maxillary molar intrusion effectively improved dental and skeletal outcomes, but there was a long-term decrease in overbite and maxillary molar position. The variable data quality, heterogeneity, and publication bias in investigated outcomes are limitations in interpreting the findings.
Topics: Humans; Open Bite; Overbite; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Cephalometry; Malocclusion, Angle Class II
PubMed: 37949782
DOI: 10.1016/j.ijom.2023.10.031 -
Journal of the World Federation of... Feb 2024Anterior open bite can be effectively treated nonsurgically via molar intrusion. This technique, involving the intrusion of posterior teeth using temporary skeletal...
Anterior open bite can be effectively treated nonsurgically via molar intrusion. This technique, involving the intrusion of posterior teeth using temporary skeletal anchorage devices, prompts counterclockwise rotation of the mandible. This rotation not only corrects anterior open bite but also contributes to a decrease in anterior facial height, improvements in lip incompetency, and forward movement of the chin. For successful outcomes, temporary skeletal anchorage devices, installed on both the buccal and palatal sides, must deliver equivalent intrusion force to the maxillary teeth. Treatment planning should consider factors such as skeletal discrepancies, vertical excess, incisor exposure, and configuration of the occlusal plane. Clinicians are advised to closely monitor periodontal changes and consider overcorrection to ensure lasting stability and maintenance of incisal overlap post-treatment.
Topics: Humans; Open Bite; Orthodontic Anchorage Procedures; Tooth Movement Techniques; Cephalometry; Molar
PubMed: 38185583
DOI: 10.1016/j.ejwf.2023.12.006 -
Journal of Esthetic and Restorative... Jun 2024To present an interdisciplinary case treated with a surgery-first orthognathic approach, followed by orthodontic and prosthodontic treatment.
OBJECTIVES
To present an interdisciplinary case treated with a surgery-first orthognathic approach, followed by orthodontic and prosthodontic treatment.
CLINICAL CONSIDERATIONS
After an accurate pre-operative virtual planning, a young patient with skeletal class II, retrognathia, and an anterior open bite was treated with bimaxillary orthognathic surgery without pre-surgical orthodontic decompensation. Orthodontic treatment was carried out post-operatively. The treatment was completed with a prosthodontic phase to improve the final esthetic outcome of the smile.
CONCLUSIONS
A surgery-first approach allowed to achieve esthetic and functional results in a reduced treatment duration that remained stable over the course of 1 year. The outcomes were consistent with prior research in terms of advantages brought by following an accurately planned surgery-first protocol. Nevertheless, longer-term follow-up was required to evaluate the treatment stability.
CLINICAL SIGNIFICANCE
An accurately planned surgery-first approach significantly helped in shortening the duration of the treatment, while providing a stable, functional, and esthetic solution to the patient's problems.
Topics: Humans; Malocclusion, Angle Class II; Orthognathic Surgical Procedures; Esthetics, Dental; Female; Orthodontics, Corrective; Retrognathia; Open Bite
PubMed: 38289013
DOI: 10.1111/jerd.13199 -
What Are "Bioplastics"? Defining Renewability, Biosynthesis, Biodegradability, and Biocompatibility.Polymers Dec 2023Today, plastic materials are mostly made from fossil resources, and they are characterized by their long lifetime and pronounced persistence in the open environment.... (Review)
Review
Today, plastic materials are mostly made from fossil resources, and they are characterized by their long lifetime and pronounced persistence in the open environment. These attributes of plastics are one cause of the ubiquitous pollution we see in our environment. When plastics end up in the environment, most of this pollution can be attributed to a lack of infrastructure for appropriately collecting and recycling plastic waste, mainly due to mismanagement. Because of the huge production volumes of plastics, their merits of being cheap to produce and process and their recalcitrance have turned into a huge disadvantage, since plastic waste has become the end point of our linear economic usage model, and massive amounts have started to accumulate in the environment, leading to microplastics pollution and other detrimental effects. A possible solution to this is offered by "bioplastics", which are materials that are either (partly) biobased and/or degradable under defined conditions. With the rise of bioplastics in the marketplace, several standards and test protocols have been developed to assess, certify, and advertise their properties in this respect. This article summarizes and critically discusses different views on bioplastics, mainly related to the properties of biodegradability and biobased carbon content; this shall allow us to find a common ground for clearly addressing and categorizing bioplastic materials, which could become an essential building block in a circular economy. Today, bioplastics account for only 1-2% of all plastics, while technically, they could replace up to 90% of all fossil-based plastics, particularly in short-lived goods and packaging, the single most important area of use for conventional plastics. Their replacement potential not only applies to thermoplastics but also to thermosets and elastomers. Bioplastics can be recycled through different means, and they can be made from renewable sources, with (bio)degradability being an option for the mismanaged fraction and special applications with an intended end of life in nature (such as in seed coatings and bite protection for trees). Bioplastics can be used in composites and differ in their properties, similarly to conventional plastics. Clear definitions for "biobased" and "biodegradable" are needed to allow stakeholders of (bio)plastics to make fact-based decisions regarding material selection, application, and end-of-life options; the same level of clarity is needed for terms like "renewable carbon" and "bio-attributed" carbon, definitions of which are summarized and discussed in this paper.
PubMed: 38139947
DOI: 10.3390/polym15244695 -
The Angle Orthodontist Nov 2023To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
OBJECTIVES
To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
MATERIALS AND METHODS
23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index.
RESULTS
All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite.
CONCLUSIONS
Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.
Topics: Humans; Adult; Open Bite; Follow-Up Studies; Tooth; Malocclusion, Angle Class II; Overbite; Cephalometry
PubMed: 37922388
DOI: 10.2319/030623-155.1 -
Journal of Maxillofacial and Oral... Dec 2023The aim of this study was to evaluate the long-term success rate of combined surgical-orthodontic therapy of skeletal anterior open bite.
INTRODUCTION
The aim of this study was to evaluate the long-term success rate of combined surgical-orthodontic therapy of skeletal anterior open bite.
MATERIALS AND METHODS
A total of 11 patients with an anterior open bite treated with a combined surgical-orthodontic therapy were retrospectively analysed via lateral cephalometric radiographs and models before treatment, 7-10 days after surgery (T1), one year post-operatively (T2) and two years post-operatively (T3).
RESULTS
Ten patients continued to experience a positive overbite at T2. This decreased to 8 at T3. Three patients experienced relapse and had a negative overbite at T3. The average pre-treatment overbite was greater in the positive overbite group compared to the relapse group. Spearman's correlation analysis revealed a correlation between preoperative maxilla-mandibular plane angle (MMPA) with the overall change in overbite. Friedman's test followed by Bonferroni post-hoc analysis was carried out to identify any statistical significance.
CONCLUSION
In conclusion, combined surgical-orthodontic treatment achieves good results for anterior open bite. Patients with a high pre-operative MMPA have a higher risk of relapse. Lower anterior facial height ratio to total anterior facial height (LAFH/TAFH) and the amount of impaction do not significantly contribute to the risk of relapse. Long-term stability of overbite for anterior open bite patients should be around 75%.
PubMed: 38105834
DOI: 10.1007/s12663-021-01642-w