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Sleep & Breathing = Schlaf & Atmung May 2024The purpose of this study was to determine if objectively measured adherence to oral appliance (OA) treatment may affect dental changes and temporomandibular disorders...
PURPOSE
The purpose of this study was to determine if objectively measured adherence to oral appliance (OA) treatment may affect dental changes and temporomandibular disorders (TMD) in patients with obstructive sleep apnea (OSA).
METHODS
The original study group consisted of adults with OSA who were referred for OA therapy. Eight indicators of subjective side effects of using OA (temporomandibular joint (TMJ) and muscle pain, pain in teeth, jaw stiffness in the morning, clicking, dry mouth, hypersalivation, gingival irritation) were evaluated by a questionnaire. Three occlusal indicators (overjet, overbite, molar occlusion) and clinical TMD signs (TMJ pain, muscle pain, clicking, jaw deviation on opening) were evaluated at baseline and at the 3-, 6-, and 12-month follow-up. In addition, objective adherence monitoring for OA was registered. Statistical analyses included the chi-square test, Fisher's exact test, paired sample t-test, and linear regression analyses.
RESULTS
A total of 58 adults with OSA were referred for OA therapy. Mean (SD) age was 50.7 (11.7) and mean apnea-hypopnea index (AHI) was 19.5 (10.0). At 1-year follow-up, the study group consisted of 28 men and 12 women. Overjet but not overbite reduced significantly after 1-year OA therapy. The average nightly wear of OA was related to overjet and overbite reduction, and to TMD signs. Hypersalivation, dry mouth, and tooth discomfort were the most common subjective side effects of OA therapy.
CONCLUSION
There was a time-dependent relationship with the nightly wear of OA and reduction in overjet and overbite, and clinical TMD signs. With 60% of mandibular advancement, dental changes and TM-disorders were considered mild/minor in the 1-year study period.
Topics: Humans; Sleep Apnea, Obstructive; Mandibular Advancement; Male; Female; Middle Aged; Adult; Patient Compliance; Temporomandibular Joint Disorders
PubMed: 38114783
DOI: 10.1007/s11325-023-02959-1 -
Case Reports in Dentistry 2023The objectives of the treatment of impacted canines differ according to the characteristics of dental malocclusion. Traction of the tooth is a conservative and viable...
The objectives of the treatment of impacted canines differ according to the characteristics of dental malocclusion. Traction of the tooth is a conservative and viable alternative, which allows for maintaining stability and occlusal function. The following case report describes the treatment of an 11.6-year-old female patient, who presented bilateral impaction of mandibular canines in contact with the midline, mixed dentition in the inter-transitional period, class I angle malocclusion, with light crowding teeth. The treatment comprised three phases. The first phase, verticalization of the mandibular canines in mixed dentition, was performed to pull the impacted bilateral mandibular canines towards the dental arch to achieve their verticalization, maintaining the molar relationship, and the position of the upper and lower incisors. In the second phase, osteogenic rest was planned to relieve post-traction stress while awaiting the replacement of the mixed dentition. Finally, the third phase in permanent dentition was to align and level canines within the arch after extraction of the deciduous canines. For the viability of the permanent mandibular canines in the dental arch, orthosurgical traction was implemented, with a traction system with closed nickel-titanium coil springs with a transitory rigid dental-mucous-supported anchorage device, which allowed control and protection of the adjacent teeth and movements with helical forces of a controlled three-dimensional range. The results of the treatment were adequate, achieving consolidated molar and canine relationships, overjet, overbite, and optimal facial balance.
PubMed: 37560509
DOI: 10.1155/2023/6943221 -
European Journal of Orthodontics Nov 2023The objective of this study was to examine the relative contributions of genetic and environmental influences on variation in dental arch form in individuals who have...
OBJECTIVE
The objective of this study was to examine the relative contributions of genetic and environmental influences on variation in dental arch form in individuals who have largely completed their craniofacial growth.
MATERIAL AND METHODS
The subjects of this study comprised dental casts of 50 monozygotic twins and 24 dizygotic twins from the collection of records of twins housed at the Adelaide Dental School, Australia. The subjects were of Western European descent, with an average age of 20.93 ± 5.58 years. Dental casts were scanned using a 3D scanner to analyse the dental arch form. Landmark-based inter-arch and intra-arch measurements were performed. Structural equation modelling was employed to analyse the quantitative data using the normal assumptions of the twin model.
RESULTS
Genetic modelling revealed that additive genetic and unique environmental factors best explained the observed variation for all occlusal traits measured, except for mandibular intercanine width. High heritability was observed for most intra-arch occlusal variables (0.61-0.85) including the maxillary and mandibular intercanine and intermolar widths, arch depth and perimeter. In contrast, moderate heritability was found for inter-arch occlusal variables (0.52-0.59) such as overjet and overbite. Sexual dimorphism was evident, with males displaying larger posterior arch width than females (P < 0.05).
LIMITATIONS
Our sample was limited to individuals of Western European ancestry.
CONCLUSION
The predominant source of occlusal variation within this group of Australian twins of Western European descent was controlled by genetic effects, and most were highly heritable. Generally, intra-arch occlusal variables showed greater heritability compared with inter-arch occlusal variables.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Dental Arch; Australia; Malocclusion, Angle Class II; Overbite; Twins, Monozygotic
PubMed: 37861389
DOI: 10.1093/ejo/cjad054 -
American Journal of Orthodontics and... Dec 2023This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners.
INTRODUCTION
This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners.
METHODS
This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse.
RESULTS
The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant.
CONCLUSIONS
AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.
Topics: Male; Female; Humans; Adult; Overbite; Retrospective Studies; Open Bite; Malocclusion, Angle Class II; Cephalometry; Recurrence; Orthodontic Appliances, Removable
PubMed: 37552148
DOI: 10.1016/j.ajodo.2023.05.026 -
Journal of Clinical Medicine May 2024We investigated treatment outcomes and post-treatment stability in 10 patients with an anterior open bite and nonsurgical orthodontics. The patients underwent...
We investigated treatment outcomes and post-treatment stability in 10 patients with an anterior open bite and nonsurgical orthodontics. The patients underwent maxillary molar intrusion using temporary anchorage devices (TADs) to deepen the overbite due to mandibular autorotation. Lateral cephalograms and dental cast models were obtained before treatment (T0), immediately after it (T1), and >1 year after it (T2). Skeletal and dental cephalometric changes and three-dimensional movements of the maxillary dentitions were evaluated. At T0, cephalometric analysis indicated that patients had skeletal class I with tendencies for a class II jaw relationship and a skeletal open bite. During active treatment (T0 to T1), the maxillary first molar intruded by 1.6 mm, the mandibular first molar extruded by 0.3 mm, the Frankfort-mandibular plane angle decreased by 1.1°, and the overbite increased by 4.1 mm. Statistically significant changes were observed in the amount of vertical movement of the maxillary first molar, Frankfort-mandibular plane angle, and overbite. Three-dimensional (3D) dental cast analysis revealed that the maxillary first and second molars intruded, whereas the anterior teeth extruded, with the second premolar as an infection point. In addition, the maxillary molar was tipped distally by 2.9° and rotated distally by 0.91°. Statistically significant changes were observed in the amount of vertical movement of the central incisor, lateral incisor, canine and first molar, and molar angulation. From T1 to T2, no significant changes in cephalometric measurements or the 3D position of the maxillary dentition were observed. The maxillary and mandibular dentitions did not significantly change during post-treatment follow-up. Maxillary molar intrusion using mini-screws is an effective treatment for open bite correction, with the achieved occlusion demonstrating 3D stability at least 1 year after treatment.
PubMed: 38792293
DOI: 10.3390/jcm13102753 -
Orthodontics & Craniofacial Research Aug 2024Evaluate long-term spontaneous occlusal changes following L7 extraction in adolescent patients.
OBJECTIVES
Evaluate long-term spontaneous occlusal changes following L7 extraction in adolescent patients.
MATERIALS AND METHODS
Study models of 144 participants (63 males, 81 females) retrospectively assessed prior to L7 extraction (9-16 years old; T1) and following L8 eruption (14-25 years old; T2). All received upper fixed appliances. A sub-group (n = 86) received no lower fixed appliances and acted as controls. Occlusal changes were compared between treatment (lower fixed appliance) and control (no lower fixed appliance) groups using PAR index. At T2, L8 occlusal outcome was assessed using ABO grading system.
RESULTS
Mean follow-up period 6 (SD 2) years. At T1, lower scores observed in control group for Lower Anterior (P < .001), Midline (P = .033) and Lateral Segments (P = .040) components. At T2, lower scores continued being observed in control group for Midline (P < .001) and Lateral segment (P = .019) components. Higher decrease in Lower Anterior PAR scores observed in treatment group (<.001) with comparable scores between groups at T2 (P = .057). Similar PAR score changes between groups for Lateral Segments, Overjet and Overbite components. At T2, no significant difference observed in Total PAR score reduction between control (83%) and treatment (82%) groups. Good-to-acceptable occlusal outcome of the L8 observed in 81.55% of cases at T2 with no difference between groups.
CONCLUSION
In growing patients with mild mandibular crowding, extraction of L7 followed by upper fixed appliance therapy, leads to favourable occlusal changes over a 6-year follow-up period, with or without lower fixed appliance therapy, being an alternative extraction protocol where lower fixed appliance therapy is not recommended.
Topics: Humans; Male; Adolescent; Female; Retrospective Studies; Tooth Extraction; Child; Molar; Malocclusion; Mandible; Orthodontic Appliances, Fixed; Young Adult; Adult; Follow-Up Studies; Dental Occlusion
PubMed: 38444245
DOI: 10.1111/ocr.12772 -
International Dental Journal Jun 2024The objective of the study was to compare the effects of orthodontic microimplant anchorage (MIA) and conventional extraoral arch anchorage (EAA) on tooth structure and... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
INTRODUCTION
The objective of the study was to compare the effects of orthodontic microimplant anchorage (MIA) and conventional extraoral arch anchorage (EAA) on tooth structure and oral inflammatory response in patients with Class II Division I malocclusion.
METHODS
A total of 104 patients with Class II malocclusion were enrolled and were randomly assigned to receive MIA or EAA treatments. Clinical efficacy was assessed at 6 months after treatment by measuring molar shift, convex distance, and hinge angle difference between maxillary and mandibular incisors. X-ray was performed for tissue evaluations. The levels of cell adhesion molecule-1 (CAM-1), matrix metalloproteinase-2 (MMP-2), and proinflammatory cytokines in gingival sulcus fluid were measured using enzyme-linked immunosorbent assay to assess inflammatory responses to the implants.
RESULTS
Our study demonstrated superior efficacy of MIA compared to EAA in terms of overall efficacy, molar shift, convex distance between upper and middle incisors, as well as hinge angle difference between upper and middle incisors. MIA also showed greater efficacy in reducing tissue fix-point measurements, including saddle point-nasal root point-superior alveolar seat point (SNA), alveolar seat point-nasal root point-inferior alveolar seat point (ANB), overlying (OJ), and overbite (OB).
CONCLUSIONS
MIA is a novel orthodontic treatment that showed stronger efficacy in inducing molar shift and correcting soft/hard tissue positions, whilst generating suppressed inflammatory responses. Our study could have significant implications for practice in the orthodontic treatment of Class II malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Orthodontic Anchorage Procedures; Male; Female; Adolescent; Treatment Outcome; Gingival Crevicular Fluid; Young Adult; Matrix Metalloproteinase 2
PubMed: 38057214
DOI: 10.1016/j.identj.2023.11.008 -
BMC Oral Health Feb 2024To analyse the anterior teeth effects of clear aligners on five different patterns of mandibular molar movement and to define the most effective configuration to be...
OBJECTIVE
To analyse the anterior teeth effects of clear aligners on five different patterns of mandibular molar movement and to define the most effective configuration to be implemented with clear aligners through finite element analysis.
METHODS
A three-dimensional mandibular model with a deep overbite in the mandible was constructed using cone beam computerized tomography (CBCT) data. The model included the mandibular dentition, mandibular periodontal ligaments, attachments, and aligners. Five models were created: (1) configuration A: second molar distalization (0.25 mm); (2) configuration B: second molar distalization (0.25 mm), first molar extrusion (0.15 mm); (3) configuration C: second molar distalization (0.25 mmm), first and second premolar extrusion(0.15 mm); (4) configuration D: second molar distalization (0.25 mm), first molar and first/second premolar extrusion(0.15 mm); and (5) configuration E: second molar distalization (0.25 mm), first molar and first/second premolar extrusion (0.15 mm), first molar and first/second premolar expansion (0.15 mm).
RESULTS
In all configurations, the anterior teeth exhibited labial tipping and the mandibular central incisor of configuration E showed the highest labial tipping. Configuration E demonstrated a relatively minor impact on mandibular molars distalization compared with configuration A. Configuration A showed the highest distal displacement value, and configuration E produced the lowest displacement value. Configuration E caused the highest periodontal ligament (PDL) pressure of the central and lateral incisors. The differences in the canines between configurations C and D,were not significant, and the stress distribution differed among the five groups.
CONCLUSIONS
All patterns utilizing clear aligners facilitated mandibular molar distalization. Extruding the premolars and second molar distalization at the same time had little impact on second molar distalization; When expansion and extrusion were simultaneously performed during the distalization of mandibular molars, our prime consideration was the alveolar bone on the labial side of the anterior teeth to prevent the occurrence of gingival recession, dehiscence, and fenestration. Due to the lack of consideration for periodontal tissues in this study, clinical protocols should be designed based on the periodontal status of the mandibular anterior teeth.
Topics: Humans; Finite Element Analysis; Molar; Incisor; Periodontal Ligament; Orthodontic Appliances, Removable; Tooth Movement Techniques
PubMed: 38341537
DOI: 10.1186/s12903-024-03906-6 -
The Journal of Craniofacial Surgery Nov 2023Post-traumatic mandibular malocclusion is a complex condition that poses a significant challenge to reconstructive surgeons. The malocclusion that ensues from bilateral...
BACKGROUND
Post-traumatic mandibular malocclusion is a complex condition that poses a significant challenge to reconstructive surgeons. The malocclusion that ensues from bilateral condylar and parasymphseal fractures presents a particular challenge as it leads to bilateral posterior shortening and lingual tilting of dental arch leading to a combination of open anterior bite, crossbite, overbite, underbite, and/or facial asymmetry. The complexity of such malocclusion requires intricate freedom of movement of the mandibular arch that can be achieved by performing a 5-segment mandibular osteotomy.
METHOD
This is a case series of 9 adult patients with significant post-traumatic mandibular malocclusion who were treated with 5-segment mandibular osteotomy technique. This article details the demographics, surgical technique and outcomes in this cohort of patients.
RESULTS
All 9 patients in this series had condylar fracture as part of the index mandibular trauma. They have a common post-traumatic deformity of the mandibular arch due to shortening of the vertical mandibular height in the fracture site and variable degrees of lingual tilting leading to crossbite. The 5-segment mandibular osteotomy provided an adequate correction of dental and facial deformities in all 9 patients. One patient had a relapse of the dental malocclusion that required postoperative rescue orthodontics. Furthermore, one patient had a significant postoperative hemorrhage that required a facial artery ligation.
CONCLUSION
Post-traumatic mandibular malocclusion is a complex deformity that poses a great challenge to practicing surgeons. Five-segment mandibular osteotomy is a technique that provides ample degrees of movement of mandibular segments that is necessary to correct such deformity.
PubMed: 37972983
DOI: 10.1097/SCS.0000000000009840 -
Journal of Pharmacy & Bioallied Sciences Feb 2024Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open...
BACKGROUND
Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open bites, but the effectiveness of Invisalign, a clear aligner therapy, in open bite correction remains a topic of interest.
MATERIALS AND METHODS
A retrospective analysis was conducted on a cohort of 50 patients with open bites who underwent Invisalign treatment. Pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs, were assessed. The open bite was defined as a negative overbite greater than 2 mm. Treatment duration, number of aligners used, and patient compliance were also recorded. Statistical analysis, including paired t-tests and subjective patient feedback, was employed to evaluate the treatment outcomes.
RESULTS
The mean pre-treatment open bite was -3.5 mm (SD = 1.2), and the mean treatment duration was 18 months (SD = 2.5). On average, patients received 24 sets of aligners (SD = 4.1) during the treatment. Post-treatment evaluation showed that the mean overbite improved to + 1.5 mm (SD = 0.8), indicating successful open bite correction. The paired -test revealed a statistically significant difference between pre-treatment and post-treatment open bite measurements ( < 0.001). Patient satisfaction was high, with 90% of participants reporting improved aesthetics and comfort.
CONCLUSION
Invisalign treatment demonstrates effectiveness in correcting open bites, with statistically significant improvements in overbite measurements.
PubMed: 38595389
DOI: 10.4103/jpbs.jpbs_1058_23