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American Journal of Orthodontics and... Aug 2022Although the Invisalign appliance has reported difficulty in achieving the overbite outcomes predicted by ClinCheck software (Align Technology, Santa Clara, Calif), the...
INTRODUCTION
Although the Invisalign appliance has reported difficulty in achieving the overbite outcomes predicted by ClinCheck software (Align Technology, Santa Clara, Calif), the effect of modifications to the material and components of the appliance are largely unquantified. This study aimed to investigate and determine the accuracy of Invisalign in correcting a deep overbite by comparing the predicted outcome from ClinCheck to the achieved posttreatment outcome for treatment groups that use different components of the appliance system.
METHODS
A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 2 groups of consecutively treated adult patients from private specialist orthodontic practices, 1 group treated with EX30 material with no bite ramps (n = 29) and 1 treated with the newer SmartTrack material and precision bite ramps (n = 39). Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. Geomagic Control X software (3D Systems, Rock Hill, SC) was used to measure overbite in the pretreatment, posttreatment, and predicted outcome stereolithography files for each patient. Results were compared with a previously published treatment group that used SmartTrack material and no precision bite ramps.
RESULTS
The regression coefficient analysis indicated that for both groups, the deeper the pretreatment overbite and the greater overbite reduction projected according to ClinCheck, there is a linear increase in the discrepancy of overbite expression posttreatment. ClinCheck overpredicted overbite reduction in 96.6% of patients with precision bite ramp in which, on average, 43.4% of the prescribed overbite reduction was expressed. For EX30 patients, ClinCheck overpredicted overbite reduction in 87.2% of patients in which, on average, 55.1% of the prescribed overbite reduction was expressed.
CONCLUSIONS
The use of precision bite ramps does not appear to significantly improve the ability of SmartTrack material to predictably open the bite. SmartTrack material with or without bite ramps does not appear to produce better bite opening predictability than that seen with EX30 material.
Topics: Adult; Dental Occlusion; Humans; Malocclusion, Angle Class II; Orthodontic Appliances, Removable; Overbite; Retrospective Studies
PubMed: 35750579
DOI: 10.1016/j.ajodo.2022.05.012 -
Clinical Oral Investigations Oct 2022This study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for...
OBJECTIVES
This study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for orthodontic treatment by quantifying the Discrepancy Index (DI) and Index of Orthodontic Treatment Need (IOTN).
MATERIALS AND METHODS
Dental records of 48 ASD and 49 non-ASD consecutive patients aged between 9 and 18 years (median age 13.0 years) referred for orthodontic treatment were reviewed and compared. The Discrepancy Index (DI) was quantified to determine the malocclusion complexity, and the Index of Orthodontic Treatment Need (IOTN), including the Dental Health Component (IOTN-DHC) and Aesthetic Component (IOTN-AC), was quantified to determine the orthodontic treatment need. Statistical analysis included descriptive analysis, Pearson chi-square tests, Fisher's exact test, Mann-Whitney U tests, and several univariate and multivariate regression analyses. The statistical analysis used descriptive analysis, Pearson chi-square test, Fisher's exact test, and multivariate logistic regression.
RESULTS
The results show that both malocclusion complexity (DI, p = 0.0010) and orthodontic treatment need (IOTN-DHC, p = 0.0025; IOTN-AC p = 0.0009) were significantly higher in children with ASD. Furthermore, children with ASD had a higher prevalence of increased overjet (p = .0016) and overbite (p = .031).
CONCLUSIONS
Malocclusion complexity and orthodontic treatment need are statistically significantly higher among children with ASD than children without ASD, independent of age and sex.
CLINICAL RELEVANCE
Children with autism may benefit from visits to a dental specialist (orthodontist) to prevent, to some extent, developing malocclusions from an early age.
Topics: Adolescent; Autism Spectrum Disorder; Child; Esthetics, Dental; Health Services Needs and Demand; Humans; Index of Orthodontic Treatment Need; Malocclusion; Malocclusion, Angle Class II; Orthodontics, Corrective; Overbite
PubMed: 35701552
DOI: 10.1007/s00784-022-04578-8 -
Evidence-based Dentistry Dec 2022Trial design A single-centre two-arm parallel group randomised controlled trial.Objectives To assess differences in dental stability, patient perceptions and compliance... (Review)
Review
Trial design A single-centre two-arm parallel group randomised controlled trial.Objectives To assess differences in dental stability, patient perceptions and compliance and retainer failures in adolescents treated with vacuum-formed retainers (VFR) compared with those receiving bonded canine-to canine retainers after five years in retention.Methods In total, 104 eligible adolescents treated with fixed appliances in both jaws in a Swedish orthodontic clinic were randomised to two retention protocols. The intervention protocol consisted of a VFR covering all erupted teeth in the maxilla and a VFR in the mandible covering first premolar to first premolar. The controls received a VFR in the maxilla covering all erupted teeth and a bonded retainer wire to the lingual surfaces of the canines. The primary outcomes were various dental stability measures assessed at: debond (T1); six months (T2); 18 months (T3); and after five years (T4) in retention. Generalised estimating equations were used to quantify the effect of the different interventions on these outcome measures. One operator assessed all outcomes and participants could not be blinded. For the secondary outcomes, the perception and compliance with the retention protocols were assessed and the prevalence and rationale of retainer failure at T4. The trial was registered at ClinicalTrials.gov (NCT03070444) and the research project was supported by the Centre for Research and Development, Region Gävleborg, Sweden.Results Of the 104 randomised patients, 30 were not available at T4, leaving 35 patients in the intervention and 39 in the comparator group. An intention-to-treat analysis was used to impute outcomes for the missing patients. Post-treatment changes at T4 were small in both jaws. In the maxilla, the Little's Irregularity Index (LII) increased similar in both retention groups (median difference: 0.3 mm). In the mandible, the median difference for the LLI in the bonded retainer group was 0.1 mm compared with 0.6 mm in VFR group. In both retention protocols, the overjet remained stable, the overbite increased and the arch lengths continued to decrease. Intercanine and intermolar width remained stable in the mandible. Intermolar width decreased significantly in the maxilla. No differences in satisfaction were found between retention protocols after five years. Also, 72% of patients had stopped or rarely wore the VFR appliances at T4. Besides some retainer failures in both groups, no serious adverse effects associated with the retainers were reported.Conclusions Most post-treatment changes in both retention protocols were small in both jaws, except for the anterior alignment in the mandible, which was more stable in the bonded retainer group. This difference is possibly not related to the retention technique but to the poor compliance with the VFRs and the inclusion of adolescents only. Satisfaction with both protocols was similar.
Topics: Humans; Maxilla; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontics, Corrective; Overbite; Randomized Controlled Trials as Topic; Adolescent
PubMed: 36526846
DOI: 10.1038/s41432-022-0845-7 -
Cephalometric evaluation of hyoid bone position in subjects with different vertical dental patterns.Nigerian Journal of Clinical Practice Mar 2021This study investigated the relationship between hyoid position and vertical dental dimensions (overbite), and the influence of gender on the location of this bone.
OBJECTIVE
This study investigated the relationship between hyoid position and vertical dental dimensions (overbite), and the influence of gender on the location of this bone.
METHODS
One hundred and seventy-four standardized lateral cephalometric radiographs were randomly selected from a pool of radiographs of patients seeking orthodontic treatment with ages ranging from 10 to 58 years. The subjects were divided into three groups according to their vertical dental dimensions (overbite) into reduced, normal, and increased overbite groups. The hyoid bone position was determined by four horizontal linear and three vertical linear line measurements. Associations between the position of the bone and different vertical dental patterns were analyzed using ANOVA and Tukey's multiple comparison analysis.
RESULTS
There was a progressive increase in the horizontal linear position of the hyoid bone parameters across the groups from the reduced through normal to increase overbite. Similarly, a statistical reduction in the vertical linear positions of the hyoid bone parameters was found across the groups from reduced overbite through normal overbite to increased overbite (P < 0.05). The vertical linear hyoid bone positions were located higher in the male than in female subjects. Tukey's multiple comparison analysis showed a highly statistically significant difference in the vertical linear hyoid bone positions between reduced and normal overbite groups and between reduced and increased overbite groups.
CONCLUSION
The hyoid bone was positioned more antero-inferiorly and more postero-superiorly in subjects with reduced overbite and increased overbite, respectively.
Topics: Adolescent; Adult; Cephalometry; Child; Female; Humans; Hyoid Bone; Male; Middle Aged; Young Adult
PubMed: 33723104
DOI: 10.4103/njcp.njcp_430_20 -
BMC Oral Health Aug 2023The main purpose of the study was to investigate the prevalence and related risk factors of malocclusion in permanent dentition among adolescents in Shanghai, and...
BACKGROUND
The main purpose of the study was to investigate the prevalence and related risk factors of malocclusion in permanent dentition among adolescents in Shanghai, and provide basic data for government's preventive strategies and intervention plans.
METHODS
1799 adolescents aged 11-15 years old from 18 middle schools in 6 districts of Shanghai were recruited to investigate oral health status and related risk factors using cluster random sampling method in 2021. Malocclusion and caries were examined by on-site inspection. The investigation criteria referred to Bjoerk and the recommendation of the WHO. The malocclusion inspection items included molars relationship, canine relationship, overbite, overjet, midline displacement, anterior crossbite, posterior crossbite, scissors bite, crowding and spacing. The subjects were asked to fill in a questionnaire including parents' education level, oral health behaviors and dietary habits. The chi-square test and logistic regression analysis were used to analyze the relationship between malocclusion and risk factors.
RESULTS
1799 adolescents were included in the study and the prevalence of malocclusion in adolescents in Shanghai was 83.5%, and the proportion of molar relationship class I, class II, and class III was 48.9%, 14.7%, and 19.0%, respectively. The most common occlusal characteristic of malocclusion was anterior crowding, followed by midline irregularities and deep overbite, with prevalence rates of 44.8%, 39.0% and 38.6%, respectively. The prevalence rate of adolescents with caries was 34.3%. Those who had dental caries and preferred soft food were more likely to have abnormal occlusal characteristics (p < 0.05).
CONCLUSION
The prevalence of malocclusion in adolescents in Shanghai is high, so it is of great significance to strengthen oral health education, allocate proper preventive strategies and carry out the early correction if necessary.
Topics: Humans; Overbite; Dental Caries; Prevalence; China; Malocclusion
PubMed: 37620836
DOI: 10.1186/s12903-023-03187-5 -
International Journal of Clinical... 2020The purpose of this research is to analyze and compare the dental and skeletal changes induced by two functional devices, Andreasen Activator and Clark's twin block, on...
AIM
The purpose of this research is to analyze and compare the dental and skeletal changes induced by two functional devices, Andreasen Activator and Clark's twin block, on the sagittal and vertical plane, by means of cephalometric analysis, of the lateral cephalograms prescribed at the beginning and at the end of the treatment for a second skeletal class, first division with normal or deep bite.
MATERIALS AND METHODS
Twenty patients, 8 females and 12 males, fulfilling criteria for inclusion, were divided randomly into two groups: group I was treated with Andreasen activator, the second group with Clark's twin block. The duration of the therapy was about 18 months plus less 2 months. Pretreatment and posttreatment cephalometric radiographs were analyzed using angular (SNA, SNB, ANB, SnaSnp-GoGn angles), linear (Sna-Snp, Co-Gn, Co-Go, Go-Gn) skeletal parameters and dental one (U1-SnaSnp angle, L1-GoGn angle, Overjet and Overbite). To evaluate the posttreatment changes in the single groups and between them, paired and unpaired -test was used.
RESULTS
In both of the two groups analyzed, all the sagittal and vertical, angular and linear, skeletal measurements appear to be increased in a statistically significant way, except SNA angle and the distance Sna-Snp. Regarding the dental parameters, in the group treated with Andreasen activator, only Overjet and Overbite showed statistically significant differences. On the other hand, twin block induced statistical changes about Overjet, Overbite and also U1/SnaSnp, but not about L1/GoGn. The advancement of the mandible determines a greater prominence of the chin and lower lip, an increment of the labial mental angle and a reduction of the convexity of the profile. Also, the decrease of the overjet and, consequently, of the dental exposure improve the esthetic appearance of the patient's face.
CONCLUSION
Both functional treatments showed a lower jaw advanced on the sagittal plane and increased in size. In the upper jaw no significant changes were observed. It was also evident a dental compensation both on sagittal and vertical planes.
CLINICAL SIGNIFICANCE
The functional devices studied, Andreasen activator and twin block, seem to obtain more skeletal than dental results when the patients were treated at the peak of pubertal growth.
HOW TO CITE THIS ARTICLE
Baccaglione G, Rota E, Ferrari M, Second Class Functional Treatment: Andreasen Activator vs Twin Block. Int J Clin Pediatr Dent 2020;13(2):144-149.
PubMed: 32742091
DOI: 10.5005/jp-journals-10005-1725 -
International Journal of Environmental... Apr 2021Specific dentofacial characteristics in wind instrumentalists should be taken in consideration when analyzing physiological and anatomical issues regarding the...
BACKGROUND
Specific dentofacial characteristics in wind instrumentalists should be taken in consideration when analyzing physiological and anatomical issues regarding the musician's embouchure, posture, and biomechanics during musical performance.
OBJECTIVES
To compare tooth cephalometric characteristics between wind instrument players and string players (overjet, overbite, lower facial height, facial convexity, lower incisor inclination, and interincisal angle).
METHODS
In total, 48 wind instrumentalists (67%) and 24 string instrumentalists (33%). These musicians performed lateral tele-radiography and the correspondent linear and angular measurements of the dentofacial cephalometric analysis. Statistical comparison of wind and string instrumentalists was made by using an independent t-test.
RESULTS
Small variations on the analyzed parameters were found between the wind and string instrument groups. Based on the cephalometric analysis the variable interincisal angle was statistically significant ( < 0.05), when comparing the wind and string instrument group.
CONCLUSIONS
Knowledge of the overjet and overbite value permits a substantial analysis on the tooth position of wind instrument players, where both of these parameters are increased and greater than the norm value. The cephalometry was an added value on the interpretation of possible factors that lead to the position of the central incisors of wind instruments. Till some extent in this group of musicians the applied forces during the embouchure mechanism on the anterior teeth and the existing perioral forces promote an equilibrium on the vector of forces. This study findings demonstrate that when evaluating the two samples, wind and string instruments there are different dentofacial configurations, however the only statistically significant differences that were found are related to the interincisal angle ( < 0.05).
Topics: Cephalometry; Face; Humans; Music; Radiography; Tooth
PubMed: 33921609
DOI: 10.3390/ijerph18084306 -
Progress in Orthodontics Aug 2020The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits. (Review)
Review
BACKGROUND
The aim of this systematic review was to identify, evaluate, and provide a current literature about the influence of heritability on the determination of occlusal traits.
MATERIALS AND METHODS
MEDLINE, SCOPUS, Web of Science, LILACS, and Google Scholar were searched without restrictions up to March 2020. Studies with twin method were considered and the risk of bias assessment was performed using quality of genetic association studies checklist (Q-Genie). The coefficient of heritability (h), model-fitting approaches, and coefficient correlation were used to estimate the genetic/environmental influence on occlusal traits. The GRADE tool was used to assess the quality of the evidence.
RESULTS
Ten studies met the eligibility criteria. Three studies presented good quality, five moderate quality, and two poor quality. Most studies have found that the intra-arch traits, mainly the maxillary arch morphology, such as width (h 16-100%), length (h 42-100%), and shape (h 42-90%), and the crowding, mainly for mandibular arch (h 35-81%), are under potential heritability influence. The traits concerning the inter-arch relationship, as overjet, overbite, posterior crossbite, and sagittal molar relation, seem not to be genetically determined. The certainty of the evidence was graded as low for all outcomes.
CONCLUSIONS
Although weak, the available evidence show that the heritability factors are determinant for the intra-arch traits, namely, arch morphology and crowding. Possibly due they are functionally related, the occlusal traits concerning the maxillary and mandibular relationship seem to have environmental factors as determinants. In this scenario, early preventive approaches can offer a more effective and efficient orthodontic treatment.
Topics: Humans; Malocclusion; Malocclusion, Angle Class II; Mandible; Maxilla; Overbite
PubMed: 32864724
DOI: 10.1186/s40510-020-00330-8 -
The Angle Orthodontist May 2022To examine relapse with thermoplastic retainers equipped with microsensors 1 year after treatment.
OBJECTIVES
To examine relapse with thermoplastic retainers equipped with microsensors 1 year after treatment.
MATERIALS AND METHODS
A total of 42 patients (29 females, 13 males) treated with four premolar extractions were included in this study. Thermoplastic appliances equipped with TheraMon microsensors (Handelsagentur Gschladt, Hargelsberg, Austria) were used to assess daily wear time (DWT), and the patients were monitored at 2-month intervals for a period of 12 months. At the end of the follow-up, the following two groups were formed based on the mean DWT: short wear time (SWT; <9 h/d) and long wear time (LWT; ≥9 h/d). Digital models were constructed before treatment (T0), at debonding (T1), and 6 months (T2) and 12 months (T3) after debonding. Little's Irregularity Index (LII) and the intercanine and intermolar widths, arch lengths, overjet, and overbite were calculated based on the digital models. Data were analyzed statistically.
RESULTS
Irregularity and overjet increased, whereas transverse measurements and arch lengths decreased with time in both groups. During the retention period, overbite decreased in the SWT group but increased in the LWT group. There were significant differences between groups only in mandibular irregularity. The LII values of the SWT group were significantly higher than those of the LWT group for the T1-T2 and T1-T3 time intervals (P < .05).
CONCLUSIONS
A mean DWT less than 9 hours/day was inadequate for controlling irregularity within clinically acceptable limits. A wear time of at least 9 h/d is recommended for the maintenance of mandibular anterior alignment.
Topics: Female; Humans; Male; Malocclusion, Angle Class II; Mandible; Orthodontic Retainers; Overbite; Recurrence
PubMed: 35076691
DOI: 10.2319/072221-578.1 -
European Journal of Orthodontics Jan 2021Long-term dental stability is one of the main objectives following combined orthodontic and orthognathic surgical treatment. It is influenced by multiple factors such as...
BACKGROUND
Long-term dental stability is one of the main objectives following combined orthodontic and orthognathic surgical treatment. It is influenced by multiple factors such as surgical, patient-related, and orthodontic aspects. While recent reviews mainly focus on short-term dental changes (0.5-2 years), longer follow-up dental stability remains hardly reviewed.
OBJECTIVES
The aim of this study was to evaluate long-term stability of dental and dentolabial changes following combined orthodontic and orthognathic surgical treatment with a minimum follow-up period of 5 years.
SEARCH METHODS
A systematic search was conducted up to December 2019 using Pubmed, Embase, Web of Science, and Cochrane Central.
SELECTION CRITERIA
Randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case series with a minimum of 10 patients, which reported long-term dental stability following combined orthodontic and orthognathic treatment, were included.
DATA COLLECTION AND ANALYSIS
Long-term changes were assessed for overjet, overbite, maxillary, and mandibular incisors' position and relationship of lip position to maxillary and mandibular incisors. Risk of bias was assessed according to the Cochrane Handbook.
RESULTS
Following the screening of 3178 articles, 11 studies were included (2 RCT, 9 retrospective) with a postoperative follow-up period ranging from 5 to 15 years. A decrease in overjet was observed for patients with skeletal class III malocclusion, whereas overjet increased in class II patients at long-term follow-up. Overbite increased in class II patients, whereas class III showed variable results. The lower incisor position was more stable vertically than horizontally; the latter showing more outcome variability. Dentolabial changes corresponded to the normal ageing process and results were not clinically significant after long-term follow-up.
CONCLUSION
Current evidence suggests variability of dental and dentolabial stability in both skeletal class II and III patients. Further prospective studies are required to develop guidelines for long-term follow-up assessment using computer tomography or cone-beam computed tomography imaging, before final conclusions can be drawn.
REGISTRATION
The protocol for this systematic review (CRD42020133844) was registered in the International Prospective Register of Systematic Reviews (PROSPERO).
Topics: Cephalometry; Humans; Malocclusion, Angle Class II; Malocclusion, Angle Class III; Orthognathic Surgery; Orthognathic Surgical Procedures; Randomized Controlled Trials as Topic
PubMed: 32901268
DOI: 10.1093/ejo/cjaa022