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European Journal of Orthodontics Nov 2023To compare the reliability, reproducibility, and time-based efficiency of automatic digital (AD) and manual digital (MD) model analyses using intraoral scan models.
OBJECTIVES
To compare the reliability, reproducibility, and time-based efficiency of automatic digital (AD) and manual digital (MD) model analyses using intraoral scan models.
MATERIAL AND METHODS
Two examiners analysed 26 intraoral scanner records using MD and AD methods for orthodontic modelling. Tooth size reproducibility was confirmed using a Bland-Altman plot. The Wilcoxon signed-rank test was conducted to compare the model analysis parameters (tooth size, sum of 12-teeth, Bolton analysis, arch width, arch perimeter, arch length discrepancy, and overjet/overbite) for each method, including the time taken for model analysis.
RESULTS
The MD group exhibited a relatively larger spread of 95% agreement limits when compared with AD group. The standard deviations of repeated tooth measurements were 0.15 mm (MD group) and 0.08 mm (AD group). The mean difference values of the 12-tooth (1.80-2.38 mm) and arch perimeter (1.42-3.23 mm) for AD group was significantly (P < 0.001) larger than that for the MD group. The arch width, Bolton, and overjet/overbite were clinically insignificant. The overall mean time required for the measurements was 8.62 min and 0.56 min for the MD and AD groups, respectively.
LIMITATIONS
Validation results may vary in different clinical cases because our evaluation was limited to mild-to-moderate crowding in the complete dentition.
CONCLUSIONS
Significant differences were observed between AD and MD groups. The AD method demonstrated reproducible analysis in a considerably reduced timeframe, along with a significant difference in measurements compared to the MD method. Therefore, AD analysis should not be interchanged with MD, and vice versa.
Topics: Humans; Overbite; Reproducibility of Results; Artificial Intelligence; Malocclusion; Models, Dental; Dental Arch
PubMed: 37418746
DOI: 10.1093/ejo/cjad032 -
American Journal of Orthodontics and... Aug 2022This study aimed to retrospectively evaluate the dentoskeletal effects of clear aligners (Invisalign) vs miniplate-supported posterior intrusion (MSPI) and identify...
A comparative assessment of the dentoskeletal effects of clear aligners vs miniplate-supported posterior intrusion with fixed appliances in adult patients with anterior open bite. A multicenter, retrospective cohort study.
INTRODUCTION
This study aimed to retrospectively evaluate the dentoskeletal effects of clear aligners (Invisalign) vs miniplate-supported posterior intrusion (MSPI) and identify factors associated with posttreatment overbite in adults with anterior open bite.
METHODS
Twenty-nine patients treated with Invisalign and 24 with MSPI combined with full-fixed orthodontic appliances were included from 5 orthodontic practices. Pretreatment and posttreatment lateral cephalometric measurements were included as outcomes. Comparisons across groups and identification of final overbite predictors were assessed with regression modeling and machine learning techniques.
RESULTS
MSPI induced significantly greater maxillary molar intrusion (1.5 mm; 95% confidence interval [CI], 0.83-2.17; P <0.001), with subsequent reduction of anterior face height (ANS-Me) (-2.77 mm; 95% CI, -3.64 to -1.91; P <0.001), Mp-SN° (-1.95°; 95% CI, -2.77 to -1.12; P <0.001), and ANB° (-1.69°; 95% CI, -2.44 to -0.94; P <0.001) compared with Invisalign. MSPI resulted in a significantly larger increase in SNB° (0.94°; 95% CI, 0.23-1.65; P = 0.01) and point-Pog projection (2.45 mm; 95% CI, 1.12-3.77; P = 0.001). Compared with MSPI, Invisalign had a significantly greater increase in the distance of maxillary (1.05 mm; 95% CI, 0.38-1.72; P = 0.003) and mandibular (0.9 mm; 95% CI, 0.19-1.60; P = 0.01) incisal edges relative to their apical bases, with borderline greater lingual tipping of only the maxillary incisors (2.82°; 95% CI, -0.44 to 6.09; P = 0.09). Appliance type and initial overbite were significant final overbite predictors across all models. However, this difference was only evident in male patients (males [1.65; 95% CI, 0.99-2.32; P <0.001]; female [-0.04; 95% CI, -0.52 to 0.44; P = 0.87]).
CONCLUSIONS
Both appliances effectively improve overbite. MSPI applied the correction via molar intrusion and counterclockwise mandibular autorotation, whereas Invisalign via maxillary and mandibular incisor extrusion.
Topics: Adult; Cephalometry; Female; Humans; Male; Malocclusion, Angle Class II; Open Bite; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Overbite; Retrospective Studies; Tooth Movement Techniques
PubMed: 35339320
DOI: 10.1016/j.ajodo.2021.03.022 -
Annals of Maxillofacial Surgery 2021The surgery-first approach provides immediate improvement in facial aesthetics in orthognathic cases with a shorter total treatment period.
THE RATIONALE
The surgery-first approach provides immediate improvement in facial aesthetics in orthognathic cases with a shorter total treatment period.
PATIENT CONCERNS
A 21-year-old male came with the chief complaint of protrusive lower front teeth and a large lower jaw. His main concern was aesthetics.
DIAGNOSIS
This was a case of skeletal Class III malocclusion with reverse overjet of 4 mm, overbite of 6 mm with a concave profile, and a protrusive chin.
TREATMENT
The patient was treated by bilateral sagittal split setback osteotomy of the mandible with surgery first approach via nonextraction therapy.
OUTCOME
After an active treatment of 15 months, improved facial profile, facial proportions, and a significant reduction of mandibular prognathism were much appreciated. The treatment results were stable after a 1-year follow-up of the treatment.
TAKE-AWAY LESSON
This case report highlights the utilization of nature's dental decompensation to achieve a desirable result, thereby attaining "more with less."
PubMed: 35265515
DOI: 10.4103/ams.ams_65_20 -
Korean Journal of Orthodontics Nov 2022Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes...
Moebius syndrome (MBS) is a congenital neurologic disorder that causes cranio-facial abnormalities. It involves paralysis of the VI and VII cranial nerves and causes bilateral or unilateral facial paralysis, eye movement disorder, and deformation of the upper and lower limbs. The orofacial dysfunctions include microstomia, micrognathia, hypotonic mimetic and lip muscles, dental enamel hypoplasia, tongue deformity, open bite or deep overbite, maxillary hypoplasia, high arched palate, mandibular hyperplasia or features indicating mandibular hypoplasia. This case report presents a 7-year-old male patient who was diagnosed with MBS at the age 2 years. The patient displayed typical clinical symptoms and was diagnosed with Class II malocclusion with a large overjet/overbite, tongue deformity and motion limitation, and lip closure incompetency. Treatment was initiated using a removable appliance for left scissor bite correction. After permanent tooth eruption, fixed appliance treatment was performed for correction of the arch width discrepancy and deep overbite. A self-ligation system and wide-width arch form wire were used during the treatment to expand the arch width. After 30 months of phase II treatment, the alignment of the dental arch and stable molar occlusion was achieved. Function and occlusion remained stable with a Class I canine and molar relationship, and a normal overjet/overbite was maintained after 9.4 years of retainer use. In MBS patients, it is important to achieve an accurate early diagnosis, and implement a multidisciplinary treatment approach and long-term retention and follow-up.
PubMed: 36070886
DOI: 10.4041/kjod22.012 -
Korean Journal of Orthodontics Nov 2023: This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography...
OBJECTIVE
: This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using cone-beam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion.
METHODS
: The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of -3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1-3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson's correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite.
RESULTS
: The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS.
CONCLUSIONS
: The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.
PubMed: 36718119
DOI: 10.4041/kjod22.187 -
Clinical Oral Investigations Sep 2020Patients with obstructive sleep apnea (OSA) are usually treated with either mandibular advancement device (MAD) or continuous positive airway pressure (CPAP) therapy....
OBJECTIVES
Patients with obstructive sleep apnea (OSA) are usually treated with either mandibular advancement device (MAD) or continuous positive airway pressure (CPAP) therapy. The objective of this study is to evaluate changes in dental occlusion associated with long-term MAD and CPAP therapy.
MATERIALS AND METHODS
Data from 14 OSA patients using MAD and 17 OSA patients using CPAP therapy were evaluated at baseline, 2-year and 10-year follow-up. Changes in dental occlusion were analyzed from dental plaster casts with a digital sliding caliper.
RESULTS
At 2-year follow-up, MAD therapy resulted in significant dental changes when compared with baseline values. In MAD therapy, overjet and overbite decreased with 1.1 ± 1.8 mm and 1.1 ± 1.2 mm respectively. With CPAP therapy overjet and overbite decreased significantly with 0.2 ± 0.5 mm and 0.3 ± 0.5 mm, respectively. Both groups also showed significant changes in molar occlusion. After a 10-year follow-up, significant and more pronounced changes were seen in overjet and overbite. In MAD therapy, overjet and overbite decreased with 3.5 ± 1.5 mm and 2.9 ± 1.5 mm respectively when compared with baseline values. In CPAP therapy, overjet and overbite decreased with 0.7 ± 1.5 mm and 0.8 ± 1.4 mm respectively when compared with baseline values.
CONCLUSIONS
This study demonstrates that MAD and CPAP therapy result in significant changes in dental occlusion. These changes appear progressive and more pronounced with MAD compared to CPAP therapy.
CLINICAL RELEVANCE
Long-term OSA treatment results in significant dental side effects that may progress over time. Informed consent is fundamental before starting MAD treatment and individualized long-term follow-up is of eminent importance.
Topics: Continuous Positive Airway Pressure; Follow-Up Studies; Humans; Mandibular Advancement; Occlusal Splints; Sleep Apnea, Obstructive
PubMed: 31863188
DOI: 10.1007/s00784-019-03175-6 -
JPMA. the Journal of the Pakistan... Jun 2022To determine the frequency of malocclusion features, convex facial profile and non-nutritive sucking habits among children with and without early weaning.
OBJECTIVE
To determine the frequency of malocclusion features, convex facial profile and non-nutritive sucking habits among children with and without early weaning.
METHODS
The cross-sectional study was conducted at the National Institute of Child Health, Karachi, from June to December 2020, and comprised of either gender aged 3-6 years. The subjects were clinically examined, and details of lactation period, bottle feeding, thumb and pacifiers sucking were gathered from the parents to assess association with malocclusion. Data was analysed using SPSS 20.
RESULTS
Of the 180 subjects, 100(55.5%) were boys and 80(45.5%) were girls. There was significant association of early weaning with non-nutritive sucking habits, absent primate spaces, deviated midlines, and complete overbite (p<0.05). Breastfeeding <2 years was significantly associated with anterior crossbite (p<0.05). Early weaning had no association with convex facial profile, distoclusion, anterior and posterior crossbite and increased overjet (p>0.05). Non-nutritive sucking habits had significant relationship with deviated dental midlines (p>0.05).
CONCLUSION
Early weaning was found to be a factor in establishing non-nutritive sucking habits, and was strongly associated with crowding, disturbed vertical overlapping of incisors and developing decreased facial height. Breastfeeding for less than the recommended duration had a tendency to lead to anterior cross-bite.
Topics: Breast Feeding; Cross-Sectional Studies; Female; Fingersucking; Habits; Humans; Male; Malocclusion; Pacifiers; Weaning
PubMed: 35751320
DOI: 10.47391/JPMA.3249 -
The Saudi Dental Journal Sep 2023An anterior bite plane (ABP) is an orthodontic appliance that prevents posterior teeth from making contact. This appliance's functional concept is to reduce muscle...
OBJECTIVES
An anterior bite plane (ABP) is an orthodontic appliance that prevents posterior teeth from making contact. This appliance's functional concept is to reduce muscle activity, overcome deep overbite, and temporomandibular joint (TMJ) disorders (TMD). However, ABP treatment for malocclusion frequently results in unfavorable reversible and irreversible long-term effects. This problem presents difficulties for dentists in developing an appropriate treatment modification plan in order to achieve the best results. As a result, the goal of this study is to observe the effects of different ABP types on the TMJ and mandible.
MATERIALS AND METHODS
Thirty-six three-month-old male Wistar strain rats were divided into three groups: control, upper flat, and upper-lower inclined ABP. The overbite and body weight were measured. TMJ was examined histologically using hematoxylin and eosin (HE). To observe the entire mandibular bone in response to ABP, mandibular planes and angulations were measured.
RESULTS
After 7 days, the upper-lower inclined ABP group has significantly lower body weight than the control group. On days 7 and 14, overbite was significantly reduced in both the upper flat and upper-lower inclined ABP groups. The superficial layer of the condyle was depleted in both ABP groups, according to HE analysis. Mandibular angle analysis revealed that the upper-lower inclined ABP group had a greater incisal and ramus angle. Furthermore, lower incisor (Li)-condyle (Co) mandibular points increased significantly more in the upper-lower inclined ABP group than in the control group.
CONCLUSION
According to this study, various forms of ABP may have an impact on the TMJ and mandibular morphology, specifically on the length, angulation, and superficial surface of the condyle.
PubMed: 37823082
DOI: 10.1016/j.sdentj.2023.06.002 -
The Saudi Dental Journal Nov 2021Untreated malocclusion can lead to compromised aesthetic function, depression, and low self-esteem. The aim of this study was to evaluate dental malocclusion in Najran,...
BACKGROUND
Untreated malocclusion can lead to compromised aesthetic function, depression, and low self-esteem. The aim of this study was to evaluate dental malocclusion in Najran, Saudi Arabia as no data existed before.
METHOD
This was a retrospective study analyzing the casts of all patients in Najran, Kingdom of Saudi Arabia, seeking orthodontic management for malocclusion between 2017 and 2019.
MEASUREMENTS
The consultant orthodontist is the single investigator involved in collecting the details of demographics followed by molar relationships, overjet, overbite, crowding and spacing using digital caliper on each dental cast. Data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp.
RESULTS
A total of 326 patients sought treatment for different types of malocclusion. There were 143 males and 183 females with an M:F ratio of 1:1.3. Age ranged from 6 to 55 years with a mean SD of 22.6 ± 8.98. The prevalence for Class I, II and III malocclusions at 95% CI was (0.76 (0.757, 0.774)), 0.251 (0.243, 0.260) and 0.529 (0.519, 0.539) respectively. Fifty-one (15.6%) patients had reversed overjet, 65 (19.9%) reduced overjet, and 86 (26.4%) increased overjet. One hundred and sixty-four (50.3%) cases of reduced overbite and 99 (30.4%) cases of deep overbite were also observed. Tooth size arch length discrepancy were noticed with crowding and spacing in 83 (26.4%) and 71 (21.8%) patients, respectively.
CONCLUSIONS
This study has shown the prevalence of Class I, Class II, and Class III malocclusion to be 72.7%, 11.6% and 15.6% respectively. Increased over jet and crowding was demonstrated in more patients, though it is not statistically significant.
PubMed: 34803290
DOI: 10.1016/j.sdentj.2020.10.002 -
National Journal of Maxillofacial... 2023Anterior segmental Bi-jaw orthognathic surgery is indicated primarily for the correction of dentoalveolar protrusion. They are also indicated for correcting...
BACKGROUND
Anterior segmental Bi-jaw orthognathic surgery is indicated primarily for the correction of dentoalveolar protrusion. They are also indicated for correcting apertognathia, closing interproximal spaces between segments and can be incorporated with other osteotomies to obtain better results.
AIM
The aim of this study was to analyze and compare the soft- and hard-tissue changes in patients who underwent combined anterior segmental bi-jaw orthognathic surgery.
SETTINGS AND DESIGN
To compare and evaluate soft- and hard-tissue changes before and after combined anterior segmental bi-jaw orthognathic surgery by assessing (a) parameters in vertical dimension and (b) parameters in horizontal dimension and patient satisfaction was also assessed following surgery at 6 months' time interval.
MATERIALS AND METHODS
It is a prospective, single center and analytical study with sample size of 20 patients. It required routine setup for orthognathic surgery and manual tracing of lateral cephalograms. The surgical outcomes were assessed by hard tissue (Sella Nasion Point A (SNA) angle, Sella Nasion Point B (SNB) angle, Point A Nasion Point B (ANB) angle, NAPg, U1-NF, L1-MP angles; NA, NB, B-Pg, Nasion-Anterior nasal spine (N-ANS) distance, Anterior nasal spine-Gnathion (ANS-Gn) distance, and overjet and overbite) and soft tissue (facial convexity, NL, LM angles; LM fold, UL and LL protrusions, Upper lip length (ULL), Lower lip length (LLL), Sn-A, Si-B, Pg-Pg*, Ls-U1, Li-L1 distances, interlabial gap, and U1 exposure) variables pre and postsurgery.
STATISTICAL ANALYSIS
Descriptive statistics involved the mean and standard deviation, and recorded data were subjected to the statistical analysis using IBM SPSS 20 statistical package. The paired t-test, Pearson correlation coefficient were used. The level of significance P < 0.05 was taken as statistically significant and P < 0.01 as very significant.
RESULTS
Overall improvement after surgery in both hard- and soft-tissue parameters was observed and significant changes were seen in every variable, except Si-B (P > 0.05). Correlations between soft- and hard-tissue changes were significant in both sagittal and vertical planes. Patients' satisfaction score showed that all patients had the high overall rate of satisfaction.
CONCLUSIONS
Our study concludes that combined anterior segmental bimaxillary orthognathic surgery is a simple technique with minimal postoperative complications and limited relapse. The changes in facial esthetics and occlusion following orthognathic surgery depend highly on the stability achieved during the postoperative period.
PubMed: 37661970
DOI: 10.4103/njms.njms_435_21