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American Journal of Orthodontics and... Sep 2023This 2-arm parallel study aimed to compare and evaluate the efficiency of Hanks Herbst (HH) and Twin-block (TB) functional appliances in treating adolescents with Class... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
This 2-arm parallel study aimed to compare and evaluate the efficiency of Hanks Herbst (HH) and Twin-block (TB) functional appliances in treating adolescents with Class II malocclusion.
METHODS
A parallel-group randomized controlled trial was undertaken in a single United Kingdom hospital. Eighty participants were recruited and randomized in a 1:1 ratio to receive either the HH or TB appliance. Eligibility criteria included children aged 10-14 years with an overjet of ≥7 mm without dental anomalies. The primary outcome was the time (in months) required to reduce overjet to normal limits (<4 mm). Secondary outcomes included treatment failure rates, complications and their impact on oral health-related quality of life (OHRQOL). Randomization was accomplished using electronic software with allocation concealed using sequentially numbered, opaque, and sealed envelopes. Blinding was only applicable for outcome assessment. Data were analyzed using descriptive statistics and regression analyses to detect between-group differences, including Cox regression for time to treatment success.
RESULTS
HH was significantly faster than TB in reducing the overjet to within normal limits (95% confidence interval [CI], -3.00 to -0.03; P = 0.046). Mean overjet reduction was more efficient with the HH than the TB appliance (ß = 1.3; 95% CI, 0.04-2.40; P = 0.04). Fifteen (37.5%) of the participants in the TB group and 7 (17.5%) in the HH group failed to complete the treatment (hazard ratio = 0.54; 95% CI, 0.32-0.91, P = 0.02). However, TB was associated with fewer routine (incidence rate ratio = 0.81; 95% CI, 0.7-0.9; P = 0.004) and emergency (incidence rate ratio = 0.1; 95% CI, 0.1-0.3; P = 0.001) visits. Chairside time was greater with the HH (ß = 2.7; 95% CI, 1.8-3.6, P = 0.001). Participants in both groups experienced complications with similar frequency. A greater deterioration in OHRQOL was found during treatment with the TB.
CONCLUSIONS
Treatment with HH resulted in more efficient and predictable overjet reduction than TB. More treatment discontinuation and greater deterioration in OHRQOL were observed with the TB. However, HH was associated with more routine and emergency visits.
REGISTRATION
ISRCTN11717011.
PROTOCOL
The protocol was not published before trial commencement.
FUNDING
No specific external or internal funding was provided. Treatment for participants was provided as part of routine orthodontic treatment in the hospital.
Topics: Adolescent; Child; Humans; Quality of Life; Orthodontic Appliances, Functional; Orthodontics, Corrective; Malocclusion, Angle Class II; Overbite; Treatment Outcome
PubMed: 37409988
DOI: 10.1016/j.ajodo.2023.06.002 -
Journal of Oral Biology and... 2020Missing maxillary lateral incisors is a common developmental anomaly and often creates a major esthetic problem due to their position in the dental arch. Treatment in...
OBJECTIVE
Missing maxillary lateral incisors is a common developmental anomaly and often creates a major esthetic problem due to their position in the dental arch. Treatment in such cases depends on either creation of space followed by prosthetic replacement or closing the space and replacing the missing lateral incisors by canines. In this report we highlight some of the key factors which should be considered for replacement of missing lateral incisors using single tooth implant.
METHODS
This clinical report describes the treatment of a patient with bilateral missing maxillary lateral incisors. An interdisciplinary approach involving Orthodontist, implant surgeon and prosthodontist was used in the treatment.
RESULTS
At the end treatment, the patient presented with class I molar and canine, normal overbite and overjet, and good facial esthetics with canine protected occlusion.
CONCLUSION
When indicated, space opening and replacement of missing lateral incisors with implant supported tooth substitution may provide excellent esthetics and functional results.
PubMed: 32489819
DOI: 10.1016/j.jobcr.2020.04.001 -
International Orthodontics Mar 2021To determine the relationship between AOB and factors such as dental arch dimensions and tongue position during swallowing and phonation.
Anterior open bite and its relationship with dental arch dimensions and tongue position during swallowing and phonation in individuals aged 8-16 years: A retrospective case-control study.
OBJECTIVE
To determine the relationship between AOB and factors such as dental arch dimensions and tongue position during swallowing and phonation.
MATERIAL AND METHODS
A case-control study was performed in two groups: 132 children with Anterior Open Bite (AOB) and 132 with normal vertical overbite (NVO), aged 8-16 years selected from the records taken by a previous study from five public schools. Dental arch dimensions were assessed through digitalized study models. Swallowing was evaluated using the Payne technique, and phoniatric assessment included an adaptation of the articulation test used to describe phonemes.
STATISTICAL ANALYSIS
Chi-Square or Fisher's exact test for comparisons between qualitative variables and the Mann Whitney or T-student were applied to compare the dental arch dimensions according to bite type. A logistic regression model was applied to control the effect of confusion between independent variables and to describe its simultaneous effect on the type of bite.
RESULTS
Intercanine, interpremolar and intermolar widths showed higher values in AOB patients with a mean deviation (MD) of 0.536 (P=0.031), 0.60 (P=0.043) and 1.15, (P<0.001) respectively. Distortions caused by tongue interposition and thrust, tongue protrusion during swallowing, mandibular arch intermolar width, total maxillary arch length, maxillary arch perimeter, and posterior arch depth accounted for 64.6% of AOB and allowed for correct predictions in 83.8% of the cases observed in the study population.
CONCLUSIONS
A significant association between tongue position and function, as well as alterations such as tongue interposition and thrust during swallowing and phonation in individuals with AOB, were observed. There is a relationship between AOB and the presence of a wider mandibular arch and a narrower, longer, and deeper maxillary arch.
Topics: Adolescent; Case-Control Studies; Child; Colombia; Deglutition; Dental Arch; Female; Humans; Male; Malocclusion; Maxilla; Open Bite; Phonation; Retrospective Studies; Schools; Tongue
PubMed: 33518486
DOI: 10.1016/j.ortho.2020.12.005 -
Progress in Orthodontics Jun 2023The introduction of bone-anchored maxillary protraction eliminated the side effects of facemask in the early treatment of patients with maxillary retrusion. This study... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The introduction of bone-anchored maxillary protraction eliminated the side effects of facemask in the early treatment of patients with maxillary retrusion. This study aimed to evaluate the effects of miniscrew-anchored maxillary protraction (MAMP) and compare them with the growth changes in an untreated control group in growing patients with Class III malocclusion.
METHODS
Forty growing patients with Class III malocclusion and retrognathic maxilla were randomly allocated into two groups: treated and control groups. In the treated group, patients were treated with full-time intermaxillary Class III elastics (C3E) anchored by a hybrid hyrax (HH) in the maxilla and a bone-supported bar in the mandible. Protraction was stopped after obtaining a positive overjet. Cephalometric radiographs were acquired before and after the treatment. Data were statistically analyzed on an intention-to-treat basis. Intergroup comparisons were also made using analysis of covariance with the readings at T0 as a covariate.
RESULTS
Forty patients agreed to participate, and 30 of them completed the study (treated group, n = 17; control group, n = 13). The average treatment duration was 11.9 months. MAMP resulted in a significant maxillary advancement (A-VR, 4.34 mm) with significant control over the mandibular growth. No significant increase in the mandibular plane angle was found in the treated group compared with the control group. The upper and lower incisors showed significant protrusion in the treated group.
CONCLUSIONS
Within the limitations of this study and high attrition rate, the MAMP protocol can effectively increase maxillary forward growth with good control over the growth of the mandible antero-posteriorly and vertically.
Topics: Humans; Child; Maxilla; Mandible; Overbite; Cephalometry; Duration of Therapy; Malocclusion, Angle Class III
PubMed: 37303011
DOI: 10.1186/s40510-023-00473-4 -
Dental Press Journal of Orthodontics 2020To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger's Treatment...
OBJECTIVE
To evaluate the prevalence and severity of malocclusion in children suffering from β-thalassemia and to assess orthodontic treatment need using Grainger's Treatment Priority Index (TPI) and index of orthodontic treatment need (IOTN)-dental health component (DHC).
METHODS
A cross-sectional study was conducted on 200 transfusion-dependent children diagnosed with homozygous β-thalassemia and 200 healthy school children aged 11-17 years. The TPI and IOTN-DHC data was recorded for both groups. Total TPI score for each subject was calculated and graded according to malocclusion severity estimate (MSE). Independent sample t-test was used to compare mean TPI scores, overjet and overbite between thalassemic and healthy children. Chi-square test was used to compare the frequency of IOTN-DHC grades, Angle's classification, and MSE grades between thalassemic and healthy children.
RESULTS
The most prevalent malocclusion was Class I in normal children (67.5%) and Class II in thalassemic children (59%). The mean overjet and overbite were significantly (p<0.001) greater in thalassemic children than in healthy children. Severe tooth displacements were 3.5 times greater in thalassemic children, compared to controls. A greater proportion of thalassemic children were in IOTN grades 3 and 4, compared to the controls (p<0.001). MSE grades 4 and 5 were significantly (p<0.001) more prevalent in thalassemic children, compared to the controls.
CONCLUSION
There is a high prevalence of Angle's Class II malocclusion in thalassemic children. Majority of these children are categorized in higher grades of IOTN-DHC and TPI-MSE, showing a great severity of malocclusion and high orthodontic treatment needs.
Topics: Adolescent; Child; Cross-Sectional Studies; Humans; Index of Orthodontic Treatment Need; Malocclusion; Malocclusion, Angle Class II; Orthodontics, Corrective; beta-Thalassemia
PubMed: 33503121
DOI: 10.1590/2177-6709.25.6.26.e1-9.onl -
Children (Basel, Switzerland) Mar 2023Scissor bite (SB.) is a rare malocclusion that is challenging to diagnose and is often associated with a retrognathic mandible and a series of functional and structural...
Scissor bite (SB.) is a rare malocclusion that is challenging to diagnose and is often associated with a retrognathic mandible and a series of functional and structural abnormalities that negatively affect the patient. This article intends to analyze the treatment approaches applied to growing patients younger than 16 years old, comparing the conventional appliances described in the literature and a clinical case treated with clear aligners with mandibular advancement (MA.). SB is primarily related to skeletal Class I and II, according to Angle classification. In the various cases analyzed, it can also be mentioned as a significant number of cases with SB of dental origin (seven of dental and four of skeletal) in young patients. In children and adolescents who still have growth potential, the therapeutic possibilities are numerous. A comprehensive literature search was manually performed from 2002 until January 2023, in PubMed and BVS databases with the following conjugated keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". The present case report on a young patient demonstrated the efficiency of the clear aligners with MA to correct an SB, associated with several functional and structural anomalies such as Class II division 1 with an increased overjet and overbite as well as a severe curve of Spee in a hypodivergent biotype.
PubMed: 37189873
DOI: 10.3390/children10040624 -
Cureus Nov 2023Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side... (Review)
Review
Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side effects from long-term therapy may result in poor patient compliance and patient drop-outs. Hence, knowledge of the possible side effects of these devices on occlusion is necessary. This article attempts to systematically review the evidence available in support of the possible long-term effects of mandibular advancement therapy on occlusion in adult sleep apnea patients. A detailed search was conducted for unpublished and published literature and their references in various electronic databases. A grey literature search was also performed. Studies until June 30, 2022, were selected. Randomized controlled trials, non-randomized trials, and cohort studies investigating the occlusal side effects of MADs for the treatment of snoring or OSA with a follow-up of at least four years were included. Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. The risk of bias was assessed by Cochrane tools for randomized and non-randomized studies. Fourteen studies were selected for the final qualitative analysis. The side effects reported were upper incisor retroclination, lower incisor proclination, decreased overjet and overbite, and change in the total occlusal contact area. The review concludes that long-term MAD therapy has statistically and clinically significant effects on occlusion.
PubMed: 38090465
DOI: 10.7759/cureus.48682 -
The Pan African Medical Journal 2022thumb sucking is one of the most common oral habits in infants and children. In our context, little is known about the effects of prolonged thumb sucking on the...
INTRODUCTION
thumb sucking is one of the most common oral habits in infants and children. In our context, little is known about the effects of prolonged thumb sucking on the orofacial sphere. Objective: determine the prevalence of thumb sucking and, identify the morphologic and functional abnormalities of the orofacial sphere associated with the duration and frequency of thumb sucking in children aged 3 to 10 years.
METHODS
a cross-sectional and analytical study was carried out in the pediatric units of the District Hospitals of Biyem-assi and Efoulan from February to June 2020 in children aged 3 to 10 years. Recruitment was consecutive, not probabilistic. After obtaining informed parental consent, a clinical examination was performed and the criteria retained were based on the ANGLE classification of the malocclusions. Socio-demographic, socio-economic, clinical characteristics were collected and morphological and functional abnormalities were observed. Statistical analysis was performed using SPSS software version 23.0. The significance threshold was set at 5%.
RESULTS
of the 116 enrolled children; 74 girls (63.79%) and 42 boys (36.21%) with a mean age of 4.80 ± 0.5 years. The highest proportion of thumb sucking was found in firstborn children (n=46, 39.65%), and in those who breastfed for less than 6 months (n=99, 85.62%). The prevalence of thumb sucking was 17.4%. Using the multivariate analysis, class II division 1 canine occlusion [OR=1.52 (1.27-2.68), p=0.03] and decreased overbite [OR=4.5 (2.5-9.3), p=0.001] while class II division 1 canine occlusion [OR=2.59 (1.3-10.1), p=0.009] and increased overjet [OR=1.89 (1.06-6.75), p=0.005] were independent morphologic abnormalities significantly associated with the frequency and the duration of thumb sucking respectively. There was no association between the duration and frequency of thumb sucking and the functional abnormalities.
CONCLUSION
thumb sucking is more common in girls and the likelihood of thumb sucking decreases with age. The prevalence of thumb sucking was 17.4%. The malocclusions observed in our population are class II division 1 canine relationship, decreased overbite and increased overjet.
Topics: Animals; Cameroon; Cross-Sectional Studies; Dogs; Fingersucking; Humans; Malocclusion; Overbite
PubMed: 36034048
DOI: 10.11604/pamj.2022.42.107.33050 -
Progress in Orthodontics Jul 2022Emoji are pictograms frequently used in social networks capable of expressing emotions. These tools can provide insights into people's behavior that could not be...
BACKGROUND
Emoji are pictograms frequently used in social networks capable of expressing emotions. These tools can provide insights into people's behavior that could not be obtained with the use of textual communication. Recently, emoji have been introduced to various research fields as successful alternatives to word-based questionnaires for measure emotional responses. The objective of this study was to preliminarily evaluate the discriminating ability and relationship of these tools with different occlusal conditions/malocclusions.
METHODS
Online surveys were applied to adult individuals (n = 201; mean age = 27.4 ± 5.7; 37.3% males, 62.7% females). Subjects issued acceptance scores (10-point scale) and expressed their emotional status using a 30-emoji list in relation to nine occlusal conditions: C1-crowding, C2-anterior open bite, C3-interincisal diastema, C4-increased overjet + deep bite (Class II div. 1), C5-anterior crossbite (Class III), C6-ideal occlusion, C7-unilateral posterior crossbite, C8-anterior open bite plus bilateral posterior crossbite plus crowding, and C9-deep bite (Class II div. 2). Cochran's Q and McNemar tests were used to compare the frequencies of choice of emoji between conditions. Correspondence analyses were applied to assess the association between occlusal conditions and emoji. Kendall's correlation coefficient was calculated to evaluate the relationship between mean acceptance scores and frequency counts of each emoji.
RESULTS
The frequency of choice between conditions showed a significant difference for 25 of the 30 emoji (P < 0.05), indicating an adequate discriminating ability of these tools. Emoji were grouped predominantly based on their emotional valence (positive/negative) and arousal/activation (high/low). Positive emoji were associated with the most accepted conditions (i.e., C6, C3), while negative emoji with the most rejected ones (i.e., C8, C1, C2). Although only weak, positive correlations between acceptance and positively valenced emoji, and negative correlations between acceptance and negatively valenced emoji were observed (P < 0.05).
CONCLUSIONS
Emoji have an adequate discriminatory ability and would allow determining emotional profiles in the face of different occlusal conditions. Further research is necessary to consolidate the use of these tools in an instrument that allows measuring emotional responses.
Topics: Adult; Emotions; Female; Humans; Male; Malocclusion; Malocclusion, Angle Class II; Open Bite; Overbite; Young Adult
PubMed: 35844016
DOI: 10.1186/s40510-022-00418-3 -
Journal of Applied Oral Science :... 2021Malocclusions are highly prevalent in childhood and adolescence, being considered a public health problem worldwide, in addition to be considered an important predictor...
BACKGROUND
Malocclusions are highly prevalent in childhood and adolescence, being considered a public health problem worldwide, in addition to be considered an important predictor in the tongue position and speech disorders.
OBJECTIVE
Evaluate the association of malocclusions with tongue position and speech distortion in mixed-dentition schoolchildren from the south of Brazil.
METHODOLOGY
This cross-sectional study was performed using a database of an epidemiological survey realized in the southern of Brazil, in 2015, for evaluating the dental and myofunctional condition of the mixed-dentition from 7-13 years' schoolchildren. The outcome variables were tongue position and speech distortion, evaluated by a trained and calibrated examiner. Characteristics regarding sociodemographic and oral health measures (Angle's classification of the malocclusion, overjet, overbite, posterior crossbite and respiratory mode) were also assessed. Poisson regression models with adjusted robust variance were used to evaluate the association among predictors variables in the outcomes. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI).
RESULTS
A total of 547 children were evaluated. Schoolchildren who presented anterior open bite (PR 2.36 95%CI 1.59-3.49) and having oral/oral-nasal breathing (RP 2.51 95%CI 1.70-3.71) are more likely to have altered position of the tongue. Both deep bite and being male represent protection factors for the abnormal tongue position. Regarding speech distortion, deep overbite presents a protective relationship to speech distortion (PR 0.41; 95%CI 0.24-0.71), whereas schoolchildren with posterior crossbite were more likely to present this problem (PR 1.77; 95%CI 1.09-2.88).
CONCLUSION
Anterior open bite and posterior crossbite were the malocclusions related to speech distortion and/or altered tongue position. Oral/oral-nasal breathing was also related to myofunctional changes. Deep bite malocclusion was a protective factor for both speech problems and altered tongue position when compared to a normal overbite.
Topics: Adolescent; Child; Cross-Sectional Studies; Dentition; Humans; Male; Malocclusion; Prevalence; Speech; Speech Disorders; Tongue
PubMed: 34406316
DOI: 10.1590/1678-7757-2020-1005