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Journal of Orthodontics Jun 2024To evaluate the effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared...
The effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared with an untreated control group: A multicentre two-arm parallel randomised controlled trial.
OBJECTIVE
To evaluate the effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared with an untreated control group in terms of perceived need for orthognathic surgery, skeletal and dental change, and psychological impact.
DESIGN
A multicentre two-armed parallel randomised controlled trial.
SETTING
Six UK hospital orthodontic units.
METHODS
A total of 57 patients were randomly allocated into either the BAMP group (BAMPG) (n = 28) or a no treatment control group (CG) (n = 29).
OUTCOMES
Data collection occurred at registration (DC1),18 months (DC2) and 3 years (DC3), where skeletal and dental changes were measured from lateral cephalograms and study models. Oral Aesthetic Subjective Impact Score (OASIS) and Oral Quality of Life (OHQOL) questionnaires were used to assess the psychological impact of treatment.
RESULTS
The mean age was 12.9 ± 0.7 years and 12.6 ± 0.9 years in the BAMPG and CG, respectively. At DC2, the BAMPG achieved a class III ANB improvement of +0.6° compared with -0.7° in the CG ( = 0.004). The overjet improvement was +1.4 mm for the BAMPG and -0.2 mm for the CG ( = 0.002). There was no evidence of any other group differences for the other skeletal or dental cephalometric outcomes ( > 0.05) or the questionnaire data (OASIS = 0.10, OHQOL = 0.75). At DC2, the 18-month follow-up, 22% of the BAMPG achieved a positive overjet. At the 3-year follow-up (DC3), fewer patients in the BAMPG were perceived to need orthognathic surgery (48%) compared with 75% of patients in the CG ( = 0.04), with an odds ratio of 0.31 (95% confidence interval = 0.10-0.95).
CONCLUSION
The BAMP technique did not show any social or psychological benefits; however, the skeletal class III improvement in ANB and the overjet change were sufficient to reduce the perceived need for orthognathic surgery by 27% compared with the CG.
PubMed: 38845172
DOI: 10.1177/14653125241255139 -
American Journal of Orthodontics and... Jun 2024This study aimed to design an artificial intelligence (AI) system for dental occlusion classification using intraoral photographs. Moreover, the performance of this...
Designing an artificial intelligence system for dental occlusion classification using intraoral photographs: A comparative analysis between artificial intelligence-based and clinical diagnoses.
INTRODUCTION
This study aimed to design an artificial intelligence (AI) system for dental occlusion classification using intraoral photographs. Moreover, the performance of this system was compared with that of an expert clinician.
METHODS
This study included 948 adult patients with permanent dentition who presented to the Department of Orthodontics, School of Dentistry, Mashhad University of Medical Sciences, during 2022-2023. The intraoral photographs taken from the patients in left, right, and frontal views (3 photographs for each patient) were collected and underwent augmentation, and about 7500 final photographs were obtained. Moreover, the patients were clinically examined by an expert orthodontist for malocclusion, overjet, and overbite and were classified into 6 groups: Class I, Class II, half-cusp Class II, Super Class I, Class III, and unclassifiable. In addition, a multistage neural network system was created and trained using the photographs of 700 patients. Then, it was used to classify the remaining 248 patients using their intraoral photographs. Finally, its performance was compared with that of the expert clinician. All statistical analyses were performed using the Stata software (version 17; Stata Corp, College Station, Tex).
RESULTS
The accuracy, precision, recall, and F1 score of the AI system in the malocclusion classification of molars were calculated to be 93.1%, 88.6%, 91.2%, and 89.7%, respectively, whereas the AI system had an accuracy, precision, recall, and F1 score of 89.1%, 88.8%, 91.42%, and 89.8% for malocclusion classification of canines, respectively. Moreover, the mean absolute error of the AI system accuracy was 1.98 ± 2.11 for overjet and 1.28 ± 1.60 for overbite classifications.
CONCLUSIONS
AI exhibited remarkable performance in detecting all classes of malocclusion, which was higher than that of orthodontists, especially in predicting angle classification. However, its performance was not acceptable in overjet and overbite measurement compared with expert orthodontists.
PubMed: 38842962
DOI: 10.1016/j.ajodo.2024.03.012 -
International Journal of Paediatric... Jun 2024Binge drinking has been linked to traumatic dental injury (TDI). Once drunk, adolescents are more prone to accidents, which may result in orofacial injury.
BACKGROUND
Binge drinking has been linked to traumatic dental injury (TDI). Once drunk, adolescents are more prone to accidents, which may result in orofacial injury.
AIM
This study evaluated the possible association of binge drinking with a number of traumatised teeth in a population of 12-year-old Brazilian adolescents in 2013 and 2015.
DESIGN
This study was longitudinal, carried out with 588 adolescents at two moments, 2013 and 2015. TDI, overjet and lip protection were assessed by calibrated examiners. Binge drinking data were collected through the Alcohol Use Disorders Identification Test. Sociodemographic indicators were obtained through a questionnaire answered by the parents/guardians. The Poisson regression model with a random effects intercept was estimated.
RESULTS
A higher prevalence of traumatised teeth was observed among adolescents who binge drink (IRR = 1.37; 95% CI: 1.05-1.80; p < .05). The prevalence was also significantly higher among adolescents in this age range with a ≥ 3-mm overjet and those with inadequate lip protection (IRR = 1.99; 95% CI: 1.44-2.76; p < .001 and IRR = 3.41; 95% CI: 2.57-4.53; p < .001, respectively).
CONCLUSION
A greater number of traumatised teeth were found among adolescents who reported binge drinking and had severe overjet and inadequate lip coverage.
PubMed: 38840309
DOI: 10.1111/ipd.13221 -
GeroScience Jun 2024Rapamycin (sirolimus) is an FDA approved drug with immune modulating properties that is being prescribed off-label in adults as a preventative therapy to maintain...
Rapamycin (sirolimus) is an FDA approved drug with immune modulating properties that is being prescribed off-label in adults as a preventative therapy to maintain healthspan. We recently published one of the first reports on 333 adults with a history of off-label rapamycin use. Along with presenting evidence that rapamycin can be used safely in adults of normal health status, we discovered that about 26% of rapamycin users also reported oral health changes. Given the recent evidence highlighting the potential benefits of rapamycin and its derivatives in enhancing oral health, we conducted a secondary data analysis to profile the oral health of off-label rapamycin users, the true incidence of mouth sores, and present specific case studies of periodontal bone loss quantification using an FDA-approved artificial intelligence platform. Contrary to expected findings and previous literature, dimensions of rapamycin usage (such as length of use, dosage, and interval) were not found to be related to the incidence of mouth ulcers in rapamycin users. Notably, among rapamycin users, the most deleterious forms of ulcers were found to be infrequent and not statistically linked to rapamycin usage, with most rapamycin users having a common transient form of mouth ulcers. Additionally, we describe the general oral health outcomes of off-label rapamycin users and provide recommendations for individuals engaging in off-label rapamycin to be regularly checked by a dentist or an oral health care provider. This report was limited by being a secondary data analysis taken from survey data that focused on a more holistic health model. Future studies will use a focused survey that collects data on more dimensions of oral health outcomes while including questions on oral health for non-rapamycin-using participants.
PubMed: 38839644
DOI: 10.1007/s11357-024-01221-0 -
Australian Dental Journal Jun 2024To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and...
BACKGROUND
To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders.
METHODS
A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed.
RESULTS
The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders.
CONCLUSIONS
Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.
PubMed: 38838027
DOI: 10.1111/adj.13023 -
Journal of Orofacial Orthopedics =... May 2024Anterior arch length (AL) and the alterations in its dimension following incisor movements were shown to be predictable for an individual patient using...
PURPOSE
Anterior arch length (AL) and the alterations in its dimension following incisor movements were shown to be predictable for an individual patient using a mathematical-geometrical model based on a third-degree parabola. Although the model has been validated previously, it is hard to apply in daily orthodontic routine. Thus, the aim of this study was to modify the model using different approaches to allow its establishment in daily routine.
METHODS
This retrospective study was based on a study collective, which was described previously and consisted of 50 randomly chosen dental casts and lateral cephalograms taken before (T0) and after (T1) orthodontic treatment with fixed appliances. A JAVA computer program (Oracle, Austin, TX, USA) was developed to predict AL changes following therapeutic changes of arch width, depth or incisor inclination/position, taking the type of tooth movement into account. Performing exemplary AL calculations with the computer program, general rules and nomograms were set up, followed by multiple linear regression analyses to establish easy-to-use regression equations.
RESULTS
The JAVA computer program is available for download. Sagittal changes showed more effect on AL than transverse modifications. Protruding incisors increased AL, but also reduced overbite. The extent of alteration in AL depended on the initial depth, width, incisor inclination, tooth movement type and distance between the incisal edge and the centre of rotation.
CONCLUSIONS
The computer program precisely predicts individual changes in AL but is time-consuming. The presented regression equations and nomograms, considering metric variables, are easier to apply clinically and the differences compared to the AL calculated by the computer program are negligible.
PubMed: 38806728
DOI: 10.1007/s00056-024-00531-4 -
International Orthodontics May 2024The aim of the present study was to compare the changes in overjet and overbite measurements achieved in adolescent patients following an initial series of Invisalign®...
OBJECTIVE
The aim of the present study was to compare the changes in overjet and overbite measurements achieved in adolescent patients following an initial series of Invisalign® aligners (Align Technology, San Jose, California) with those planned by orthodontists via its ClinCheck® digital treatment planning facility.
METHODS
Data provided by Align regarding patients who had completed an initial series of Invisalign® aligner treatment and were less than 18-years old were assessed in relation to pre-treatment, planned and achieved overjet and overbite measurements. Descriptive statistics, Wilcoxon rank-sum, Mann Whitney calculations were computed.
RESULTS
A total of 290 patients satisfied inclusion criteria. The median (interquartile range (IQR)) age was 14.17 (13,15.42) years. The median achieved overjet and overbite changes were less than those planned (p<0.01) with 53.33% of the planned median overjet increase achieved and 52.94% of planned median overjet reduction achieved. Additionally, 58.33% of the planned median overbite increase was achieved and 55.55% of the planned median overbite reduction was achieved. A total of 21.52% patients recorded no change or an increase from pre-treatment to the achieved overjet where reduction was planned, whereas 41.67% recorded no change or a reduction in overjet where increase was planned. A total of 18.72% recorded no change or an increase in overbite where reduction was planned, whereas 20.75% recorded no change or a reduction in overbite where increase was planned.
CONCLUSIONS
Less than 60% of the planned overjet and overbite changes per patient were achieved. Between 18.72 and 41.67% of patients experienced no change or changes in overjet and overbite in the opposite direction to that planned. This is likely to be clinically significant.
PubMed: 38805975
DOI: 10.1016/j.ortho.2024.100888 -
International Journal of Dentistry 2024Understanding the correlation between temporomandibular joint disorder (TMD) parameters and various occlusal features can play a significant role in diagnosing and...
BACKGROUND
Understanding the correlation between temporomandibular joint disorder (TMD) parameters and various occlusal features can play a significant role in diagnosing and treating occlusal problems and their potential consequences on TMD.
OBJECTIVES
To investigate the relationship of occlusal features and some of the TMD parameters. . The current cross-sectional study was conducted on 200 TMD patients seeking dental treatment at different dental centers in Baghdad city, aged 18-35 years. All participants underwent assessment for occlusal features, which were molar and canine classifications, overjet, posterior buccal or lingual crossbites, and overbites, and TMD parameters (muscle pain, TMJ pain, and clicking) using the Chi-square test for statistical analysis.
RESULTS
Regarding molar classification, there were strong positive correlations between subjects with TMD and having different molar classifications (class I, II, and III) bilaterally or unilaterally; furthermore, there were strong positive correlations between subjects with TMD and having different canine classifications. Moreover, there were significant correlations between subjects with increased, normal, or decreased overjet and the TMD parameters. In addition, there were weak positive correlations between TMD occurrence and buccal or lingual posterior crossbite. On the other hand, there were significant correlations between subjects with a decreased overbite and the presence of TMD parameters.
CONCLUSION
TMD had a multifactorial background rather than dependability on a specific molar or canine classification type. There was also a correlation between overjet and TMD muscle pain, while decreased overbite was correlated to muscle and TMJ pain. Conversely, there is no vital correlation between posterior buccal or lingual crossbite occurrence and TMD parameters.
PubMed: 38798761
DOI: 10.1155/2024/8715166 -
Journal of Clinical Medicine May 2024This study aimed to investigate the relationship between the Curve of Spee (COS) depth and malocclusion characteristics in a population from Sibiu County, Romania. The...
This study aimed to investigate the relationship between the Curve of Spee (COS) depth and malocclusion characteristics in a population from Sibiu County, Romania. The research sought to understand how the COS's anatomical dimensions correlate with different classes of malocclusion and the position of the frontal teeth. A total of 265 participants from the Dentistry Ambulatory of the Military Hospital of Sibiu were included in this study. It employed digital intraoral scanning technology to measure the COS, overjet, and overbite, with malocclusion classification. Statistical analyses, including correlation and regression, were conducted to examine the relationships between COS depth, frontal teeth position, and malocclusion characteristics. The average COS depth measured was 1.0564 mm, presenting variability when compared to existing literature. Most of the study participants had Class I malocclusion. A significant positive correlation between COS depth and overjet was identified, with no notable gender-based differences in these occlusal parameters. The findings affirm the integral role of COS in occlusal dynamics and malocclusion diagnosis. The COS measurement of a mean of 1.0564 mm, when compared to other results emphasizes the differences in occlusal curvature among various populations. The results contribute to a refined understanding of occlusal relationships, supporting the need for personalized orthodontic and prosthetic treatments based on precise anatomical measurements.
PubMed: 38792296
DOI: 10.3390/jcm13102750 -
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