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Zhonghua Kou Qiang Yi Xue Za Zhi =... Apr 2024Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring...
Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring orthodontic retreatment. While in such cases, patients usually have already had their teeth extracted, or are with periodontal, joint, and other dental problems, which often require multidisciplinary treatment. The retreatment of orthodontic patients is difficult, and the treatment options are limited. The characteristics of clear aligner treatment, such as comfortable and beautiful appearance, high degree of digital precision, and personalized tooth arrangement to simulate the final outcome, make it popular in the orthodontic retreatment. This article discusses and summarizes the details of orthodontic design, case monitoring, and the application of clear aligner in orthodontic retreatment of failed cases. Before starting treatment, the difficulty assessment tool (clear aligner treatment complexity assessment tool) can be used to evaluate the difficulty of clear aligner treatment. Orthodontists are recommended to treat orthodontic patients with clear aligners within their ability to avoid treatment failure. The key to the success of the extraction case treatment with clear aligner is to make the correct diagnosis and select the right cases. In the treatment planning, attention should be paid to the restoration of anterior tooth torque, making good use of molar distalization to obtain the space, vertical control, and improving posterior tooth relationship. Proper selection of cases and reasonable design in clear aligner treatment are expected to obtain tooth alignment, good intercuspation, normal overbite and overjet, periodontal health, parallel roots, and to achieve the goal of aesthetic, functional, stable, and healthy orthodontic treatment.
Topics: Humans; Esthetics, Dental; Orthodontic Appliances, Removable; Tooth Movement Techniques; Dental Care; Retreatment
PubMed: 38548599
DOI: 10.3760/cma.j.cn112144-20240109-00017 -
Journal of the World Federation of... Jun 2024To compare dentofacial effects of distalization with miniscrew-supported pendulum and infrazygomatic crest miniscrews. (Comparative Study)
Comparative Study
BACKGROUND
To compare dentofacial effects of distalization with miniscrew-supported pendulum and infrazygomatic crest miniscrews.
METHODS
The study included 36 patients whose lateral cephalometric radiographs were obtained before (T0) and after (T1) distalization. Patients were divided into two groups according to the treatment methods: 1) distalization with miniscrew-supported pendulum (MSP) (n = 19; 14 girls and 5 boys; mean age 16.9 ± 1.46 years) and 2) distalization with infrazygomatic crest (IZC) miniscrews (n = 17; 8 girls and 9 boys; mean age 17.0 ± 1.68 years). Dental, skeletal and soft tissue measurements were performed on lateral cephalograms taken from individuals.
RESULTS
A significant molar distalization was achieved both in the MSP group (3.52 ± 0.76 mm at 8.71 ± 2.02 months) and the IZC group (3.5 ± 0.74 mm at 9.7 ± 2.5 months) (P < 0.001 for both). Premolar distalization was significantly lower in the MSP group (1.73 ± 1.09 mm) than in the IZC group (2.81 ± 0.79 mm) (P < 0.01). Significant molar tipping was observed in both groups (P < 0.001), while no significant difference was found between the groups (P > 0.05). Retrusion of maxillary incisors were significantly higher in the IZC group (2.75 mm) than in the MSP group (0.98 mm) (P < 0.01). A significant difference was found between the two groups with regard to the changes in overjet and overbite (P < 0.05).
CONCLUSIONS
Both distalization methods were found to be effective in achieving a Class I molar relationship in patients with Class II malocclusion.
Topics: Humans; Female; Male; Bone Screws; Molar; Cephalometry; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Adolescent; Retrospective Studies; Maxilla; Orthodontic Appliance Design; Incisor; Zygoma; Mandible; Follow-Up Studies; Malocclusion, Angle Class II; Treatment Outcome; Palate; Overbite
PubMed: 38522972
DOI: 10.1016/j.ejwf.2024.01.006 -
Journal of Orthodontic Science 2024Measuring the condylar volume changes after treatment with skeletally anchored type IV Herbst appliance vs. Twin Force Bite Corrector (TFBC) in class II malocclusion in...
Assessment of the condylar response of two differently anchored fixed functional appliances in class II malocclusion in young adult orthodontic patients: A randomized clinical trial.
OBJECTIVE
Measuring the condylar volume changes after treatment with skeletally anchored type IV Herbst appliance vs. Twin Force Bite Corrector (TFBC) in class II malocclusion in young adult patients.
MATERIALS AND METHODS
Twenty class II malocclusion participants were randomly involved in our randomized clinical study. They are divided equally into two groups: group I (10 patients with an age range of 16 to 18 years and a mean age of (17.15 ± 0.62) (five males and five females) with a mean Angle formed between (A) point and (Nasion) point and (B) point, to determine anteroposterior relation between maxilla and mandible (ANB) of 6.20 (1.03) and a mean mandibular length of 106.1 (1.7), who were treated by a skeletally anchored type IV Herbst appliance, supported at the mandible by two mini-plates fixed bilaterally at the mandibular symphysis; group II (10 patients with an age range of 15 to 18 years and a mean age of (16.85 ± 0.33) (six males and four females) with a mean ANB of 6.80 (0.89) and a mean mandibular length of 107.3 (2.36), who were treated by a TFBC that was installed just mesial to the tube of the maxillary first permanent molar and distal to the bracket of the lower canine for 4 months. According to the Index of Orthognathic Functional Treatment Need (IOFTN) index, the participants in both groups have grade 4 (great need for treatment) as they have excessive overjet (6-9 mm). Cone-beam computed tomography (CBCT) was taken just before installing fixed functional appliances and after the removal. The condylar volume was measured using Dolphin software. Parametric measurements were performed by the independent -test, while non-parametric variables (percent change) were compared by the Mann-Whitney U-test.
RESULTS
On the right side, the Herbst group recorded a percent increase (median = 1.23%), while TFBC recorded a median percent decrease (-7.85%). This change is statistically significant ( = 0.008).
CONCLUSIONS
The difference in the condylar volume was significantly higher with the mini-plate anchored Herbst appliance than with the dentally anchored TFBC group.
PubMed: 38516116
DOI: 10.4103/jos.jos_112_23 -
Journal of Orthodontic Science 2024Anterior open bite (AOB) malocclusion is one of the highly challenging malocclusions. Cephalometric radiographs have been used for the diagnosis of occlusal anomalies in...
BACKGROUND
Anterior open bite (AOB) malocclusion is one of the highly challenging malocclusions. Cephalometric radiographs have been used for the diagnosis of occlusal anomalies in the vertical and anteroposterior directions. This study aims to compare skeletal and dental features in open and non-open bite subjects to identify factors that help predict and categorize open bites in a Nigerian population.
MATERIALS AND METHODS
Pretreatment cephalometric radiographs of 82 patients were recruited into this study. This study comprised 41 AOB patients and 41 (Class 1 malocclusion) patients (control group). The radiographs were obtained from the orthodontic unit, Department of Child Dental Health of the Lagos University Teaching Hospital, Idi-Araba Lagos. Cephalometric tracing and analysis of the obtained radiographs were used to identify and compare the skeletal and dental differences between the two groups.
RESULTS
The mean age of the participants was 20.47 ± 8.05 years. The patients consisted of 26 (31.7%) males and 56 (68.3%) females. There was a significant difference in the open bite depth indicator (ODI) of the open bite ( value < 0.001). There was a statistically significant increase in the vertical skeletal parameters - lower facial height (LFH), total facial height (TFH), posterior facial height (PFH), Frankfort-mandibular plane angle (FMA), mandibular-maxillary angle (MMA), and gonial angle in the AOB group compared to the control group. The vertical height of the dentoalveolar segments measured was all significantly increased in the open bite group compared to the control group.
CONCLUSION
The results suggest that the skeletal and dental vertical parameters, including ODI of the open bite subjects, varied compared with the non-open bite subjects in the Nigerian population studied and could be used to predict AOB tendency.
PubMed: 38516112
DOI: 10.4103/jos.jos_56_23 -
Case Reports in Dentistry 2024In addition to affecting oral functions such as temporomandibular joint function, mastication, and speech, malocclusion caused by skeletal maxillary prognathism also...
In addition to affecting oral functions such as temporomandibular joint function, mastication, and speech, malocclusion caused by skeletal maxillary prognathism also entails sociopsychological implications. Surgical orthodontic treatment to improve occlusion and oral function and to correct esthetic disharmony is important to improve patients' quality of life. We report the case of a 32-year-old woman who visited our hospital with a chief complaint of proclined upper front teeth. Clinical examination revealed maxillary overgrowth and severe labial inclination of the maxillary incisors with palatal gingival recession. The incisal protrusion was corrected with a maxillary anterior alveolar osteotomy-a surgical orthodontic method that could improve the overbite without causing excessive lingual inclination, while also minimizing orthodontic movement of the maxillary anterior teeth. This treatment is generally indicated in cases of maxillary prognathism with a relatively stable occlusal relationship in the molar region. As a result of the treatment, the patient's chief complaint improved and a long-term functional occlusion was achieved. This paper outlines the pre- and posttreatment skeletal and occlusal changes.
PubMed: 38497089
DOI: 10.1155/2024/3850765 -
Shanghai Kou Qiang Yi Xue = Shanghai... Dec 2023To investigate the effectiveness of combined orthodontic and restoration treatment for introverted deep overbite patients with severe wear.
PURPOSE
To investigate the effectiveness of combined orthodontic and restoration treatment for introverted deep overbite patients with severe wear.
METHODS
A total of 86 introverted deep overbite patients with severe wear admitted to Cangzhou People's Hospital from December 2020 to June 2022 were collected and divided into the control group and the experimental group by gender, age, degree of wear and tear, with 43 cases in each group. The control group received orthodontic treatment, while the experimental group received combined orthodontic and restoration treatment. The gingival index (GI), periodontal index(PI), smile index, temporomandibular joint space [anterior space, superior space, posterior space and In (P/A)], tooth function (chewing function, pronunciation function, dental occlusal function) and chewing efficiency of 2 groups before and after treatment were compared. Statistical analysis was performed with SPSS 22.0 software package.
RESULTS
Compared with the control group, the orthodontic treatment time of the experimental group patients was significantly reduced(P<0.05). Before treatment, there was no significant difference in GI, PI, smile index, buccal gap rate, temporomandibular joint space, swallowing function and chewing efficiency between 2 groups(P>0.05). After treatment, compared with the control group, the GI, PI, anterior space were significantly reduced(P<0.05); the smile index, posterior space and In (P/A), chewing function, pronunciation function, tooth occlusion and chewing efficiency significantly increased (P<0.05).
CONCLUSIONS
Both orthodontic treatment and combined orthodontic and restoration treatment can be used to treat introverted deep overbite patients with severe wear. However, combination of orthodontic and restoration treatment has significant advantages.
Topics: Humans; Overbite; Temporomandibular Joint; Mastication
PubMed: 38494977
DOI: No ID Found -
BMC Oral Health Mar 2024Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over...
BACKGROUND
Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth.
METHODS
This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant.
RESULTS
The mean accuracy of overbite correction was 37.63% after 1 set, followed by 11.19%, 6.32%, and 13.80% (2-4 sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1 and 2 sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1 set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque.
CONCLUSIONS
The most overbite correction occurs during the 1 set of aligners, and refinement treatment does not significantly improve the deep bite correction.
Topics: Humans; Young Adult; Adult; Overbite; Retrospective Studies; Tooth Movement Techniques; Malocclusion, Angle Class II; Orthodontic Appliances, Removable
PubMed: 38491450
DOI: 10.1186/s12903-024-04099-8 -
Brazilian Oral Research 2024The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly,...
The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children's oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children's mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2-8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience.
Topics: Child; Female; Humans; Child, Preschool; Microcephaly; Cross-Sectional Studies; Dental Caries; Zika Virus Infection; Malocclusion; Zika Virus
PubMed: 38477806
DOI: 10.1590/1807-3107bor-2024.vol38.0020 -
International Orthodontics Jun 2024Treatment of skeletal class II growing patients often requires the use of functional appliances, aimed at promoting mandibular advancement. Among these, Herbst appliance...
Is significant mandibular advancement possible after the peak of puberty? Dento-osseous palatal expansion and the STM4 technique (Skeletal Therapy Manni Telescopic Herbst 4 miniscrews): A case report.
INTRODUCTION
Treatment of skeletal class II growing patients often requires the use of functional appliances, aimed at promoting mandibular advancement. Among these, Herbst appliance is recommended for its effectiveness, efficiency, and reduced need for compliance. Despite its skeletal favourable effects, well-known dental compensations can occur, especially when the appliance is not used close to the pubertal peak: upper incisors retroclination, lower incisors proclination, upper molars distalization and lower molars mesialization could reduce the overjet needed for a proper mandibular advancement. To counteract these unfavourable effects skeletal anchorage could be crucial.
AIM
The aim of this case report is to describe and evaluate the effects of using a skeletally anchored Herbst appliance in an 18-year-old (CVM5) male patient with skeletal Class II malocclusion and a convex profile.
TREATMENT PROTOCOL
The treatment started with a tooth-bone-borne palatal expansion, then the upper arch was bonded with pre-adjusted ceramic brackets. After 2months, a Manni Telescopic Herbst (MTH) supported by 4 miniscrews (two in the maxilla and two in the mandible) was applied. To avoid anchorage loss, TADs were connected with elastic chains to the arches. Nine months later, the Herbst was removed, the lower teeth were bonded and the patient wore class 2 elastics to stabilise the occlusion.
RESULTS AND CONCLUSIONS
After 24months the treatment goal was achieved with a considerable improvement of the profile and a clinically significant mandibular advancement (Pogonion moved forward 7mm). A one-year follow-up lateral X-rays showed a good stability of the result.
Topics: Humans; Male; Adolescent; Malocclusion, Angle Class II; Orthodontic Appliances, Functional; Palatal Expansion Technique; Mandibular Advancement; Orthodontic Anchorage Procedures; Bone Screws; Puberty; Cephalometry; Orthodontic Appliance Design; Treatment Outcome
PubMed: 38471383
DOI: 10.1016/j.ortho.2024.100868 -
Scientific Reports Mar 2024Non-syndromic permanent tooth agenesis affects a significant proportion of the population, especially if third molars are considered. Although tooth agenesis has been...
Non-syndromic permanent tooth agenesis affects a significant proportion of the population, especially if third molars are considered. Although tooth agenesis has been linked to a smaller craniofacial size, reduced facial convexity and a shorter skeletal face, the occlusal characteristics of individuals with tooth agenesis remain largely unexplored. Therefore, this study investigated potential associations between tooth agenesis and metric occlusal traits in 806 individuals (491 with 4.1 missing teeth per subject, including third molars, and 315 without any tooth agenesis). Dentoskeletal morphology was defined through anatomical landmarks on pre-treatment cephalometric radiographs. Multivariate regression models, adjusted for sex and age, showed that tooth agenesis was significantly associated with a reduced overjet, an increased interincisal angle, and shorter upper and lower dental arch lengths, but not with overbite. Moreover, apart from reduced tooth length and dentoalveolar effects, as the number of missing teeth increased the upper front teeth were progressively retruded according to the craniofacial complex and to the face. Thus, tooth agenesis has a substantial influence on dental and occlusal characteristics, as well as on the sagittal position and inclination of anterior teeth. These findings emphasize the necessity for personalized, multidisciplinary approaches in individuals with multiple agenesis to successfully meet treatment goals.
Topics: Humans; Malocclusion; Tooth; Dentition, Permanent; Malocclusion, Angle Class II; Overbite; Anodontia; Cephalometry; Molar, Third
PubMed: 38462644
DOI: 10.1038/s41598-024-56449-9