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European Journal of Paediatric Dentistry Mar 2024The integrity of primary dentition is essential in the development of the jaws and permanent occlusion. The consequences of a premature loss of primary molars are: space... (Review)
Review
AIM
The integrity of primary dentition is essential in the development of the jaws and permanent occlusion. The consequences of a premature loss of primary molars are: space loss, crowding, risk of impaction of the permanent teeth, ectopic eruption, anomalous inclination of the teeth adjacent to the loss molar, reduction of arch length. The mesial displacement of the posterior permanent teeth during eruption can cause a loss of space, which can be regained with orthodontic appliances. Therefore, a careful diagnosis is of great importance to be able to decide what appliance is indicated to recover from this situation. Molar distalisation consists in displacing permanent molars distally, allowing them to reach class I relationship and to recover the correct space for the second bicuspids when the second deciduous molar has been lost early.
METHODS
The aim of this study is to carry out a narrative literature review regarding the different appliances and their effectiveness in regaining space after premature loss of the upper primary molars.
CONCLUSION
The paediatric dentist should be aware of the advantages and disadvantages related to each device and select the most appropriate distalisation appliance based on an individual plan of diagnosis and a careful treatment. The distalisation of the upper molar must be adequately stabilised and so it is important to consider also some retainers such as Nance's appliance, the Palatal Plate, the extraoral traction, the utility arch, or II Class elastic bands.
Topics: Child; Humans; Molar; Tooth Eruption; Malocclusion; Dentition, Permanent; Tooth, Impacted
PubMed: 38353522
DOI: 10.23804/ejpd.2024.2110 -
Cureus Jan 2024Orthodontists, like any other medical professional, are susceptible to cumulative stressors and their undesirable consequences. The study aims to assess the...
BACKGROUND
Orthodontists, like any other medical professional, are susceptible to cumulative stressors and their undesirable consequences. The study aims to assess the self-perceived occupational stress levels and the psychological link between predictors and stress among orthodontic practitioners in India.
MATERIALS AND METHODS
The participants in this cross-sectional study are active members of the Indian Orthodontic Society (IOS). The data for the survey were collected by a previously validated closed-ended occupational stress assessment (OSA) questionnaire and a job satisfaction questionnaire, which were sent through the registered e-mails. A five-point Likert scale was used to assess the severity of individual stressors, and an overall severity score was obtained by summing up the individual scores. The predictors of stress based on socio-demographic parameters were assessed using a binomial multiple logistic equation. Statistical significance was set at a p-value of <0.05.
RESULTS
A total of 311 responses were received. Male orthodontists, unmarried, in the age group of 30-40 years, working in urban areas without any academic attachment were more stressed compared to the other groups in the respective categories. Tiredness/headache (39%) was reported as the most common consequence of occupational stress. The most concerning stressor was patients not wearing retainers. Orthodontists showed overall job satisfaction that is negatively correlated to overall stress (p <0.0001)(r = -0.260).
CONCLUSION
A profound variation in stress levels was found among the orthodontists with their socio-demographic and professional characteristics. Despite the stress, orthodontists were highly satisfied with their careers.
PubMed: 38352100
DOI: 10.7759/cureus.52266 -
Folia Medica Dec 2023The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming.
The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming.
Topics: Orthodontic Retainers; Printing, Three-Dimensional
PubMed: 38351789
DOI: 10.3897/folmed.65.e107299 -
European Journal of Orthodontics Apr 2024
PubMed: 38345244
DOI: 10.1093/ejo/cjae007 -
The Angle Orthodontist Dec 2023To explore retainer protocols and how they are influenced by orthodontic presentation and the nature of occlusal correction.
OBJECTIVE
To explore retainer protocols and how they are influenced by orthodontic presentation and the nature of occlusal correction.
MATERIALS AND METHODS
A prepiloted 45-item online questionnaire targeting orthodontists was developed. The questionnaire covered clinical preferences in terms of retainer type, fabrication, and follow-up during retention; the clinical indications for adjunctive surgical procedures; and the use of active designs to mitigate relapse in specific malocclusions.
RESULTS
A total of 206 responses were obtained. The majority of the respondents prescribed maxillary removable and mandibular fixed retainers, with almost half (49.1%) reviewing patients for more than 1 year primarily in person (95.1%). The majority prescribed vacuum-formed (69.6%) 1-mm-thick (44.3%) retainers. Only 37.3% were aware of the type of material used, with polyethylene terephthalate glycol copolymer, followed by polypropylene, being the most common. Hawley retainers were preferred following nonsurgical maxillary expansion and with suboptimal interdigitation. A preference for clear retainers and/or fixed retainers was found in open-bite cases and deep-bite cases. Supracrestal fiberotomy was prescribed commonly (61.1%) for rotations greater than 90°. No retainer was rarely prescribed except after the correction of an anterior crossbite.
CONCLUSIONS
Blanket prescription of orthodontic retention is common, with limited awareness of clear plastic retainer materials. Future trials evaluating the effectiveness of approaches for retainer prescription based on the presenting malocclusion would be timely.
PubMed: 38319063
DOI: 10.2319/060923-400.1 -
Journal of Dental Sciences Jan 2024Preserving the outcome of orthodontic treatment is both important and challenging. However, there is insufficient evidence regarding the best way to ensure long-term...
BACKGROUND/PURPOSE
Preserving the outcome of orthodontic treatment is both important and challenging. However, there is insufficient evidence regarding the best way to ensure long-term treatment outcome. The aim of this study was to evaluate a pre-fabricated chain retainer (PFCR) in terms of: ability to maintain satisfactory treatment outcomes; periodontal and dental health; complications; and patient satisfaction.
MATERIALS AND METHODS
Overall, 130 patients who had completed orthodontic treatment with a fixed appliance during the period 2016-2019 (follow-up time range, 24-55 months) at a specialist orthodontic clinic in Varberg, Sweden and who had a PFCR in the lower jaw were invited to take part in the study. Little's irregularity index (LII) was recorded on dental casts. Caries, gingivitis, calculus, probing pocket depth, and gingival retractions were registered during clinical examinations. Patient satisfaction and retainer complications were evaluated using a questionnaire.
RESULTS
In total, 76 patients (58.5%) agreed to participate. All patients, except for one, had their retainer still in place, and the complication rate was 40%. The LII scores were in the range of 0-4 mm (mean, 1.42 mm). At the retainer site, 82% had calculus, 74% had gingivitis, 1% had pocket depth >4 mm, 10.5% had gingival retractions >2 mm, and 0% had caries. All the patients expressed satisfaction with their retainer.
CONCLUSION
PFCRs exhibit characteristics similar to those of traditional bonded retainers in terms of complications, stability, side-effects and patient experience. Therefore, they can be considered a viable alternative to traditional retainers installed in the lower anterior teeth.
PubMed: 38303849
DOI: 10.1016/j.jds.2023.05.020 -
BMC Oral Health Jan 2024Parallel. (Randomized Controlled Trial)
Randomized Controlled Trial
Cephalometric and digital model analysis of dentoskeletal effects of infrazygomatic miniscrew vs. Essix- anchored Carriere Motion appliance for distalization of maxillary buccal segment: a randomized clinical trial.
TRIAL DESIGN
Parallel.
OBJECTIVE
To compare skeletally anchored Carriere Motion appliance (CMA) for distalization of the maxillary buccal segment vs. Essix anchored CMA.
METHODS
Thirty-two class II malocclusion patients were randomly allocated into two equal groups. One group was treated with infrazygomatic (IZC) miniscrew- anchored CMA (IZCG) and the other group treated with Essix retainer- anchored CMA (EXG). Two lateral cephalograms and two digital models for upper and lower arches were taken for each patient: immediately before intervention and after distalization had been completed.
RESULTS
Distalization period was not significantly different between the two groups. In contrast to EXG, IZCG showed insignificant difference in ANB, lower incisor proclination, and mesial movement of the lower first molar. There was significant rotation with distal movement of maxillary canine and first molar in both groups.
CONCLUSION
IZC anchored CMA could eliminate the side effects of class II elastics regarding lower incisor proclination, mesial movement lower molars with a more significant amount of distalization of the maxillary buccal segment but with significant molar rotation.
TRIAL REGISTRATION
The ClinicalTrials.gov Protocol Registration and Results System (PRS) has this RCT registered as (NCT05499221) on 12/08/2022.
Topics: Humans; Treatment Outcome; Tooth Movement Techniques; Maxilla; Malocclusion, Angle Class II; Cephalometry; Orthodontic Appliance Design; Orthodontic Anchorage Procedures
PubMed: 38297285
DOI: 10.1186/s12903-024-03925-3 -
BMC Oral Health Jan 2024Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and...
BACKGROUND
Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and smooth thermoformed polyurethane and copolymer retainer samples after staining in different solutions and destaining with different approaches.
METHODS
Four hundred copolyester (Essix® ACE) and 400 polyurethane (Zendura®) samples with different surface textures, smooth and rough, were stained in 4 different solutions (n = 100 per solution) over 28 days. Each of the four groups of 100 stained samples of each material was subdivided into 5 groups of 20 samples and subjected to different destaining solutions. Light transmittance and color changes were evaluated using a spectrometer and a spectrophotometer. Mean differences were compared using a two-way analysis of variance (ANOVA) and posthoc multiple comparison tests at P = 0.05.
RESULTS
No significant differences in light transmittance were found between both untreated materials. Both materials were stained in a similar fashion and showed no significant differences between two materials after staining. Coffee and tea stained both materials more significantly than wine, but there was a significant difference of changes of color and light transmittance between rough and smooth surfaces during the destaining in coffee- and tea-stained samples of copolyester material. All destaining solutions were effective at removing all stains on the samples. The surface roughness of the material plays a significant role in the ability of the materials to be destained, demonstrating a more significant greater effect on cleaning rough samples for improvements in light-transmittance and greater changes in color.
CONCLUSIONS
This study concluded that the surface of materials plays a significant role in the material destaining and staining. In addition, the different polymers used for retainer fabrication exhibited different responses during the destaining process depending on types of stains.
Topics: Humans; Coffee; Polyurethanes; Spectrophotometry; Staining and Labeling; Coloring Agents; Tea; Materials Testing; Color; Surface Properties; Composite Resins
PubMed: 38297268
DOI: 10.1186/s12903-024-03887-6 -
Clinical Oral Investigations Jan 2024We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its...
OBJECTIVE
We aimed to develop a tool for virtual orthodontic bracket removal based on deep learning algorithms for feature extraction from bonded teeth and to demonstrate its application in a bracket position assessment scenario.
MATERIALS AND METHODS
Our segmentation network for virtual bracket removal was trained using dataset A, containing 978 bonded teeth, 20 original teeth, and 20 brackets generated by scanners. The accuracy and segmentation time of the network were tested by dataset B, which included an additional 118 bonded teeth without knowing the original tooth morphology. This tool was then applied for bracket position assessment. The clinical crown center, bracket center, and orientations of separated teeth and brackets were extracted for analyzing the linear distribution and angular deviation of bonded brackets.
RESULTS
This tool performed virtual bracket removal in 2.9 ms per tooth with accuracies of 98.93% and 97.42% (P < 0.01) in datasets A and B, respectively. The tooth surface and bracket characteristics were extracted and used to evaluate the results of manually bonded brackets by 49 orthodontists. Personal preferences for bracket angulation and bracket distribution were displayed graphically and tabularly.
CONCLUSIONS
The tool's efficiency and precision are satisfactory, and it can be operated without original tooth data. It can be used to display the bonding deviation in the bracket position assessment scenario.
CLINICAL SIGNIFICANCE
With the aid of this tool, unnecessary bracket removal can be avoided when evaluating bracket positions and modifying treatment plans. It has the potential to produce retainers and orthodontic devices prior to tooth debonding.
Topics: Orthodontic Brackets; Deep Learning; Dental Bonding; Dental Debonding; Microscopy, Electron, Scanning
PubMed: 38280038
DOI: 10.1007/s00784-023-05440-1 -
Cureus Dec 2023The present systematic review was done to assess the available literatures on changes in the number of occlusal contacts (NOC), occlusal contact surface areas, and... (Review)
Review
The present systematic review was done to assess the available literatures on changes in the number of occlusal contacts (NOC), occlusal contact surface areas, and occlusal force distribution (OFD) with vacuum-formed retainers (VFRs) or clear overlay retainers during retention and to compare them with other retainers. Six electronic databases (Web of Science, Scopus, PubMed, Cochrane Library, Lilacs, and Google Scholar) were searched. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) reporting on occlusal contact changes with VFRs were included. A total of nine articles were included in this review: three RCTs, five prospective controlled trials (PCTs), and one CCT. The Cochrane risk of bias tool and ROBINS-I tool were used for risk of bias assessment. The three RCTs showed moderate risk of bias, and out of five CCTs, four showed low risk of bias, and one showed moderate risk of bias. One CCT showed a low risk of bias in the ROBINS-I tool. Two out of four studies reported improved occlusal surface area (OSA) with VFRs when assessed at the end of six months and 12 months; one out of four studies reported improved NOC; and one study reported a decrease in OFD anteriorly and an increase in OFD posteriorly after two months of retention. On comparison between the groups, the other retainer groups showed more NOCs compared to VFRs. The limited available evidence suggests an increase in OSA and no change in NOCs and OFD with VFRs during retention. No significant differences between VFRs and other retainers for OSA and OFD were noted, and more NOCs were noted for other retainer groups.
PubMed: 38239549
DOI: 10.7759/cureus.50751