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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 -
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 -
Cureus Feb 2024An anterior open bite is a form of vertical discrepancy that presents as a lack of contact between maxillary and mandibular segments. The treatment modalities usually...
Evaluation of Dimensional Changes in Maxillary and Frontal Sinus in Adult Patients With Anterior Open Bite and Normal Overbite: A Retrospective Cone Beam Computed Tomography (CBCT) Study.
INTRODUCTION
An anterior open bite is a form of vertical discrepancy that presents as a lack of contact between maxillary and mandibular segments. The treatment modalities usually involve either intrusion of posterior teeth or extrusion of anterior or a combination of both. The anatomical relationship between the apex of the maxillary molar roots to the inferior wall of the maxillary sinus floor is crucial in planning posterior intrusion. The paranasal sinuses influence the growth of the facial structures that eventually get altered in various malocclusions. Studies have proven that the height of the sinus gets modified in anterior open bite owing to pneumatization. This study aims to evaluate the distance from the root apex of maxillary first molars (mesiobuccal, distobuccal, and palatal roots) to the maxillary sinus floor to evaluate the significance of the vertical pneumatization of the sinus on planning for true intrusion in anterior open bite and to assess the correlation between frontal and maxillary sinuses in an anterior open bite.
METHODS
This retrospective study evaluated 30 pre-treatment cone beam computed tomographies (CBCTs) of patients out of which 15 were with anterior open bite and 15 with ideal overbite. Linear measurements were carried out using care stream software in CBCTs.
RESULTS
There was a significant correlation between the distance of the palatal root and the distobuccal root of the maxillary first molar to the maxillary sinus floor bilaterally in the anterior open bite (p<0.04). A significant moderate positive correlation of the maxillary and frontal sinus height in anterior open bite (p<0.006). A significant moderate negative correlation between the distance from the palatal root to the maxillary sinus floor and maxillary sinus height in anterior open bite (p<0.001).
CONCLUSION
Vertical pneumatisation of the maxillary sinus has caused a significant negative correlation between the apex of the palatal root of the maxillary first molar tooth and the maxillary sinus floor in the anterior open bite. The palatal root being the closest to the sinus floor, and the distobuccal root being second nearest. There is a significant correlation between the height of the sinuses in the anterior open bite.
PubMed: 38455800
DOI: 10.7759/cureus.53710 -
Orthodontics & Craniofacial Research Mar 2024Evaluate long-term spontaneous occlusal changes following L7 extraction in adolescent patients.
OBJECTIVES
Evaluate long-term spontaneous occlusal changes following L7 extraction in adolescent patients.
MATERIALS AND METHODS
Study models of 144 participants (63 males, 81 females) retrospectively assessed prior to L7 extraction (9-16 years old; T1) and following L8 eruption (14-25 years old; T2). All received upper fixed appliances. A sub-group (n = 86) received no lower fixed appliances and acted as controls. Occlusal changes were compared between treatment (lower fixed appliance) and control (no lower fixed appliance) groups using PAR index. At T2, L8 occlusal outcome was assessed using ABO grading system.
RESULTS
Mean follow-up period 6 (SD 2) years. At T1, lower scores observed in control group for Lower Anterior (P < .001), Midline (P = .033) and Lateral Segments (P = .040) components. At T2, lower scores continued being observed in control group for Midline (P < .001) and Lateral segment (P = .019) components. Higher decrease in Lower Anterior PAR scores observed in treatment group (<.001) with comparable scores between groups at T2 (P = .057). Similar PAR score changes between groups for Lateral Segments, Overjet and Overbite components. At T2, no significant difference observed in Total PAR score reduction between control (83%) and treatment (82%) groups. Good-to-acceptable occlusal outcome of the L8 observed in 81.55% of cases at T2 with no difference between groups.
CONCLUSION
In growing patients with mild mandibular crowding, extraction of L7 followed by upper fixed appliance therapy, leads to favourable occlusal changes over a 6-year follow-up period, with or without lower fixed appliance therapy, being an alternative extraction protocol where lower fixed appliance therapy is not recommended.
PubMed: 38444245
DOI: 10.1111/ocr.12772 -
Cureus Feb 2024Objective This study aimed to investigate the correlation of craniofacial morphology with maxillary sinus morphology and to evaluate whether orthodontic treatment...
Objective This study aimed to investigate the correlation of craniofacial morphology with maxillary sinus morphology and to evaluate whether orthodontic treatment facilitates maxillary sinus enlargement in adults. Materials and methods A total of 45 adult women underwent cephalography and computed tomography before and after orthodontic treatment. All participants were classified into three groups: skeletal class I, II, and III. The average dimensions and volume of the maxillary sinus were calculated in each subgroup. Furthermore, multiple regression analysis was used to analyze the correlations of maxillary sinus dimensions with 20 cephalometric variables. Results Before treatment, the maxillary sinus width, height, depth, and volume were 32.2 ± 3.9 mm, 39.5 ± 3.8 mm, 38.6 ± 1.8 mm, and 36,179.3 ± 5,454.0 mm in skeletal class I, 33.9 ± 6.2 mm, 37.3 ± 3.5 mm, 38.6 ± 2.4 mm, and 34,729.8 ± 6,686.6 mm in skeletal class II, and 32.0 ± 4.3 mm, 41.8 ± 5.0 mm, 38.0 ± 2.8 mm, and 35,592.3 ± 10,334.3 mm in skeletal class III, respectively. Despite no significant differences in maxillary sinus width, depth, or volume, the height was significantly lower in the skeletal class II than in the other two. Regardless of the skeletal pattern, maxillary sinus height and volume increased considerably after treatment. Moreover, the maxillary sinus width was substantially involved in pretreatment U1 to SN and overbite and posttreatment U1 to NA and overjet. Conclusion Except for the height, the maxillary sinus dimensions were almost similar, irrespective of the skeletal classification. The posttreatment sinus height and volume were significantly greater than the pretreatment values, although the sinus width and length showed no significant changes during orthodontic treatment. This implies that orthodontic treatment may facilitate the enlargement of the maxillary sinus even after physical growth.
PubMed: 38435147
DOI: 10.7759/cureus.53363 -
Cureus Jan 2024The straight-wire device offers the best finishing potential and control. This case study focuses on the treatment of severe deep bite and Class II malocclusion...
Simultaneous Intrusion and Retraction of Maxillary Anterior Teeth in Class II Malocclusion Using the Kalra Simultaneous Intrusion and Retraction (K-SIR) Loop: A Case Report.
The straight-wire device offers the best finishing potential and control. This case study focuses on the treatment of severe deep bite and Class II malocclusion involving first premolar extraction of the upper arch using a Kalra Simultaneous Intrusion and Retraction loop. Using minimal force and creating enough space for anterior teeth to retract while maintaining the Class II molar relationship was the aim of the therapy. Due to the unsightly excessive maxillary incisor showing at rest, the decision was made to intrude anterior teeth to treat a deep overbite. Good and consistent changes occurred post-treatment.
PubMed: 38425610
DOI: 10.7759/cureus.53241 -
Unveiling the Influence of the Curve of Spee on Bite Force and Chewing Ability: A Comparative Study.International Journal of Clinical... 2024To investigate the impact of the curve of Spee (CS) accentuation on bite force, chewing ability, and additionally, other factors that influence chewing ability and bite...
AIM
To investigate the impact of the curve of Spee (CS) accentuation on bite force, chewing ability, and additionally, other factors that influence chewing ability and bite force such as restorations, caries, gender, habits, and TMJ problems.
MATERIALS AND METHODS
231 participants (118 male and 113 female, mean age = ±27.96 years) were recruited for this cross-section study. Participants completed a data collection sheet in which age, gender, Angle's classification of malocclusion, overjet, overbite, TMJ problems, habits, restorations, and caries experience were recorded. Two examiners made a lower impression, chewing ability test and measured the bite force for each participant. Measurement of the CS was obtained digitally from the poured dental cast, and the categorization was as follows: flat (<1 mm), normal (1-2 mm), or deep (>2 mm).
RESULTS
The mean maximum bite force (MBF) was 468.722 N for participants with flat CS, 389.822 N for normal CS, 647.08 N for deep CS, and 384.667 N for reverse CS. The average MBF was higher for participants with deep CS ( < 0.05). MBF force was higher in males. However, BMI was not significantly related to MBF values. Participants with normal and flat CS have comparable chewing capacity ( > 0.05). Also, a significant difference in bite force and chewing ability was found between the three categories of CS ( < 0.05).
CONCLUSION
Bite force variations across various CS types were linked to gender and habits. Chewing ability showed no differences concerning gender, habits, TMJ problems, caries, or restorations, emphasizing CS's significant impact on bite force while showcasing the unchanged nature of chewing ability amidst diverse factors.
Topics: Humans; Male; Female; Bite Force; Mastication; Cross-Sectional Studies
PubMed: 38420595
DOI: 10.1155/2024/6533841 -
Korean Journal of Orthodontics Mar 2024: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner...
OBJECTIVE
: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness.
METHODS
: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment.
RESULTS
: Deep overbite was successfully corrected ( < 0.05), accompanied by mandibular incisor proclination ( < 0.05). There were no statistically significant change in the true incisor intrusion ( > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease ( < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area ( < 0.05); accompanied by thickening in the labial apical area ( < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss.
CONCLUSIONS
: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.
PubMed: 38413215
DOI: 10.4041/kjod23.173 -
BMC Oral Health Feb 2024Our meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Our meta-analysis aimed to evaluate the efficacy of applying Herbst and Twin Block appliances in the treatment of Class II malocclusion among children.
METHODS
Databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China VIP Database (VIP), and Wanfang were thoroughly searched from inception to August 9, 2023. The outcomes included skeletal, dental, and soft tissue changes. The weighted mean difference (WMD) was used as the effect indicator, and the effect size was expressed with a 95% confidence interval (CI). The heterogeneity of each outcome effect size was tested, and the heterogeneity statistic I ≥ 50% was analyzed by the random-effect model, otherwise, the fixed-effect model was conducted. Sensitivity analysis was performed.
RESULTS
A total of 12 studies involving 574 patients were included in this meta-analysis. Herbst appliance had a statistically significant increase in mandibular body length (WMD: 1.44, 95% CI: 0.93 to 1.96, P < 0.001) compared with the Twin Block appliance. More increases in angle and distance of L1 to mandibular plane (MP) were found in the Herbst appliance compared with the Twin Block appliance. Significant and greater improvements in molar relationship (WMD: 0.79, 95% CI: 0.28 to 1.29, P = 0.002), posterior facial height (WMD: -1.23, 95% CI: -2.08 to -0.38, P = 0.005), convexity angle (WMD: -1.89, 95% CI: -3.12 to -0.66, P = 0.003), and Sella-Nasion plane angle (U1 to SN) (WMD: 3.34, 95% CI: 2.25 to 4.43, P < 0.001) were achieved in the Twin Block appliance. Herbst and Twin Block appliances produced similar effects in the skeletal and dentoalveolar changes including Sella-Nasion-point A (SNA), Sella-Nasion-point B, point A-Nasion-point B (ANB), overjet, and overbite.
CONCLUSION
As the findings revealed both Herbst and Twin Block appliances contributed successfully to the correction of Class II malocclusion. Compared with the Twin Block appliance, the Herbst appliance may have more advantages in mandibular bone movement. Twin Block therapy resulted in more improvement in the aesthetics of the face.
Topics: Child; Humans; Cephalometry; Orthodontics, Corrective; Malocclusion, Angle Class II; Orthodontic Appliances, Functional; Mandible
PubMed: 38409017
DOI: 10.1186/s12903-024-04027-w