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BMC Oral Health Jun 2024to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at... (Comparative Study)
Comparative Study
BACKGROUND
to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at the end of the first set of aligners and at the end of the therapy in the upper and lower arch.
METHODS
36 patients (20 F, 16 M; mean age 8.3 ± 1.5 years) were selected retrospectively from the Department of Orthodontics of the Hospital of Rome "Tor Vergata". All subjects were treated with CA with no other auxiliaries than attachments. For each patient a standardized sequential expansion protocol was planned for both arches. Digital dental casts were created at three observation periods from an intraoral scanner: prior to treatment (T0), at the end of the first set of aligners (T1), at the end of treatment (T2). The 3D models in planned position determined by the first Clincheck (CC) were obtained for comparison with T1 and T2. Six linear transversal measurements were used to evaluate the dimensional changes and the predictability of expansion movements, comparing T1-CC and T2-CC.
RESULTS
a statistically significant increase within the pre-treatment and the final outcomes for all the variables examined was found. In the upper arch, the greatest level of predictability was detected at the level of the first (46.44%) and second deciduous molar width (44.95%) at T1. The analysis of T2-CC changes showed a significant increase in the percentage of predictability of expansion at the level of the first permanent molars, at mesial (54.86%) and distal (58.92%) width. In the lower arch, a higher percentage of predictability than the upper arch was reported at T1-CC and T2-CC, with the greatest values at the level of second (T1-CC: 48.70%; T2-CC: 75.32%) and first deciduous molar width (T1-CC: 45.71%; T2-CC: 72.75%).
CONCLUSIONS
CA can induce significant transversal increments. The predictability of expansion is variable, but it did not exceed the 50% during the first set of aligners. It was necessary to apply refinement set to achieve a good predictability for expansion of about 70%. The expansion in the lower arch was observed to be more predictable than in the upper arch.
Topics: Humans; Dentition, Mixed; Retrospective Studies; Female; Child; Male; Models, Dental; Dental Arch; Palatal Expansion Technique; Orthodontic Appliance Design; Imaging, Three-Dimensional; Tooth Movement Techniques; Maxilla; Mandible; Orthodontic Appliances, Removable; Forecasting; Cephalometry; Malocclusion; Treatment Outcome
PubMed: 38879479
DOI: 10.1186/s12903-024-04435-y -
Dental Clinics of North America Jul 2024Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient.... (Review)
Review
Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective.
Topics: Humans; Sleep Apnea, Obstructive; Child; Adult; Patient Care Team; Orthodontists; Polysomnography; Tonsillectomy; Adenoidectomy; Mass Screening; Professional Role; Orthodontic Appliances
PubMed: 38879281
DOI: 10.1016/j.cden.2024.03.005 -
Head & Face Medicine Jun 2024Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can...
INTRODUCTION
Amelogenesis imperfecta (AI) is a genetically determined, non-syndromic enamel dysplasia that may manifest as hypoplasia, hypomaturation, or hypocalcification and can commonly be classified into four primary groups. In this retrospective analysis, specific orofacial characteristics are described and associated with each of the AI types based on a patient cohort from Witten/Herdecke University, Germany.
METHODS
Data from 19 patients (ten male and nine female, mean age 12.27 ± 4.06 years) with AI who presented at the Department of Orthodontics between July 2011 and December 2023 were analyzed. Baseline skeletal and dental conditions were assessed, including the presence of hypodontia, displacements, and taurodontism. AI was classified into classes I-IV based on phenotype. Treatment needs were evaluated according to the main findings following the German KIG classification, while the radiological enamel situation was determined using panoramic radiographs.
RESULTS
An approximately equal distribution between classes II and III was found and a slight inclination toward a dolichofacial configuration (ΔML-NSL: 5.07 ± 9.23°, ΔML-NL: 4.24 ± 8.04°). Regarding orthodontic findings, disturbance in tooth eruption as well as open bite were the most prevalent issues (both 36.8%, n = 7). The most common AI classes were type I and II, which show an almost even distribution about the skeletal classes in sagittal dimension, while dolichofacial configuration was found most frequently in vertical dimension.
CONCLUSION
Both clinical and radiological orthodontic findings in context with AI are subject to extensive distribution. It seems that no specific orofacial findings can be confirmed in association with AI with regard to the common simple classes I-IV. It may be more appropriate to differentiate the many subtypes according to their genetic aspects to identify possible associated orthodontic findings.
Topics: Humans; Amelogenesis Imperfecta; Male; Female; Retrospective Studies; Child; Adolescent; Germany; Radiography, Panoramic; Orthodontics, Corrective; Malocclusion
PubMed: 38877506
DOI: 10.1186/s13005-024-00436-y -
Journal of Oral Biology and... 2024Orthognathic surgery results in the positional change of the maxilla and mandible that may affect speech. The present study evaluated the effect of combined maxillary...
INTRODUCTION
Orthognathic surgery results in the positional change of the maxilla and mandible that may affect speech. The present study evaluated the effect of combined maxillary advancement and mandibular setback surgery on articulation proficiency and speech intelligibility in patients with non-syndromic skeletal Class III malocclusion.
METHODS
In this prospective study, twenty-five patients with skeletal class III malocclusion and consecutively treated with Lefort-1 maxillary advancement and mandibular setback (BSSO) orthognathic surgery were included in this study. The speech sample was recorded with a digital audio tape recorder one day before surgery and at 3, 6, 9, 12 and 18 months after surgery. Three qualified and experienced speech and language pathologists evaluated articulation errors and intelligibility of speech samples. Repeated One-way analysis of variance was used to compare articulation proficiency and speech intelligibility at different time intervals.
RESULTS
The substitution, omission, distortion and addition errors showed no significant changes at 3 months and 6 months. The total articulation errors decreased to zero at 9 months and no significant increase was observed till 18 months (P < 0.05). Speech intelligibility showed statistically non-significant improvement at any time interval. Cephalometric skeletal parameters SNA and N ḻ A°. were significantly correlated with addition and total articulation errors at 18 months follow up.
CONCLUSIONS
The ortho-surgical treatment improves speech (decreases. articulation errors) in most of the patients usually 6-9 months post-surgery. Speech intelligibility is not affected by bimaxillary orthognathic surgery in skeletal class III patients. The articulation errors were correlated to changes in position of maxilla.
PubMed: 38868459
DOI: 10.1016/j.jobcr.2024.05.017 -
International Orthodontics Jun 2024To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared...
Dentoalveolar, periodontal and skeletal effects of maxillary expansion techniques assisted by temporary anchorage devices compared with conventional protocols in growing patients with transverse maxillary deficiency: A systematic review and meta-analysis.
OBJECTIVES
To synthesise the dentoalveolar, periodontal and skeletal changes that occur when using maxillary expansion techniques assisted by temporary anchorage devices compared to conventional protocols.
METHODS
Five databases and grey literature were consulted, up to December 2023, focusing on intervention designs and excluding other type of studies. The quality assessment was conducted by using the adaptation for orthodontics of the CONSORT statement, the guidelines for reporting non-randomised studies, the RoB-2 tool, and the ROBINS-I tool. A descriptive summary and meta-analysis using RevMan 5.4 were performed.
RESULTS
Nine clinical trials were included (n=377 patients, mean age 13.2±0.6) with a diagnosis of transverse maxillary deficiency. The analysed studies showed qualitative dentoalveolar and periodontal changes after expansion, which were greater on the maxillary first premolars in tooth-borne appliances. Meta-analyses for some effects were included from two studies (n=64); patients who used tooth-borne appliances had greater effects of buccal intercoronal width between the premolars with statistically significant differences (Std Mean difference 2.34; 95% CI: 0.04-4.65 p=0.05). Conversely, those patients who used bone-borne or hybrid appliances had greater effects of buccal intercoronal width between molars with statistically significant differences (Std Mean difference -0.64; 95% CI: -1.38-0.10; p=0.09).
CONCLUSIONS
According to the studies analysed, all measurements increased in the intervention groups after expansion. Quantitative analyses show different findings at dentoalveolar level when tooth-borne, bone-borne or hybrid appliances are considered. Nevertheless, the results should be taken with caution due to the heterogeneity of the studies. The protocol was registered at PROSPERO (CRD42021283170), with no funding to report.
PubMed: 38865748
DOI: 10.1016/j.ortho.2024.100891 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: To evaluate the effectiveness of the use of circumferential supracrestal fiberotomy in the treatment of tortoanomalies to improve the effectiveness of treatment,...
OBJECTIVE
Aim: To evaluate the effectiveness of the use of circumferential supracrestal fiberotomy in the treatment of tortoanomalies to improve the effectiveness of treatment, prevent recurrence and increase the stability of the achieved result.
PATIENTS AND METHODS
Materials and Methods: Our study consists in determining the effectiveness of the use of methods that prevent the recurrence of tortoanomalies - circumferential supracrestal fiberotomy (CSF) in patients over the age of 16 years and the effect of CSF on the gingival junction in the treatment of tortoanomalіes with fixed orthodontic multibonding equipment.
RESULTS
Results: The high level of stability of results proves expediency operations circumferential supracrestal fiberotomy and papilla splitting at orthodontic treatment of frontal teeth density at patients older 16 years and for increasing stability of results of treatment by prevention of relapse tortoanomalies. Efficiency of the offered ways of treatment is proved clinically and anthropometrically on the early and remote terms of supervision (1, 6, 12 months).
CONCLUSION
Conclusions: The high level of stability of results proves expediency operations circumferential supracrestal fiberotomy and papilla splitting at orthodontic treatment of frontal teeth density at patients older 16 years and for increasing stability of results of treatment by prevention of relapse tortoanomalies. Efficiency of the offered ways of treatment is proved clinically and anthropometrically on the early and remote terms of supervision (1, 6, 12 months).
Topics: Humans; Female; Male; Adolescent; Malocclusion; Treatment Outcome; Young Adult; Adult
PubMed: 38865633
DOI: 10.36740/WLek202404121 -
Cureus May 2024Malocclusion has a psychological impact related to the patient's age. It also influences the quality of life. This research aims to test the null hypothesis that...
An Assessment of the Subjective Psychological and Social Effects of Malocclusion-Related Dental Aesthetics and Its Influence on Body Self-Image and Oral Health-Related Quality of Life in Young Adults.
INTRODUCTION
Malocclusion has a psychological impact related to the patient's age. It also influences the quality of life. This research aims to test the null hypothesis that there is no association between the self-perceived psychosocial impacts of dental aesthetics with the severity of malocclusion, oral health-related quality of life (OHRQoL), and self-image of the body in young adults seeking orthodontic treatment.
MATERIALS AND METHODS
A convenience sample of young adults between 19 and 30 years old was selected for the study. The severity of malocclusion and orthodontic treatment needs were evaluated using the Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile-14 (OHIP-14), and Body Satisfaction Scale (BSS) were used to evaluate the self-perceived effects of malocclusion.
STATISTICAL ANALYSIS
The Kruskal-Wallis test is used to analyze the distribution of components with different grades of DAI. Spearman's correlation test evaluated the correlation between independent variables and their domains. The study utilized stepwise multiple linear regression analysis to assess the predictive value of independent factors on the PIDAQ and its domains.
RESULTS
A total of 181 subjects with a mean age of 24.4 ± 1.5 years, 42% males and 58% females, participated in this study. There was a significant correlation (p < 0.05) between all variables (OHIP-14, DAI, and BSS) and PIDAQ. There were significant correlations between the independent variables and the total score of PIDAQ (R2 = 0.16), psychological impact (R2 = 0.09), and social impact (R2 = 0.18), as well as dental self-confidence (R2 = 0.21) and aesthetic concern (R2 = 0.16).
CONCLUSION
In young adults, the self-perceived impact of dental aesthetics is moderated by the severity of malocclusion, oral health-related quality of life, and body satisfaction. The null hypothesis is rejected.
PubMed: 38864051
DOI: 10.7759/cureus.60120 -
The Cleft Palate-craniofacial Journal :... Jun 2024To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to...
OBJECTIVES
To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems.
DESIGN
A retrospective study.
SETTING
Dental college and hospital.
PARTICIPANTS
Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected.
MAIN OUTCOME
The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done.
RESULTS
The study found significant differences in nasal length ( = .003) and depth ( < .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length ( = .01).
CONCLUSION
The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.
PubMed: 38860313
DOI: 10.1177/10556656241261908 -
Journal of Orthodontics Jun 2024New technologies have paved the way for newer fabrication techniques, such as rapid prototyping, which has gained popularity in the fabrication of several orthodontic...
BACKGROUND
New technologies have paved the way for newer fabrication techniques, such as rapid prototyping, which has gained popularity in the fabrication of several orthodontic appliances including retainers.
AIM
To evaluate the stability, survival time and periodontal health associated with vacuum-formed retainers (VFRs), bonded retainers (BRs) and rapid prototype retainers (RPRs) over a period of 12 months in retention.
STUDY DESIGN
Prospective clinical study.
METHODS
A total of 72 participants completing fixed orthodontic treatment were allocated to the following three groups by the investigators based upon their initial malocclusion, compliant and preferences: VFR; BR; and RPR. The primary outcome was Little's Irregularity Index (LII). Other stability parameters, including arch length (AL), inter-canine width (ICW) and inter-molar width (IMW), were also assessed immediately after debonding (T0) and 12 months (T2) after debonding. In addition, survival time, and calculus index and gingival index (GI) were assessed.
RESULTS
LII showed a significant difference ( = 0.00) between the groups and was increased in the VFR group (0.18 ± 0.22 mm) compared to the BR (0.03 ± 0.05 mm) and RPR (0.01 ± 0.03 mm) groups but was not clinically significant. The mean survival time of maxillary retainers was longest for the RPR group (220.63 days; 95% confidence interval [CI] = 194.1-247.16) but there was no significant difference between the three groups ( = 0.43). The mean survival time of mandibular retainers was higher and the same for the VFR and RPR groups (240 days; 95% CI = 240-240) and there was no significant difference between the three groups ( = 0.38). The calculus index score ( = 0.00) was statistically significant between the groups, with an increased score for the BR group (0.33 ± 0.27) compared to the VFR (0.07 ± 0.16) and RPR (0.13 ± 0.22) groups. Similarly, the GI score ( = 0.02) was statistically significant between the groups and was increased in the BR group (0.01 ± 0.19) compared to the VFR (-0.15 ± 0.18) and RPR (-0.06 ± 0.15) groups. The increase in calculus index and GI scores for the BR group were not clinically significant.
CONCLUSION
There were no clinically significant differences between the three retainer groups in terms of stability, periodontal health and time to failure.
PubMed: 38859624
DOI: 10.1177/14653125241255702 -
Cureus Jun 2024Angle's class III malocclusions are characterized by the anterior positioning of the mandible in relation to the maxilla. The discrepancy can be caused by an anterior...
Angle's class III malocclusions are characterized by the anterior positioning of the mandible in relation to the maxilla. The discrepancy can be caused by an anterior deficiency of the maxilla, excessive mandibular prognathism, or a combination of both. Acromegaly is a dysfunction caused by the excessive production of growth hormone (GH), which leads to systemic changes and orofacial manifestations. In acromegaly caused by a pituitary adenoma, which secretes an excessive amount of GH, disproportionate mandibular growth may occur, leading to skeletal class III malocclusion in adulthood. Excessive growth stops when the tumor is removed, but the skeletal deformity persists, requiring orthognathic surgery to reposition the mandible. This article reports the case of a 31-year-old man referred to the maxillofacial surgery consultation due to severe Angle's class III malocclusion, with prognathism, mandibular asymmetry, and maxillary retrusion. He had a history of disproportionate soft tissue growth (hands and feet) up to 18 years old, less evident after that age. Considering the possibility of acromegaly due to a pituitary adenoma, imaging studies (CT scan and magnetic resonance imaging (MRI)) and directed analytical studies were requested. When the diagnosis was confirmed, the patient was referred to endocrinology and neurosurgery consultations. After undergoing endoscopic resection of the pituitary adenoma, the patient underwent surgery-first orthognathic surgery to correct the dental malocclusion.
PubMed: 38855491
DOI: 10.7759/cureus.61999