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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 -
Orthodontics & Craniofacial Research Aug 2024The curve of Spee is deemed important characteristic of the dentition for a balanced occlusion and distribution of masticatory forces, while orthodontic levelling of an...
OBJECTIVE
The curve of Spee is deemed important characteristic of the dentition for a balanced occlusion and distribution of masticatory forces, while orthodontic levelling of an accentuated curve of Spee is generally included as a treatment goal for deepbite correction. However, relapse is often seen and can be problematic.
METHODS
A retrospective longitudinal study of predominantly young patients with a deep curve of Spee, who had been treated orthodontically with 0.018"-slot Edgewise fixed appliances, was performed. The depth of the curve of Spee was digitally measured before treatment (T1), at debond (T2), and an average of 7 years post-debond (T3) and analysed statistically at 5%.
RESULTS
A total of 157 patients were included (56.7% female; 11.6-year-old at T1), 16.6% of which were treated with premolars extractions. Non-extraction treatment reduced the curve of Spee at the first premolar from 1.87 mm (T1) to 0.22 mm (T2), which relapsed 0.12 mm (T3; P = .04). The respective depths for the second premolar were 2.0 mm (T1), reduced to 0.80 mm (T2). No significant relapse was seen for the second premolar (0.08 mm; P > .05) or the first permanent molar (0.06 mm; P > .05). No overall significant differences in absolute relapse were seen between extraction and non-extraction patients, but premolar extractions were associated with less clinically relevant relapse at the first molar (odds ratio 0.27; 95%-confidence interval 0.08-0.88; P = .003).
CONCLUSION
Steep curves of Spee can be satisfactorily levelled orthodontically with satisfactory stability in the long term, while premolar extractions might be associated with less relapse.
Topics: Humans; Female; Longitudinal Studies; Retrospective Studies; Male; Child; Recurrence; Overbite; Orthodontic Appliances, Fixed; Adolescent; Tooth Extraction; Orthodontics, Corrective
PubMed: 38404201
DOI: 10.1111/ocr.12756 -
Journal of the World Federation of... Jun 2024This study aimed to investigate unplanned tooth movements in deepbite correction with Invisalign. (Comparative Study)
Comparative Study
BACKGROUND
This study aimed to investigate unplanned tooth movements in deepbite correction with Invisalign.
METHODS
The sample consisted of 34 adult patients with deepbite malocclusion treated with Invisalign. Pretreatment and predicted digital models were exported from ClinCheck software, while the post-treatment model was obtained from an intraoral scan taken at the end of the first set of aligners. Digital models' superimposition was done using the eModel "Compare" software. Frequency and percentage of occurrence of unplanned linear and angular movements, their magnitude, and direction were then determined. In addition, comparison of unplanned movements was performed between anterior and posterior teeth as well as between linear and angular measurements.
RESULTS
The percentage of unplanned movements ranged from 1.68% to 25.63% in the maxilla and 3.36% to 23.95% in the mandible, being most evident in the first and second molars. Unplanned movements were statistically significantly more frequent in posterior teeth compared with the anterior teeth (P > 0.05). In addition, the frequency of angular movements was statistically significantly higher for each tooth than linear movement (P < 0.05) with a higher mean value. Unplanned mesiodistal movements were the least frequent.
CONCLUSIONS
Unplanned linear as well as angular movements were evident in almost all teeth. Unplanned faciolingual inclination and mesiodistal angulation movements were the most frequently observed. Unplanned vertical movements can affect the predictability of deepbite correction and thus merit particular attention in those cases.
Topics: Humans; Retrospective Studies; Tooth Movement Techniques; Adult; Female; Male; Young Adult; Overbite; Molar; Incisor; Maxilla; Mandible; Cephalometry; Models, Dental; Bicuspid; Orthodontic Appliance Design; Adolescent; Orthodontic Appliances, Removable; Imaging, Three-Dimensional
PubMed: 38402054
DOI: 10.1016/j.ejwf.2023.12.008 -
Dentistry Journal Jan 2024The purpose of this study was to evaluate short- and long-term changes in growing patients with Class II malocclusion and open bite after rapid maxillary expansion...
The purpose of this study was to evaluate short- and long-term changes in growing patients with Class II malocclusion and open bite after rapid maxillary expansion (RME). A retrospective cohort study was conducted with 16 growing patients with open-bite malocclusion enrolled in a group treated with a rapid maxillary expander (RME) with a crib (TG), and 16 untreated patients with similar malocclusion in the control group (CG). Cephalograms were recorded before starting the treatment (T0), at the end of the latency phase (T1), and before the fixed therapy (T2) in order to analyze skeletal and dental changes in vertical, transversal, and sagittal relationships. Statistical analysis was performed with α = 0.05 as level of significance. At the end of the active expansion (T1), all subjects in the TG showed a corrected overbite with a statistically significant difference compared to the CG ( > 0.05). A significant decrease in jaw divergence was found in the TG compared to the CG ( < 0.05). At T2, all treated patients maintained a correct overbite. Statistical analysis revealed a significant decrease in maxillary, mandibular, and intermaxillary divergence in the TG compared to the CG ( < 0.05). This protocol could be effective in growing open-bite patients, showing a long-term decrease in facial divergence. The fixed crib allowed to normalize myofunctional activity.
PubMed: 38392226
DOI: 10.3390/dj12020022 -
Case Reports in Dentistry 2024Crowns have been recommended to treat decayed teeth and rebuild teeth function. The dental management of children with autism is a tremendous challenge for pediatric...
Crowns have been recommended to treat decayed teeth and rebuild teeth function. The dental management of children with autism is a tremendous challenge for pediatric dentists due to the impaired behaviors and communication disorders. In this context, a 5-year-old boy with autism was treated to solve carious lesions under the assistance of general anesthesia. The posterior occlusal function was restored, and the crossbite existing in the primary anterior teeth was approached merely by NuSmile® zirconia crowns (ZCs) rather than orthodontic intervention. We conducted an 18-month period. Throughout the long-term follow-up, the boy's masticatory efficiency was remarkably improved and the anterior teeth had transferred into the correct position with adequate overbite to maintain the new relationship, thus ameliorating the appearance of tissue on the labial surface and enhancing his quality of life and oral health.
PubMed: 38390344
DOI: 10.1155/2024/5556502 -
The Saudi Dental Journal Jan 2024To determine the prevalence of primary dentition malocclusion and its linked risk indicators among a group of Saudi preschool children.
OBJECTIVES
To determine the prevalence of primary dentition malocclusion and its linked risk indicators among a group of Saudi preschool children.
METHODS
A cross-sectional study was carried out on preschool children aged 3 to 5 years residing in Riyadh City, the capital of Saudi Arabia. The study sample included 709 Saudi children of both genders with complete primary dentition. Oral examination was conducted for children to assess the anteroposterior, transverse, and vertical dimensions, arch spacings, and oral habits.
RESULTS
The prevalence of malocclusion was 59.1% among the study participants. A deep overbite and increased overjet were found in 26.23 % and 25.11%, respectively. Arch space problems were reported, including missing primate spaces in 24.12%, missing developmental spacing in 27.93%, and crowding in 14.1%. An association between mothers aged 25 years and younger at childbirth was linked with their child's malocclusion in the primary dentition (p-value of 0.03).
CONCLUSION
The prevalence of primary dentition malocclusion among a specific group of Saudi preschool children was significantly high. Increased overbite and overjet were the most prevalent occlusal discrepancies, followed by arch spacing problems. The younger mother's age at childbirth is significantly associated with her child's malocclusion. The study results can serve as a baseline for future investigations.
PubMed: 38375380
DOI: 10.1016/j.sdentj.2023.09.003 -
BMC Oral Health Feb 2024Despite the popularity of clear aligners, their predictability has not been assessed adequately. Moreover, no study has investigated their effects on numerous... (Clinical Trial)
Clinical Trial
Effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face: a preliminary retrospective before-after clinical trial.
INTRODUCTION
Despite the popularity of clear aligners, their predictability has not been assessed adequately. Moreover, no study has investigated their effects on numerous dentomaxillary variables. Therefore, this study was conducted for the first time, assessing several new or controversial items. The aim of the study was to evaluate the effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face.
METHODS
This preliminary retrospective before-after non-randomized clinical trial was performed on 168 observations of 84 patients (33.60±9.28 years, 54 females) treated with 0.75mm Invisalign appliances. Pretreatment and posttreatment values were measured for: mandibular plane angle, occlusal plane angle, Y-Axis, ANB, facial angle, lower anterior facial height, overbite, and the distances of the molars from the palate and mandibular plane were measured. The alterations in parameters caused by treatment (delta values) were calculated for each measurement. Effects of treatment and some parameters on delta values were analyzed statistically (α=0.05).
RESULTS
Mean±SD of ΔMP-FH, ΔOP-FH, ΔY-Axis, ΔLAFH, ΔNPog-FH, ΔANB, ΔOverbite, ΔSNB, Δ6-PP, Δ7-PP, Δ6-MP, and Δ7-MP were respectively 0.11±1.61, 0.80±1.56, 0.15±1.18, 0.07±0.91, -0.22±1.25, 0.03±0.62, 0.04±1.15, -0.06±1.14, -0.36±0.94, -0.32±1.14, 0.19±0.96, 0.18±1.10. Only the alterations in OP-FH, 6-PP, and 7-PP were significant (P≤0.011). Age, sex, treatment duration, or pretreatment mandibular plane angle were not correlated with any delta values. However, the pretreatment occlusal plane angle was negatively correlated with ΔOP-FH and ΔY-Axis. Crowding was correlated negatively with ΔOP-FH and ΔY-Axis and positively with ΔNPog-FH. Overjet was negatively correlated with ΔANB and ΔOverbite (P≤0.035).
CONCLUSIONS
Invisalign intruded first/second maxillary molars and increased the occlusal plane angle. Age, sex, and treatment duration were not correlated with post-treatment anatomic alterations.
Topics: Female; Humans; Cephalometry; Malocclusion; Malocclusion, Angle Class II; Mandible; Molar; Orthodontic Appliances, Removable; Retrospective Studies; Tooth; Tooth Movement Techniques; Controlled Before-After Studies
PubMed: 38350970
DOI: 10.1186/s12903-024-03972-w -
Cureus Jan 2024This report presents a case of a 16-year-old female patient with skeletal class II and dental class II division I malocclusion that was treated with fixed orthodontic...
This report presents a case of a 16-year-old female patient with skeletal class II and dental class II division I malocclusion that was treated with fixed orthodontic appliances and through growth modulation. Two appliances were used: a Hyrax expander and a high-pull headgear with extraction. The treatment objectives of achieving a class I molar and canine relationship, resolving the crowding in the upper and lower arches, correcting the midline shift, and improving the patient's facial profile and lip position were achieved, resulting in a good occlusion with normal overbite and overjet.
PubMed: 38347989
DOI: 10.7759/cureus.52213 -
International Journal of Clinical... 2023Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this...
BACKGROUND
Skeletal class III malocclusion is a challenging condition that orthodontists frequently come across. The facemask (FM) is a device commonly used to treat this malocclusion. However, the stability of this orthopedic correction remains unclear, and collective documentation of the short-, mid-, and long-term stability after FM therapy is necessary.
AIM
The aim of the systematic review was to assess posttreatment stability following FM therapy in patients with skeletal class III malocclusion.
MATERIALS AND METHODS
Through a predefined search strategy, electronic searching was conducted in PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane, Ovid, Embase, Scopus, and Web of Science until 30 June 2022. Eligible study selection, data extraction, and evaluation of the risk of bias were performed independently by two review authors according to the Cochrane tool for assessing the risk of bias in randomized trials (RoB 2.0 tool) and the Risk of Bias in Nonrandomized Studies-of Interventions (ROBINS-I) tool for nonrandomized trials. A total of 14 studies were finally considered eligible. The systematic review revealed that the maxillo-mandibular differential reverted to class III. The maxillary changes achieved were variable, with SNA angles ranging between -0.7° and 1.9°. Changes in the mandible were greater with an increase in the SNB angle ranging between 0.33° and 3.62°. The lower anterior facial height increased. The maxillary and mandibular incisors were proclined, and the overjet and overbite decreased. The soft tissue changes were insignificant.
CONCLUSION
The effects of FM therapy were found to be stable in the short-term follow-up period. The long-term follow-up revealed that the effects of FM therapy remained stable for the maxilla. However, the mandible continued to grow in a horizontal and unfavorable direction until the adolescent growth spurt.
CLINICAL SIGNIFICANCE
The major variable that determines the long-term success of FM therapy is the amount and direction of mandibular growth during the adolescent growth spurt. More focus on restricting unfavorable mandibular growth and duration of retention is needed for post-FM therapy.
OTHERS
PROSPERO (CRD42021218960).
HOW TO CITE THIS ARTICLE
Raghupathy Y, Ananthanarayanan V, Kailasam V, Posttreatment Stability Following Facemask Therapy in Patients with Skeletal Class III Malocclusion: A Systematic Review. Int J Clin Pediatr Dent 2023;16(6):897-907.
PubMed: 38344378
DOI: 10.5005/jp-journals-10005-2686