-
Journal of Orthodontic Science 2023The Damon system is an effective, less-invasive treatment that provides orthodontic dentists with an adequate biomechanical process, offering a reduction in treatment...
The Damon system is an effective, less-invasive treatment that provides orthodontic dentists with an adequate biomechanical process, offering a reduction in treatment time; patients with temporomandibular dysfunction present even greater complexity in their clinical picture, relying on clinical and radiographic differential diagnoses to facilitate a good prognosis. The objective was to apply the orthodontic treatment (Damon technique) to stabilize patients with temporomandibular dysfunction. The patient with premature loss of the first lower molars (36 and 46) experienced pathological alterations in the temporomandibular joints (TMJs) (bilaterally). The diagnosis was reached using the clinical history of temporomandibular joint disorders (diagnostic criteria) axis II: moderate pain (VAS) in muscles, moderate stress (Hamilton 51/60), lateral and panoramic cephalic radiographs, magnetic resonance imaging of bilateral TMJ, cephalometry, photographs, and models. Treatment with the Damon system is recommended to recover optimal functional occlusion in a short period, followed by referral for oral rehabilitation as an adjunct to the treatment plan. The verticalization of the second molars, maximum optimal intercuspidation, appropriate overbite and overjet, and pain control in the TMJ were evaluated. Stabilization of the disc condyle complex by eliminating interference and premature points of contact providing cervical/cranio/mandibular balance.
PubMed: 38234652
DOI: 10.4103/jos.jos_100_22 -
Journal of Oral & Maxillofacial Research 2023Dentofacial deformity following juvenile idiopathic arthritis with temporomandibular joint involvement is associated with functional, aesthetic, and psychosocial...
OBJECTIVES
Dentofacial deformity following juvenile idiopathic arthritis with temporomandibular joint involvement is associated with functional, aesthetic, and psychosocial impairment. Surgical treatment may involve combinations of orthognathic surgery. The aims of this retrospective study were to assess orofacial symptoms, functional and aesthetic status, and stability after orthognathic surgery.
MATERIAL AND METHODS
Nineteen patients with juvenile idiopathic arthritis of the temporomandibular joint (TMJ) and dentofacial deformities were included. All patients were treated with combinations of bilateral sagittal split osteotomy, Le Fort I and/or genioplasty, between September 10, 2007 and October 17, 2017. Analysis of patient symptoms and clinical registrations, and frontal/lateral cephalograms was performed pre- and postoperative and long-term (mean: 3.8 and 2.6 years, respectively).
RESULTS
Patients experienced no changes in orofacial symptoms or TMJ function, and stable normalisation of horizontal and vertical incisal relations at long-term (horizontal overbite; vertical overbite: P < 0.05). Mandibular lengthening was achieved postoperatively (from mean 79.7 to 87.2 mm; P = 0.004) and was stable. Sella-nasion to A point (SNA) and sella-nasion to B point (SNB) angles increased postoperatively (SNA, mean 79.9° to 82.8°; P = 0.022 and SNB, mean 73.9° to 77.8°; P = 0.003), however, largely reverted to preoperative status at long-term.
CONCLUSIONS
Orthognathic surgery normalized incisal relations while providing stable mandibular lengthening without long-term deterioration of temporomandibular joint function or orofacial symptoms. No long-term effect on jaw advancements was observed.
PubMed: 38222878
DOI: 10.5037/jomr.2023.14404 -
Dental Press Journal of Orthodontics 2024The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi)... (Clinical Trial)
Clinical Trial
OBJECTIVE
The purpose of this prospective clinical trial was to explore the dental and soft tissue changes accompanying the use of skeletally anchored nickel-titanium (NiTi) extrusion arch in the correction of anterior open bite (AOB).
MATERIAL AND METHODS
Twenty female patients with a mean age of 16.5 ± 1.5 years and a mean dentoalveolar AOB of 2.38±0.7 mm participated in this study. All patients were treated with an maxillary 0.017×0.025-in NiTi extrusion arch, with the aid of miniscrews inserted between the maxillary second premolars and first molars bilaterally, to act as indirect anchorage. Three-dimensional digital models and lateral cephalometric radiographs were taken just before the insertion of the extrusion arch (T0) and after 10 months (T1). Paired-sample t-tests were used in analyzing the data, to evaluate the changes after treatment (T1-T0). A significance level of p < 0.05 was used.
RESULTS
AOB was successfully closed in all patients, with a 4.35 ± 0.61 mm increase in the overbite. Maxillary incisors significantly extruded (2.52 ± 1.02 mm) and significantly reclined (5.78 ± 0.77°), with a resultant decrease in the overjet of 1.58 ± 0.5mm. A significant intrusion of maxillary first molars with no change in their inclination was observed. The upper lip showed a significant retraction tendency to the E-plane, and a significant increase in the nasolabial angle was observed.
CONCLUSION
The skeletally anchored NiTi extrusion arch was an effective technique in treating AOB, with no adverse effects on the molars.
Topics: Humans; Female; Adolescent; Open Bite; Prospective Studies; Cephalometry; Incisor; Lip; Overbite
PubMed: 38198349
DOI: 10.1590/2177-6709.28.6.e2323110.oar -
The Angle Orthodontist Mar 2024To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those...
OBJECTIVES
To compare posttreatment stability in skeletal Class III patients between those treated by total mandibular arch distalization (TMAD) with buccal mini-implants and those by mandibular setback surgery (MSS).
MATERIALS AND METHODS
The samples included 40 Class III adults, 20 treated by TMAD using buccal interradicular mini-implants and 20 treated with MSS. Lateral cephalograms were taken at pretreatment, posttreatment, and at least 1-year follow-up, and 24 variables were compared using statistical analysis.
RESULTS
Mandibular first molars moved distally 1.9 mm with intrusion of 1.1 mm after treatment in the TMAD group. The mandibular incisors moved distally by 2.3 mm. The MSS group exhibited a significant skeletal change of the mandible, whereas the TMAD group did not. During retention, there were no skeletal or dental changes other than 0.6 mm labial movement of the mandibular incisors (P < .05) in the MSS group. There was 1.4° of mesial tipping (P < .01) and 0.4 mm of mesial movement of the mandibular molars and 1.9° of labial tipping (P < .001) and 0.8 mm of mesial movement of the mandibular incisors in the TMAD group. These dental changes were not significantly different between the two groups.
CONCLUSIONS
The TMAD group showed a slightly decreased overjet with labial tipping of the mandibular incisors and mesial tipping of the first molars during retention. Posttreatment stability of the mandibular dentition was not significantly different between the groups. It can be useful to plan camouflage treatment by TMAD with mini-implants in mild-to-moderate Class III patients.
Topics: Adult; Humans; Maxilla; Tooth Movement Techniques; Cephalometry; Mandible; Overbite
PubMed: 38195065
DOI: 10.2319/062723-447.1 -
The Angle Orthodontist May 2024To compare orthodontic treatment (OT) outcome in adolescents undergoing nonextraction fixed OT with or without bonding of second molars using the score of the American...
OBJECTIVES
To compare orthodontic treatment (OT) outcome in adolescents undergoing nonextraction fixed OT with or without bonding of second molars using the score of the American Board of Orthodontics Cast Radiograph Evaluation (C-R-Eval).
MATERIALS AND METHODS
This study included healthy adolescents with skeletal Class I or mild Class II/Class III malocclusion, normal or deep overbite (OB), and mild-to-moderate dental crowding (<5 mm) who underwent nonextraction fixed OT with ("bonded" group) or without ("not-bonded" group) bonding of second molars. Patient treatment records, pre- and posttreatment digital models, lateral cephalograms, and orthopantomograms were assessed. The evaluated outcomes included leveling of the curve of Spee (COS), OB, control of incisor mandibular plane angle (IMPA), number of emergency visits (related to poking wires and/or bracket failure of the terminal molar tubes), treatment duration, and C-R-Eval. Treatment variables were compared across time points and among groups.
RESULTS
The sample included 30 patients (mean age 16.07 ± 1.80 years) in the bonded group and 32 patients (mean age 15.69 ± 1.86 years) in the not-bonded group. The mean overall C-R-Eval score was significantly higher (P < .001) in the not-bonded group (25.25 ± 3.98) than in the bonded group (17.70 ± 2.97). There were no significant differences in mean changes of COS, OB, IMPA, or treatment duration among groups. The mean number of emergency visits was significantly higher in the bonded (3.3 ± 0.6) than the not-bonded group (1.9 ± 0.4) (P < .001).
CONCLUSIONS
Bonding of second molars enhances the outcome of nonextraction fixed OT as demonstrated by the C-R-Eval without increasing treatment duration, irrespective of more emergency visits.
Topics: Adolescent; Humans; Molar; Orthodontics, Corrective; Treatment Outcome; Radiography, Panoramic; Cephalometry; Malocclusion, Angle Class II; Organophosphorus Compounds
PubMed: 38195055
DOI: 10.2319/071223-487.1 -
BMC Oral Health Jan 2024The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with...
BACKGROUND
The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with the Austro Repositioner associated with fixed appliances and its capacity to control the vertical dimension in dolichofacial patients.
METHODS
A group of patients with Class II malocclusion due to mandibular retrognathism and a dolichofacial growth pattern treated with the Austro Repositioner combined with fixed appliances were compared to a matched untreated control group of subjects with Class II malocclusion. Evaluations were made on the basis of lateral cephalograms taken at T1 (initial records), T2 (end of treatment), and T3 (1 year after treatment). Statistical comparisons were performed with paired- and two-sample t tests.
RESULTS
The experimental (treated) group comprised 30 patients, 14 boys and 16 girls, and the control group comprised 30 subjects (15 boys and 15 girls) with similar ages at T1, T2 and T3. In the treated group, a significant decrease in the ANB angle was found (- 3.79 ± 1.46; p < 0.001). No significant differences were found in the maxillary skeletal measurements. In contrast, the SNB angle showed a significant increase of 3.77 ± 1.49 in the treated group compared with a nonsignificant increase of 0.77 ± 1.55 in the control group (p = 0.002). Vertical changes showed a significant decrease in the FMA angle (- 3.36 ± 1.62), while the lower anterior facial height distance and the overbite increased significantly in the treated group, reflecting a change in vertical dimensions after treatment. No significant changes were observed in either the treated or control group during the one-year posttreatment period; thus, the treatment results remained stable.
CONCLUSIONS
The Austro Repositioner combined with fixed appliances could be considered an optimal treatment modality in Class II dolichofacial patients.
Topics: Male; Female; Humans; Malocclusion, Angle Class II; Cell Proliferation; Orthodontic Appliances, Fixed; Patients; Vertical Dimension
PubMed: 38191391
DOI: 10.1186/s12903-023-03692-7 -
Frontiers in Psychiatry 2023Schizophrenia is a major mental disorder, with an estimated incidence of 1%. Since they are sensitive to sensory changes, orthodontic treatment to move teeth should be...
BACKGROUND
Schizophrenia is a major mental disorder, with an estimated incidence of 1%. Since they are sensitive to sensory changes, orthodontic treatment to move teeth should be avoided as aggressively as possible in these patients because of strong concerns about the possibility of causing adverse psychological effects, thus there are few reports on orthodontic treatment for schizophrenia patients. We report a case of severe open bite caused by medication after the onset of schizophrenia, even though the patient's occlusion had been stable for a long time after surgical orthodontic treatment. Medication control and the use of a minimally invasive orthodontic appliance improved the occlusion without adversely affecting the patient's mental health.
CASE
A 22-year-old woman presented to the clinic with a chief complaint of an anterior open bite. Intraoral findings showed an overbite (vertical overlap of the incisor ) of -3.0 mm and an overjet (horizontal overlap of the incisor teeth) of -0.5 mm. The preoperative orthodontic treatment included bilateral extraction of the maxillary first premolars. Subsequently, orthognathic surgery was performed to achieve a harmonized skeletal relationship and occlusion. Occlusion was stable for 3 years after surgery. However, 10 years after surgery, the patient returned to the clinic complaining of an anterior open bite (overbite = -4.0 mm). Six years prior to the return, the patient was diagnosed with schizophrenia. We thought that ignoring the patient's strong desire to treat her open bite might also cause psychological problems; therefore, in addition to medication control, we treated her using a minimally invasive removable orthodontic appliance (retainer with tongue crib). Her anterior open bite improved (overbite, +1.0 mm) to within the normal range.
CONCLUSION
In this case, medication control was thought to be essential to improve her drug-induced open bite. However, minimally invasive orthodontic treatment, such as the use of a removable appliance, might be helpful in promoting her mental stability as well as for improving occlusion. Careful support is required to obtain information about the patient's mental state and medications through close cooperation with psychiatrists.
PubMed: 38173706
DOI: 10.3389/fpsyt.2023.1304215 -
International Orthodontics Mar 2024This case report describes a 19-year-old man presented with a 5.7-mm deep overbite, Class II division 2 malocclusion with the right upper maxillary canine completely...
Clear aligner treatment assisted by mini screw for an adult with Class II division 2 malocclusion and a right upper canine completely outside of the dental arch: A case report.
This case report describes a 19-year-old man presented with a 5.7-mm deep overbite, Class II division 2 malocclusion with the right upper maxillary canine completely buccal ectopia, deviated midline in the upper arch, severe crowding and retroclination of the maxillary and mandibular incisors. The patient was treated with clear aligners to correct the Class II relationship and the deep overbite. A series of clear aligners were used to move bilateral maxillary molars distally with unilateral mini-screw anchorage. The final results showed that clear aligners with mini-screws could effectively achieve the required upper distal molar movement thanks to a reasonable design of the stages and anchorage. The treatment was completed in 19 months and the patient was satisfied with the treatment outcome in this context of mild to moderate Class II division 2 malocclusion.
Topics: Male; Adult; Humans; Young Adult; Overbite; Dental Arch; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Cephalometry; Malocclusion, Angle Class II; Bone Screws; Orthodontic Appliances, Removable
PubMed: 38160659
DOI: 10.1016/j.ortho.2023.100837 -
Journal of Clinical Medicine Dec 2023(1) Aims: The main objective of this retrospective study was to assess the long-term stability of difficult orthodontic treatments treated to an excellent result and to...
(1) Aims: The main objective of this retrospective study was to assess the long-term stability of difficult orthodontic treatments treated to an excellent result and to correlate stability to possible prognostic factors. Secondary objectives were to observe the changes in retention protocol over time and to assess Oral Health-related Quality of Life (OHRQoL) after a long-term post-treatment follow-up. (2) Methods: Cases presented for final examination by orthodontic postgraduate students were retrospectively screened for eligibility. Eligible patients were recalled for a post-treatment recall appointment (T2), consisting of a clinical examination and intraoral scan, and were asked to complete the Oral Health Impact Profile-14 (OHIP-14-DK). Gender, age at treatment commencement (T0), treatment modality and duration, and retention protocol were extracted from the records. At T2, the duration of the retention period was recorded, and retainers in place were clinically compared to the original retention protocol. The following variables were assessed on the sets of models at T0, T1 (end of treatment), and T2: arch length and width, overjet and overbite, Dental Aesthetic Index (DAI), Peer Assessment Rating score (PAR), and Little's Irregularity Index (LII). Multiple regression models were conducted. (3) Results: Eighty-five subjects attended T2. The mean post-treatment follow-up was 9.4 years +/- 2.4. In the upper arch, at T1, 74 patients had a combination of fixed and removable retainers, while at T2, 55 had a fixed retainer only. In the lower arch, at T1, 67 patients had a fixed retainer only, with this number increasing to 76 at T2. From T0 to T1, the PAR score improved by 96.1%, with the improvement remaining at 77.5% at T2. The stability of lower inter-canine and upper inter-premolar widths was significantly correlated with the extent of changes during treatment. The presence of a lower fixed retainer at T2 and a low LII at T1 were prognostic factors for stability. The mean weighted total OHIP-14 score at T2 was very low (1.6 ± 2.4 points). (4) Conclusions: In a sample with an initial high-severity malocclusion and treated to an excellent outcome, long-term stability was very good. Good stability can be retained when a lower fixed retainer is present at T2 and when a low LII is achieved at T1.
PubMed: 38137761
DOI: 10.3390/jcm12247692 -
Cureus Nov 2023Fixed functional appliances are widely used for the treatment of retrognathic mandibles in skeletal class II malocclusion. The primary objective of the present...
INTRODUCTION
Fixed functional appliances are widely used for the treatment of retrognathic mandibles in skeletal class II malocclusion. The primary objective of the present investigation was to evaluate and compare the treatment effects induced by PowerScope (American Orthodontics, Sheboygan, WI) and AdvanSync2 (Ormco, Orange, CA). The hypothesis posited that there were no notable disparities in the therapeutic impacts of the two appliances.
MATERIALS AND METHODS
A retrospective study was undertaken involving 90 subjects with retrognathic mandibles. Group 1 was treated with AdvanSync2, group 2 received PowerScope treatment, and group 3 consisted of an untreated class II control sample. Lateral cephalograms were traced at pre-treatment (T0) and post-treatment (T1), to measure various skeletal, dental, and soft tissue parameters. The comparison between the groups was done using analysis of variance (ANOVA) and post-hoc analysis by Tukey's test.
RESULTS
Significant changes were observed in all the parameters, comparing the effects of both appliances to the control group (p < 0.05). AdvanSync2 displayed statistically significant skeletal effects on the maxilla and mandible (p < 0.05). The statistically significant differences were also seen for dental effects such as reduction in overbite and overjet. On the other hand, PowerScope exhibited effects that were not considered statistically significant on the maxilla, instead primarily manifesting dento-alveolar changes that led to a considerable reduction in overbite. In comparison to the control group, both appliances notably produced soft tissue changes.
CONCLUSIONS
Our study rejected the null hypothesis. AdvanSync2 yielded superior skeletal outcomes with greater mandibular advancement, compared to PowerScope, which exhibited enhanced dento-alveolar alterations. AdvanSync2 took less treatment time, compared to PowerScope.
PubMed: 38125227
DOI: 10.7759/cureus.49105