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Sleep & Breathing = Schlaf & Atmung May 2024The purpose of this study was to determine if objectively measured adherence to oral appliance (OA) treatment may affect dental changes and temporomandibular disorders...
PURPOSE
The purpose of this study was to determine if objectively measured adherence to oral appliance (OA) treatment may affect dental changes and temporomandibular disorders (TMD) in patients with obstructive sleep apnea (OSA).
METHODS
The original study group consisted of adults with OSA who were referred for OA therapy. Eight indicators of subjective side effects of using OA (temporomandibular joint (TMJ) and muscle pain, pain in teeth, jaw stiffness in the morning, clicking, dry mouth, hypersalivation, gingival irritation) were evaluated by a questionnaire. Three occlusal indicators (overjet, overbite, molar occlusion) and clinical TMD signs (TMJ pain, muscle pain, clicking, jaw deviation on opening) were evaluated at baseline and at the 3-, 6-, and 12-month follow-up. In addition, objective adherence monitoring for OA was registered. Statistical analyses included the chi-square test, Fisher's exact test, paired sample t-test, and linear regression analyses.
RESULTS
A total of 58 adults with OSA were referred for OA therapy. Mean (SD) age was 50.7 (11.7) and mean apnea-hypopnea index (AHI) was 19.5 (10.0). At 1-year follow-up, the study group consisted of 28 men and 12 women. Overjet but not overbite reduced significantly after 1-year OA therapy. The average nightly wear of OA was related to overjet and overbite reduction, and to TMD signs. Hypersalivation, dry mouth, and tooth discomfort were the most common subjective side effects of OA therapy.
CONCLUSION
There was a time-dependent relationship with the nightly wear of OA and reduction in overjet and overbite, and clinical TMD signs. With 60% of mandibular advancement, dental changes and TM-disorders were considered mild/minor in the 1-year study period.
Topics: Humans; Sleep Apnea, Obstructive; Mandibular Advancement; Male; Female; Middle Aged; Adult; Patient Compliance; Temporomandibular Joint Disorders
PubMed: 38114783
DOI: 10.1007/s11325-023-02959-1 -
Cureus Nov 2023Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side... (Review)
Review
Mandibular advancement devices (MADs) remain a popular non-invasive treatment modality for the management of obstructive sleep apnea (OSA). However, the occlusal side effects from long-term therapy may result in poor patient compliance and patient drop-outs. Hence, knowledge of the possible side effects of these devices on occlusion is necessary. This article attempts to systematically review the evidence available in support of the possible long-term effects of mandibular advancement therapy on occlusion in adult sleep apnea patients. A detailed search was conducted for unpublished and published literature and their references in various electronic databases. A grey literature search was also performed. Studies until June 30, 2022, were selected. Randomized controlled trials, non-randomized trials, and cohort studies investigating the occlusal side effects of MADs for the treatment of snoring or OSA with a follow-up of at least four years were included. Study selection, data extraction, and risk of bias assessment were performed individually and in duplicate. The risk of bias was assessed by Cochrane tools for randomized and non-randomized studies. Fourteen studies were selected for the final qualitative analysis. The side effects reported were upper incisor retroclination, lower incisor proclination, decreased overjet and overbite, and change in the total occlusal contact area. The review concludes that long-term MAD therapy has statistically and clinically significant effects on occlusion.
PubMed: 38090465
DOI: 10.7759/cureus.48682 -
Journal of Clinical Medicine Nov 2023The correspondence between various aspects of human postural parameters and the spatial relation of the jaws is of increasing interest among scientists. Emerging...
BACKGROUND
The correspondence between various aspects of human postural parameters and the spatial relation of the jaws is of increasing interest among scientists. Emerging research suggests that the stomatognathic system and posture play, in a broad sense, significant roles.
OBJECTIVES
The aim of the study was to analyze the relationship between various malocclusion types and gait parameters, the distribution of foot pressure on the ground, and body balance.
METHODS
The study involved 155 patients aged 12-16. The subjects were divided into groups according to their malocclusion-Angle's class II ( = 32), Canine class II ( = 31), and Overbite ( = 46). The control group ( = 46) comprised children not demonstrating any defects. The study data were collected by direct observation of the oral cavity. Gait analysis was carried out using the Wiva Science sensor, and the distribution of foot forces on the ground and body balance was determined via the E.P.S R/1 pedobarographic mat. The non-parametric Mann-Whitney U test was applied for statistical analysis.
RESULTS
Analysis of the results obtained showed statistically significant differences in left step duration ( = 0.042) and the duration of the right step ( = 0.021), as well as the projection of the body's center of gravity on the left foot ( = 0.027).
CONCLUSIONS
Distoocclusion in the anterior part of the mandible may cause different positioning of the head and neck, as well as varying tension of the muscles, further leading to balance disorders while walking.
PubMed: 38068386
DOI: 10.3390/jcm12237334 -
International Dental Journal Jun 2024The objective of the study was to compare the effects of orthodontic microimplant anchorage (MIA) and conventional extraoral arch anchorage (EAA) on tooth structure and... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
INTRODUCTION
The objective of the study was to compare the effects of orthodontic microimplant anchorage (MIA) and conventional extraoral arch anchorage (EAA) on tooth structure and oral inflammatory response in patients with Class II Division I malocclusion.
METHODS
A total of 104 patients with Class II malocclusion were enrolled and were randomly assigned to receive MIA or EAA treatments. Clinical efficacy was assessed at 6 months after treatment by measuring molar shift, convex distance, and hinge angle difference between maxillary and mandibular incisors. X-ray was performed for tissue evaluations. The levels of cell adhesion molecule-1 (CAM-1), matrix metalloproteinase-2 (MMP-2), and proinflammatory cytokines in gingival sulcus fluid were measured using enzyme-linked immunosorbent assay to assess inflammatory responses to the implants.
RESULTS
Our study demonstrated superior efficacy of MIA compared to EAA in terms of overall efficacy, molar shift, convex distance between upper and middle incisors, as well as hinge angle difference between upper and middle incisors. MIA also showed greater efficacy in reducing tissue fix-point measurements, including saddle point-nasal root point-superior alveolar seat point (SNA), alveolar seat point-nasal root point-inferior alveolar seat point (ANB), overlying (OJ), and overbite (OB).
CONCLUSIONS
MIA is a novel orthodontic treatment that showed stronger efficacy in inducing molar shift and correcting soft/hard tissue positions, whilst generating suppressed inflammatory responses. Our study could have significant implications for practice in the orthodontic treatment of Class II malocclusion.
Topics: Humans; Malocclusion, Angle Class II; Orthodontic Anchorage Procedures; Male; Female; Adolescent; Treatment Outcome; Gingival Crevicular Fluid; Young Adult; Matrix Metalloproteinase 2
PubMed: 38057214
DOI: 10.1016/j.identj.2023.11.008 -
The Angle Orthodontist Mar 2024To compare the accuracy of mandibular incisor intrusion with Invisalign (Align Technology, Santa Clara, Calif) in adolescents to that in adults.
OBJECTIVE
To compare the accuracy of mandibular incisor intrusion with Invisalign (Align Technology, Santa Clara, Calif) in adolescents to that in adults.
MATERIALS AND METHODS
This prospective clinical study included 58 patients treated with either Invisalign Teen or Invisalign Full. Mandibular central and lateral incisors were measured on digital models created from intraoral scans. Predicted values were determined by superimposing the initial and final ClinCheck models, and achieved values were determined by superimposing the initial ClinCheck models and the digital models from the final scans. Individual teeth were superimposed with a best-fit analysis and measured using Compare software (version 8.1; GeoDigm, Falcon Heights, Minn).
RESULTS
The mean accuracies of mandibular incisor intrusion were 63.5% in adolescents and 45.3% in adults, and this difference was statistically significant. The amounts of achieved intrusion were 1.7 mm in adolescents and 0.9 mm in adults, and this difference was also statistically significant. Overall, there was a weak negative correlation between age and accuracy; as age advanced, the accuracy of mandibular incisor intrusion diminished slightly.
CONCLUSIONS
Mandibular incisor intrusion with Invisalign is significantly more accurate in adolescents than in adults. Orthodontists could contemplate reducing the degree of overcorrection for mandibular incisor intrusion in adolescents with deep overbites undergoing Invisalign Teen but still implementing the reverse curve of Spee mechanics.
Topics: Adult; Humans; Adolescent; Prospective Studies; Overbite; Incisor; Tooth Movement Techniques; Orthodontic Appliances, Removable
PubMed: 37939782
DOI: 10.2319/050223-320.1 -
The Angle Orthodontist Nov 2023To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
OBJECTIVES
To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults.
MATERIALS AND METHODS
23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index.
RESULTS
All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite.
CONCLUSIONS
Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.
Topics: Humans; Adult; Open Bite; Follow-Up Studies; Tooth; Malocclusion, Angle Class II; Overbite; Cephalometry
PubMed: 37922388
DOI: 10.2319/030623-155.1 -
Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial.The Angle Orthodontist Nov 2023To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion.
MATERIALS AND METHODS
Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis.
RESULTS
After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05).
CONCLUSIONS
Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
Topics: Adult; Humans; Root Resorption; Overbite; Open Bite; Malocclusion, Angle Class II; Molar; Tooth Movement Techniques; Orthodontic Anchorage Procedures; Orthodontic Appliances, Removable; Maxilla
PubMed: 37922387
DOI: 10.2319/010723-14.1 -
Journal of the Formosan Medical... Apr 2024Newly developed temporary anchorage devices (TADs) serve a strong orthodontic anchorage to intrude molars for correction of anterior open bite (AOB). We measured...
BACKGROUND/PURPOSE
Newly developed temporary anchorage devices (TADs) serve a strong orthodontic anchorage to intrude molars for correction of anterior open bite (AOB). We measured cephalometric changes in skeletal open bite patients which developed subsequently to temporomandibular joint disorders with bilateral point contacts at terminal molars.
METHODS
We retrospectively recruited 32 patients who had been treated their TMD before orthodontic correction (overbite: -3.14 ± 1.86 mm). Partial orthodontic appliances were used to intrude posterior teeth using TADs until positive OB obtained (T1). Full fixed appliances were then used to achieve proper overjet and overbite (T2). We collected lateral cephalograms before (T0), during (T1) and after (T2) treatment, and at follow-ups (T3). Using ANOVA, we analyzed the differences among these time points to determine treatment changes and stability of orthodontic results.
RESULTS
In this group predominantly comprising young adult women, orthodontic treatment with TADs significantly reduced upper posterior dental heights (T2-T0:-1.84 ± 0.66 mm) and facilitated the retraction and uprighting upper incisors (T2-T0: -9.92 ± 1.72°), to achieve appropriate OJ (T2-T0: -3.21 ± 0.49 mm) and OB (T2-T0: 4.10 ± 0.28 mm) with p < 0.05. Except upper posterior dental height, most of cephalometric changes including OJ, OB, and upper incisal axis remained significant at follow-ups with retention time of 3.7 ± 2.6 years. Only three out of 30 patients experienced small amount of open bite at T3.
CONCLUSION
Orthodontic correction of OJ remained relatively stable among 90 % of patients with TMJ degeneration by intrusion via TADs. This modern but conservative orthodontic approach can improve occlusal functions in skeletal open bites.
Topics: Young Adult; Humans; Female; Open Bite; Overbite; Retrospective Studies; Mandible; Malocclusion, Angle Class II; Temporomandibular Joint
PubMed: 37865535
DOI: 10.1016/j.jfma.2023.10.006 -
European Journal of Orthodontics Nov 2023The objective of this study was to examine the relative contributions of genetic and environmental influences on variation in dental arch form in individuals who have...
OBJECTIVE
The objective of this study was to examine the relative contributions of genetic and environmental influences on variation in dental arch form in individuals who have largely completed their craniofacial growth.
MATERIAL AND METHODS
The subjects of this study comprised dental casts of 50 monozygotic twins and 24 dizygotic twins from the collection of records of twins housed at the Adelaide Dental School, Australia. The subjects were of Western European descent, with an average age of 20.93 ± 5.58 years. Dental casts were scanned using a 3D scanner to analyse the dental arch form. Landmark-based inter-arch and intra-arch measurements were performed. Structural equation modelling was employed to analyse the quantitative data using the normal assumptions of the twin model.
RESULTS
Genetic modelling revealed that additive genetic and unique environmental factors best explained the observed variation for all occlusal traits measured, except for mandibular intercanine width. High heritability was observed for most intra-arch occlusal variables (0.61-0.85) including the maxillary and mandibular intercanine and intermolar widths, arch depth and perimeter. In contrast, moderate heritability was found for inter-arch occlusal variables (0.52-0.59) such as overjet and overbite. Sexual dimorphism was evident, with males displaying larger posterior arch width than females (P < 0.05).
LIMITATIONS
Our sample was limited to individuals of Western European ancestry.
CONCLUSION
The predominant source of occlusal variation within this group of Australian twins of Western European descent was controlled by genetic effects, and most were highly heritable. Generally, intra-arch occlusal variables showed greater heritability compared with inter-arch occlusal variables.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Dental Arch; Australia; Malocclusion, Angle Class II; Overbite; Twins, Monozygotic
PubMed: 37861389
DOI: 10.1093/ejo/cjad054 -
Case Reports in Dentistry 2023Class III malocclusion needs complex orthodontic treatment. This case report describes a 16-year-old male patient with skeletal class III malocclusion with a negative...
Class III malocclusion needs complex orthodontic treatment. This case report describes a 16-year-old male patient with skeletal class III malocclusion with a negative overjet and overbite. Upper incisors were proclined with the accentuated curve of Wilson. Treatment has changed the functional curve of Wilson that has improved functional dynamic occlusion. The patient was treated using a Carriere® Motion™ Class III (CM3) and SLX 3D Brackets system. After a 25-month treatment, the patient reached class I molars and canines relationships on both sides with good facial aesthetics and good functional occlusion. The result was also satisfactory for the patient. A one-year follow-up confirmed that the outcome was stable.
PubMed: 37842329
DOI: 10.1155/2023/8848581