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Journal of International Society of... 2023Mini screws placed buccal to the maxillary first or second molars in the infra zygomatic crest (IZC) region can be used as anchors for various types of tooth movement....
AIMS AND OBJECTIVES
Mini screws placed buccal to the maxillary first or second molars in the infra zygomatic crest (IZC) region can be used as anchors for various types of tooth movement. En masse distal movement of the maxillary dentition with IZC anchorage is routinely practiced nowadays as more patients demand a non-extraction treatment and it should be evaluated. The goal of this study was to assess dentoalveolar and airway changes in individuals with class II malocclusion after en masse distal movement of the maxillary dentition utilizing infrazygomatic anchorage.
MATERIALS AND METHODS
This prospective study included patients who required en masse distal movement of the maxillary dentition. Following initial leveling and aligning, mini screws were placed in the IZC region, and the maxillary arch was distalized en-masse. Pre (T0) and post distalization (T1) lateral cephalograms were traced for dentoalveolar and airway changes. Statistical tests were done with SPSS software. Shapiro-Wilk test for normality and paired test for comparison between before and after en masse distalization were done.
RESULTS
The changes in dental angular and linear measurements such as U1 to N-A, L1 to N-B and interincisal angle, U1 to N-A and U1 to point A distance, U1 to palatal plane, L1 to N-B, L1 to Apo line distance, U6 to PtV were statistically significant ( > 0.05). Linear parameters such as L1 to ApO line, upper airway, and lower airway were not statistically significant (<0.05).
CONCLUSION
Class II div I malocclusions can be efficiently corrected without extractions using IZC anchorage by en masse distal movement of the maxillary dentition. Significant reduction in upper anterior inclination, intrusion of maxillary anterior teeth, and distal movement of the posterior teeth were noted. No changes in airway dimensions were noted.
PubMed: 37153929
DOI: 10.4103/jispcd.JISPCD_193_22 -
EFORT Open Reviews Jul 2020Pertrochanteric hip fractures are among the most common and the use of short cephalomedullary nails as the treatment of choice is increasing.A systematic review... (Review)
Review
Pertrochanteric hip fractures are among the most common and the use of short cephalomedullary nails as the treatment of choice is increasing.A systematic review regarding distal locking options for short cephalomedullary nails was undertaken using Medline/PubMed®, Embase® and Cochrane Library® in order to evaluate current indications, associated complications and to provide treatment recommendations.The results seem to support the use of distal static locking for unstable fractures, dynamic locking for length stable/rotational unstable fractures and no locking for stable fractures.Complications associated with distal locking include iatrogenic fractures, thigh pain, delayed union and nonunion, implant failure, screw loosening and breaking, drill bit breaking, soft tissue irritation, femoral artery branch injury, intramuscular haematoma and compartment syndrome. It is also associated with longer operative time and radiation exposure.In unlocked constructs, dorsomedial comminution and nail/medullary canal mismatch contribute to peri-implant fractures. Anterior cortical impingement is associated with cut-out and nonunion.Most studies comparing distally locked and unlocked nails report a short follow-up.Distal locking mode should be based on the fracture's stability. Cite this article: 2020;5:421-429. DOI: 10.1302/2058-5241.5.190045.
PubMed: 32818069
DOI: 10.1302/2058-5241.5.190045 -
The Angle Orthodontist Nov 2008To use published data to evaluate quantitatively the dental effects of noncompliance intramaxillary appliances in individuals with Class II malocclusion. (Review)
Review
OBJECTIVE
To use published data to evaluate quantitatively the dental effects of noncompliance intramaxillary appliances in individuals with Class II malocclusion.
MATERIALS AND METHODS
A literature search was carried out identifing 13 prospective or retrospective clinical studies matching inclusion criteria. Only appliances with conventional anchorage designs were considered for the review. The data provided in these publications were grouped and analyzed in terms of molar distalization, tipping and vertical movements, and incisor and premolar mesialization, tipping, and vertical movements.
RESULTS
Maxillary first molars showed distal crown movement and tipping greater than the mesial crown movement and tipping shown by incisors and premolars. Vertical movements of incisors and premolars were in general extrusive, but molars were intrusive or extrusive, depending on the study and the type of appliance used. Appliances that acted palatally seemed to display a smaller distal tipping movement, as well as smaller incisor and premolar mesial tipping movements, when compared with those that acted buccally. Friction-free appliances, namely the pendulum, produced a large amount of mesiodistal movement and tipping, if no therapeutic uprighting activation was applied.
CONCLUSIONS
Noncompliance intramaxillary molar distalization appliances all act by distalizing molars with a concomitant and unavoidable loss of anchorage, as revealed by incisor and premolar mesial movement. Buccal acting and palatal acting appliances demonstrate almost similar results, with palatal acting appliances showing less tipping. Friction-free palatal acting appliances appear to produce better molar distalizing effects, but with a concomitant notable loss of anchorage.
Topics: Bicuspid; Humans; Incisor; Malocclusion, Angle Class II; Maxilla; Molar; Orthodontic Appliance Design; Orthodontic Appliances; Prospective Studies; Retrospective Studies; Tooth Movement Techniques
PubMed: 18947282
DOI: 10.2319/101507-406.1 -
Clinical Biomechanics (Bristol, Avon) Feb 2020Percutaneous osseointegrated devices for skeletal fixation of prosthetic limbs have the potential to improve clinical outcomes in the transhumeral amputee population....
BACKGROUND
Percutaneous osseointegrated devices for skeletal fixation of prosthetic limbs have the potential to improve clinical outcomes in the transhumeral amputee population. Initial endoprosthesis stability is paramount for long-term osseointegration and safe clinical introduction of this technology. We evaluated an endoprosthetic design featuring a distally porous coated titanium stem with proximal slots for placement of bicortical interlocking screws.
METHODS
Yield load, ultimate failure load, and construct stiffness were measured in 18 pairs of fresh-frozen and thawed cadaver humeri, at distal and proximal amputation levels, without and with screws, under axial pull-out, torsion, and bending loads. Paired statistical comparisons were performed without screws at the two resection levels, and at distal and proximal levels with and without screws.
FINDINGS
Without screws, the location of the amputation influenced the stability only in torsional yield (p = 0.032) and torsional ultimate failure (p = 0.033). Proximally, the torsional yield and the torsional ultimate failure were 44% and 47% of that distally. Screws improved stability. In axial pull-out, screws increased the distal ultimate failure 3.2 times (p = 0.003). In torsion, screws increased the yield at the proximal level 1.9 times (p = 0.035), distal ultimate failure load 3.3 times (p = 0.016) and proximal ultimate failure 6.4 times (p = 0.013). In bending, screws increased ultimate failure at the proximal level 1.6 times (p = 0.026).
INTERPRETATION
Proximal slots and bicortical interlocking screws may find application in percutaneous osseointegrated devices for patients with amputations, especially in the less stable proximal bone of a short residual limb.
Topics: Amputees; Biomechanical Phenomena; Bone Plates; Bone Screws; Female; Humans; Humerus; Male; Mechanical Phenomena; Osseointegration
PubMed: 31862604
DOI: 10.1016/j.clinbiomech.2019.12.005 -
Bioengineering (Basel, Switzerland) Dec 2023The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic... (Review)
Review
The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.
PubMed: 38135981
DOI: 10.3390/bioengineering10121390 -
Journal of Clinical and Experimental... Jul 2019Maxillary molar distalization is the most frequently used nonextraction treatment in the correction of Class II malocclusion. The use of traditional intra-oral devices...
BACKGROUND
Maxillary molar distalization is the most frequently used nonextraction treatment in the correction of Class II malocclusion. The use of traditional intra-oral devices shows unreliable results. Nowadays the use of miniscrew-supported appliances helps prevent anchorage loss. The aim of this pilot study is to compare the amount of upper first molar distalization and the dentoalveolar side effects using traditional distal jet appliance and miniscrew-supported distal jet appliance.
MATERIAL AND METHODS
20 patients were randomly assigned to receive a treatment with miniscrew-supported distal jet appliance (Group A) or with traditional distal jet appliance (Group B). To ensure a safe and minimally invasive miniscrew insertion a surgical guide was used. Digital models and lateral cephalograms were obtained and analyzed before orthodontic treatment and at 6-month follow-up. Intergroup differences were determined using T- test. The significance was set at ≤0.05. The intra-operator reliability was evaluated using a 2 sample T-test. The difference was not statistically significant ( ≤0.05 ), demonstrating an intra-operator reliability.
RESULTS
In Group A, a greater maxillary first molar distalization was recorded (=0.002). Considering the dentoalveolar side effects, in Group A, a spontaneous distalization of the first premolars and a retroclination of central incisors were determined. In Group B, the first premolars tipped mesially with a proclination of the maxillary central incisors.
CONCLUSIONS
Miniscrew-supported distal jet appliance achieved a greater first molar distalization at 6-month follow-up and did not cause dento-alveolar side effects, such as the mesial drift of the premolars and the incisors. Molar distalization, distal jet appliance, skeletal anchorage, miniscrew, 3D printed surgical guide.
PubMed: 31516664
DOI: 10.4317/jced.55780 -
Cureus Nov 2023The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through... (Review)
Review
The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through lower molar and premolar visualization, as well as providing normal anterior overjet. The purpose of this systematic study was to determine the efficacy of clear aligners in treating class III malocclusion with mandibular molar distalization. A wide range of searches were done on various search engines like Cochrane, Web of Science, Embase, PubMed, Scopus, and Google Scholar to collect relevant articles related to our study. This review's article selection was guided by the PRISMA flowchart. The electronic findings provided numerous articles with nearly 78 articles regarding clear aligners in class III malocclusion with molar distalization. From this, seven full-text papers were evaluated for eligibility criteria, with two articles being rejected with justification and five articles being elaborated in the current systematic review. The current evidence of this review suggested that the clear aligners were effective in correcting class III malocclusion with molar distalization. The amount of molar distalization is about 2 to 3 mm, which helps in achieving molar and canine relationship in class I, with a high compliance level and also improvement of the facial profile.
PubMed: 38046776
DOI: 10.7759/cureus.48134 -
BioMed Research International 2023It is essential to be aware of the potential effects of orthodontic treatment on tissues and anatomical structures associated with the masticatory system, especially the...
OBJECTIVE
It is essential to be aware of the potential effects of orthodontic treatment on tissues and anatomical structures associated with the masticatory system, especially the temporomandibular joint (TMJ). Little information is available about the consequences of molar distalization on the TMJ. Therefore, this study is aimed at investigating the changes of the condyle-fossa relationship after molar distalization using the distal jet appliance.
MATERIALS AND METHODS
The sample consisted of twenty-five patients (mean age 20.4 ± 2.6) who underwent molar distalization by the distal jet appliance. CBCT scans were taken before (T0) and after (T1) the completion of the molar distalization. Joint spaces (anterior, superior, and posterior) and cephalometric vertical angles (SN.GOME and Björk sum) were measured and compared at T0 and T1.
RESULTS
Superior and posterior joint spaces increased significantly after molar distalization (PS 0.29 mm, < 0.001, SS 0.06 mm, < 0.5). Vertical cephalometric angles also increased after molar distalization by the distal jet appliance (SN.GOME 0.92°, Björk 1.11°).
CONCLUSION
There was a statistically significant increase in the superior and posterior joint spaces after molar distalization. However, this increase may not be of clinical importance. The vertical dimension has also increased.
Topics: Humans; Adolescent; Young Adult; Adult; Malocclusion, Angle Class II; Glenoid Cavity; Maxilla; Temporomandibular Joint; Molar; Cephalometry; Tooth Movement Techniques
PubMed: 37409266
DOI: 10.1155/2023/5549951 -
Journal of Orthopaedics 2019This article is a systematic review of the recent published literature on the biomechanics of volar locking plate fixation of distal radius fractures. PUBMED/MEDLINE and... (Review)
Review
This article is a systematic review of the recent published literature on the biomechanics of volar locking plate fixation of distal radius fractures. PUBMED/MEDLINE and EMBASE databases were searched on 13th Sep 2018. Biomechanical papers on volar locking plate fixation of distal radius fractures since 2010 were included. Papers were analysed and included studies were appraised by the author using the validated quality assessment GRADE tool. The search revealed 456 papers between January 2010 and the present day whose abstracts were reviewed for relevance and 21 papers were included for full paper review. The aim of this systematic review was to evaluate the evidence to determine the surgical techniques and strategies that are associated with the best biomechanical outcomes of volar plating for distal radius fractures. Review of the literature revealed that it was not necessary to fill all available distal locking screws, there was little evidence to support the use of 2 rows of screws distally over 1 row. Screws of 75% length of the distal cortex are sufficient to withstand standard postoperative regimes in extrarticular fractures. The was a paucity of evidence to conclude multidirectional locking plates were superior to fixed angle plates or that one brand of plate was superior to another.
PubMed: 31528050
DOI: 10.1016/j.jor.2019.04.006 -
Journal of Personalized Medicine May 2023The aim of this study was to analyze a novel digital technique to quantify the distal tooth displacement and derotation angle produced by the Carriere Motion Appliance...
The aim of this study was to analyze a novel digital technique to quantify the distal tooth displacement and derotation angle produced by the Carriere Motion Appliance (CMA). Twenty-one patients with a class II molar and canine relationship underwent orthodontic treatment with CMA. All patients were exposed before (STL1) and after the CMA placement (STL2), submitted to a digital impression, and afterwards, data were uploaded to specific cephalometric software to allow automatic mesh network alignment of the STL digital files. Subsequently, the distal tooth displacement of the upper canines and first upper molars, as well as the derotation angle of the first upper molars were analyzed using the Pearson correlation coefficient (ρ). Repeatability and reproducibility were analyzed using Gage R&R statistical analysis. An increase in canine displacement was correlated with an increase in contralateral canine displacement (ρ = 0.759; < 0.000). An increase in canine displacement was correlated with an increase in molar displacement (ρ = 0.715; < 0.001). An increase in upper first molar displacement was correlated with an increase in the contralateral upper first molar displacement (ρ = 0.609; < 0.003) and the canine displacement (ρ = 0.728; < 0.001). The distal tooth displacement showed a repeatability of 0.62% and reproducibility of 7.49%, and the derotation angle showed a repeatability of 0.30% and reproducibility of 0.12%. The novel digital measurement technique is a reproducible, repeatable, and accurate method for quantifying the distal tooth displacement of the upper canine and first upper molar, as well as the derotation angle of the first upper molars after using CMA.
PubMed: 37241029
DOI: 10.3390/jpm13050859