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European Archives of Paediatric... Oct 2018This critical appraisal attempts to answer the question: What is the best method of space maintenance (SM) following premature loss of a primary molar in children under... (Review)
Review
AIM
This critical appraisal attempts to answer the question: What is the best method of space maintenance (SM) following premature loss of a primary molar in children under 12 years old?
METHODS
A search to identify studies relevant to the PICO was conducted. Single case reports and studies prior to 1986 were excluded. The principles of GRADE were followed to appraise the evidence.
RESULTS
20 studies were identified, which evaluated 2265 space maintainers (SMs). Two studies were graded high quality, four moderate, eight low, and six very low. All studies reported on longevity outcomes and most on adverse effects.
CONCLUSIONS
There was no strong evidence favouring a particular SM, the following recommendations were made: (a) strong recommendations: In cases where rubber dam cannot be used clinicians should not use Glass Fibre Reinforced Composite Resin (GFRCR) SMs. (b) Weak recommendations: Crown and Loop SMs are recommended for loss of primary first molars; GFRCR SMs (placed under rubber dam) are recommended for loss of primary second molars. Bilateral SMs may have questionable efficacy and their use where there is loss of multiple molars in the same quadrant should be weighed against the risk of unwanted tooth movements, loss of a removable SM or no space maintenance at all.
Topics: Child; Humans; Molar; Orthodontic Appliance Design; Orthodontic Appliances; Space Maintenance, Orthodontic; Tooth, Deciduous
PubMed: 30187262
DOI: 10.1007/s40368-018-0357-5 -
BMC Oral Health Aug 2019A common strategy in the non-extraction treatment of Class II molar relationship is maxillary molar distalization, which could increase lower face height and cause...
BACKGROUND
A common strategy in the non-extraction treatment of Class II molar relationship is maxillary molar distalization, which could increase lower face height and cause clockwise mandibular rotation. The aim of this retrospective study was to analyse the effects on vertical dentoskeletal dimension of young adults treated with sequential distalization with orthodontic aligners.
METHODS
Lateral cephalometric radiographs of 10 subjects (8 females 2 males; mean age 22.7 ± 5.3 years) treated with upper molars sequential distalization with orthodontic aligners (Invisalign, Align Technology, San Josè, California, USA) were analyzed.
RESULTS
No statistically significant difference was observed for the primary outcome SN-GoGn between T0 and T1 and it was recorded a mean variation of 0.1 ± 2.0 degrees. Statistically significant differences were found in the linear position of the upper molars (6-PP, 7-PP) the molar class relationship parameter (MR) and the upper incisive inclination (1^PP) with at least p < 0.01.
CONCLUSIONS
Upper molar distalization with orthodontic aligners guarantee an excellent control of the vertical dimension representing an ideal solution for the treatment of hyperdivergent or openbite subjects. It also allows an excellent control of the incisal torque without loss of anchorage during the orthodontic procedure.
Topics: Adolescent; Adult; California; Cephalometry; Female; Humans; Incisor; Male; Malocclusion, Angle Class II; Maxilla; Molar; Orthodontic Appliance Design; Orthodontic Appliances, Removable; Retrospective Studies; Tooth Movement Techniques; Vertical Dimension; Young Adult
PubMed: 31409348
DOI: 10.1186/s12903-019-0880-8 -
The Angle Orthodontist Jul 2020To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.
OBJECTIVE
To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.
MATERIALS AND METHODS
Patients identified retrospectively and consecutively from one private practice had been treated with either clear aligners (Invisalign, Align Technology, Santa Clara, Calif) or fixed appliances (0.022 Damon, Ormco, Orange, Calif; n = 26/group). Assessments of occlusion were made using the American Board of Orthodontics Discrepancy Index (DI) for initial records and Cast-Radiograph Evaluation (CRE) for final records. Number of appointments, number of emergency visits, and overall treatment time were determined from chart reviews. Data were analyzed using Pearson's correlation, Wilcoxon rank tests, unpaired t-tests, and Chi-square tests, with significance set to P ≤ .05.
RESULTS
Pretreatment, the aligner and fixed groups showed no significant difference in overall severity (DI: 11.9 ± 5.3 vs 11.6 ± 4.8) or in any individual DI category. Posttreatment scores showed finishes for the aligner group had fewer discrepancies from ideal relative to the fixed appliance group (CRE: 30.1 ± 8.3 vs 37.0 ± 9.3; P < .01). Patients treated with aligners had fewer appointments (13.7 ± 4.4 vs 19.3 ± 3.6; P < .0001), fewer emergency visits (0.8 ± 1.0 vs 3.6 ± 2.5; P < .0001), and shorter overall treatment time (16.9 ± 5.7 vs 23.4 ± 4.4 months; P < .0001).
CONCLUSIONS
Outcomes for treatment of mild malocclusions in adolescents showed equivalent effectiveness of clear aligners compared to fixed appliances, with significantly improved results for clear aligner treatment in terms of tooth alignment, occlusal relations, and overjet. Assessment of the number of appointments, number of emergency visits, and overall treatment time showed better outcomes for treatment with clear aligners.
Topics: Adolescent; Humans; Malocclusion; Orthodontic Appliance Design; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Outcome Assessment, Health Care; Retrospective Studies; Treatment Outcome
PubMed: 33378505
DOI: 10.2319/122919-844.1 -
American Journal of Orthodontics and... Sep 2020The purpose of this research was to provide an update on the accuracy of tooth movement with Invisalign (Align Technology, Santa Clara, Calif).
INTRODUCTION
The purpose of this research was to provide an update on the accuracy of tooth movement with Invisalign (Align Technology, Santa Clara, Calif).
METHODS
This prospective clinical study included 38 patients treated with Invisalign Full or Invisalign Teen. All teeth, from the central incisor to the second molar, 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 posttreatment scans. Individual teeth were superimposed with a best-fit analysis and measured using Compare software (version 8.1; GeoDigm, Falcon Heights, Minn). The types of tooth movements studied were a mesial-distal crown tip, buccal-lingual crown tip, extrusion, intrusion, and mesial-distal rotation.
RESULTS
The mean accuracy of Invisalign for all tooth movements was 50%. The highest overall accuracy was achieved with a buccal-lingual crown tip (56%), whereas the lowest overall accuracy occurred with rotation (46%). The accuracies for mesial rotation of the mandibular first molar (28%), distal rotation of the maxillary canine (37%), and intrusion of the mandibular incisors (35%) were particularly low.
CONCLUSIONS
There was a marked improvement in the overall accuracy; however, the strengths and weaknesses of tooth movement with Invisalign remained relatively the same.
Topics: Adolescent; Follow-Up Studies; Humans; Orthodontic Appliance Design; Orthodontic Appliances, Removable; Prospective Studies; Tooth Movement Techniques
PubMed: 32620479
DOI: 10.1016/j.ajodo.2019.12.015 -
Head & Face Medicine May 2021The aim of this study was to analyze the use of modified, cast splint Herbst appliances for the treatment of skeletal class II as an alternative to surgical bite...
OBJECTIVE
The aim of this study was to analyze the use of modified, cast splint Herbst appliances for the treatment of skeletal class II as an alternative to surgical bite correction over a period of five years.
MATERIALS AND METHODS
The patient cases all originate from the patients of the Department of Orthodontics at the University Medical Center of the Johannes Gutenberg University Mainz, Germany and the orthodontic practice Dres. Zöller, Kaiserslautern, Germany. Inclusion criteria were orthodontic treatment with the Herbst appliance and its modifications. The type of modification, number and frequency of the different modifications were determined on the basis of patient files, X-ray documents, photos and models.
RESULTS
Of a total of 2881 new admissions over a period of five years, 1751 patients came from the Department of Orthodontics at the University Medical Center of the Johannes Gutenberg University Mainz and 1130 from the orthodontic practice in Kaiserslautern. A total of 336 patients were treated with a Herbst appliance during the period mentioned. 14 (13%) of the cases from the Herbst patient collective of the University Medical Center and 45 (19%) of the cases from the orthodontic practice were classified as modifications. The following modifications could be determined in descending order: University Medical Center Mainz: Herbst for anchorage during space closure (65%) > distalization (14%) ≥ bar construction as a space maintainer (14%) > Herbst applicance for anchoring for the adjustment of impacted teeth (7%); orthodontic practice Kaiserslautern: Herbst appliance with quadhelix in the maxilla (42%) > distalization (27%) > space closure (15%) > bar construction as a space maintainer (9%) > adjustment of impacted teeth (7%), multiple modifications occurred at 11%. The combination of quadhelix and Herbst appliance as well as multiple modifications have not yet been used in the University Medical Center Mainz. As an alternative to dysgnathia surgery, 23 adult patients (> 18 years) from the University Medical Center and 22 from the orthodontic practice were treated with a Herbst appliance.
CONCLUSION
Nearly 12% of Herbst appliances are used in everyday orthodontic practice and almost 18% of these are used with modification(s). The high anchoring quality and force-effect geometry of the Herbst appliance is suitable for combining and treating various other treatment tasks in addition to the classical treatment task of class II therapy.
Topics: Cephalometry; Germany; Humans; Individuality; Malocclusion, Angle Class II; Orthodontic Appliances, Functional; Prevalence
PubMed: 33952290
DOI: 10.1186/s13005-021-00266-2 -
American Journal of Orthodontics and... Apr 1998Pain-free and mobility-free orthodontics are not discussed often, although they obviously would be significant advances and very desirable practice-builders. These... (Review)
Review
Pain-free and mobility-free orthodontics are not discussed often, although they obviously would be significant advances and very desirable practice-builders. These advantages have occasionally been reported in the orthodontic literature by different authors who used magnetic force fields for molar distalization, aiding tooth eruption, etc., and are presented here in Group I. Group II discusses several different possible mechanisms of action, including among others, an accelerated osteogenic rate and a sensory neuron action potential blockade. All the available evidence seems to confirm that pain-free and mobility-free orthodontics is a real phenomenon.
Topics: Animals; Facial Pain; Gingiva; Humans; Magnetics; Orthodontic Appliance Design; Orthodontic Appliances; Orthodontics, Corrective; Osteogenesis; Tooth Mobility
PubMed: 9563351
DOI: No ID Found -
The Angle Orthodontist Mar 2022To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts... (Review)
Review
OBJECTIVES
To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners).
MATERIALS AND METHODS
Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed.
RESULTS
Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: -4.867 to -0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found.
CONCLUSIONS
Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.
Topics: Bite Force; Mastication; Orthodontic Appliances; Orthodontic Appliances, Fixed; Tongue
PubMed: 34878525
DOI: 10.2319/061221-469.1 -
American Journal of Orthodontics and... Jan 2022As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on...
INTRODUCTION
As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2, the World Health Organization declared a global pandemic on March 11, 2020. Governments worldwide adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was lockdown; workers who could work from home were instructed to do so, and nonessential businesses-including dental clinics-were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period.
METHODS
The sample comprised 350 orthodontic patients (mean age, 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adıyaman, Turkey, after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of an orthodontic bracket, elastic ligature, molar band, and miniscrew failures of oral ulcers were recorded, and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed.
RESULTS
It was revealed that 15.42% (n = 54) of all patients had ≥1 bracket bonding failure, and 8.16% (n = 4) of the patients with miniscrew implantation had ≥1 miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown.
CONCLUSIONS
The results indicated that orthodontic appliances might have higher frequencies of failure during a lockdown than normal times, and lockdown periods may worsen the periodontal health status of the patients.
Topics: Adolescent; Adult; COVID-19; Communicable Disease Control; Female; Humans; Incidence; Male; Orthodontic Appliances; Orthodontic Brackets; Periodontal Index; SARS-CoV-2; Young Adult
PubMed: 34509332
DOI: 10.1016/j.ajodo.2021.01.022 -
Dental Press Journal of Orthodontics 2020Due to the search for more aesthetic and comfortable alternatives to perform orthodontic treatments and to the great technological development, orthodontic aligners have...
INTRODUCTION
Due to the search for more aesthetic and comfortable alternatives to perform orthodontic treatments and to the great technological development, orthodontic aligners have assumed great importance. More and more complex treatments have been carried out with these appliances without, however, having all aspects involved in their use being studied in depth. Its biomechanical planning requires different approaches than those used in fixed orthodontics, as the force systems involved in movements, responses and side effects are distinct, and the professional must be prepared when opting for the technique.
OBJECTIVE
The objective of this article is to perform an evaluation of the force systems created on the space closure with aligners, its characteristics, and problems, as well as make some suggestions to overcome the difficulties inherent to its use.
CONCLUSION
Space closure with aligners is possible, but depends on the correct selection of the patient, in addition to requiring the proper planning of the applied forces. The use of auxiliary resources and overcorrections to address the deficiencies of the aligner systems should always be considered. Digital planning should be used as a map of the force systems that will be applied, and not just as a marketing tool, keeping in mind that determining the objectives and the way to achieve them is the responsibility of the orthodontist, and that treatment plans must be individualized for each situation, following appropriate biomechanical precepts.
Topics: Esthetics, Dental; Humans; Orthodontic Appliance Design; Orthodontic Appliances, Removable; Orthodontists; Tooth Movement Techniques
PubMed: 32965392
DOI: 10.1590/2177-6709.25.4.085-100.sar -
BioMed Research International 2022The article is aimed at improving the understanding of the sociocultural profile of adult orthodontic patients and their expectations. In particular, it addresses three...
PURPOSE
The article is aimed at improving the understanding of the sociocultural profile of adult orthodontic patients and their expectations. In particular, it addresses three main aspects: the motivation and needs that underpin the decision to start orthodontic treatment, how it influences the patients' daily life, and the different oral hygiene demands.
MATERIALS AND METHODS
An online survey was completed by 276 patients undergoing orthodontic treatment with different techniques. The questions asked concerned gender, age, type of appliance, any previous orthodontic treatments, type of any previous retainers, reasons for therapy, satisfaction, pain, problems in eating, daily number of teeth brushings and flossings before and during the treatment, perception of cost, sensation of visibility of the appliance, and if they would recommend orthodontic treatment.
RESULTS
A significant role within our sample is played by gender; 87.94% consisted of female patients out of which 72.57% wanted to improve their aesthetics, while only 54.84% of male patients cited the same reason. Invisible aligners were preferred by 67.70% of the patients due to them being considered the least painful, causing the fewest problems with eating, and the least visible. Metal braces were perceived as the less expensive treatment. Over a third of the patients (33.85%) had previously undergone orthodontic treatment, among them 54.05% wore a mobile retainer, 31.08% a fixed one, and 14.86% both. Daily tooth brushing and flossing increased during therapy with clear aligners by 48.94% and 126.39%, respectively.
CONCLUSIONS
The greatest demand for orthodontic treatments comes from women, as they pay more attention to aesthetics, which makes the clear aligners the most common choice. The relapse after orthodontic treatment seems to cause a higher demand for retreatment, and oral hygiene habits significantly improve during orthodontic treatment, especially with the clear aligners.
Topics: Adult; Female; Humans; Male; Motivation; Orthodontic Appliances, Fixed; Perception; Surveys and Questionnaires; Toothbrushing
PubMed: 35281602
DOI: 10.1155/2022/2754051