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International Dental Journal Oct 2022The aim of this review was to determine whether the type of removable appliance, as well as the age and sex of the patient, may affect the extension or reduction of wear...
OBJECTIVES
The aim of this review was to determine whether the type of removable appliance, as well as the age and sex of the patient, may affect the extension or reduction of wear time by assessing the correlation between the mean actual and orthodontist-recommended wear times.
METHODS
Randomised case control trials, cohort studies, case series, observational studies, reviews, and retrospective analyses were identified. The quality of the studies was assessed using the Cochrane Collaboration Tool and modified Newcastle-Ottawa Scale. The electronic databases Embase, PubMed, Scopus, and Web of Science were reviewed, and 542 articles were obtained, of which 31 were qualified for qualitative synthesis. The data from 1674 participants were collected and a weighted average was determined for the mean wear time of each appliance.
RESULTS
Regardless of the type of extra- or intraoral appliances, mean wear time was shorter than recommended, although patients using intraoral appliances cooperated more. The best compliance was noted for Schwarz appliances (73.70%) and plate retainers (85%). There was no evidence of an influence of patients' age and sex on compliance during treatment.
CONCLUSIONS
The considerable inconsistency and imprecision of articles could affect the reliability of the results. Previous studies analysing the effectiveness of treatment with removable appliances based on an arbitrarily assumed average wear time need to be revised in order to verify the actual wear time with the use of microsensors.
Topics: Case-Control Studies; Humans; Orthodontic Appliances, Removable; Patient Compliance; Reproducibility of Results; Retrospective Studies
PubMed: 35961844
DOI: 10.1016/j.identj.2022.07.004 -
L' Orthodontie Francaise Sep 2018
Topics: Humans; Orthodontic Anchorage Procedures; Orthodontic Appliance Design; Orthodontic Appliances; Orthodontics
PubMed: 30255838
DOI: 10.1051/orthodfr/2018023 -
The Angle Orthodontist Nov 2010This pilot study was performed to test the hypothesis that an orthodontic oral appliance (OA) that is designed to work against the backwardly directed forces on the... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This pilot study was performed to test the hypothesis that an orthodontic oral appliance (OA) that is designed to work against the backwardly directed forces on the upper incisors may counteract the reduction in overjet from these devices.
MATERIALS AND METHODS
Thirty patients with normal bites, good oral health, and milder sleep apnea were randomized to treatment with either OAs or orthodontic OAs. Bite changes were evaluated on plaster casts and radiographs and by questionnaires after a mean of 2.4 years in 19 frequent users.
RESULTS
Four of nine patients in the orthodontic OA group increased their overjet by > or =0.4 mm, while none of the 10 patients in the OA group experienced that effect.
CONCLUSION
Only the orthodontic OA increases the overjet; this design may therefore be beneficial to patients at risk of negative effects on their bite during OA treatment.
Topics: Cephalometry; Female; Humans; Incisor; Male; Occlusal Splints; Orthodontic Appliance Design; Orthodontic Appliances; Overbite; Pilot Projects; Sleep Apnea, Obstructive; Snoring; Surveys and Questionnaires
PubMed: 20677963
DOI: 10.2319/012210-46.1 -
The Angle Orthodontist Jan 2020To evaluate the perception of esthetic orthodontic appliances by means of eye-tracking measurements and survey investigation.
OBJECTIVE
To evaluate the perception of esthetic orthodontic appliances by means of eye-tracking measurements and survey investigation.
MATERIALS AND METHODS
En face and close-up images with different orthodontic appliances (aligner appliance [a], aligner appliance and attachments [b], lingual appliance [c], ceramic brackets [d], no appliance [e; control]) were shown to 140 participants. Eye movement and gaze direction was recorded by eye-tracking system. For different anatomical areas and areas of the appliances, time to first fixation and total fixation time were recorded. The questions included in a visual analog scale regarding individual sentiency were answered by the participants.
RESULTS
For all groups, the anatomical landmarks were inspected in the following order: (1) eyes, (2) mouth, (3) nose, (4) hair, and (5) ears. Only in group d, first fixation was on the mouth region (1.10 ± 1.05 seconds). All appliances except the lingual appliance (1.87 ± 1.31 seconds) resulted in a longer fixation on the mouth area (a, 2.97 ± 1.32 seconds; b, 3.35 ± 1.38 seconds; d, 3.29 ± 1.36 seconds). For close-up pictures, the fastest (0.58 seconds) and longest (3.14 seconds) fixation was found for group d, followed by group b (1.02 seconds/2.3 seconds), group a (2.57 seconds/0.83 seconds), and group c (3.28 seconds/0.05 seconds). Visual analog scale scoring of questions on visibility were consistent with eye-tracking measurements. With increasing visibility, the feeling of esthetic impairment was considered higher.
CONCLUSIONS
Lingual orthodontic appliances do not change how the face is perceived. Other esthetic orthodontic appliances may change the pattern of facial inspection and are different in subjective perception.
Topics: Cross-Sectional Studies; Esthetics, Dental; Humans; Orthodontic Appliance Design; Orthodontic Appliances; Orthodontic Brackets
PubMed: 31403837
DOI: 10.2319/031419-198.1 -
The Angle Orthodontist Sep 2018To evaluate the genotoxic and cytotoxic effects of Haas appliances through micronuclei test and cytogenetic damage analysis in buccal mucosa epithelial cells of patients...
OBJECTIVES
To evaluate the genotoxic and cytotoxic effects of Haas appliances through micronuclei test and cytogenetic damage analysis in buccal mucosa epithelial cells of patients undergoing orthodontic treatment.
MATERIALS AND METHODS
Twenty-eight patients, 6-12 years of age and of both genders, who required a Haas appliance for the correction of a posterior crossbite were included. Epithelial cells from the mucosa were collected by gently scraping the inside of both the right and left cheeks. The cells were collected before the insertion of the appliance (T0), 1 month after the device was installed (T1), and again 3 months after the appliance was immobilized (T2). The cells were processed to obtain slides. Feulgen/Fast Green was used as the staining method, and the number of normal, karyolytic, pyknotic, nuclear buds, bi/trinucleated, and micronucleus cells were counted under light microscopy. Cellular abnormalities were evaluated with parametric and nonparametric tests for comparison of the means by analysis of variance testing, Tukey posttest, or the Kruskal-Wallis test and then by Dunn's posttest. The significance level was 5%.
RESULTS
There were no statistically significant changes in the micronuclei in the evaluated periods ( P > .05). Nuclear buds increased at T1 ( P < .05), returning to baseline levels at T2. Other abnormalities (cariolytic, pyknotic, and bi/trinucleated cells) showed a significant increase at T1 and T2 ( P < .0001).
CONCLUSIONS
The Haas appliance did not cause an increase in micronuclei in cells of the buccal mucosa. However, statistically significant increases in cariolytic, pyknotic, and bi/trinucleated cells were observed during treatment, suggesting possible DNA damage.
Topics: Child; DNA Damage; Female; Humans; Male; Malocclusion; Micronucleus Tests; Mouth Mucosa; Orthodontic Appliances, Fixed; Palatal Expansion Technique
PubMed: 29761706
DOI: 10.2319/101117-687.1 -
The Angle Orthodontist Nov 2023To compare the efficacy and efficiency of treatment with clear aligners (CAT) vs fixed appliances (FAT) in adolescents with Class I and II moderate to severe...
OBJECTIVE
To compare the efficacy and efficiency of treatment with clear aligners (CAT) vs fixed appliances (FAT) in adolescents with Class I and II moderate to severe malocclusions.
MATERIALS AND METHODS
One operator's (Garfinkle) cases from 2014 to 2019, started at age 12-18 years, with pre- and posttreatment records were identified and used according to an institutional review board-approved protocol. Records were measured by two calibrated, blinded investigators, aided by software (OrthoCAD [Cadent, Fairview, N.J.], Dolphin Imaging & Management Solutions [Chatsworth, Calif]). Discrepancy index (DI) and cast radiograph evaluation (CRE) scores, treatment duration, number of scheduled and emergency visits, and reported appliance and interarch elastic wear compliance were compared between groups using Wilcoxon rank sum and Fisher's exact tests. Cephalometric superimpositions were completed to evaluate craniofacial growth and dental changes.
RESULTS
Records from 72 cases met the criteria and were included. For the 47 CAT and 25 FAT cases, mean DI (21 ± 5 and 24 ± 8, respectively; P = .20) and CRE (35 ± 10 and 34 ± 9, respectively; P = .90) scores were not significantly different. Other case attributes and reported appliance and interarch elastic wear compliance were also not significantly different. CAT vs FAT cases had significantly smaller treatment durations (24 ± 6 vs 27 ± 5 months; P = .01) and visit numbers (16 ± 5 vs 24 ± 4; P < .01), but emergency visit numbers were not significantly different (2 ± 2 vs 3 ± 2; P = .08).
CONCLUSIONS
In adolescents with Class I and II malocclusions and moderate to severe DI scores, on average, CAT vs FAT cases were completed 3 months faster with eight fewer visits, but treatment efficacy was not significantly different.
Topics: Adolescent; Humans; Child; Malocclusion; Treatment Outcome; Orthodontic Appliances, Fixed; Radiography; Orthodontic Appliances, Removable
PubMed: 37407511
DOI: 10.2319/020923-94.1 -
The Angle Orthodontist Jul 2020To evaluate the effect of orthodontic appliances on physicochemical, biochemical, and oxidative stress changes in salivary parameters during treatment.
OBJECTIVES
To evaluate the effect of orthodontic appliances on physicochemical, biochemical, and oxidative stress changes in salivary parameters during treatment.
MATERIALS AND METHODS
A cohort study was conducted with 112 healthy patients. Salivary samples were taken at baseline, 1 month, and 9 months after placement of the orthodontic appliances used in treatment.
RESULTS
A statistically significant difference was observed in certain examined salivary parameters, including enzymes, electrolytes, and oxidative stress markers.
CONCLUSIONS
The use of aligners had a lower prevalence of disturbing salivary parameters. Orthodontist must consider these changes to prevent the occurrence of white spot lesions.
Topics: Cohort Studies; Humans; Orthodontic Appliances; Saliva
PubMed: 33378497
DOI: 10.2319/082919-562.1 -
British Dental Journal May 2022Knowledge of managing traumatic dental injuries (TDIs) is imperative for all dental practitioners. With the number of adults undertaking orthodontic treatment...
Knowledge of managing traumatic dental injuries (TDIs) is imperative for all dental practitioners. With the number of adults undertaking orthodontic treatment increasing, and children and adolescents alike continually being treated for orthodontics under the NHS in the UK, it is imperative that all clinicians - specialists and generalists - are aware of how to manage the orthodontic appliance in a patient presenting with a TDI in their active phase of orthodontics.This guidance will aid practitioners in implementing pragmatic approaches to manage the orthodontic appliance in a patient presenting with a TDI. Key focus will be given on fixed appliance therapy. Case examples and flow diagrams outlining best practice are given to manage the TDI and orthodontic appliance concurrently.
Topics: Adolescent; Adult; Child; Dentists; Humans; Orthodontic Appliances; Orthodontics; Professional Role; Tooth Injuries
PubMed: 35624257
DOI: 10.1038/s41415-022-4244-4 -
The Angle Orthodontist Nov 2021To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech.
MATERIALS AND METHODS
This was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana's clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ2, Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%).
RESULTS
In the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days.
CONCLUSIONS
Although the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.
Topics: Adolescent; Adult; Brazil; Humans; Malocclusion; Malocclusion, Angle Class I; Orthodontic Appliances, Fixed; Speech; Young Adult
PubMed: 34037699
DOI: 10.2319/110620-917.1 -
Brazilian Journal of Otorhinolaryngology 2022Obstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is... (Review)
Review
INTRODUCTION
Obstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is crucial for obstructive sleep apnea treatment success. Functional orthodontic appliances that stimulate mandibular growth by forward mandibular positioning are an alternative therapeutic option in growing patients.
OBJECTIVE
To perform a literature review about the effects of functional orthodontic appliances used to correct the mandibular deficiency in obstructive sleep apnea treatment.
METHODS
The literature search was conducted in June 2020 using Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid; SciELO Web of Science; EMBASE Bireme and BBO Bireme electronic databases. The search included papers published in English, until June 2020, whose methodology referred to the types and effects of functional orthopedic appliances on obstructive sleep apnea treatment in children.
RESULTS
The search strategy identified thirteen articles; only four articles were randomized clinical studies. All studies using the oral appliances or functional orthopedic appliances for obstructive sleep apnea in children resulted in improvements in the apnea-hypopnea index score. The cephalometric (2D) and tomographic (3D) evaluations revealed enlargement of the upper airway and increase in the upper airspace, improving the respiratory function in the short term.
CONCLUSION
Functional appliances may be an alternative treatment for obstructive sleep apnea, but it cannot be concluded that they are effective in treating pediatric obstructive sleep apnea. There are significant deficiencies in the existing evidence, mainly due to absence of control groups, small sample sizes, lack of randomization and no long-term results.
Topics: Cephalometry; Child; Humans; Mandibular Advancement; Orthodontic Appliances, Functional; Sleep Apnea, Obstructive; Treatment Outcome
PubMed: 33757756
DOI: 10.1016/j.bjorl.2021.02.010