RESUMEN
PURPOSE: There is currently a lack of evidence pertaining to gingival crevicular fluid cytokine levels in patients treated with the pendulum appliance. This study aimed to compare changes in cytokine secretion levels in gingival crevicular fluid (GFC) between the aligner and pendulum appliance in patients undergoing molar distalization. METHODS: GFC samples were collected from 28 participants with asymmetrical dental class II malocclusion who were undergoing molar distalization using aligners or pendulum appliances. An enzyme-linked immunosorbent assay was used to detect cytokine secretion levels during asymmetrical molar distalization for up to 14 days. Periodontal health indices and tooth movements were also assessed. RESULTS: No significant difference was found for the distalization distance between the two appliances. The Silness and Loe Plaque Index and Lobene Modified Gingival Index increased in the pendulum group but not in the aligner group at 14 days. Interleukin-1ß and tumor necrosis factorα were upregulated in both groups. In the pendulum group, receptor activator of nuclear factor kappaΒ ligand and osteoprotegerin secretion levels were significantly upregulated and downregulated, respectively; smaller changes in these two cytokines were observed in the aligner group. CONCLUSIONS: Pendulum appliances exert stronger forces than aligners, which cause more changes in the secretion of inflammatory mediators in young patients.
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Citocinas , Maloclusión Clase II de Angle , Humanos , Aparatos Ortodóncicos/efectos adversos , Líquido del Surco Gingival , Estudios Prospectivos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Diente Molar/patología , Técnicas de Movimiento Dental , Diseño de Aparato Ortodóncico , Cefalometría , MaxilarRESUMEN
Objectives: The objective of this trial was to evaluate the dental changes, periodontal health, and tooth vitality in mini-screw-supported en-masse retraction with two corticotomy-based acceleration techniques. Study Design. The sample included 38 adult patients presenting with class II division 1 malocclusion (three males, 35 females; age range between 18 and 30 years), needing the extraction of upper first premolars followed by en-masse retraction. The sample was divided randomly and equally into two groups. Randomization was carried out by random numbers generated by the computer with a 1 : 1 allocation ratio. The allocation concealment was carried out by sequentially numbered, opaque, sealed envelopes. The interventions were traditional corticotomy (TC) versus flapless corticotomy (FC). Mini-screws were inserted between the upper second premolar and first molar, bilaterally. The primary outcome was evaluating dental changes. Secondary outcomes were the periodontal health and pulp vitality of the maxillary teeth. Mann-Whitney U test and two-sample t-test with Bonferroni correction were used to analyze the data. Results: The en-masse retraction rate in the first three months was higher in the TC group than the FC group (1.82, 1.66, and 1.39 mm/month vs 1.60, 1.42, and 1.22 mm/month, respectively) with statistically significant differences (P < 0.001, P < 0.001, P=0.001, respectively). The en-masse retraction amount was greater in the TC group than the FC group (6.84 mm vs 6.18 mm, respectively) with statistically significant differences (P=0.002). There was an increase in the inter-canine and inter-molar widths with a minor distal movement of the upper first molar in the two groups, with no significant differences between them (P > 0.008). The values of gingival, papillary bleeding and plaque indices in the TC group were significantly greater than those in the FC group after performing the corticotomy (P < 0.001, P < 0.003, P=0.002, respectively). No gingival recession was found on any of the examined teeth in both groups. All teeth maintained their vitality at all measurement times in both groups. No severe harms were noticed in any group. Conclusions: Both traditional and flapless corticotomy techniques resulted in clinically similar rates of the en-masse retraction of upper anterior teeth, with similar dental changes and no significant periodontal complications or tooth vitality loss. The minimally invasive flapless corticotomy appeared to be a good alternative to the more invasive traditional corticotomy. This trial is registered with https://www.clinicaltrials.gov (Identification code: NCT04847492), retrospectively registered.
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Maloclusión Clase II de Angle/cirugía , Extracción Dental/métodos , Adolescente , Adulto , Tornillos Óseos , Femenino , Humanos , Masculino , Maloclusión Clase II de Angle/diagnóstico , Terapéutica , Extracción Dental/normas , Adulto JovenRESUMEN
OBJECTIVE: Respiration is a vital functional process that has effects on normal craniofacial development. Since the upper airway formations and dentofacial structures are adjacent to each other, the interaction between them is possible. The aim of this study is to evaluate the effects of removable functional appliances used in the treatment of patients with mandibular and maxillary growth retardation-stenosis in Class I, Class II, and Class III malocclusion on the upper airway. MATERIALS AND METHODS: Thirty two patients were studied in the study. The patients were divided into 4 groups according to treatment modalities. Maxillary expansion device group (Group A), Twinblock-Monoblock group (Group B), Face mask group (Group C), and Chincup group (Group D). The upper airway size in the lateral cephalometric images of the patients before orthodontic treatment with removable functional appliances (T0) and the upper airway size in the lateral cephalometric images taken after the end of the orthodontic treatment with the removable functional appliances (T1) were retrospectively compared. RESULT: Most upper airway size increased after orthodontic treatment (T1) in the individuals who received orthodontic treatment with A, B, C, and D type removable functional appliances compared to pre-treatment (T0). When the changes in upper airway size pre-treatment (T0) and post-treatment (T1) were compared, the change in upper airway size according to treatment groups was found to be statistically different (p <0.05). CONCLUSION: Since a large part of the upper airway is located in the craniofacial complex, orthodontists also examine the airway for diagnosis and planning and can regulate the airway in case of occlusion that has occurred or may occur. This puts orthodontists in an important place to intervene when complications occur or may develop in the upper airway. By determining the effects of removable functional appliances on the airways, airway problems that may be experienced at an early age can be prevented.
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Maloclusión Clase II de Angle , Cefalometría/métodos , Humanos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Maxilar , Técnica de Expansión Palatina , Estudios RetrospectivosRESUMEN
PURPOSE: The objective of this study was to investigate how daily wear time (DWT) influences class II malocclusion treatment efficiency. MATERIALS AND METHODS: The study group consisted of 55 patients (mean age 10.4 years) diagnosed with a class II/1 malocclusion. Twin block appliances, with built-in Theramon® microsensors (MC Technology, Hargelsberg, Austria) to monitor patients' cooperation (daily wear time assessment), were used for treatment. Cephalograms were taken and the following initial and final measurements were compared: Co-Gn, Co-Go, Co-Olp, Pg-Olp, WITS, SNA, SNB, ANB, Co-Go-Me, overjet, molar and canine relationships. The Shapiro-Wilk test, Wilcoxon signed-rank test, Student's t-test, Levene's test, Mann-Whitney U test, Kruskal-Wallis test, χ2 test, and Spearman's rank correlation coefficient with pâ¯< 0.05 set as the statistical significance level were used to determine the correlation of the outcomes with DWT; a ROC (receiver operating characteristic) curve was calculated to illustrate diagnostic ability of the binary classifier system. RESULTS: DWT was very highly positively correlated with change of the Pg-Olp parameter and highly with an improvement in the ANB, SNA, and SNB angles, an increase in the WITS parameter and an increase in Co-Gn distance. DWTsâ¯< 7.5â¯h correlated with significantly less improvement of the investigated variables. However, DWTâ¯> 7.5â¯h did not significantly correlate with the improvement of the overjet and most of the linear parameters in the mandible. The ROC curve and its AUC (area under curve) allowed the determination of a DWT of 7â¯h and 48â¯min to be capable of establishing a class I relationship with 83% probability. CONCLUSIONS: Class II treatment efficiency was influenced by DWT; an 8â¯h threshold value had an 83% probability of establishing a class I relationship.
Asunto(s)
Maloclusión Clase II de Angle , Aparatos Ortodóncicos Funcionales , Sobremordida , Cefalometría , Humanos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Mandíbula , Maxilar , Diente Molar , Sobremordida/terapiaRESUMEN
OBJECTIVE: To identify the best-suited cephalometric parameter for assessing the sagittal skeletal discrepancy in the Indian population. DESIGN: An in vitro, observational, single-blinded, retrospective study. SETTING: Department of Orthodontics and Dentofacial Orthopaedics. METHODS: A total of 94 lateral cephalograms were used in this study. The study involved one key person and two examiners. The key person collected the radiographs, coded, analysed and classified them into three groups (skeletal classes I, II and III). Subsequently, the coded radiographs were independently analysed by the two examiners. They classified the cases by matching a minimum of 6 out of 11 parameters. On completion of diagnosis by the examiners, the samples were decoded and matched with the original diagnosis given by the key person. The samples in which identification of a particular cephalometric parameter matched the original evaluation as given by the key person was regarded as correctly diagnosed. The number of correctly assessed cases was used to judge the diagnostic performance of all the parameters in all the cases. Cross-validation of the method was performed, and a diagnostic algorithm was developed for diagnosis. RESULTS: ß angle and Pi angle showed a positive predictive value of 1 in both skeletal class I and II cases. ANB angle, W angle and HBN angle showed a positive predictive value of 1 in skeletal class III cases. CONCLUSION: No single cephalometric parameter can independently be used to diagnose sagittal skeletal discrepancy in all cases. However, a conclusive diagnosis on the type of sagittal skeletal malocclusion can be made by using a simple and easy to use diagnostic algorithmic process having a combination of cephalometric parameters.
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Cefalometría , Heurística , Maloclusión de Angle Clase III , Maloclusión Clase II de Angle , Maloclusión Clase I de Angle , Cefalometría/métodos , Humanos , Maloclusión Clase I de Angle/diagnóstico , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Estudios RetrospectivosRESUMEN
OBJECTIVE: To evaluate the validity of craniofacial growth predictors in class II and III malocclusion. MATERIAL AND METHODS: An electronic search was conducted until August 2020 in PubMed, Cochrane Library, Embase, EBSCOhost, ScienceDirect, Scopus, Bireme, Lilacs and Scielo including all languages. The articles were selected and analyzed by two authors independently and the selected studies was assessed using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The quality of evidence and strength of recommendation was assessed by the GRADE tool. RESULTS: In a selection process of two phases, 10 articles were included. The studies were grouped according to malocclusion growth predictor in (1) class II (n = 4); (2) class III (n = 5) and (3) class II and III (n = 1). The predictors were mainly based on data extracted from cephalometries and characterized by: equations, structural analysis, techniques and computer programs among others. The analyzed studies were methodologically heterogeneous and had low to moderate quality. For class II malocclusion, the predictors proposed in the studies with the best methodological quality were based on mathematical models and the Fishman system of maturation assessment. For class III malocclusion, the Fishman system could provide adequate growth prediction for short- and long-term. CONCLUSIONS: Because of the heterogeneity of the design, methodology and the quality of the articles reviewed, it is not possible to establish only a growth prediction system for class II and III malocclusion. High-quality cohort studies are needed, well defined data extraction from cephalometries, radiographies and clinical characteristics are required to design a reliable predictor.
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Maloclusión de Angle Clase III , Maloclusión Clase II de Angle , Maloclusión , Cefalometría , Humanos , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnósticoRESUMEN
BACKGROUND: One of the arguments against early intervention for micrognathia in Pierre Robin sequence is the concept that the growth of the mandible will eventually "catch up." Long-term growth of the mandible and occlusal relationships of conservatively managed Pierre Robin sequence patients remain unknown. In this study, the authors evaluated the orthognathic surgery requirements for Pierre Robin sequence patients at skeletal maturity. METHODS: Orthognathic surgical requirements of conservatively managed Pierre Robin sequence and isolated cleft patients (aged ≥13 years) at two institutions were reviewed and analyzed using t test, chi-square test, and Fisher's exact test. Values of p < 0.05 were considered statistically significant. RESULTS: Of the Pierre Robin sequence patients (n = 64; mean age ± SD, 17.9 ± 2.9 years), 65.6 percent were syndromic (primarily Stickler and velocardiofacial syndrome), 96.9 percent had a cleft palate, and 39.1 percent required orthognathic surgery at skeletal maturity. Nonsyndromic and syndromic Pierre Robin sequence patients demonstrated no differences in occlusal relationships or mandibular surgery frequency. The majority of Pierre Robin sequence patients requiring mandibular advancement had a class II occlusion. Comparison of Pierre Robin sequence patients to isolated cleft palate patients (n = 17) revealed a comparable frequency of orthognathic surgery between the two; however, Pierre Robin sequence patients did require mandibular advancement surgery at a greater frequency than cleft palate patients (p = 0.006). CONCLUSIONS: The present study found that 39.1 percent of conservatively managed Pierre Robin sequence patients required orthognathic surgery at skeletal maturity, of which the vast majority required mandibular advancement for class II malocclusion. These data suggest that mandibular micrognathia in conservatively managed Pierre Robin sequence patients may not resolve over time and may require surgical intervention. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
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Fisura del Paladar/cirugía , Tratamiento Conservador/efectos adversos , Maloclusión Clase II de Angle/epidemiología , Procedimientos Quirúrgicos Ortognáticos/estadística & datos numéricos , Síndrome de Pierre Robin/terapia , Adolescente , Cefalometría/estadística & datos numéricos , Fisura del Paladar/complicaciones , Tratamiento Conservador/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/prevención & control , Maloclusión Clase II de Angle/cirugía , Mandíbula/anatomía & histología , Mandíbula/crecimiento & desarrollo , Mandíbula/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Síndrome de Pierre Robin/complicaciones , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVES: Malocclusion features differ across various populations and ethnicities. At this time, no data are available regarding the dentofacial differences between Syrian and European adolescents with Class II division 1 malocclusion, which is one of the most frequently treated pathologies in orthodontic practice. The present combined cephalometric and tooth-size study aimed to compare the dentoskeletal and tooth-size characteristics of Syrian and Hungarian adolescents with Class II division 1 malocclusion. RESULTS: Class II division 1 malocclusion in Hungarian adolescents was a sagittal discrepancy, while in Syrian adolescents, it was a result of excessive vertical development. Syrian adolescents had a significantly excessive vertical development when compared with Hungarian adolescents, regardless of sex (p < 0.01). Hungarian boys had significantly more protruded maxillae (p < 0.001) and less retruded mandibles (p < 0.01) when compared with Syrian boys, while Hungarian girls had significantly shorter mandibles relative to those of Syrian girls (p < 0.01). Syrian girls had significantly more protrusive lower incisors (p < 0.001), accompanied by significantly larger anterior tooth-size ratios when compared to Hungarian girls (p < 0.001). In conclusion, these findings underscore the importance of considering ethnic differences during orthodontic diagnosis and may have implications for optimizing orthodontic treatments in Syrian and Hungarian adolescents with Class II division 1 malocclusion.
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Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/etnología , Adolescente , Niño , Femenino , Humanos , Hungría/etnología , Masculino , Estudios Retrospectivos , Factores Sexuales , Siria/etnologíaRESUMEN
DATE OF BIRTH: 29/07/1993; gender: female. PRE-TREATMENT DOCUMENTS: 19 years 2 months old: 29/07/1993. DIAGNOSIS: Skeletal class II with mandibular laterognathia and retrusion, hypodivergent facial pattern; class II division 1, transverse maxillary deficiency with left unilateral posterior cross bite; missing teeth before treatment: 18 28 38 48. TREATMENT PLANNING: Orthosurgical treatment (bimaxillary surgery); Bimaxillary lingual fixed appliances. DURATION OF ACTIVE TREATMENT: 2 years. POST-TREATMENT DOCUMENTS: 22 years 5 months old; 09/01/2015. POST-RETENTION DOCUMENTS: 05/01/2016; 23 years 5 months old. RETENTION PERIOD: 3 years.
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Maloclusión Clase II de Angle/terapia , Ortodoncia Correctiva/métodos , Mentón , Asimetría Facial/terapia , Femenino , Humanos , Maloclusión , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/diagnóstico , Mandíbula , Maxilar/cirugía , Aparatos Ortodóncicos Fijos , Ortodoncia , Planificación de Atención al Paciente , Adulto JovenRESUMEN
En este artículo se consideran las condiciones que pueden modificar la valoración de la relación esquelética en el diagnóstico de la Clase II: desprogramación a relación céntrica, valoración de la clase esquelética, posición sagital del maxilar y de la mandíbula, el espacio de las vías aéreas, el torque de incisivos superiores e inferiores, la forma de la sínfisis, la interrelación con los planos vertical y transversal, y los caracteres faciales secundarios. A partir de estas conclusiones diagnósticas se desarrolla un plan de tratamiento que es equivalente tanto en casos de dentición mixta como permanente, pero utilizando diferentes aparatologías para conseguir mejores resultados de acuerdo al estado evolutivo de las arcadas dentarias(AU)
In this article, the conditions that can modify the evaluation of skeletal relationship in the diagnosis of Class II malocclusions are considered: deprogramming to centric relation, evaluation of skeletal class, sagittal position of maxilla and mandible, upper airways space, lower and upper incisors torque, shape of the symphysis, interrelationship between vertical and transverse planes, and secondary facial characteristics. From these diagnostic conclusions, a treatment plan is developed, that is similar in both mixed and permanent dentition cases, but using different appliances to get better results according to the evolutionary state of dental arches(AU)
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Humanos , Femenino , Maloclusión Clase II de Angle , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Cefalometría , Dentición Permanente , Dentición MixtaRESUMEN
INTRODUCTION: Obstructive adenoid hypertrophy is cited as one of the causes of mouth breathing and leads to disharmony in the development of orofacial structures. The objective of this study was to compare the measurements of dental arches according to the grade and the obstructive character of adenoids. MATERIALS AND METHODS: A cross-sectional study was carried out with 86 children. The grade and the obstructive character of adenoids were determined from Holmberg and Cohen's radiographic methods respectively. Dental arch measurements were taken on dental casts. A t-test and a Chi2 test were performed respectively to compare the quantitative and qualitative variables of dental arches according to the obstructive character. An Anova test made it possible to compare the quantitative variables according to the grade as Holmberg defined it. For variables that showed significant differences, a Post Hoc test was used. The significance level was set at P=0.05. RESULTS: Subjects with obstructive adenoids had a shorter posterior mandibular length (P=0.04) and a greater overbite (P=0.04) than those with non-obstructive adenoids. Those with grade 4 had a greater arch depth (P=0.02) and were more prone to open bite(P=0.03). CONCLUSION: A prevention program involving the otorhinolaryngologist and the orthodontist for subjects with obstructive adenoids or grade 4 is necessary to minimize their influence on dental arch relationships.
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Tonsila Faríngea/patología , Arco Dental/patología , Nasofaringe/patología , Apnea Obstructiva del Sueño/patología , Niño , Estudios Transversales , Femenino , Humanos , Hipertrofia/complicaciones , Masculino , Maloclusión/diagnóstico , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/etiología , Mandíbula/patología , Respiración por la Boca , Mordida Abierta , Sobremordida/etiologíaRESUMEN
RESUMEN Introducción: la relación entre las maloclusiones y la postura del sistema cráneo cervical ha generado un interés creciente entre los ortodontistas. Objetivo: describir la relación entre la oclusión dentaria y la postura del sistema cráneo-cervical en niños con maloclusiones clase II y clase III. Materiales y métodos: estudio descriptivo transversal. El universo estuvo formado por 19 niños, de 7 a 12 años, con maloclusiones clase II y III de Angle. Ingresados en el Servicio de Ortodoncia de la Facultad de Estomatología de La Habana, en octubre del 2016. Se realizó examen bucal y telerradiografía. Los resultados se presentaron en tablas. Resultados: predominó la clase II de Angle, donde la distoclusión molar fue más marcada en el lado derecho (-2,95 mm) y en la clase III la mesioclusión mayor correspondió al izquierdo (2,25 mm como promedio). En ambas predominó la ½ unidad (36,8 % en clase II). El ángulo cráneo-vertebral y el espacio suboccipital estuvieron dentro del rango normal; 104,65º y 7,99 mm, en clase II y en clase III, 103,78º y 6,90 mm como promedio. La profundidad de la columna cervical fue 6,26 mm y 6,20 mm respectivamente; lo que significó una rectificación de columna cervical. Conclusiones: se encontró más frecuente la clase II de Angle. La posición de la cabeza fue normal en ambas clases y la columna cervical rectificada. Se identificaron relaciones inversas entre la magnitud de la maloclusión con la posición de la cabeza y la columna cervical.
ABSTRACT Introduction: the relationship between malocclusions and the crania-cervical system posture has generated a a growing interest among orthodontists. Objective: to describe the relationship between dental occlusion and the position of the crania-cervical system in children with class II and class III malocclusions. Materials and methods: cross-sectional, descriptive study. The universe was 19 children, aged from 7 to 12 years, class II and III Angle's malocclusions, admitted in the Orthodontics service of the Faculty of Stomatology of Havana in October 2016. Oral examination and teleradiography were performed. The results were presented in tables. Results: Class II of Angle predominated, where the molar distoclusion was more marked on the right side (-2.95 mm) and in class III the greater mesioclusion corresponded to the left (2.25 mm as average). In both, the ½ unit predominated (36.8% in Class II). The cranio-vertebral angle and the suboccipital space were within the normal range; 104.65º and 7.99 mm in class II and in class III 103.78º and 6.90 mm as average. The depth of the cervical spine was 6.26 mm and 6.20 mm respectively; which meant a rectification of the cervical spine. Conclusions: Angle's Class II was found more frequent. The position of the head was normal in both classes and also the rectified cervical spine. Inverse relationships were identified between the magnitude of the malocclusion and the position of the head and cervical spine. The objective of this work is to present a clinical case and the importance of a nurse intervention.
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Humanos , Niño , Cráneo/fisiopatología , Columna Vertebral/fisiopatología , Sistema Estomatognático/fisiopatología , Oclusión Dental , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Epidemiología Descriptiva , Estudios TransversalesRESUMEN
Objective: To verify the dental age of individuals with Angle Class II, division 2 malocclusion. Material and Methods: The sample consisted of 200 panoramic radiographs of schoolchildren from the city of Fortaleza in the state of Ceará, in the northeast of Brazil. These radiographs were divided into two groups (N=100): a Control group comprising radiographs of patients with normal occlusion and a CIID2 group comprising radiographs of patients with an Angle Class II, division 2 malocclusion. The Demirjian method was used to identify dental age. All the radiographs were evaluated by a sole duly trained and calibrated technician. The Kappa coefficient for inter-annotator agreement was 0.98 based on the criteria of eruption stage of each tooth. Statistical analysis was performed using the Chi-squared test, Student's t-test and the Mann-Whitney test, with a level of significance of 5%. Results: There was a significant statistical difference between the dental ages of the groups tested. The CIID2 group had a lower dental age than the control group, signifying late eruption in patients with an Angle Class II, division 2 malocclusion. Conclusion: Patients with an Angle Class II, division 2 malocclusion had a lower dental age than patients with normal occlusion, suggesting that orthodontic treatment should be delayed. The first molars, second pre-molars and canines suffered late eruption.
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Humanos , Masculino , Femenino , Erupción Dental , Radiografía Panorámica/métodos , Oclusión Dental , Crecimiento y Desarrollo , Maloclusión Clase II de Angle/diagnóstico , Brasil , Distribución de Chi-Cuadrado , Estudios Transversales/métodos , Estudios Retrospectivos , Estadísticas no ParamétricasRESUMEN
Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of -3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.
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Cefalometría/métodos , Curva ROC , Maloclusión/diagnóstico , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Distribución de Chi-Cuadrado , Epidemiología Descriptiva , Análisis de Varianza , ColombiaRESUMEN
Objective: To compare the success of self-drilling and self-tapping methods in the retraction of maxillary anterior teeth. Material and Methods: The study was conducted in 57 subjects with Cl II malocclusion who needed to be treated with extraction of four maxillary teeth. The selftapping method was used on the left side and the self-drilling method was used on the right side. Then, the pain rate of each method was recorded by the numerical rating scale (NRS). Statistical analysis was done by t-test and Chi-square test. The significance level in this study was considered at p-value<0.05. Results: Considering the clinical mobility as the failure, the success of treatment was equal in both methods and was 93%. The inflammation around the mini-screws was 8.8%. A significant relationship was found between the variables inflammation and success (p<0.05). The mean pain was 2.47 but there was no significant difference between the two methods in terms of pain score (p>0.05). There was a significant difference between the groups (p=0.03). The pain was significantly higher in the female. Conclusion: There is no difference between self-drilling and self-tapping methods in terms of success. Comparison of the pain between two genders according to the replantation method showed a significant difference in pain sensation between two genders. The pain sensation mean in female group was greater than male group.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Técnicas de Movimiento Dental/métodos , Implantes Dentales , Oseointegración , Métodos de Anclaje en Ortodoncia/métodos , Maloclusión Clase II de Angle/diagnóstico , Técnicas In Vitro/métodos , Distribución de Chi-Cuadrado , IránRESUMEN
INTRODUCTION: Numerous cephalometric analyses have been proposed to diagnose the sagittal discrepancy of the craniofacial structures. OBJECTIVE: This study aimed at evaluating the reliability and validity of different skeletal analyses for the identification of sagittal skeletal pattern. METHODS: A total of 146 subjects (males = 77; females = 69; mean age = 23.6 ± 4.6 years) were included. The ANB angle, Wits appraisal, Beta angle, AB plane angle, Downs angle of convexity and W angle were used to assess the anteroposterior skeletal pattern on lateral cephalograms. The sample was classified into Class I, II and III groups as determined by the diagnostic results of majority of the parameters. The validity and reliability of the aforementioned analyses were determined using Kappa statistics, sensitivity and positive predictive value (PPV). RESULTS: A substantial agreement was present between ANB angle and the diagnosis made by the final group (k = 0.802). In the Class I group, Downs angle of convexity showed the highest sensitivity (0.968), whereas ANB showed the highest PPV (0.910). In the Class II group, ANB angle showed the highest sensitivity (0.928) and PPV (0.951). In the Class III group, the ANB angle, the Wits appraisal and the Beta angle showed the highest sensitivity (0.902), whereas the Downs angle of convexity and the ANB angle showed the highest PPV (1.00). CONCLUSION: The ANB angle was found to be the most valid and reliable indicator in all sagittal groups. Downs angle of convexity, Wits appraisal and Beta angle may be used as valid indicators to assess the Class III sagittal pattern.
Asunto(s)
Cefalometría , Maloclusión/diagnóstico , Adolescente , Adulto , Cefalometría/métodos , Cefalometría/normas , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/diagnóstico , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnóstico , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Adulto JovenRESUMEN
A 33-year-old woman had a chief complaint of difficulty chewing, caused by a constricted mandibular arch and a unilateral full buccal crossbite (scissors-bite or Brodie bite). She requested minimally invasive treatment but agreed to anchorage with extra-alveolar temporary anchorage devices as needed. Her facial form was convex with protrusive but competent lips. Skeletally, the maxilla was protrusive (SNA, 86°) with an ANB angle of 5°. Amounts of crowding were 5 mm in the mandibular arch and 3 mm in the maxillary arch. The mandibular midline was deviated to the left about 2 mm, which was consistent with a medially and inferiorly displaced mandibular right condyle. Ectopic eruption of the maxillary right permanent first molar to the buccal side of the mandibular first molar cusps resulted in a 2-mm functional shift of the mandible to the left, which subsequently developed into a full buccal crossbite on the right side. Treatment was a conservative nonextraction approach with passive self-ligating brackets. Glass ionomer bite turbos were bonded on the occlusal surfaces of the maxillary left molars at 1 month into treatment. An extra-alveolar temporary anchorage device, a 2 × 12-mm OrthoBoneScrew (Newton A, HsinChu City, Taiwan), was inserted in the right mandibular buccal shelf. Elastomeric chains, anchored by the OrthoBoneScrew, extended to lingual buttons bonded on the lingually inclined mandibular right molars. Cross elastics were added as secondary uprighting mechanics. The maxillary right bite turbos were reduced at 4 months and removed 1 month later. At 11 months, bite turbos were bonded on the lingual surfaces of the maxillary central incisors, and an OrthoBoneScrew was inserted in each infrazygomatic crest. The Class II relationship was resolved with bimaxillary retraction of the maxillary arch with infrazygomatic crest anchorage and intermaxillary elastics. Interproximal reduction was performed to correct the black interdental spaces and the anterior flaring of the incisors. The scissors-bite and lingually inclined mandibular right posterior segment were sufficiently corrected after 3 months of treatment to establish adequate intermaxillary occlusion in the right posterior segments to intrude the maxillary right molars. The anterior bite turbos opened space for extrusion of the posterior teeth to level the mandibular arch, and the infrazygomatic crest bone screws anchored the retraction of the maxillary arch. In 27 months, this difficult malocclusion, with a Discrepancy Index score of 25, was treated to a Cast-Radiograph Evaluation score of 22 and a pink and white esthetic score of 3.
Asunto(s)
Tornillos Óseos , Oclusión Dental , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase I de Angle/terapia , Mandíbula/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Sobremordida/terapia , Adulto , Cefalometría , Femenino , Humanos , Incisivo/patología , Maloclusión Clase I de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Modelos Dentales , Diente Molar/patología , Mordida Abierta/terapia , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Aparatos Ortodóncicos Removibles , Soportes Ortodóncicos , Alambres para Ortodoncia , Ortodoncia Correctiva , Sobremordida/complicaciones , Sobremordida/diagnóstico , Sobremordida/diagnóstico por imagen , Planificación de Atención al Paciente , Radiografía Panorámica , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento , Dimensión VerticalRESUMEN
Abstract Introduction: Numerous cephalometric analyses have been proposed to diagnose the sagittal discrepancy of the craniofacial structures. Objective: This study aimed at evaluating the reliability and validity of different skeletal analyses for the identification of sagittal skeletal pattern. Methods: A total of 146 subjects (males = 77; females = 69; mean age = 23.6 ± 4.6 years) were included. The ANB angle, Wits appraisal, Beta angle, AB plane angle, Downs angle of convexity and W angle were used to assess the anteroposterior skeletal pattern on lateral cephalograms. The sample was classified into Class I, II and III groups as determined by the diagnostic results of majority of the parameters. The validity and reliability of the aforementioned analyses were determined using Kappa statistics, sensitivity and positive predictive value (PPV). Results: A substantial agreement was present between ANB angle and the diagnosis made by the final group (k = 0.802). In the Class I group, Downs angle of convexity showed the highest sensitivity (0.968), whereas ANB showed the highest PPV (0.910). In the Class II group, ANB angle showed the highest sensitivity (0.928) and PPV (0.951). In the Class III group, the ANB angle, the Wits appraisal and the Beta angle showed the highest sensitivity (0.902), whereas the Downs angle of convexity and the ANB angle showed the highest PPV (1.00). Conclusion: The ANB angle was found to be the most valid and reliable indicator in all sagittal groups. Downs angle of convexity, Wits appraisal and Beta angle may be used as valid indicators to assess the Class III sagittal pattern.
Resumo Introdução: numerosas análises cefalométricas foram propostas para diagnosticar a discrepância sagital das estruturas craniofaciais. Objetivo: este estudo teve como objetivo avaliar a confiabilidade e validade de diferentes análises esqueléticas para a identificação do padrão esquelético sagital. Métodos: foram incluídos 146 indivíduos (homens = 77; mulheres = 69; idade média = 23,6 ± 4,6 anos). O ângulo ANB, a avaliação de Wits, o ângulo Beta, o ângulo do plano AB, o ângulo de convexidade de Downs e o ângulo W foram utilizados para avaliar o padrão esquelético anteroposterior em cefalogramas laterais. A amostra foi classificada nos grupos Classe I, II e III, conforme os resultados diagnósticos da maioria dos parâmetros. A validade e a confiabilidade das análises acima mencionadas foram determinadas usando estatísticas Kappa, sensibilidade e valor preditivo positivo (VPP). Resultados: foi encontrada uma concordância significativa entre o ângulo ANB e o diagnóstico feito pelo grupo final (k = 0,802). No grupo Classe I, o ângulo de convexidade de Downs mostrou a maior sensibilidade (0,968), enquanto o ANB apresentou o maior VPP (0,910). No grupo Classe II, o ângulo ANB mostrou a maior sensibilidade (0,928) e o maior VPP (0,951). No grupo Classe III, o ângulo ANB, a avaliação de Wits e o ângulo Beta apresentaram a maior sensibilidade (0,902), enquanto o ângulo de convexidade de Downs e o ângulo ANB apresentaram o maior VPP (1,00). Conclusão: o ângulo ANB foi considerado o indicador mais válido e confiável em todos os grupos sagitais. O ângulo de convexidade de Downs, a avaliação de Wits e o ângulo Beta podem ser usados como indicadores válidos para avaliar o padrão sagital de Classe III.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Cefalometría/métodos , Maloclusión/diagnóstico , Cefalometría/normas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Maloclusión Clase I de Angle/diagnóstico , Maloclusión Clase II de Angle/diagnóstico , Maloclusión de Angle Clase III/diagnósticoRESUMEN
PURPOSE: Juvenile idiopathic arthritis (JIA) is an autoimmune disease with multiple potential causal factors. In case of temporomandibular joint (TMJ) affection, the inflammatory reaction can result in restricted mandibular growth with implied skeletal and facial deformities. Aim of the present study was to examine dentoalveolar and occlusion characteristics in children with JIA. PATIENTS AND METHODS: The sample consisted of 66 children (27 boys, 39 girls) with JIA. Thirty-three of them showed unilateral or bilateral condylar destruction, while the other half did not manifest any TMJ involvement. Corresponding dental casts of these patients were evaluated and Angle classification, overjet, overbite, crossbite, crowding, and ectopic teeth were registered. All dental casts were subsequently scanned and digitized to analyze 26 additional variables. Subgroups according to sex and condylar affection were formed. Statistical analysis was performed using Fisher's least significant difference (LSD) post hoc test of analysis of variance (ANOVA). RESULTS: The prevalence of Class II, division 1 malocclusion in this JIA sample was high (28.8%). Compared to girls, boys had significantly greater dental arch widths and lengths. The group with bilateral condylar affection had significantly decreased lower arch length and increased irregularity index (pâ¯< 0.035) compared to the non-affected group. CONCLUSIONS: Bilateral condylar involvement in children with JIA seems to reduce the lower arch length, while increasing the irregularity index of the lower front teeth.
Asunto(s)
Artritis Juvenil/diagnóstico , Maloclusión/diagnóstico , Cóndilo Mandibular , Trastornos de la Articulación Temporomandibular/diagnóstico , Adolescente , Artritis Juvenil/epidemiología , Niño , Estudios Transversales , Arco Dental/anomalías , Técnica de Colado Dental , Femenino , Humanos , Masculino , Maloclusión/epidemiología , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase II de Angle/epidemiología , Modelos Dentales , Factores Sexuales , Trastornos de la Articulación Temporomandibular/epidemiologíaRESUMEN
BACKGROUND: Managing orthodontic treatment is often very difficult for the orthodontist. Many devices are used during the orthopedic phase of orthodontic treatment, always with different functions. We describe a case of orthodontic management treated with the Equilibrator O.S.A. device (equilibrator designed by Ovidi, Santi, and Aprile for Eptamed SRL; Cesena, Italy; www.eptamed.com ). CASE PRESENTATION: A healthy 10-year-old white boy presented with a skeletal class II, division 1 malocclusion, molar class II, exhibiting an overjet of 7 mm prior to treatment. For treatment, we only used the Equilibrator O.S.A. device. CONCLUSIONS: We successfully treated an orthopedic/orthodontic case with a particular device that we describe here.