Reliability and reproducibility of the method of assessment of midpalatal suture maturation: A tomographic study.

OBJECTIVES: To assess reliability and reproducibility of the individual assessment of midpalatal suture maturation in computed tomography among orthodontists and radiologists for potential diagnosis application. MATERIALS AND METHODS: Sixty axial slices from cone-beam computed tomography and multi-slice CT scans of patients aged between 11 and 21 years old (33 females and 27 males) were selected. For the investigation of reliability and reproducibility of the method, two groups of examiners were established. The first group consisted of 11 orthodontists and the second consisted of 10 radiologists. Each group examined the images and performed individual assessment of the midpalatal suture maturation method twice within an interval of 21 days. During the first and second analyses, the sequence of images was randomized to reduce potential bias. Weighted Cohen's kappa was performed to assess inter- and intra-examiners' agreement. The percentage of perfect agreement and the number of stages apart for each disagreement were calculated. The significance level was P < .05. RESULTS: The overall inter-examiner agreement was satisfactory in the first (kappaw: 0.37) and the second (kappaw: 0.34) analyses. Intra-examiner agreement outcomes were similar between orthodontists (kappaw: 0.44) and radiologists (kappaw: 0.41). The percentage of perfect agreement was 43.2%. CONCLUSIONS: The method for individual assessment of midpalatal suture maturation revealed potential reliability and reproducibility. However, the agreement rate observed in the present study was not high enough for a method designed for routine clinical applications.

Dentoalveolar effects produced by different appliances on early treatment of anterior open bite: A randomized clinical trial.

OBJECTIVES:: To compare different appliances for early anterior open bite (AOB) correction. MATERIALS AND METHODS:: This was a parallel, randomized clinical trial. A prospective sample of patients with AOB was recruited consecutively. Eligibility criteria included angle class I malocclusion with AOB equal to or greater than 1 mm. Participants were allocated by simple randomization to 4 groups: bonded spurs, chin cup, fixed palatal crib, and removable palatal crib. Dentoalveolar changes among the groups were assessed by blinded observers by comparing lateral cephalograms taken before (T1) and 12 months after treatment (T2; analysis of variance followed by Tukey test). Of the measurements, 30% were reassessed for reliability (intraclass correlation coefficient and Bland-Altman agreement test; α = 5%; 95% confidence interval). RESULTS:: A total of 99 patients with a mean AOB of 3.7 mm (mean age 8.4 ± 0.8 years, both genders) were recruited. Dropouts occurred in all the groups, yielding a final sample size of 81 analyzed individuals. Intergroup comparisons of differences (T2-T1) showed significant differences for the incisor positioning variables (1.1, 1-PP, 6-PP, IMPA, 1.NB and 1-GoMe). However, there was no significant difference in AOB reduction among the groups, with an average correction of 3.1 mm. CONCLUSIONS:: All of the tested devices promoted dental changes, especially in the anterior region, and contributed to AOB reduction during the study period. However, fixed palatal crib demonstrated greater impact on the positioning of the incisors.

Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study.

OBJECTIVE: To evaluate the dimensional changes of dental arches on digital models of open bite treatment with fixed and removable palatal cribs. MATERIALS AND METHODS: The sample comprised 41 patients of both sexes who were white, aged 7-10 years, and who had mixed dentition, Angle Class I molar relationship, and a negative overbite of at least 1 mm. The sample was randomly divided into two groups: G1, fixed palatal crib; and G2, removable palatal crib. Cast models, obtained initially (T1) and after 1 year of treatment (T2), were scanned by a three-dimensional (3D) scanner, 3Shape R700, producing a 3D image. Measurements were performed by a calibrated examiner using OrthoAnalyzer™ 3D software. RESULTS: At T2-T1, differences were observed between the groups regarding vertical dentoalveolar development and overjet. There was more mandibular incisor extrusion for G1 (-1.66 mm) than for G2 (-0.54 mm). An overjet increase was observed in G1 (0.56 mm), in contrast to a reduction in G2 (-0.40 mm). There was a similar overbite increase for both groups (3.51 mm for fixed palatal crib and 3.88 mm for removable palatal crib). CONCLUSIONS: Both the treatment protocols are similarly effective for anterior open bite correction, providing an overbite increase with dentoalveolar arch changes, especially in the anterior region.