Management Strategies for Open Bite Relapse: A Systematic Review and Meta-Analysis.

The purpose of orthodontic therapy is to correct malocclusion and produce a stable outcome that endures over time. Long-term stability can be difficult to achieve, and many patients relapse after treatment, particularly in instances of open bite relapse (OBR). This systematic review aimed to analyze different types of management strategies for OBR and conduct a meta-analysis to find the best method of dealing with relapse. A comprehensive search was carried out across six major online databases using relevant keywords pertaining to our study, including "open bite relapse," "orthodontic retention," "orthodontic surgery," "orthodontic appliance," "orthodontic management," "orthodontic treatment," "orofacial myofunctional therapy (OMT)," "skeletal anchorage," and "treatment follow-up period." Eleven studies were selected after the application of relevant inclusion and exclusion strategies. The mean follow-up period of treatment for the studies ranged from six months to 4.5 years. Of all the management strategies assessed, OMT was found to be the least effective for OBR management. Surgical management modalities, such as mandibular repositioning and molar intrusion using skeletal anchorage, in conjunction with the usage of orthodontic appliances, were found to be noticeably effective, especially in the cases of participants who were <18 years of age. However, when utilized on a singular basis, either of them was found to be lacking the desired effect. The overall odds ratio (OR) of 0.48 (0.37, 0.64) and risk ratio (RR) of 0.62 (0.51, 0.74) were obtained after the meta-analysis of the different interventions for OBR, indicating statistical significance. There were only 11 studies included in the study, so it's possible that not all management strategies for OBR were fully understood. The limited number of studies may also have affected the generalizability of the findings. Although statistical differences were obtained to a certain degree, more clinical trials are needed to assess the effect of such surgical modalities as a viable management tool for OBR, since these represent a significant limiting factor in terms of the overall cost of the treatment placed upon the patient. Prior to the start of the research, registration was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The research protocol was created to meet the goals and was properly filed with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023401991).

Role of Three-Dimensional Printing in Treatment Planning for Orthognathic Surgery: A Systematic Review.

Three-dimensional (3D) printing refers to a wide range of additive manufacturing processes that enable the construction of structures and models. It has been rapidly adopted for a variety of surgical applications, including the printing of patient-specific anatomical models, implants and prostheses, external fixators and splints, as well as surgical instrumentation and cutting guides. In comparison to traditional methods, 3D-printed models and surgical guides offer a deeper understanding of intricate maxillofacial structures and spatial relationships. This review article examines the utilization of 3D printing in orthognathic surgery, particularly in the context of treatment planning. It discusses how 3D printing has revolutionized this sector by providing enhanced visualization, precise surgical planning, reduction in operating time, and improved patient communication. Various databases, including PubMed, Google Scholar, ScienceDirect, and Medline, were searched with relevant keywords. A total of 410 articles were retrieved, of which 71 were included in this study. This article concludes that the utilization of 3D printing in the treatment planning of orthognathic surgery offers a wide range of advantages, such as increased patient satisfaction and improved functional and aesthetic outcomes.

Meta-analysis of outcomes related to the quality of life after orthodontic-surgical treatment.

Orthognathic surgery causes functional and aesthetic changes, which could affect patients' quality of life (QOL). The current analysis assessed the impact of orthodontic-surgical treatment on the parameters affecting the QOL using different scoring systems. The criteria for inclusion were studies written in various languages that compared the effects of the intervention on patients' QOL before surgery and at various periods after surgery (3 weeks to several months), which resulted in including 19 studies into this meta-analysis. The outcomes of these studies underwent random-effect modeling to calculate the mean difference (MD) and 95% confidence intervals (95% CIs) of the impact of different surgical techniques on clinical parameters, and publication bias was analyzed with Begg's test. According to the total score of the Orthognathic Quality of Life Questionnaire (OQLQ), surgery significantly affected patients' QOL after 2 months or less (p = 0.049), up to 6 months (p < 0.001), and when comparing 2 months or less with up to 6 months (2-6 months) (p < 0.001). In addition, the total Oral Health Impact Profile-14 (OHIP-14) score showed a significant difference in the QOL after 6 months (p = 0.003) and up to 12 months (p = 0.002) after surgery. Therefore, orthodontic-surgical treatment significantly improves patients' QOL after surgery compared to before surgery.

Autotransplantation with tooth replica: Technical note.

INTRODUCTION: Dental autotransplantation is a surgical procedure that involves the implantation of a tooth with incomplete root development to replace an injured or missing tooth. An initial surgery was performed to attempt orthodontic traction without success after 6 months. TECHNIQUE: Preoperative assessment included mandibular cone beam computed tomography to visualise two canines. The double autotransplantation technique was performed under general anaesthesia using three-dimensional resin-printed dental replicas. The extra-alveolar time for each tooth was reportedly <1 min, and pulp sensibility was observed 3 months later. CONCLUSION: In the digital era, dental autotransplantation has become an essential part of orthodontic-surgical treatment in children and adolescents with dental agenesis or non-preservable teeth. The use of three-dimensional dental replicas printed from radiological data offers a reliable, reproducible, and valid therapeutic solution with an advantageous benefit/risk balance.

Corticotomy in orthodontic treatment: systematic review.

OBJECTIVE: The aim of this study is to evaluate corticotomies effects to accelerate or facilitate dental movements in different kind of orthodontic treatments. DATA: This report followed the PRISMA Statement. A total of 9 articles were included in review. SOURCES: Two reviewers performed a literature search up to December 2018 in four databases: PubMed, Web of Science, Scopus and SciELO. STUDY SELECTION: Controlled clinical trials and randomized controlled clinical trials conducted in human patients and published during the last 10 years in English were eligible to be selected. The articles should give detailed information about the results and treatment parameters. There were no limitations established in terms of the type of malocclusion to be corrected or the type of orthodontic treatment performed. RESULTS: The methodological quality and evidence of the selected studies was low. Most of the studies observed a statistically significant increase in the rate of dental movement, when performing alveolar corticotomies as coadjuvants of orthodontic treatment; either with the conventional technique or with piezocision. The effect of combining corticotomy with bone grafts was assessed. CONCLUSIONS: High heterogeneity among studies made it difficult to draw clear conclusions. However, within the limitations of this review, the corticotomy procedures were able to statistically and clinically produce significant temporary decrease in orthodontic tooth movement rate. This technique does not seem to involve major complications compared to conventional orthodontic treatments. CLINICAL RELEVANCE: The use of this technique can reduce treatment time and therefore the undesirable effects associated with prolonged treatments.

Surgery-first approach with 3D customized passive self-ligating brackets and 3D surgical planning: Case report

ABSTRACT It is possible to unify three-dimensional customized orthodontic techniques and three-dimensional surgical technology. In this case report, it is introduced a treatment scheme consisting of passive self-ligation customized brackets and virtual surgical planning combined with the orthognathic surgery-first approach in a Class III malocclusion patient. Excellent facial and occlusal outcomes were obtained in a reduced treatment time of five months.

RESUMO É possível unificar técnicas ortodônticas personalizadas e tecnologia de planejamento cirúrgico 3D. No presente relato de caso, apresenta-se um plano de tratamento envolvendo o uso de braquetes autoligáveis passivos personalizados e planejamento cirúrgico virtual, combinado com cirurgia ortognática de benefício antecipado, em um paciente com má oclusão de Classe III. Foram obtidos excelentes resultados faciais e oclusais em um tempo reduzido de tratamento, de 5 meses.

Periodontal surgery of the maxillary impacted canine for orthodontic purposes: Proposal for a surgical decision tree.

In a private practice, between January 2010 and December 2015, 621 impacted teeth were exposed for orthodontic purposes. The majority were maxillary canines (464=74.71%), followed by maxillary central incisors (36=5.80%), mandibular canines (32=5.15%) and, finally, second premolars (30=4.83%). The 464 maxillary canines were present in 356 patients with a mean age, at the time of the intervention, of 15 years and 3 months (7 years and 10 months to 45 years and one month). The gender distribution was 60.7% (F) to 39.3% (M); 32.8% of maxillary canines were buccal and 67.2% were palatal. Only 6 canines did not move, with a success rate of 98.7%. At the pretreatment interview, the orthodontists explained that orthodontic-surgical placement of an impacted canine lengthened treatment time by an average 6 months, but in some cases by 12 months or more. The purpose of this surgery is to help the orthodontist to position the impacted tooth in the dental arch with all the periodontal structures and with the best possible integration esthetics. The objective of this article is to illustrate the periodontal orthodontic surgery of the maxillary canine and to propose a surgical decision tree.