The impact of premature birth on the mandibular cortical bone of children.

SUMMARY: Children born prematurely often have reduced skeletal mineralization. The aim in this study was to compare the cortical thickness of the lower jaw on radiographs of 8- to 10-year-old children with histories of preterm or full term births. There were no significant differences in cortical thickness between full term and preterm children at this age. INTRODUCTION: The purpose of this study was to compare the cortical thickness of the mandible on panoramic radiographs of 8- to 10-year-old children with histories of preterm or full term births. METHODS: Panoramic radiography was performed on 36 extremely preterm, 38 very preterm and 42 full term children at the age of 8 to 10 years. Five observers independently measured the mandibular cortical width on the panoramic radiographs at four defined sites bilaterally. Altogether, 928 sites were available. Measurements were performed twice on a random 24% of the sites by four observers. One-way analysis of variance with Tukey's post hoc test was used to test differences between groups. Intraclass correlation coefficient (ICC) was calculated for interobserver agreement while intra-observer agreement was expressed as measurement precision. RESULTS: Significant differences of mandibular cortical width were found between extremely preterm and very preterm children for five of the eight measurement sites with the very preterm showing the highest value. No significant differences were found between full term and either very preterm or extremely preterm except for one measurement site, with the extremely preterm showing the lowest value. ICC varied between 0.30 and 0.83 for the different sites (mean 0.62). The precision of a single measurement varied between 0.11 and 0.45 mm (mean 0.25 mm). CONCLUSIONS: From the evidence that very preterm children had significantly thicker mandibular cortices than extremely preterm children, we suggest that these findings may reflect the effect of mineral supplementation provided to premature infants, causing a 'shifting up' of bone mineral status relative to the full term peer group while maintaining the difference between very preterm and extremely preterm born children.

A comparative analysis of distal maxillary molar movement produced by a new lingual intra-arch Ni-Ti coil appliance and a magnetic appliance.

The aim of the study was to evaluate cephalometrically the dental and skeletal treatment effects of a new lingual intra-arch Ni-Ti coil appliance for molar distalization and to compare these with those of an established intra-arch appliance that uses repelling magnets for distal molar movement. Two groups of 21 adolescents, all girls, participated in this retrospective study. One group was treated with the new lingual Ni-Ti coil appliance for 6.5 months and the other with the magnetic appliance for 5.8 months. The treatment effects were analysed by measurements on lateral head radiographs at the start of treatment and after the molar distalization was completed. The mean amount of distal molar movement was 2.5 mm (SD 0.69) in the lingual coil group and 2.6 mm (SD 0.51) in the magnet group. A significantly higher degree of distal molar tipping was found in the magnet group, -8.8 degrees, compared with -2.2 degrees for the lingual coil group. Due to anchorage loss, the maxillary incisors moved forwards, and the overjet was increased by an average of 1.2 mm in the lingual coil group and 1.7 mm in the magnet group. The results indicate that the new lingual Ni-Ti coil appliance was better choice than the magnet appliance for distal bodily movement of maxillary molars. The benefits of the new Ni-Ti appliance were due to the design preventing molar tipping and its single activation.

Class II correction with magnets and superelastic coils followed by straight-wire mechanotherapy. Occlusal changes during and after dental therapy.

The investigation comprised 18 consecutively selected patients, mean age 14.7 years at the start of treatment, with Class II malocclusion, deep overbite and space deficiency in the maxillary arch. The first phase of the treatment consisted of 6 months simultaneous distal movement of maxillary first and second molars with repelling samarium-cobalt magnets on one side and a superelastic nickel-titanium coil on the contralateral side together with an anterior biteplane to achieve bite opening. For the second phase of the treatment, a straight-wire appliance was used for an average treatment time of 1.3 years. Lateral head radiographs and dental casts were available at the start of treatment, after molar distalisation, at the end of treatment and 1 year post-treatment. The treatment resulted mainly in dental changes. The dental Class II molar relation was corrected to Class I by bodily distal movement of maxillary molars and by mesial movement of the mandibular molars. The correction of molar relation was significantly greater on coil sides than on magnet sides, mean 3.4 mm, and 3.0 mm, respectively. Despite anchorage loss associated with the maxillary molar movement, i.e. mesial movement of the maxillary incisors (mean 1.8 mm), the net overjet was reduced, mean 2.5 mm, by the use of Class II elastics. The average net improvement of bite opening was 2.6 mm, mainly due to extrusion of mandibular and maxillary molars. During the 1-year post-treatment period no significant dental or skeletal changes were found. The long-term implications of the treatment results need further consideration.

Attractive magnets for orthodontic extrusion of crown-root fractured teeth.

A subgingival crown-root fracture presents the clinician with a difficult restorative problem, including reaching the fracture line, and is complicated by the need to maintain the periodontal tissues in good health. The treatment options up to now have usually been limited to extrusion of the remaining root with a conventional orthodontic appliance, surgical intraalveolar transplantation of the root or extraction with bridge replacement. In this report, a new method of orthodontic extrusion with attractive magnets is presented. One or two neodymium-iron-boron magnets were attached to the remaining root and a second, larger neodymium-iron-boron magnet was incorporated in a removable appliance. The roots were extruded 2 to 3 mm with a force range from 50 to 240 cN during a treatment period of 9 to 11 weeks. Good force control at short distances, no friction, and no material fatigue of permanent rare earth magnets resulted in successful rapid extrusion. No evidence of soft tissue dehiscences, aberrant tooth mobility, or root resorption was found.

Orthodontic magnets. A study of force and field pattern, biocompatibility and clinical effects.

Magnetic forces have been incorporated into orthodontic mechanics during recent years. However, the biocompatibility of magnet alloys and the possible risk of harmful or unusual reactions in tissues exposed to static magnetic fields have been characterized as inconsistent and often contradictory. It has also been questioned whether magnetic forces have significant advantages over traditional mechanics. The present series of studies aimed to analyse the force and field properties, the biocompatibility and the clinical effects of rare earth magnets as well as to compare the efficiency of tooth movement between magnets and another force system. Samarium-cobalt magnets for molar distalization were tested in experimental models for force and field properties. The cytotoxicity of different magnet alloys (rare earth types) as well as of clinically used and recycled magnets was assessed by two in vitro methods, the millipore filter method and an extraction method. The effect of static magnetic fields on human gingival tissue and dental pulp was examined histologically for alterations in cell pattern and cell morphology. The effects of using repelling samarium-cobalt magnets for simultaneous distalization of maxillary first and second molars were analysed in individuals with Class II malocclusion. The efficiency of molar distalization was also intra-individually compared between repelling magnets and superelastic NiTi-coils in individuals with Class II malocclusion and deep bite. The magnet forces decreased approximately with the reciprocal square of the separation distance between the magnets. No fatigue of force over time could be seen. The static magnetic fields were weak and had a limited extent and the flux density dropped exponentially in all directions with increased distance from the magnets, implying a small exposure area when the magnets are used clinically. Rare earth magnets showed good biocompatibility, particularly coated magnets. However, uncoated samarium-cobalt magnets showed significant cytotoxicity. It was also found that stainless-steel-coated samarium-cobalt magnets could be recycled with maintained good biocompatibility. After exposure to static magnetic fields, normal clinical and histological conditions in the human gingival tissue and normal histological features in the human dental pulp were found. Repelling magnets were effective in producing maxillary molar distalization but some side effects like anchorage loss and molar tipping were found. The superelastic coils were shown to be even more efficient than the repelling magnets for maxillary molar distalization in individuals with Class II malocclusion and deep bite.