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1.
Orthod Craniofac Res ; 27(4): 527-534, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38299945

RESUMO

INTRODUCTION: To evaluate biomechanics of an aligner utilizing divots and the effect of their vertical placement on the right maxillary central incisor. METHODS: An in vitro Orthodontic SIMulator (OSIM) was used to test forces and moments generated by aligners incorporating divots. The OSIM arch was scanned to generate a. STL version that was modified to create four models by placing divots on different positions of the right central maxillary incisor: GI - divots on gingival-third of lingual surface and incisal-third of labial surface; GM - divots on gingival-third of lingual surface and middle-third of labial surface; MI - divots on middle-third of lingual surface and incisal-third of labial surface; MM - divots on middle-third of lingual surface and middle-third of labial surface. Aligners (n = 30/model) were fabricated using a 0.75 mm thick polyethylene terephthalate material and Biostar® machine following the manufacturer's recommendations. A one-way MANOVA followed by one-way ANOVA (α = 0.05) was utilized to test effect of models on buccolingual force (Fy) and mesiodistal moment (Mx) at 0.20 mm of lingual displacement of the right maxillary central incisor. RESULTS: Mean Mx for GI (-5.68 ± 7.38 Nmm), GM (3.75 ± 5.54 Nmm), MI (-4.27 ± 1.48 Nmm) and MM (1.96 ± 0.99 Nmm) models showed statistical differences between GI and GM, GI and MM, GM and MI and MI and MM. GI exerted the largest Fy (1.87 ± 0.75 N) followed by GM (1.10 ± 0.47 N), MI (0.70 ± 0.23 N) and MM (0.28 ± 0.08 N) with significant differences between GI and GM, GI and MI, GI and MM and GM and MM models. CONCLUSIONS: Vertical divot placement on a right central incisor had a significant effect on aligner biomechanics. Buccolingual forces exerted by models GI, GM and MI were within the range suggested by literature for bodily tooth movement without major root tipping for GM and MI models.


Assuntos
Incisivo , Técnicas de Movimentação Dentária , Fenômenos Biomecânicos , Humanos , Técnicas de Movimentação Dentária/instrumentação , Técnicas In Vitro , Análise do Estresse Dentário , Desenho de Aparelho Ortodôntico , Maxila , Estresse Mecânico
2.
Am J Orthod Dentofacial Orthop ; 160(3): 401-409, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34456005

RESUMO

INTRODUCTION: The objective of this study was to evaluate the forces and moments exerted by orthodontic aligners on 3 different displaced maxillary teeth and their adjacent supporting teeth. METHODS: An in vitro orthodontic simulator was used to measure the forces and moments of a 0.75-mm thick glycol-modified polyethylene terephthalate material for 3 maxillary teeth: central incisor, canine, and second premolar. Forces and moments were recorded for tested teeth displaced lingually one by one for 0.20 mm. Repeated measures of multivariate analysis of variance was used to assess the outcome. RESULTS: The mean buccolingual force applied on a displaced canine (2.25 ± 0.38 N) was significantly (P <0.001) more than the central incisor (1.49 ± 0.18 N) and second premolar (1.50 ± 0.16 N). The mean moment (that tends to tip the teeth buccally) exerted on a canine (-20.11 ± 5.27 Nmm) was significantly more (P <0.001) than the central incisor (-8.42 ± 1.67 Nmm) and second premolar (-11.45 ± 1.29 Nmm). The forces and moments acting on teeth adjacent to the displaced tooth were clinically significant and acted in opposing directions to those on the displaced tooth. CONCLUSIONS: The results of this study highlighted that for the same amount of displacement on a given tooth, the forces and moments imposed by the orthodontic aligner depend on location around the arch. These findings highlight the need to further study aligner mechanics around the dental arch and optimize aligner design to impose desired mechanical loads to avoid detrimental effects during orthodontic tooth movement.


Assuntos
Incisivo , Desenho de Aparelho Ortodôntico , Fenômenos Biomecânicos , Maxila , Técnicas de Movimentação Dentária
3.
Orthod Craniofac Res ; 23(2): 133-142, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31651082

RESUMO

OBJECTIVE: To analyse through a systematic review the effectiveness of clear aligners by assessing: (a) predictability of clear aligners and (b) treatment outcome comparison of clear aligner therapy with fixed appliance therapy. METHODS: An electronic search was made from January 2014 to April 2019 using MEDLINE, Embase, Web of Science and LILACS databases without any limitations on language. Three reviewers independently assessed the articles. Quality assessment of observational studies and randomized control trial was done by using the ROBINS tool and Cochrane risk of bias tool, respectively. GRADE instrument was used to assess certainty level for each identified outcome. RESULTS: Seven eligible articles (one randomized controlled trial and six retrospective cohort) were included in our systematic review. Most of the studies (six out of seven) had a moderate risk of bias and one had a high risk of bias. CONCLUSIONS: 'Low to moderate level' of certainty in regard to specific clear aligner therapy tooth movements' efficiency was identified. Clear aligners may produce clinically acceptable outcomes that could be comparable to fixed appliance therapy for buccolingual inclination of upper and lower incisors in mild to moderate malocclusions. However, not all potential clinical scenarios have been assessed in the included studies. Most of the tooth movements may not be predictable enough to be accomplished with only one set of trays with clear aligners despite the recent advances in technology.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Humanos , Incisivo , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Técnicas de Movimentação Dentária
4.
Eur J Orthod ; 37(4): 356-66, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25194145

RESUMO

INTRODUCTION: Objectives were to investigate the factors affecting the overall reporting quality and the reporting quality trend of each item over the last 10 years for orthodontic randomized controlled trials (RCTs). MATERIAL AND METHODS: MEDLINE, The Cochrane Library, and EMBASE databases were searched (2003-12) to retrieve studies. Four major orthodontic journals and reference list of included articles were hand searched to identify additional RCTs. The overall reporting quality for all included RCTs (2003-12) was assessed using CONSORT, 2001 (ORQs 2001, score 0-20). In addition, CONSORT, 2010 (ORQs 2010, score 0-27), was used for RCTs published after 2010. Generalized estimated equations (GEEs) model was used for analysis (ORQs 2001 and ORQs 2010). Cochran-Armitage trend test was used to evaluate the reporting quality trend of each individual item based on the CONSORT, 2001. RESULTS: Totally 309 relevant studies were identified, out of which 86 were published after 2010. The median for total ORQs 2001 and ORQs 2010 was 9 (interquartile range 7-12) and 12 (interquartile range 9-15), respectively. Year and journal of publication were significant predictors for both ORQs 2001 and ORQs 2010. Location, sample size, and multicentre trials were significant predictors only for ORQs 2001, and not for ORQs 2010. Trend test showed that reporting quality of four items, namely identification of trial as randomized, sample size, blinding, and randomization has improved significantly with time. CONCLUSION: There is an improvement in the reporting quality. However, it is still suboptimal. To improve the reporting quality, the CONSORT guidelines should be followed strictly.


Assuntos
Ortodontia/normas , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Lista de Checagem , Humanos , Estudos Multicêntricos como Assunto , Publicações Periódicas como Assunto , Projetos de Pesquisa/normas , Tamanho da Amostra
5.
Int J Orthod Milwaukee ; 25(3): 43-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25745724

RESUMO

Molar uprighting cases require individualized treatment planning depending upon condition of ridge, growth pattern of patient, periodontal condition, lower facial height, position of third molar and anchorage. Uprighting of molar was done in two cases--effectively using simple tip back spring in one case and implant in another.


Assuntos
Dente Molar/patologia , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Processo Alveolar/patologia , Parafusos Ósseos , Feminino , Humanos , Má Oclusão Classe I de Angle/terapia , Miniaturização , Dente Serotino/patologia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Fechamento de Espaço Ortodôntico/instrumentação , Fechamento de Espaço Ortodôntico/métodos , Fios Ortodônticos , Ligamento Periodontal/patologia , Técnicas de Movimentação Dentária/instrumentação , Dimensão Vertical
6.
J Biomed Mater Res B Appl Biomater ; 111(1): 194-202, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36318602

RESUMO

The primary objective of this work was to investigate the effect of material selection and tooth position on orthodontic aligner biomechanics. Additionally, material property changes with thermoforming were studied to elucidate its role in material performance in-vitro. An orthodontic simulator (OSIM) was used to evaluate forces and moments at 0.20 mm of lingual displacement for central incisor, canine and second premolar using Polyethylene terephthalate (PET), Polyurethane (PU) and Glycol-modified polyethylene terephthalate (PET-G) materials. The OSIM was scanned to generate a model used to fabricate aligners using manufacturer-specified thermoforming procedures. Repeated measures of MANOVA was used to analyze the effect of teeth and material on forces/moments. The role of thermoforming was evaluated by flexural modulus estimated by 3-point bend tests. Pre-thermoformed and post-thermoformed samples were prepared using as-received sheets and those thermoformed over a simplified arch using rectangular geometry, respectively. Groups were compared using Two-way ANOVA. The PET, PU, and PET-G materials exerted maximum buccal force and corresponding moments on the canine. PU exerted more buccal force than PET-G on the canine and second premolar, and more than PET on the second premolar. The impact of thermoforming varied according to the specific polymer: PET-G remained stable, there was a slight change for PET, and a significant increase was noted for PU from pre-thermoformed to post-thermoforming. The results of this study elucidate the influence of material and arch position on the exerted forces and moments. Further, the mechanical properties of thermoplastic materials should be evaluated after thermoforming to characterize their properties for clinical application.


Assuntos
Desenho de Aparelho Ortodôntico , Técnicas de Movimentação Dentária , Técnicas de Movimentação Dentária/métodos , Fenômenos Biomecânicos , Polietilenotereftalatos , Dente Pré-Molar , Polietilenoglicóis
7.
Angle Orthod ; 90(5): 688-694, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378485

RESUMO

OBJECTIVE: To compare the biomechanics of straight labial, straight lingual, and mushroom lingual archwire systems when used in posterior arch expansion. MATERIALS AND METHODS: An electro-mechanical orthodontic simulator allowing for buccal-lingual and vertical displacements of individual teeth and three-dimensional force/moment measurements was instrumented with anatomically shaped teeth for the maxillary arch. In-Ovation L brackets were bonded to lingual surfaces, and Carriere SLX brackets were bonded to labial surfaces to ensure consistency of slot dimensions. Titanium molybdenum archwires were bent to an ideal arch form, and the teeth on the orthodontic simulator were set to a passive position. Posterior teeth from the canine to second molar were moved lingually to replicate a constricted arch. From the constricted position, the posterior teeth were simultaneously moved until the expansive force decreased below 0.2 N. Initial force/moment systems and the amount of predicted expansion were compared for posterior teeth at a significance level of α = 0.05. RESULTS: Archwire type affected both the expected expansion and initial force/moment systems produced in the constricted position. In general, the lingual systems produced the most expansion. The archwire systems were not able to return the teeth to their ideal position, with the closest system reaching 41% of the intended expansion. CONCLUSIONS: In general, lingual systems were able to produce greater expansion in the posterior regions when compared with labial systems. However, less than half of the intended arch expansion was achieved with all systems tested.


Assuntos
Braquetes Ortodônticos , Fios Ortodônticos , Fenômenos Biomecânicos , Incisivo , Desenho de Aparelho Ortodôntico , Técnicas de Movimentação Dentária
8.
Angle Orthod ; 89(4): 617-623, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30753091

RESUMO

OBJECTIVES: To evaluate the effectiveness of verbal behavior modification, acetaminophen, and the combined effectiveness of verbal behavior modification along with acetaminophen on orthodontic pain. MATERIALS AND METHODS: One hundred and forty orthodontic fixed appliance patients were randomly assigned to four groups. Group A was administered acetaminophen, group B was given verbal behavior modification, group C was administered acetaminophen as well as verbal behavior modification, and group D was placebo-controlled. A visual analog scale was used to assess pain intensity after 1 week of separator placement. RESULTS: Group A had less mean pain intensity when compared to group B at 6 hours (P < .001) and at 1 (P < .001) and 2 (P = .002) days. Group C patients encountered less mean pain intensity when compared to group B patients at 6 hours (P < .001) and at 1 (P < .001), 2 (P < .001), and 4 (P = .001) days. There was a statistically significant difference between groups A and C (group C experienced less pain intensity) after 6 hours (P = .004) and at day 4 (P = .009) after separator placement. CONCLUSIONS: Acetaminophen is the main agent of orthodontic pain reduction after separator placement, with verbal behavior serving as an adjunct to it.


Assuntos
Acetaminofen , Analgésicos não Narcóticos , Manejo da Dor , Técnicas de Movimentação Dentária , Comportamento Verbal , Acetaminofen/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Terapia Comportamental , Método Duplo-Cego , Humanos , Ibuprofeno , Dor/etiologia , Medição da Dor , Método Simples-Cego , Técnicas de Movimentação Dentária/efeitos adversos
9.
Prog Orthod ; 19(1): 18, 2018 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-29938297

RESUMO

In this review, most of the known and postulated mechanisms of osteopontin (OPN) and its role in bone remodeling and orthodontic tooth movement are discussed based on available literature. OPN, a multifunctional protein, is considered crucial for bone remodeling, biomineralization, and periodontal remodeling during mechanical tension and stress (orthodontic tooth movement). It contributes to bone remodeling by promoting osteoclastogenesis and osteoclast activity through CD44- and αvß3-mediated cell signaling. Further, it has a definitive role in bone remodeling by the formation of podosomes, osteoclast survival, and osteoclast motility. OPN has been shown to have a regulatory effect on hydroxyapatite crystal (HAP) growth and potently inhibits the mineralization of osteoblast cultures in a phosphate-dependent manner. Bone remodeling is vital for orthodontic tooth movement. Significant compressive and tensional forces on the periodontium induce the signaling pathways mediated by various osteogenic genes including OPN, bone sialoprotein, Osterix, and osteocalcin. The signaling pathways involved in the regulation of OPN and its effect on the periodontal tissues during orthodontic tooth movement are further discussed in this review. A limited number of studies have suggested the use of OPN as a biomarker to assess orthodontic treatment. Furthermore, the association of single nucleotide polymorphisms (SNPs) in OPN coding gene Spp1 with orthodontically induced root resorption remains largely unexplored. Accordingly, future research directions for OPN are outlined in this review.


Assuntos
Remodelação Óssea/fisiologia , Osteopontina/fisiologia , Técnicas de Movimentação Dentária , Animais , Humanos
10.
J Int Oral Health ; 5(3): 42-7, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24155601

RESUMO

BACKGROUND: There has been considerable interest in developing alternative methods of cavity preparation and caries removal due to disadvantages of using traditional rotating instruments which can result in heat, pressure ,dentin dessication, vibration and pain. Hence, the aim of this study was to compare different methods of caries removal in terms of efficacy, time taken and pain during caries removal. MATERIALS & METHODS: A total of 150 carious teeth were selected among 80 children of 6-10 years of age, following Radiovisiography (RVG) according to specific inclusion criteria and caries removal was done by hand instruments ,air rotor and carisolv respectively. The efficacy, time taken and pain threshold were evaluated during caries removal by Ericson D et al scale, Time scale (Raber H et al), visual analogue scale (Nayak R et al) and verbal pain scale (Cinzia Brunelli et al) respectively. Data was collected and statistically analysed. RESULTS: Mean value of time taken for removal of caries by carisolv group (580.26 sec) was found to be significantly higher as compared to conventional hand excavation and air rotor. Air rotor was found to be the most efficient method (mean value 1.20). Mean value of pain perception was significantly less with carisolv (0.82) as compared to air rotor and hand instrument. CONCLUSION: It was concluded that chemicomechanical removal of caries with Carisolv was found to be effective measure of caries removal and could be considered as viable alternatives to painful procedures like airotor in management of dental caries especially in children. How to cite this article: Goomer P, Jain R L, Kaur H, Sood R. Comparison of the Efficacy of Chemicomechanical Caries Removal with Conventional Methods - A Clinical Study. J Int Oral Health 2013; 5(3):42-47.

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