RESUMO
OBJECTIVE: This study presents a novel digital interproximal enamel reduction (IER) clinical procedure, aiming to improve the effectiveness of IER processes in orthodontic treatment. METHODS: A malocclusion case of skeletal-class I and angle-class I was selected for the experimental investigation. A three-dimensional (3D) model of the dentition was constructed using scanning data from a plaster model. The IER volume was measured by the overlay area of two neighboring crowns on the arranged virtual teeth. For the upper dentition, a guide plate was innovatively designed based on the original surface of the dentition and the calculated IER volume. The guide plate was fabricated using stereolithography 3D printing (SLA), and was successfully employed during the IER operation. For the lower dentition, the IER procedure was performed using the free-hand method, guided by the predesigned IER volume. Preoperative and postoperative 3D models of the dentition were compared to assess the accuracy of both IER methods. RESULTS: The standard deviation of upper dentition IER with guide plate was calculated as 0.13 mm, while that of lower dentition IER by freehand was 0.24 mm. CONCLUSION: Through the integration of laser scanning, 3D reconstruction, virtual arrangement, guide plate design, and 3D printing, this study not only explores a novel digital IER method, but also demonstrates its clinical applicability. The findings provide compelling evidence of the method's superior accuracy in clinical practice, offering a new approach for high-precision IER operations in orthodontic treatment.
Assuntos
Esmalte Dentário , Ortodontia , Impressão Tridimensional , Humanos , Ortodontia/métodos , Ortodontia/instrumentação , Má Oclusão/terapia , Má Oclusão/cirurgia , Imageamento TridimensionalRESUMO
BACKGROUND: Malocclusion, characterized by dental misalignment and improper occlusal relationships, significantly impacts oral health and daily functioning, with a global prevalence of 56%. Lateral cephalogram is a crucial diagnostic tool in orthodontic treatment, providing insights into various structural characteristics. METHODS: This study introduces a pre-training approach using multi-center lateral cephalograms for self-supervised learning, aimed at improving model generalization across diverse clinical data domains. Additionally, a multi-attribute classification network is proposed, leveraging attribute correlations to optimize parameters and enhance classification performance. RESULTS: Comprehensive evaluation on both public and clinical datasets showcases the superiority of the proposed framework, achieving an impressive average accuracy of 90.02%. The developed Self-supervised Pre-training and Multi-Attribute (SPMA) network achieves a best match ratio (MR) score of 71.38% and a low Hamming loss (HL) of 0.0425%, demonstrating its efficacy in orthodontic diagnosis from lateral cephalograms. CONCLUSIONS: This work contributes significantly to advancing automated diagnostic tools in orthodontics, addressing the critical need for accurate and efficient malocclusion diagnosis. The outcomes not only improve the efficiency and accuracy of diagnosis, but also have the potential to reduce healthcare costs associated with orthodontic treatments.
Assuntos
Cefalometria , Má Oclusão , Humanos , Má Oclusão/diagnóstico , Ortodontia , Aprendizado de Máquina Supervisionado , Automação , Diagnóstico por Computador/métodos , Processamento de Imagem Assistida por Computador/métodosRESUMO
BACKGROUND: Ethics is based on moral principles that should be the foundation for every healthcare decision, however, ethical concepts can often be challenging to define in specific clinical scenarios. There are several instances where a practising clinician often finds it difficult to make a proper decision despite maintaining integrity and professionalism. The objective of the present study was to explore the ethical dilemma faced by orthodontists practicing in Saudi Arabia concerning orthodontic treatment. METHOD: This was a questionnaire-based cross-sectional study that was adapted from the scenarios of ethical dilemmas presented by Jerrold in 1998. Ten orthodontists from each province of Saudi Arabia were requested to participate in this study and the questionnaire were sent through email and their responses were analysed. RESULTS: A total of 37 responses were obtained (out of 130) with a response rate of 28.46%. Among them 23 were female and 14 were male. Most participants belonged to the age group 30-39 years and most of them have clinical experience of more than 5 years. There was a wide variation in the responses among the participants in all the scenarios presented. The median likelihood of getting similar scenarios in their clinical practice in Saudi Arabia ranged from 3 to 3.5. CONCLUSION: There was a wide variation in the opinion among the practising orthodontists in Saudi Arabia in the scenarios presented. The presented scenarios are less likely to be perceived in the local context and some new situations of ethical dilemmas are identified.
Assuntos
Ortodontistas , Humanos , Arábia Saudita , Feminino , Masculino , Estudos Transversais , Projetos Piloto , Adulto , Inquéritos e Questionários , Ortodontistas/ética , Ortodontia/ética , Atitude do Pessoal de Saúde , Ética Odontológica , Tomada de Decisões/éticaRESUMO
BACKGROUND: Mastery of orthodontic bracket bonding is an essential component of the undergraduate orthodontic curriculum. Traditional bracket bonding training using simple plaster models has some shortcomings, including a disconnect from clinical practice and poor perception of the criteria and accuracy. This study aims to optimize the bracket bonding course by comparing the traditional teaching method with simplified American Board of Orthodontics Objective Grading System (ABO-OGS)-oriented training methods. METHODS: Fourth-year dental students from Fujian Medical University, spanning the 2015 to 2017 cohorts, participated in the orthodontic bracket bonding course. Students from these three cohorts were trained using the traditional plaster model method, the digital 2D ABO-OGS-oriented method, and the typodont ABO-OGS-oriented method, respectively. After the course, students and teachers completed a six-level Likert scale questionnaire to evaluate the teaching objectives, methods, and efficacy. RESULTS: Both teachers and students agreed that the traditional bracket bonding training and the simplified ABO-OGS-oriented bracket bonding training were effective, with most students mastering the bracket bonding procedure. The simplified ABO-OGS-oriented bracket bonding was perceived as more novel and engaging compared to the traditional method (P < 0.05). However, the digital 2D ABO-OGS method was significantly less effective than the other two methods (P < 0.05). Instructors rated the typodont ABO-OGS-oriented training higher than the students did (P < 0.05). CONCLUSION: Both the traditional and simplified ABO-OGS-oriented courses for bracket bonding yielded favorable results, with the simplified ABO-OGS approach being more engaging and innovative. The findings emphasize the critical role of hands-on practice in achieving optimal proficiency in bracket bonding techniques. A hybrid educational model that integrates digital 2D or 3D ABO-OGS-oriented training with offline practical sessions shows considerable potential for qualifying training and examination of orthodontic residency students.
Assuntos
Educação em Odontologia , Braquetes Ortodônticos , Estudantes de Odontologia , Humanos , Educação em Odontologia/métodos , Ortodontia/educação , Currículo , Colagem Dentária , Modelos Dentários , Feminino , Avaliação Educacional , MasculinoRESUMO
OBJECTIVES: To conduct a comprehensive bibliometric analysis of the literature on artificial intelligence (AI) applications in orthodontics to provide a detailed overview of the current research trends, influential works, and future directions. MATERIALS AND METHODS: A research strategy in The Web of Science Core Collection has been conducted to identify original articles regarding the use of AI in orthodontics. Articles were screened and selected by two independent reviewers and the following data were imported and processed for analysis: rankings, centrality metrics, publication trends, co-occurrence and clustering of keywords, journals, articles, authors, nations, and organizations. Data were analyzed using CiteSpace 6.3.R2 and VOSviewer. RESULTS: Almost 83% of the 381 chosen articles were released in the last three and a half years. Studies were published either in highly impacted orthodontic journals and also in journals related to informatics engineering, computer science, and medical imaging. Two-thirds of the available literature originated from China, the USA, and South Korea. AI-driven cephalometric landmarking and automatic segmentation were the main areas of research. CONCLUSIONS: This report offers a thorough overview of the AI current trend in orthodontics and it highlights prominent research areas focused on increasing the speed and efficiency of orthodontic care. Furthermore, it offers insight into potential directions for future research. CLINICAL RELEVANCE: Collaborative research efforts will be necessary to strengthen the maturity and robustness of AI models and to make AI-based clinical research sufficiently reliable for routine orthodontic clinical practice.
Assuntos
Inteligência Artificial , Bibliometria , Ortodontia , Humanos , CefalometriaRESUMO
OBJECTIVES: Information on the oral health of patients with anorexia nervosa remains not satisfactory. The aim of this systematic review is to evaluate oral health parameters in anorexic patients compared to healthy individuals. Furthermore, potential clinical implications for orthodontic treatment are discussed from an orthodontic perspective. MATERIALS AND METHODS: Electronic databases were searched for case-control and controlled clinical trial studies on dentofacial manifestations in anorexic patients up to 2/2024. Study selection, data extraction and risk of bias assessment was done independently by two authors. Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity analyses. RESULTS: Eleven out of 573 initially identified studies were included. They involved oral health analyses of general anorexic patients ≥ 12 years (mean age 18.4). The meta-analysis showed that anorexia nervosa was associated with a significantly increased caries experience (DMFT), plaque accumulation and gingival inflammation (BOP). PH and salivary flow rate were significantly altered in patients with anorexia nervosa, although no significant relationship between α-amylase levels and anorexia nervosa was demonstrated. CONCLUSIONS: These data enabled us to formulate modalities for anorexia-specific orthodontic treatments. Based on the results, patients with anorexia nervosa exhibit an increased risk of caries and gingival inflammatory signs. CLINICAL RELEVANCE: The systematic information on dentofacial manifestations obtained in this study should be considered to better manage the oral health of anorexia patients.
Assuntos
Anorexia Nervosa , Saúde Bucal , Humanos , Anorexia Nervosa/complicações , Ortodontia Corretiva , Cárie DentáriaRESUMO
INTRODUCTION: This randomized clinical trial compared arch dimensional changes, dentoskeletal changes, and the rate of overbite correction in deep bite adults treated with fixed appliances and either maxillary incisor bite turbos (IBT) or canine bite turbos (CBT). MATERIALS AND METHODS: Forty-six deep bite subjects treated with fixed appliances were randomized into IBT (n = 23) and CBT (n = 23) groups. Changes in intercanine width (ICW), arch height (AH), and Little's Irregularity Index (LII) were analyzed from before treatment (T0) to 3 months after aligning with 0.012" NiTi archwires in both arches (T1). Cephalometric changes between T0 and the visit when normal overbite was achieved (T2) were assessed. Within-group and between-group comparisons were analyzed at a significance level of 0.05. RESULTS: In both groups, mandibular ICW, and maxillary and mandibular AH significantly increased while maxillary and mandibular LII decreased. Maxillary and mandibular incisor proclination and molar extrusion were observed. The IBT group showed significantly greater changes in mandibular ICW, maxillary and mandibular AH, and mandibular incisor proclination than the CBT group. However, the overbite correction rate and the LII reduction were not significantly different between the groups. CONCLUSIONS: The IBT and CBT produced similar effects on arch dimensions and dentoskeletal changes. However, the IBT group demonstrated greater arch dimensional changes. CLINICAL RELEVANCE: Clinicians may consider IBT if flaring incisors is desired. Alternatively, CBT is better for cases with limited incisor proclination and where minimizing arch dimension change is needed, such as in narrow ridge situations. CLINICAL TRIAL REGISTRATION: The trial was registered at Thai Clinical Trial Registry on https://www.thaiclinicaltrials.org , under the identifier TCTR20230811013.
Assuntos
Cefalometria , Dente Canino , Arco Dental , Incisivo , Aparelhos Ortodônticos Fixos , Técnicas de Movimentação Dentária , Adulto , Feminino , Humanos , Masculino , Dente Canino/patologia , Arco Dental/patologia , Má Oclusão/terapia , Maxila , Desenho de Aparelho Ortodôntico , Sobremordida/terapia , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Resultado do TratamentoRESUMO
OBJECTIVES: To compare the long-term remineralization of initial caries lesion (ICL) treated with different remineralizing agents during orthodontic retention using optical coherence tomography (OCT). MATERIALS AND METHODS: This randomised clinical trial recruited 30 patients on fixed appliances with at least one ICL labially on any maxillary incisor. At debond (baseline), they were allocated to three groups, where twice daily fluoride toothpaste was given: (1) as control; (2) supplemented with daily casein phosphopeptide amorphous calcium phosphate with fluoride (CPP-ACPF); or (3) supplemented with three-monthly professional applied fluoride varnish (FV). Primary outcome was the OCT backscatter reflectance changes of the ICL, measured as integrated reflectivity (IR). Follow-ups were at three-month intervals up to 12 months. The trial was registered with Clinicaltrials.gov (NCT04788550). RESULTS: Analyses included 26 participants (nine control; nine CPP-ACPF; eight FV). There were significant reduction in integrated reflectivity over time. Post hoc comparisons showed reductions were significant up to 150-micron depth at 6-months, and up to 250-micron depth at both 9- and 12-months follow-up compared to baseline. At 12-months, FV had the lowest IR values, followed by CPP-ACPF and control, but the differences between groups were not significant. CONCLUSIONS: After 12-months observation, use of fluoridated toothpaste alone or supplemented with either fluoride varnish or CPP-ACPF promotes enamel remineralization up to 250-micron depth. CLINICAL RELEVANCE: Daily fluoridated toothpaste with regular 3-monthly recall visits from the start of orthodontic retention is recommended for effective control of initial caries lesions. FV and CPP-ACPF supplementation can be considered but their long-term benefits remain inconclusive.
Assuntos
Cariostáticos , Caseínas , Cárie Dentária , Tomografia de Coerência Óptica , Remineralização Dentária , Cremes Dentais , Humanos , Feminino , Cárie Dentária/prevenção & controle , Masculino , Caseínas/uso terapêutico , Remineralização Dentária/métodos , Cariostáticos/uso terapêutico , Cremes Dentais/uso terapêutico , Fluoretos Tópicos/uso terapêutico , Fluoretos/uso terapêutico , Adolescente , Resultado do Tratamento , Aparelhos Ortodônticos Fixos , IncisivoRESUMO
OBJECTIVE: To assess the upper central incisor's (U1) external apical root resorption (EARR) and incisive canal (IC) changes and their influencing factors under clear aligners and passive self-ligating fixed braces in first premolar extraction cases using CBCT. MATERIALS AND METHODS: This retrospective study included 60 participants (120 teeth) with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores. Participants were divided into clear aligner (CA) and passive self-ligating fixed appliance (FA) groups, with 30 participants per group. Pre- and post-treatment EARR, IC dimensional changes, U1-IC proximity, and orthodontic movements were analyzed through CBCT using Invivo 6.0.3 software. Descriptive and analytical statistics are performed, and a P-value < 0.05 is considered statistically significant. RESULTS: The CA group exhibited statistically significantly lower U1-EARR compared to FA group. However, there were no significant differences in overall IC dimensions (P < 0.05). In FA, contact or invasion of U1 with IC are associated with a significant increase in EARR, but not in CA. The invasion also reveals significant reductions in IC dimensions in FA, whereas CA exhibited more limited changes (P < 0.05). Retraction and intrusion were significantly positively correlated with U1-EARR in FA, whereas intrusion only was correlated positively with U1-EARR in CA (P < 0.05). In both FA and CA, there was no significant correlation between the torque and U1 EARR (P > 0.05). Retraction, intrusion, and torque movements had differential impacts on IC dimensions in FA and CA treatments. CONCLUSION: In this study, our findings indicate that in cases involving the extraction of first premolars, Invisalign® clear aligners may have less U1-EARR than passive self-ligating fixed braces but no significant differences in the overall IC dimensions between both appliances. Clear aligners may reveal better outcomes in U1 EARR/IC changes concerning U1-IC proximity and different orthodontic movements. These findings may be necessary for orthodontists to consider during treatment planning. CLINICAL RELEVANCE: Clear aligners may be an appropriate choice in first premolar extraction cases, especially when the U1 is closer to IC or when there is a need for more retraction, intrusion, and torque. Their potential to reduce root resorption while preserving IC dimensions may make them more advantageous over passive self-ligating fixed braces in these scenarios.
Assuntos
Dente Pré-Molar , Tomografia Computadorizada de Feixe Cônico , Incisivo , Reabsorção da Raiz , Extração Dentária , Técnicas de Movimentação Dentária , Humanos , Reabsorção da Raiz/diagnóstico por imagem , Estudos Retrospectivos , Feminino , Masculino , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Imageamento Tridimensional/métodos , Adolescente , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Braquetes Ortodônticos , MaxilaRESUMO
Sotos syndrome is a genetic disorder characterized by distinct craniofacial features, overgrowth in childhood, and impaired intellectual development. We herein report the successful orthodontic treatment of a 14-year-old boy with Sotos syndrome caused by a heterozygous mutation in the NSD1 gene. He showed severe hypodontia, impaction of the maxillary second molars and a skeletal Class III jaw-base relationship. Orthodontic management, including space control by protraction of the maxillary first molars and traction of the impacted molars, was performed using fixed appliances and miniscrews. As a result, acceptable occlusion was obtained without any discernible relapse 18 months postretention.
Assuntos
Anodontia , Dente Molar , Ortodontia Corretiva , Síndrome de Sotos , Dente Impactado , Humanos , Masculino , Adolescente , Síndrome de Sotos/complicações , Síndrome de Sotos/genética , Anodontia/genética , Anodontia/terapia , Dente Molar/crescimento & desenvolvimento , Dente Impactado/genética , Dente Impactado/terapia , Ortodontia Corretiva/métodos , MaxilaRESUMO
OBJECTIVE: This prospective controlled study aimed to assess whether changes in mandibular incisor inclination during orthodontic treatment with fixed appliances affect gingival thickness (GT) and the width of keratinized gingiva (WKG), and having as reference an untreated group of participants. MATERIALS AND METHODS: Forty consecutively recruited adult orthodontic patients and 40 untreated volunteers, matched for age and gender and selected from the same background population serving as controls, were included. Mandibular incisor inclination was measured in lateral cephalograms before treatment commencement (T0) and 1 month before fixed appliances' removal (T1). Gingival thickness was measured using an Ultrasound Device (US) and width of keratinized gingiva (WKG) using a standard periodontal probe within the frames of a full periodontal examination at T0, T1, and 1 year after bracket removal (T2), that is, at about 30 months from T1. RESULTS: Nineteen females and 21 males in each group [mean age in years (range): intervention group 23.1 (16.8-43.3); control: 21.85 (18.2-43.9)] were analysed. Overall, change in incisor proclination [mean change in Incisor Mandibular Angle Plane-IMPA (ΔIMPA) was 6.35° (SD 5.08°)] was not associated with any significant change in soft tissue thickness and with alterations in WKG. The group receiving fixed appliances did not exhibit thickening or thinning of GT in comparison to the control group; the WKG was reduced in the intervention group in comparison to the untreated group, where it essentially remained unchanged (#41: coeff.: -0.29, P value: .1, 95% CIs: -0.65, 0.06; #31: coeff.: -0.51, P value: .01, 95% CIs: -0.88, -0.14). CONCLUSIONS: Lower incisor proclination during orthodontic treatment does not appear to significantly alter GT and WKG, but orthodontic treatment, overall, leads to reduction of the WKG.
Assuntos
Cefalometria , Gengiva , Incisivo , Mandíbula , Humanos , Feminino , Masculino , Incisivo/diagnóstico por imagem , Estudos Prospectivos , Gengiva/diagnóstico por imagem , Adolescente , Adulto , Adulto Jovem , Mandíbula/diagnóstico por imagem , Cefalometria/métodos , Aparelhos Ortodônticos Fixos , Estudos de Casos e Controles , Braquetes Ortodônticos , Ultrassonografia/métodos , Ortodontia Corretiva/métodos , Ortodontia Corretiva/instrumentação , SeguimentosRESUMO
BACKGROUND: The study aimed to compare the short- and long-term effectiveness of hybrid Hyrax (HH) -Facemask (FM) and HH-mentoplate (MP) treatment protocols for maxillary protraction using Alt-RAMEC. METHODS: A single-center 2-arm parallel randomized controlled trial. Participants: 28 skeletal class III patients (female: 14, male: 14; average age: 9.7â ±â 1.3 years;) were included. Interventions: Two treatment groups where protraction therapy was combined with Alt-RAMEC. Group 1: Facemask group (Hybrid Hyraxâ +â Facemask) and Group 2: Mentoplate group (Hybrid Hyraxâ +â Mentoplate). Objective: To compare skeletal and dental changes between groups using low dose computed tomography (CT) scan from which virtual lateral cephalograms were generated. Outcome: Outcomes include changes in Wits appraisal (primary outcome), and cephalometric analysis of skeletal and dental changes (secondary outcomes) at 1 year and 5 years after treatment initiation. Randomization: 28 patients were allocated to either treatment-protocols using sequentially numbered opaque, sealed envelopes. The randomization sequence was generated with a 1:1 allocation ratio. Blinding: Due to the nature of the trial, the operator and children could not be blinded to the treatment allocation. However, blinding was used when assessing the outcomes. RESULTS: Follow-up: one patient was lost at the one-year follow-up and an additional three patients were lost at the 5-year follow-up. Outcomes: Both treatment protocols effectively improved intermaxillary relationship. Wits measurements showed improvements of 4.42 mm (FM) and 2.86 mm (MP) at T1, decreasing slightly to 3.33 mm (FM) and 1.50 mm (MP) at T2. While vertical control and incisor inclination were comparable between groups long-term, short-term differences were noted in upper and lower incisor inclination. Results remained equally stable after five years (T2). Harms: minor harms were encountered with the anchor hooks (fracture or mucosal irritation), however none led to treatment cessation. CONCLUSIONS: Early class III treatment with HHâ +â MP provided similar outcomes and stability to that of HHâ +â FM suggesting that the choice between FM and MP should be based on individual patient factors rather than presumed mechanical advantages. TRIAL REGISTRATION: Clinical Trials ID: NCT02711111.
Assuntos
Cefalometria , Aparelhos de Tração Extrabucal , Má Oclusão Classe III de Angle , Maxila , Técnica de Expansão Palatina , Humanos , Masculino , Feminino , Má Oclusão Classe III de Angle/terapia , Criança , Cefalometria/métodos , Técnica de Expansão Palatina/instrumentação , Desenho de Aparelho Ortodôntico , Resultado do Tratamento , Tomografia Computadorizada por Raios X/métodos , Seguimentos , IncisivoRESUMO
BACKGROUND: Extraction of premolars is usually prescribed for the orthodontic treatment of cases with inadequate space within the dental arch or when anterior teeth retraction is indicated; however, it has been advocated that this treatment approach could negatively influence the airways. OBJECTIVE: To identify and critically appraise studies of premolar extractions during orthodontic treatment on upper airway dimensions. Search methods: Electronic unrestricted searches in nine databases until October 2024. Selection criteria: Clinical studies on humans comparing comprehensive orthodontic treatment with versus without the extraction of premolars using cone-beam computed tomography to assess upper airway volume or minimum cross-sectional area (minCSA). Data collection and analysis: After duplicate study selection, data extraction, and risk-of-bias assessment according to Cochrane, random-effects meta-analyses of Mean Differences (MD) with their 95% confidence intervals (CI) were performed, followed by subgroup/meta-regression analyses and assessment of the quality of evidence. RESULTS: Twelve papers corresponding to 11 unique retrospective non-randomized studies were included, covering 891 patients (35.8% male; 20.0 years-old on average). No statistically significant differences in the effect of orthodontic treatment on the volume of the nasopharynx, palatopharynx, glossopharynx, oropharynx or oral cavity were seen between patients treated with versus without premolar extractions (Pâ >â .05). Similarly, no significant differences were seen between extraction and non-extraction patients in terms of minCSA of the nasopharynx, palatopharynx, or glossopharynx (Pâ >â .05). On the contrary, patients treated with premolar extractions showed increased minCSA of the oropharynx compared to those treated without premolar extractions (4 studies; MDâ =â 23.00 mm2; 95% CIâ =â 10.74-35.26 mm2; Pâ =â .009). No significant effects from patient age, sex, or equivalence of the extraction/non-extraction groups were found, while the strength of evidence was moderate in all cases due to the inclusion of non-randomized studies with high risk of bias. CONCLUSIONS: Limited evidence of moderate strength indicates that, on average, premolar extractions during comprehensive orthodontic treatment have little to no effect on the volume and minCSA of the airways. REGISTRATION: CRD42024621355.
Assuntos
Dente Pré-Molar , Extração Dentária , Humanos , Dente Pré-Molar/cirurgia , Dente Pré-Molar/diagnóstico por imagem , Extração Dentária/métodos , Ortodontia Corretiva/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Sistema Respiratório/diagnóstico por imagemRESUMO
OBJECTIVE: To review the literature to identify the present evidence on the extraction of second molars in orthodontics. MATERIALS & METHOD: A search of the MEDLINE/PubMed®, Scopus, Web of Science™, and ProQuest® databases for full-text articles was done on March 5, 2024. The search went back till the 1st of January 1991 and was limited to articles in English. The results of the first search went through a preliminary check to remove duplicates and then the titles and abstracts of the articles were read to exclude the irrelevant studies, case studies, or reviews. The abstracts of the selected studies were read carefully to verify if the inclusion criteria were met. Finally, the full texts of the potentially eligible studies were read to apply the eligibility criteria and decide whether to include them in the review or not. The eligibility criteria were set following the PICO (population, intervention, comparison, and outcome) standard. The included studies were thoroughly summarized by extracting the most important information. RESULTS: The electronic search located a total of 103 articles distributed among the databases. Removing duplicates left 48 Studies. After careful assessment of the titles and abstracts, 32 studies were excluded leaving 16 studies. Applying the inclusion/exclusion criteria resulted in the exclusion of 2 studies and including 14 studies in the scoping review. CONCLUSIONS: There is quite low level of evidence to support second molar extraction in orthodontics. Conducting a systematic review would not add much to the evidence as well-conducted RCTs are needed first.
Assuntos
Dente Molar , Extração Dentária , Humanos , Ortodontia Corretiva/métodosRESUMO
BACKGROUND: Anterior open bite is a challenging condition for pediatric dentists and orthodontists as it causes aesthetic, speech, feeding, and psychological problems; this emphasizes the need for early diagnosis and interception of this malocclusion. AIM: This study aimed to evaluate the effects of prefabricated metal-bonded tongue tamers and customized bonded spurs in the early treatment of anterior open bite. MATERIALS AND METHODS: A sample of seventy-five children aged 7-9 years were assigned into three groups in which anterior open bite was treated using tongue tamers (group-I), customized composite bonded spurs(group-II), and conventional fixed palatal cribs (group-III). Study model and cephalometric x-ray evaluations were done before and after a three-month follow-up. Data was gathered and statistically analyzed using ANOVA and Bonferroni tests. RESULTS: Model overbite at central and lateral incisors was increased in all groups. The highest increase was found in group-I(3.16 ± 1.17, 2.81 ± 0.94)and group-III(3.08 ± 1.10,2.99 ± 1.00) though the difference was not statistically significant. Also, cephalometric overbite was non-significantly increased in all groups with a high increase in group-III(3.13 ± 1.10). Overjet decreased in all groups, with the greatest reduction observed in group-I(-2.58 ± 1.02 and -2.47 ± 0.80 in model and cephalometric respectively) and was significantly different from group-II using pairwise analysis. There was a decrease in SNA and ANB in all groups with more significant improvement in groups-I(-1.20 ± 0.88,-1.65 ± 0.74) and -III(-1.31 ± 0.92, -1.62 ± 0.75) than group-II(-0.63 ± 0.46, -0.90 ± 0.43). Moreover, FMA measurements decreased significantly in group-I (-2.6 ± 1.11). Regarding SNB measurement, there was a non-significant increase in all three groups with the highest increase in group-I(0.49 ± 0.48) followed by group-III(0.34 ± 0.63). The U1/FHP and L1/GoGn angles were non-significantly decreased in all tested groups with the highest decrease in group-I(-1.76 ± 1.00 and-2.54 ± 0.87 respectively). CONCLUSION: Early treatment of anterior open bite, along with tongue tamers' simplicity and aesthetics promoted the malocclusion correction and occlusal function restoration. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05792553 , "Effects of Tongue Tamers as an Early Treatment of Anterior Open Bite", Retrospectively registered: 31/03/2023.
Assuntos
Cefalometria , Mordida Aberta , Humanos , Mordida Aberta/terapia , Criança , Feminino , Masculino , Desenho de Aparelho Ortodôntico , Incisivo , Sobremordida/terapia , Ortodontia Interceptora/instrumentação , Ortodontia Interceptora/métodos , Aparelhos Ortodônticos FixosRESUMO
BACKGROUND: Dental trauma is a frequent injury seen commonly in young children. There is a link between malocclusion and the incidence of traumatic dental injuries. Orthodontic therapy has been suggested as a preventative measure in correcting unfavourable malocclusions and potentially avoiding traumatic dental injuries. To date, it is poorly understood if the complications reported following traumatic dental injuries are amplified during and following orthodontic treatment. The aim of this study was to evaluate whether orthodontists considered the endodontic implications associated with the orthodontic treatment of teeth with a history of dental trauma. METHOD: A mixed methods vignette survey was designed, piloted, and distributed online to UK registered specialist orthodontists. The survey was split into three parts and consisted of three vignette clinical scenarios with open and closed questions. RESULTS: A total of 76 orthodontists responded from the United Kingdom. Of the participants, 46% (n = 35) of the orthodontists felt they had insufficient training in dental trauma and 42% (n = 32) lacked confidence in the treatment of traumatic injuries. The study participants reported non-standardised pre- treatment examination, limited dental trauma experience and insufficient training. In addition, 32% (n = 24) of clinicians felt that there is a lack of guidance in the orthodontic management of traumatised teeth and pulpal sequelae. CONCLUSION: Orthodontists are not following a standardised protocol in their examination of teeth with a history of trauma prior to orthodontic treatment. There is a need within the orthodontic specialty to create a standardised protocol to assess teeth with a history of dental trauma.
Assuntos
Traumatismos Dentários , Humanos , Traumatismos Dentários/complicações , Reino Unido , Ortodontistas , Inquéritos e Questionários , Feminino , Masculino , Atitude do Pessoal de Saúde , Adulto , Ortodontia Corretiva/efeitos adversosRESUMO
OBJECTIVES: The goal is to gather more information on orthodontic traction of impacted canines in the arch or their extraction. METHODS: We focused our search on English-language papers published between January 1, 2004, and July 24, 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. The search strategy employed the Boolean terms "impacted" AND "canine". In addition to the overview, this article discusses a number of clinical instances involving canine disinclusion. RESULTS: The study analyzed 2748 papers from databases like Web of Science, PubMed, and Scopus, resulting in 1455 articles after eliminating duplicates. After examining titles and abstracts, 897 entries were removed. The remaining 558 papers were confirmed, with 543 items removed due to being off-topic. The study includes a qualitative analysis of the 15 final articles. CONCLUSIONS: This article concludes that both extraction and orthodontic traction are effective treatments for impacted canines, with the choice depending on patient-specific factors. Advances in surgical techniques and imaging technologies have improved outcomes, while a multidisciplinary, patient-centered approach remains essential. Future research should focus on refining treatment selection criteria and integrating genetic and technological advancements.
Assuntos
Dente Canino , Dente Impactado , Dente Impactado/cirurgia , Humanos , Dente Canino/cirurgia , Extração Dentária , Resultado do Tratamento , Ortodontia Corretiva/métodos , Extrusão Ortodôntica/métodosRESUMO
BACKGROUND: The aim of our study was to develop and evaluate a deep learning model (BiStageNet) for automatic detection of dens evaginatus (DE) premolars on orthodontic intraoral photographs. Additionally, based on the training results, we developed a DE detection platform for orthodontic clinical applications. METHODS: We manually selected the premolar areas for automatic premolar recognition training using a dataset of 1,400 high-quality intraoral photographs. Next, we labeled each premolar for DE detection training using a dataset of 2,128 images. We introduced the Dice coefficient, accuracy, sensitivity, specificity, F1-score, ROC curve as well as areas under the ROC curve to evaluate the learning results of our model. Finally, we constructed an automatic DE detection platform based on our trained model (BiStageNet) using Pytorch. RESULTS: Our DE detection platform achieved a mean Dice coefficient of 0.961 in premolar recognition, with a diagnostic accuracy of 85.0%, sensitivity of 88.0%, specificity of 82.0%, F1 Score of 0.854, and AUC of 0.93. Experimental results revealed that dental interns, when manually identifying DE, showed low specificity. With the tool's assistance, specificity significantly improved for all interns, effectively reducing false positives without sacrificing sensitivity. This led to enhanced diagnostic precision, evidenced by improved PPV, NPV, and F1-Scores. CONCLUSION: Our BiStageNet was capable of recognizing premolars and detecting DE with high accuracy on intraoral photographs. On top of that, our self-developed DE detection platform was promising for clinical application and promotion.
Assuntos
Dente Pré-Molar , Fotografia Dentária , Humanos , Dente Pré-Molar/anatomia & histologia , Fotografia Dentária/métodos , Aprendizado Profundo , Sensibilidade e Especificidade , Fotografação , OrtodontiaRESUMO
This case report describes orthodontic treatment of an adult female with severe skeletal Class II malocclusion on a Class II skeletal base complicated by deficient chin, condylar resorption and anterior open bite (The IOFTN score = 4.4, ANB °=11.3, SN-MP °=58.2). Treatment carried out with 4 1st premolar extractions and using two mini-implants (diameter: 1.6 mm; length: 10 mm; Cibei Medical Instruments, Ningbo, China) that were inserted between the maxillary first molar and second premolar to intrude the bilateral maxillary first molars using elastic traction. Alveolar bone dehiscences were detected on the palatal or lingual side of the anterior teeth roots after orthodontic camouflage treatment. During the 3-year follow-up period, acceptable periodontal health and favourable alveolar bone modeling of maxillary and mandibular anterior teeth were detected. No further lesions developed in the condyle during the treatment period. This case confirmed that the capacity of palatal or lingual alveolar bone remodeling, which might be greater than previously believed, but the specific mechanism is still unclear.
Assuntos
Má Oclusão Classe II de Angle , Côndilo Mandibular , Humanos , Feminino , Má Oclusão Classe II de Angle/terapia , Má Oclusão Classe II de Angle/complicações , Côndilo Mandibular/patologia , Seguimentos , Cefalometria , Incisivo , Perda do Osso Alveolar/etiologia , Dente Pré-Molar , Técnicas de Movimentação Dentária/métodos , Mordida Aberta/terapia , Remodelação Óssea , Procedimentos de Ancoragem Ortodôntica/métodos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Extração Dentária , Processo Alveolar/patologia , Ortodontia Corretiva/métodos , Dente Molar , Tomografia Computadorizada de Feixe Cônico , AdultoRESUMO
OBJECTIVE: The objective of this study was to evaluate the cytotoxicity of fixed functional appliances that are commonly used in the treatment of Class II malocclusion caused by mandibular retrognathia, using the MTT cell viability assays [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] (Sigma Chemical Co., Milan, Italy). MATERIALS AND METHODS: The cytotoxicity of five different fixed functional appliances commonly used in orthodontic treatments was assessed. The appliances evaluated included Jasper Jumper (American Orthodontics, Wisconsin, USA), Power Scope (American Orthodontics, Wisconsin, USA), Herbst (American Orthodontics, Wisconsin, USA), Forsus™ Fatigue Resistant Device Kits (3 M, MN, USA), and Twin Force Bite Corrector (Henry Schein Orthodontics, California, USA). Assays were conducted using one appliance from each type, resulting in a total of seven groups. Cytotoxicity testing was performed using the MTT assay on a human gingival fibroblast (HGF) cell line. Data analysis was conducted using the Kruskal-Wallis test with a significance level of p = 0.05. RESULTS: All appliances demonstrated cell viability rates exceeding 90%, categorizing them as non-cytotoxic under ISO 10993-5 standards. Herbst exhibited the highest proliferation index (2.62 ± 1.13), while Power Scope (2.05 ± 1.06) and Jasper Jumper (1.90 ± 1.23) showed the lowest indices. Despite these variations, statistical analysis revealed no significant cytotoxic effects when compared to the control group (p > 0.05). All appliances were confirmed as biologically safe for cell health. CONCLUSION: The findings demonstrate that all evaluated appliances exhibit a biocompatible interaction with HGF cells, with no evidence of adverse cytotoxic effects. These results support the safe clinical use of these fixed functional appliances in orthodontic treatment.