Interdisciplinary Care for a Patient with Amelogenesis Imperfecta: A Clinical Report.

This manuscript describes an interdisciplinary approach over a period of 8 years combining surgical and prosthodontic treatment of a young patient diagnosed with hypocalcified-type amelogenesis imperfecta and anterior open bite. The treatment procedures included transitional restorations, orthodontic treatment, and maxillofacial surgery with a one-piece Le Fort I osteotomy, bilateral mandibular osteotomy, and genioplasty. The definitive prosthetic rehabilitation consisted of 28 zirconia-based ceramic single crowns restoring both esthetics and function. Photographs and radiographs associated with clinical evaluation were used in the maintenance period. Two-year follow-up revealed satisfactory results and no deterioration in the restorations.

Interdisciplinary rehabilitation using CAD-CAM technology for a young patient with severe malocclusion and amelogenesis imperfecta: A 5-year follow-up case report.

Treatment of acute cases of amelogenesis imperfecta is challenging in children due to the absence of a consensus statement on therapy recommendations. This article presents the effectiveness of an interdisciplinary approach, including orthodontics, orthognathic surgery, and prosthodontics using digital technology, in a child with amelogenesis imperfecta and skeletal deformities. The early management over a 6-year period had a very positive impact on the quality of life related to oral health. The full-mouth rehabilitation in adulthood with all-ceramic crowns showed a fully satisfactory result after 60 months of follow-up.

In vivo evaluation of immediately loaded stainless steel and titanium orthodontic screws in a growing bone.

The present work intends to evaluate the use of immediate loaded orthodontic screws in a growing model, and to study the specific bone response. Thirty-two screws (half of stainless steel and half of titanium) were inserted in the alveolar bone of 8 growing pigs. The devices were immediately loaded with a 100 g orthodontic force. Two loading periods were assessed: 4 and 12 weeks. Both systems of screws were clinically assessed. Histological observations and histomorphometric analysis evaluated the percent of "bone-to-implant contact" and static and dynamic bone parameters in the vicinity of the devices (test zone) and in a bone area located 1.5 cm posterior to the devices (control zone). Both systems exhibit similar responses for the survival rate; 87.5% and 81.3% for stainless steel and titanium respectively (p = 0.64; 4-week period), and 62.5% and 50.0% for stainless steel and titanium respectively (p = 0.09; 12-week period). No significant differences between the devices were found regarding the percent of "bone-to-implant contact" (p = 0.1) or the static and dynamic bone parameters. However, the 5% threshold of "bone-to-implant contact" was obtained after 4 weeks with the stainless steel devices, leading to increased survival rate values. Bone in the vicinity of the miniscrew implants showed evidence of a significant increase in bone trabecular thickness when compared to bone in the control zone (p = 0.05). In our study, it is likely that increased trabecular thickness is a way for low density bone to respond to the stress induced by loading.

[Friction: self-ligating brackets]. / Etude sur le frottement: les boîtiers auto-ligaturants.

The manufacturers of self-ligating brackets advertise a reduction of the friction engendered between the wire and the bracket, which is an essential parameter for treatment's speed and comfort. We have compared the friction obtained with four types of self-ligating brackets - In-Ovation R, Damon 3, Smart Clip and Quick - with that of a standard bracket Omniarch associated with an elastomeric ligature. All bracket were tested on a bench of traction with three types of wires: steel .019"x.025", TMA .019"x.025" and NEO sentalloy F300 .020"x.020". The results confirm a clear friction reduction for all tested wire.

[Not Available]. / Distraction symphysaire et orthodontie.

Facing a dental crowding, the orthodontist has several therapeutic options. If maxillary expansion is often used, mandibular orthodontic expansion is proscribed because of its tendency of inefficiency and relapse. Mandibular symphyseal distraction osteogenesis allows to remove this proscription. This therapeutic protocol consists in a pre-surgery orthodontic preparation phase followed by surgery (symphyseal osteotomy and placement of the distraction device), a latency period (five to seven days), then an activation period (most of the time 1 mm/day in two steps) followed by a consolidation period (three months) during which the orthodontic treatment can be resumed. Skeletal and alveolar expansion corrects dental crowding. This surgical technique is versatile, minimally invasive, and stable with time. Major indications are hypoplastic symphysis, anterior crowding, relapse of orthodontic treatments and some syndromes. This method can also be an answer to aesthetic concerns or an alternative for treatment of dental crowding. Face à un encombrement dentaire, l'orthodontiste dispose de plusieurs options thérapeutiques. Si au maxillaire, l'expansion est fréquemment utilisée, l'expansion mandibulaire orthodontique est proscrite, car inefficace et récidivante. La distraction symphysaire permet de lever cet interdit. Ce protocole thérapeutique comprend : une préparation orthodontique pré-chirurgicale, une chirurgie (ostéotomie symphysaire et pose du distracteur), une période de latence (cinq à sept jours), puis une période d'activation (le plus souvent 1 mm/j en deux fois) suivie d'une période de consolidation (trois mois) pendant laquelle le traitement orthodontique peut être repris. L'expansion basale et alvéolaire corrige l'encombrement dentaire. Cette technique est polyvalente, peu invasive et stable dans le temps. Ses indications majeures sont l'hyposymphysie, l'encombrement incisif, la récidive de traitements orthodontiques et certains grands syndromes. Cette méthode peut aussi être proposée pour répondre à des préoccupations esthétiques ou comme alternative aux traitements classiques de l'encombrement dentaire.

[Cephalometric deciding factors in the early treatment of Class III malocclusion]. / Facteurs décisionnels céphalométriques dans les traitements précoces des classes III squelettiques.

Many authors recommend early treatment for patients with Class III malocclusions in order to make their appearance more acceptable and also to re-channel the growth of basal bone into a normal pattern. However, the long-term effects and the stability of the results of this type of treatment have not been studied extensively. In the best interests of our patients, it would behoove us to know when early intervention is indicated and in what circumstances a strategy of watchful waiting and postponement of definitive treatment until the end of the growth period would be preferable. This retrospective study of a population of 30 patients from six to nine years old with skeletal and dental Class III malocclusions offers information on results obtained in early interceptive treatment, the potential for relapse, and the cephalometric criteria upon which a determination of the probable success or failure of treatment at this precocious stage can be made. A one-year treatment period began with rapid palatal expansion and was completed with alignment of the upper arch with a full-bonded appliance on the upper arch that was followed by orthopedic force delivered through an antero-posterior Delaire type facemask. In an evaluation eight years after the close of this early treatment, patients were separated into two groups, one of orthopedic success and the other of orthopedic failure. The inclination of the upper incisors proved to have descriptive value: the cases determined to be failures showed more inclination, a sign of early compensation. This meant that labio-version of upper incisors could be considered a predictive sign of relapse of an early treatment result. By means of a multiple regression analysis, we were able to discern three cephalometric components whose positive or negative readings would help to predict the probable prognosis for the success or failure of early treatment.

Galvanic corrosion between orthodontic wires and brackets in fluoride mouthwashes.

The aim of this investigation was to determine the influence of fluoride in certain mouthwashes on the risk of corrosion through galvanic coupling of orthodontic wires and brackets. Two titanium alloy wires, nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi), and the three most commonly used brackets, titanium (Ti), iron-chromium-nickel (FeCrNi) and cobalt-chromium (CoCr), were tested in a reference solution of Fusayama-Meyer artificial saliva and in two commercially available fluoride (250 ppm) mouthwashes, Elmex and Meridol. Corrosion resistance was assessed by inductively coupled plasma-atomic emission spectrometry (ICP-MS), analysis of released metal ions, and a scanning electron microscope (SEM) study of the metal surfaces after immersion of different wire-bracket pairs in the test solutions. The study was completed by an electrochemical analysis. Meridol mouthwash, which contains stannous fluoride, was the solution in which the NiTi wires coupled with the different brackets showed the highest corrosion risk, while in Elmex mouthwash, which contains sodium fluoride, the CuNiTi wires presented the highest corrosion risk. Such corrosion has two consequences: deterioration in mechanical performance of the wire-bracket system, which would negatively affect the final aesthetic result, and the risk of local allergic reactions caused by released Ni ions. The results suggest that mouthwashes should be prescribed according to the orthodontic materials used. A new type of mouthwash for use during orthodontic therapy could be an interesting development in this field.

Corrosion resistance of three orthodontic brackets: a comparative study of three fluoride mouthwashes.

In the present study, three types of orthodontic brackets were investigated: cobalt-chromium (CoCr), iron-chromium-nickel (FeCrNi) and titanium (Ti) based. Their corrosion resistance was compared with that of platinum (Pt), which was chosen as the reference material because of its excellent electrochemical properties. The test solutions were Elmex, Meridol and Acorea fluoride mouthwashes. Fusayama Meyer artificial saliva was used as the reference solution. The corrosion resistance of the different brackets in the three mouthwashes was assessed electrochemically to determine the corrosion potential and corrosion current density, and polarization resistance values were then calculated. A scanning electron microscopic (SEM) study and an analysis of released metal ions confirmed the electrochemical studies. The results showed that the bracket materials could be divided into two groups: Ti and FeCrNi in one, and CoCr, which has properties close to those of Pt, in the other. Similarly, two groups of electrolytes were identified: Elmex and Acorea mouthwashes in one group, and Meridol mouthwash in the second group. The results indicate that because of the risk of corrosion Meridol mouthwash should not be prescribed for patients wearing Ti or FeCrNi-based orthodontic brackets.