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1.
J Orofac Orthop ; 83(5): 307-317, 2022 Sep.
Article in English | MEDLINE | ID: mdl-33893516

ABSTRACT

PURPOSE: The aim of this randomized prospective clinical study was to determine whether there are differences between customized lingual brackets and conventional labial brackets regarding the alignment of the mandibular arch and a reduction of the irregularity index during an 18-week treatment interval. METHODS: A total of 20 patients who presented with class I malocclusion for scheduled orthodontic treatment without tooth extraction were included. The patients were randomly assigned by numbered, opaque, sealed envelopes to treatment with customized lingual brackets or conventional labial brackets. During the initial alignment (T0), 0.012″ (T1), 0.014″ (T2), and 0.016″ (T3) nickel-titanium archwires were applied, respectively, and the control visits were scheduled at 6­week intervals. In all sessions, digital models were obtained by an intraoral scanning device after removal of the archwire and were analyzed by software. Little's irregularity index, intercanine width, intermolar width and arch length were evaluated at three time points and were statistically analyzed with a repeated measures analysis of variance (ANOVA). Changes in these measurements at the three intervals (T1-T0, T2-T1, T3-T2) and overall treatment effects were also compared using the Student t­test. RESULTS: Comparing the two treatments regimes, intergroup mean values at T0, T1, T2, and T3 were not significantly different regarding the irregularity index, intercanine width, intermolar width and arch length. CONCLUSION: In this pilot study, no differences between the two treatment approaches could be detected for the phase of initial mandibular alignment.


Subject(s)
Malocclusion, Angle Class I , Orthodontic Brackets , Orthodontic Wires , Humans , Malocclusion, Angle Class I/surgery , Orthodontic Appliance Design , Pilot Projects , Prospective Studies
2.
Int Orthod ; 18(4): 839-849, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32839141

ABSTRACT

BACKGROUND: Transverse problems can be exacerbated by highly compensated occlusion in patients with skeletal asymmetry, which makes pre-surgical decompensation harder to achieve. OBJECTIVE: This case report describes a case of combined orthognathic surgery with facial asymmetry. We used pre-orthodontic surgical simulation to visualize the goal for presurgical orthodontics, planning for a one-jaw surgical treatment option. METHODS: The planned asymmetric expansion was performed using a maxillary skeletal expander (MSE II) with surgical corticopuncture over only the left side before MSE activation. Surgery was performed to achieve mandibular left outward yaw rotation to correct the patient's facial asymmetry after the planned amount of expansion was reached. RESULTS: The results showed substantial improvement of facial aesthetics as well as skeletal symmetry. Cooperation and communication between surgeon and orthodontist ensured that the final results were satisfactory.


Subject(s)
Facial Asymmetry/surgery , Orthognathic Surgery/methods , Orthognathic Surgical Procedures/methods , Palatal Expansion Technique , Dental Occlusion , Facial Asymmetry/diagnostic imaging , Female , Humans , Malocclusion, Angle Class I/diagnostic imaging , Malocclusion, Angle Class I/surgery , Mandible/diagnostic imaging , Mandible/surgery , Maxilla/diagnostic imaging , Maxilla/surgery , Orthodontics, Corrective , Osteotomy/methods , Patient Care Planning , Treatment Outcome , Young Adult
3.
J Craniofac Surg ; 31(3): 716-719, 2020.
Article in English | MEDLINE | ID: mdl-32049900

ABSTRACT

BACKGROUND: Maxillomandibular advancement is an effective surgical option for obstructive sleep apnea (OSA) that achieves enlargement of the upper airway by physically expanding the facial skeleton. The authors sought to determine whether an advancement of 10 mm predicts surgical success and if any correlation existed between the magnitude of mandibular/maxillary advancement and improvement in polysomnography metrics using aggregated individual patient data from multiple studies. METHODS: A search of the PubMed database was performed to identify relevant articles that included preoperative and postoperative polysomnography data and measurements of the advancement of both the maxillary and mandibular portions of the face in patients with normal or class I malocclusion. Each patient was stratified into "Success" or "Failure" groups based on criteria defining a "Success" as a 50% preoperative to post-operative decrease in AHI or RDI and a post-operative AHI or RDI <20. RESULTS: A review of the PubMed database yielded 162 articles. Review of these resulted in 9 manuscripts and a total of 109 patients who met the inclusion criteria. There was no statistically significant difference in the amount of anterior advancement of either the mandible (P = 0.96) or the maxilla (P = 0.23) between the "Success" or "Failure" groups. CONCLUSIONS: While there is a paucity of individual data available, the current data does not support an ideal amount of maxillary or mandibular advancement that is required to obtain a surgical success in the treatment of OSA. Until a multicenter, prospective, randomized trial is performed, surgical planning should be tailored to patient-specific anatomy to achieve the desired result.


Subject(s)
Malocclusion, Angle Class I/surgery , Sleep Apnea, Obstructive/etiology , Humans , Malocclusion, Angle Class I/complications , Mandible/physiopathology , Mandibular Advancement , Maxilla/surgery , Polysomnography , Treatment Outcome
5.
Am J Orthod Dentofacial Orthop ; 156(1): 113-124, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31256824

ABSTRACT

Scissor bite often remains unnoticed by patients although it can adversely affect facial symmetry, jaw growth, and mastication. This case report illustrates the efficacy of temporary skeletal anchorage devices (TSADs) and a modified lingual arch in correcting severe scissor bite. A 28-year-old woman presented with severe scissor bite in the mandibular right posterior segment. To treat this condition, TSADs were used for maxillary posterior intrusion and a modified lingual arch for buccally uprighting mandibular posterior teeth. Long-term retention records demonstrate stable treatment results.


Subject(s)
Dental Occlusion , Malocclusion, Angle Class II/therapy , Malocclusion, Angle Class I/therapy , Orthodontics, Corrective/methods , Adult , Cephalometry/methods , Female , Humans , Malocclusion, Angle Class I/diagnostic imaging , Malocclusion, Angle Class I/surgery , Malocclusion, Angle Class II/diagnostic imaging , Malocclusion, Angle Class II/surgery , Mandible/diagnostic imaging , Mandible/pathology , Mandible/surgery , Maxilla/diagnostic imaging , Maxilla/pathology , Maxilla/surgery , Models, Dental , Orthodontic Anchorage Procedures/instrumentation , Orthodontic Anchorage Procedures/methods , Orthodontic Appliance Design , Orthodontic Appliances , Orthodontic Wires , Orthodontics, Corrective/instrumentation , Palatal Expansion Technique , Patient Care Planning , Time Factors , Treatment Outcome
6.
Am J Orthod Dentofacial Orthop ; 155(4): 584-591, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30935613

ABSTRACT

Surgical interventions on the alveolar ridges aimed at facilitating orthodontic tooth movement have been extensively reported. However, unexpected events or complications still occur in daily practice. The purpose of this report was to present a novel 3-dimensional (3D) computer-assisted piezocision guide (CAPG) designed to be translucent for increased visibility, rigid for enhanced support during guidance, and porous for profuse irrigation during procedure. Such a design can function to minimize the risk of surgical complications. In this case, we present a novel 3D-printed CAPG to facilitate a minimally invasive periodontal accelerated osteogenic orthodontics (PAOO) procedure with a guide that provides accuracy, adequate visibility, and greater access for the coolant to reach the surgery site. By navigating the cone-beam computed tomography data, we precisely know the cortical bone thickness, root direction, and interrelations between anatomic structures in an individual situation, which allows us to design our cutting slot for the required length and depth according to the operator's knowledge. Finally, 3D printing was applied, transferring our surgical plan to fabricate the CAPG. Moreover, the well designed pores on the CAPG allow effective irrigation during the piezocision procedure. This minimally invasive procedure was uneventful, and no devitalized tooth or alveolar bone was found.


Subject(s)
Orthognathic Surgical Procedures/methods , Piezosurgery/methods , Printing, Three-Dimensional , Alveolar Process/surgery , Female , Humans , Malocclusion, Angle Class I/surgery , Middle Aged , Orthodontics, Corrective/methods
7.
Dental Press J Orthod ; 23(5): 82-92, 2018.
Article in English | MEDLINE | ID: mdl-30427497

ABSTRACT

The esthetic benefits are among the main goals of orthodontic treatment; therefore, tooth extractions have been avoided as a protocol for orthodontic treatment because they may impair the facial profile. The present article discusses aspects as the magnitude and response of soft tissue profile due to changes in incisor positioning, and the effect of different sequences of premolar extraction. One case report illustrates the subject, with favorable and stable esthetic and occlusal outcomes five years after orthodontic treatment with extraction of second premolars.


Subject(s)
Bicuspid/surgery , Face/anatomy & histology , Tooth Extraction/adverse effects , Adult , Bicuspid/diagnostic imaging , Cephalometry , Esthetics, Dental , Female , Humans , Malocclusion, Angle Class I/surgery , Photography, Dental , Radiography, Panoramic
8.
Prog Orthod ; 19(1): 44, 2018 Oct 29.
Article in English | MEDLINE | ID: mdl-30370430

ABSTRACT

BACKGROUND: Discision method may provide an alternative to the piezocision approach in accelerated orthodontic treatment. The purpose of this study was to investigate the efficacy of discision on accelerated orthodontic tooth movement in comparison to the piezocision method in moderate crowding Angle Class I malocclusions. METHODS: Thirty-five female individuals were included in this clinical study. The participants were classified into three groups as conventional fixed non-extraction orthodontic treatment only (OT, n = 14), piezocision in addition to fixed non-extraction orthodontic treatment (PG, n = 9), and discision in addition to fixed non-extraction orthodontic treatment (DG, n = 12). The piezocisions and discisions were performed 1 week after placement of bonding brackets. The patients were seen at 2-3 week-intervals. Initial Little's irregularity index scores were recorded from dental casts. Periodontal parameters were measured initially, after the 1-month orthodontic treatment. Probing pocket depth, bleeding on probing, plaque index, and gingival index were recorded. Visual analog scale (VAS) was performed over the first month at different times following the bracket bonding for pain assessment. The total orthodontic treatment duration was noted. RESULTS: The duration of orthodontic treatment was statistically decreased in PG and DG compared to OT (P = 0.003). There was no statistical difference between PG and DG in orthodontic treatment duration (P > 0.05). There was no statistical difference between the two experimental groups in terms of VAS and periodontal parameter values (P > 0.05). CONCLUSIONS: This is the first clinical orthodontic study to assess the effect of discision on the rate of orthodontic tooth movement. Discision is comparable to piezocision in terms of tooth movement acceleration, pain level, and periodontal status. The discision seems to be effective in reducing the time of orthodontic treatment.


Subject(s)
Gingiva/surgery , Malocclusion, Angle Class I/surgery , Piezosurgery , Tooth Movement Techniques/methods , Adolescent , Dental Plaque Index , Female , Humans , Periodontal Index , Time Factors , Tooth Movement Techniques/instrumentation , Young Adult
9.
Dental press j. orthod. (Impr.) ; 23(5): 82-92, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975014

ABSTRACT

Abstract The esthetic benefits are among the main goals of orthodontic treatment; therefore, tooth extractions have been avoided as a protocol for orthodontic treatment because they may impair the facial profile. The present article discusses aspects as the magnitude and response of soft tissue profile due to changes in incisor positioning, and the effect of different sequences of premolar extraction. One case report illustrates the subject, with favorable and stable esthetic and occlusal outcomes five years after orthodontic treatment with extraction of second premolars.


Resumo Os benefícios estéticos estão entre os principais objetivos do tratamento ortodôntico. Por isso, as extrações dentárias têm sido evitadas como protocolo de tratamento ortodôntico, pois podem prejudicar o perfil facial. No presente artigo, serão discutidos aspectos como a magnitude da resposta do perfil de tecidos moles em decorrência das mudanças na posição dos incisivos e os efeitos de diferentes sequências de extrações de pré-molares. Um caso clínico ilustrará o tema, com resultados estéticos e oclusais favoráveis e estáveis cinco anos após o tratamento ortodôntico com extrações de segundos pré-molares.


Subject(s)
Humans , Female , Adult , Tooth Extraction/adverse effects , Bicuspid/surgery , Face/anatomy & histology , Bicuspid/diagnostic imaging , Radiography, Panoramic , Cephalometry , Photography, Dental , Esthetics, Dental , Malocclusion, Angle Class I/surgery
10.
Angle Orthod ; 88(1): 107-121, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29087728

ABSTRACT

Treatment of multiple impacted teeth is challenging. Three-dimensional treatment planning can help in delivering a better outcome. This case report presents a patient with an incomplete dental transposition between the canine and lateral incisor of the maxillary right side associated with the impaction of a dilacerated right central incisor. Using a two-stage surgical exposure and augmented corticotomy, the patient's occlusion and smile esthetics were significantly improved, and Class I occlusal relationships with optimal overjet and overbite were achieved after 50 months of orthodontic treatment. Thirty-month posttreatment records revealed a stable result.


Subject(s)
Malocclusion, Angle Class I/therapy , Orthodontic Anchorage Procedures/instrumentation , Tooth Movement Techniques/instrumentation , Tooth, Impacted/therapy , Cephalometry , Child , Cone-Beam Computed Tomography , Facial Asymmetry , Humans , Male , Malocclusion, Angle Class I/diagnostic imaging , Malocclusion, Angle Class I/surgery , Maxilla/diagnostic imaging , Orthodontic Appliance Design , Radiography, Panoramic , Tooth, Impacted/diagnostic imaging , Tooth, Impacted/surgery
11.
J Craniofac Surg ; 28(8): e757-e760, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28922248

ABSTRACT

BACKGROUNDS: This article presents maxillary corticotomies with bone-to-bone retraction and anterior segmental osteotomy (ASO) as an alternative to 2-jaw orthognathics in the bimaxilary protrusion patient with partially anchylosed maxillary anterior tooth. METHODS: The 18-year-old male, complaining of anterior protrusion, with a trauma history to the maxillary central incisor, and requesting rapid treatment, was treated with maxillary corticotomies in 2 stages and ASO in the mandible. The mandibular ASO and palatal corticotomy were done under local anesthesia and 2 weeks later, labial corticotomy followed. The anterior segment was retracted bodily using buccal C-tubes and a combination of the C-lingual retractor and palatal C-plate. RESULTS: Due to a concern about ankylosis of the maxillary right central incisor, retraction of the anterior bone/tooth segment was chosen over any attempt to move teeth through the bone. After bone-to-bone retraction, the remaining extraction space was closed by protraction of posteriors. The total treatment period was 18 months. There was good retraction of the anterior segment and retrusion of the lips. CONCLUSIONS: A combination of maxillary corticotomies with skeletal anchorage for bone-to-bone retraction and a mandibular ASO under local anesthesia might be an alternative treatment option for excellent profile change in a short treatment period.


Subject(s)
Malocclusion, Angle Class I/surgery , Maxilla/surgery , Overbite/surgery , Tooth Movement Techniques , Adolescent , Humans , Incisor/injuries , Male , Mandibular Osteotomy , Palate/surgery
12.
Am J Orthod Dentofacial Orthop ; 152(3): 320-326, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28863912

ABSTRACT

INTRODUCTION: In this study, we aimed to compare the amount and frequency of extraction space reopening after 2- and 4-premolar extraction treatments in Class II and 4-premolar extractions in Class I malocclusion patients. METHODS: The sample comprised 105 subjects with full-cusp Class II and Class I malocclusions, divided into 3 groups. Group 1 consisted of 33 full-cusp Class II malocclusion patients treated with a 2-premolar extraction protocol. Group 2 had 34 full-cusp Class II malocclusion patients treated with 4-premolar extractions, and group 3 included 38 Class I malocclusion patients treated with 4-premolar extractions. The Peer Assessment Rating index was used to assess initial malocclusion severity and quality of the occlusal outcome, measured on dental casts. The amounts of extraction spaces were measured with a digital caliper on the final and long-term posttreatment dental casts, after an average of 9.79 years posttreatment. Intergroup comparisons were performed by analysis of variance, followed by Tukey tests and chi-square tests. RESULTS: There were no significant differences regarding the amount and frequency of extraction space reopening among the groups. CONCLUSIONS: Two- and 4-premolar extractions in Class II and 4-premolar extraction treatment in Class I malocclusion patients show similar reopening of extraction spaces in the long term.


Subject(s)
Malocclusion, Angle Class II/surgery , Malocclusion, Angle Class I/surgery , Tooth Extraction , Adolescent , Bicuspid/surgery , Female , Humans , Male , Prevalence , Tooth Extraction/adverse effects , Tooth Extraction/methods , Treatment Outcome
13.
Stomatologiia (Mosk) ; 96(3): 45-48, 2017.
Article in Russian | MEDLINE | ID: mdl-28617407

ABSTRACT

The aim of the study was to evaluate the efficiency of cephalometry in orthodontic treatment planning in patients with teeth crowding and Angle Class I molars relation. Cephalometric parameters were analyzed in 70 patients that completed orthodontic treatment in 'Orthodont' dental clinic (Samara). Cephalometric X-rays were taken at baseline examination and after treatment. In patients with crowding and Class I molars relationship treated with extraction of all four first premolars correlation between N-Se and mandibular and maxillary length was disturbed. These patients showed higher N-Se and reduced jaws length than patients with no extraction or extraction of 2 premolars. The observed increase of G angle with reduced mandibular length assumes compensatory changes of mandible position. These disproportions were aggravated by facial growth. In certain cases cephalometric assessment is inefficient for treatment strategy choice.


Subject(s)
Cephalometry , Malocclusion, Angle Class I/surgery , Orthodontics, Corrective/methods , Age Factors , Humans , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imaging , Planning Techniques , Tooth Extraction
14.
J Oral Implantol ; 43(3): 211-217, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28650795

ABSTRACT

The aim of this study was to quantify the cortical and cancellous bone in the mandibular symphysis and relate it to the teeth and to the skeletal class. A descriptive study was conducted using cone beam computerized tomography (CBCT). Class I and class III subjects were included, defined according to dental occlusion and cephalogram results. Linear measurements were taken on the CBCT of the mandibular canines, lateral incisors, and central incisors, where the analysis was related to the axial and apical axes considering the bone in relation to the dental area. With previous definitions, an observer took 2 measurements of the height of the mandibular symphysis, cortical bone of the buccal and lower region, and thickness of cancellous bone at different levels; the correlation coefficient between the first and second measurement was 0.99 and presented P = .001. The results were analyzed with analysis of variance and Tukey's honest significant difference test, with P < .05 being statistically significant. The symphysis height was significantly greater in class III subjects. The cortical bone was an average 1.67 ± 0.44 mm in vertical distance in the skeletal class I group and 1.74 ± 0.47 mm in the class III group. The cancellous bone had an average width of 5.03 ± 1.94 mm in the skeletal class I group and 4.74 ± 2.05 mm in the class III group. It was observed that cancellous bone was significantly thicker at the incisor level than at the canine level. There were anatomical differences between skeletal class I and class III subjects, although the clinical significance may be questionable. With the values from these analyses, it may be concluded that there are no significant differences in quantitation of the cortical and cancellous bone in the anterior mandibular symphysis.


Subject(s)
Malocclusion, Angle Class III/surgery , Malocclusion, Angle Class I/surgery , Mandible/anatomy & histology , Mandible/transplantation , Cancellous Bone/anatomy & histology , Cancellous Bone/diagnostic imaging , Cancellous Bone/transplantation , Cone-Beam Computed Tomography , Cortical Bone/anatomy & histology , Cortical Bone/diagnostic imaging , Cortical Bone/transplantation , Humans , Mandible/diagnostic imaging
15.
Eur J Orthod ; 39(6): 586-594, 2017 Nov 30.
Article in English | MEDLINE | ID: mdl-28402521

ABSTRACT

BACKGROUND: Piezoelectric surgery is a newly introduced technique for rapid tooth movement. However, the efficiency of this technique has not been investigated on en-masse retraction cases yet. OBJECTIVE: To investigate the efficiency of piezosurgery technique in accelerating miniscrew supported en-masse retraction and study the biological tissue response. In addition, to show if this technique induces a difference in dental, skeletal and soft tissue changes on lateral cephalograms, and in canine and molar rotations, besides intercanine and intermolar widths on dental casts. DESIGN, SETTING, PARTICIPANTS: We conducted a randomized, single-centred, parallel-group, controlled trial, requiring upper right and left first premolar extractions on 30 patients above the minimum age of 14 years at the beginning of retraction. INTERVENTIONS: Piezosurgery-assisted versus conventional en-masse retraction anchored from miniscrews placed between second premolars and first molars, bilaterally. OUTCOMES: The main outcome was the en-masse retraction rate. Secondary outcomes were gingival crevicular fluid (GCF) volume and GCF content of receptor activator of nuclear factor κß ligand (RANKL), changes regarding cephalometric and dental cast variables, and miniscrew success rates. RANDOMIZATION: Accomplished with opaque, sealed envelopes. BLINDING: Applicable for data assessment only. RECRUITMENT: Commenced in February 2013 and ended in October 2014. RESULTS: Thirty-one patients were included in the study and divided into 2 groups of piezosurgery (n = 16) and control (n = 15). After 9.3 months of follow-up, no statistically significant difference was observed between groups for neither retraction rates (P = 0.958) nor GCF parameters (P > 0.05). Changes in lateral cephalometric and dental cast variables, and miniscrew success rates did not show significant differences either. CONCLUSION: Based on the results of this study, piezosurgery technique was found to be ineffective in accelerating en-masse retraction, and promoting a difference in the studied GCF parameters, skeletal and dental variables. REGISTRATION: The trial was not registered. PROTOCOL: The full protocol of this PhD thesis study can be accessed from tez.yok.gov.tr. FUNDING: This work was supported by Baskent University Research Fund. No conflict of interest was declared.


Subject(s)
Bone Screws , Orthodontic Anchorage Procedures/instrumentation , Piezosurgery/methods , Tooth Movement Techniques/methods , Adolescent , Adult , Bicuspid/surgery , Cephalometry , Female , Humans , Male , Malocclusion, Angle Class I/surgery , Malocclusion, Angle Class II/surgery , Molar/surgery , Orthodontic Anchorage Procedures/methods , Treatment Outcome , Young Adult
16.
Int Orthod ; 15(2): 278-296, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28431998

ABSTRACT

Date of birth: 12/10/1987; sex: female. A. PRETREATMENT RECORDS: 24 years 8 months; 16/06/2011. DIAGNOSIS: Skeletal and dental Class I, maxillary endognathia, anterior vertical excess with open bite; teeth missing prior to treatment: 18, 28, 38, 48. TREATMENT PLAN: Appliances and devices: single-stage surgical-orthodontic treatment using pretorqued and preangled bimaxillary multibracket appliances with 0.022×0.028″ archwire, along with an expander during the surgical phase and then a transpalatal arch to stabilize the transverse correction. START OF TREATMENT: 24 years 8 months; 16/06/2011. B. POSTTREATMENT RECORDS: 26/10/2012; 26 years. RETENTION: Maxillary: bonded wire from 13 to 23 and slip-cover retainer; 29/01/2013; mandibular: bonded wire from 33 to 43; 29/01/2013. C. POST-RETENTION RECORDS (1 YEAR MINIMUM): 14/12/2013; 27 years; date of end of retention: 14/12/2013: maxillary: bonded wire from 13 to 23; mandibular: bonded wire from 33 to 43; duration of retention: 12 months.


Subject(s)
Malocclusion, Angle Class I/therapy , Open Bite/therapy , Cephalometry , Esthetics, Dental , Female , Humans , Malocclusion, Angle Class I/diagnostic imaging , Malocclusion, Angle Class I/surgery , Maxillary Osteotomy , Open Bite/diagnostic imaging , Open Bite/surgery , Orthodontic Brackets , Orthodontic Retainers , Orthodontics, Corrective , Palatal Expansion Technique , Patient Care Planning , Radiography, Panoramic , Young Adult
17.
Am J Orthod Dentofacial Orthop ; 151(4): 685-690, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28364891

ABSTRACT

INTRODUCTION: Different treatment protocols implemented for correction of Class I malocclusion aim at achieving ideal occlusal characteristics. This study was planned to evaluate the improvement in the occlusal characteristics of Class I patients treated with nonextraction (NE), all first premolar extractions (PME), and mandibular incisor extraction (MIE) as assessed by the percentage of improvement in Peer Assessment Rating (PAR) scores. METHODS: This retrospective cross-sectional study was conducted on the pretreatment and posttreatment dental casts of 108 subjects with Class I malocclusion. The total sample was divided into 3 equal groups according to the treatment protocol implemented: NE, PME, and MIE. The mean pretreatment and posttreatment PAR scores, and the percentages of improvement were compared among the 3 treatment modalities using Kruskal-Wallis and post-hoc Dunnett T3 tests. RESULTS: The mean percentages of improvement in the PAR score were 75.8% ± 25.8% in the NE group, 73.1% ± 19.4% in the PME group, and 70.6% ± 24.1% in the MIE group. There was no significant difference (P = 0.351) in the percentages of improvement in PAR scores among the 3 treatment modalities. However, the mean pretreatment and posttreatment PAR scores varied significantly (P <0.001) in the 3 groups. The average pretreatment and posttreatment PAR scores were highest in the MIE group and lowest in the NE group. CONCLUSIONS: The comparable percentages of improvement in PAR scores among the 3 groups denote that equivalent occlusal corrections were achieved in Class I patients treated with the NE, PME, and MIE protocols.


Subject(s)
Bicuspid/surgery , Incisor/surgery , Malocclusion, Angle Class I/surgery , Peer Review , Tooth Extraction , Adolescent , Adult , Cross-Sectional Studies , Humans , Malocclusion, Angle Class I/diagnosis , Malocclusion, Angle Class I/therapy , Mandible , Peer Review/methods , Peer Review/standards , Retrospective Studies , Treatment Outcome , Young Adult
18.
Am J Orthod Dentofacial Orthop ; 151(4): 735-743, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28364897

ABSTRACT

INTRODUCTION: The aims of this study were to identify a sample of borderline Class I extraction and nonextraction patients and to investigate posttreatment changes in arch-width and perimeter measurements. METHODS: A parent sample of 580 Class I patients was subjected to discriminant analysis, and a borderline subsample of 62 patients, 31 treated with extraction of 4 first premolars and 31 treated without extractions, was obtained. The patients' plaster casts were digitally scanned, and the maxillary and mandibular intercanine and intermolar widths and perimeters were assessed. RESULTS: The extraction group showed increases in maxillary and mandibular intercanine widths (P <0.001) and decreases in mandibular intermolar width and in maxillary and mandibular perimeters (P <0.001). The nonextraction group showed increases in all 4 arch-width measurements (P ≤0.003), whereas the maxillary and mandibular perimeters were maintained. The posttreatment differences between the 2 groups showed significant differences in the maxillary (P <0.001) and mandibular intermolar widths (P <0.001). Also, the comparison of the arch perimeters between the 2 treatment groups showed adjusted differences of -8.51 mm (P <0.001) and -8.44 mm (P <0.001) for the maxillary and mandibular arches, respectively. The intercanine widths showed no changes between the 2 treatment groups. CONCLUSIONS: Borderline Class I patients treated with extraction of 4 first premolars had decreased maxillary and mandibular intermolar and perimeter measurements compared with nonextraction patients. The maxillary and mandibular intercanine widths showed no significant difference between the 2 treatment groups.


Subject(s)
Malocclusion, Angle Class I/therapy , Tooth Extraction , Adolescent , Casts, Surgical , Female , Humans , Male , Malocclusion, Angle Class I/surgery , Orthodontics, Corrective/methods , Tooth Extraction/methods , Treatment Outcome
19.
Article in English | MEDLINE | ID: mdl-27720661

ABSTRACT

OBJECTIVE: This study was aimed at investigating the correlation between intraoperative blood loss and operation-related factors in the treatment of bimaxillary protrusion with four different procedures. STUDY DESIGN: Ninety-four patients were separated into the following four surgical groups: group 1: anterior subapical osteotomy of the maxilla (ASO Mx) + bilateral parasymphyseal osteotomy of the mandible (BPsO Md) + genioplasty (GeP); group 2: ASO Mx + BPsO Md; group 3: ASO Mx + ASO Md + GeP; and group 4: ASO Mx + ASO Md. Patient- and operation-related factors (age, intraoperative blood loss, operation time, and preoperative and postoperative blood parameters) were compared among the four groups. RESULTS: The mean operation time and intraoperative blood loss were 438.7 minutes and 369.9 mL in group 1; 432.5 minutes and 356.5 mL in group 2; 393.3 minutes and 387.3 mL in group 3; and 353.5 minutes and 289.5 mL in group 4. Intergroup differences in intraoperative blood loss were not significant. A significant correlation between intraoperative blood loss and operation time was found in group 4 but not in the other groups. CONCLUSIONS: No significant differences in blood loss were found among the four different surgical procedures in the treatment of bimaxillary protrusion.


Subject(s)
Blood Loss, Surgical , Genioplasty , Malocclusion, Angle Class I/surgery , Mandibular Osteotomy , Maxillary Osteotomy , Adult , Blood Transfusion/statistics & numerical data , Female , Humans , Male , Treatment Outcome
20.
Bauru; s.n; 2017. 77 p. tab, ilus, graf.
Thesis in Portuguese | BBO - Dentistry | ID: biblio-880410

ABSTRACT

Os softwares de avaliação em três dimensões revolucionaram os planejamentos da cirurgia ortognática. Com eles é possível realizar desde simulações dos movimentos cirúrgicos, até avaliação das vias aéreas superiores (VAS) em volume e área, o que não era possível nas radiografias bidimensionais. Muitos pacientes recorrem à cirurgia ortognática com finalidade de melhorar a oclusão e a estética. Dependendo da movimentação cirúrgica, o espaço aéreo pode aumentar ou diminuir. O presente trabalho tem como objetivo avaliar as alterações de área e de volume do espaço aéreo faríngeo em pacientes submetidos à cirurgia ortognática de avanço bimaxilar. Foi realizada a análise da área axial mínima e do volume aéreo superior pré-operatório (T0) e pós-operatório (T1) de 50 pacientes, sendo 17 do sexo masculino e 33 do sexo feminino, com média de idade de 36,6 (±12,1) anos. As avaliações foram feitas através de tomografia computadorizada de feixe cônico, utilizando o Programa Nemoceph 3DOS. Foi utilizado o teste ´´t`` pareado para comparar os dados pré e pós-operatórios de volume e o teste de Wilcoxon para comparar os dados pré e pós-operatório de área axial mínima. Todos os testes foram realizados com o programa Statistica, adotando um nível de significância de 5%. No estudo do erro do método, não houve erro casual nem sistemático entre a primeira e a segunda aferição das variáveis (p > 0,05 em todas as medidas). A cirurgia de avanço bimaxilar apresentou uma média de 70,46% (59,38) de aumento volumétrico e uma mediana de 61,27% de aumento na área axial mínima, onde a mesma variou de -22,50% à 659,06%. Com este trabalho, conclui-se que o avanço bimaxilar proporciona um aumento significativo de volume e área axial mínima das vias aéreas superiores, porém este ganho não é homogêneo em todos os pacientes.(AU)


Software in three dimensions has come to revolutionize the orthognathic surgery planning. With them it is possible to perform from simulations of the surgical movements, until evaluation of the upper airways in volume and area, which wasnt possible in two dimensions software. Many patients resort to orthognathic surgery in order to improve occlusion and facial profile. Depending of the surgical movements, the airway space may increase or decrease. The aim of the study is to evaluate the changes in the area and volume of the pharyngeal airway space in patients submitted to bimaxillary advancement in orthognathic surgery. It was analyzed the minimum axial area and the volume of the pharyngeal airway space preoperative (T0) and postoperative (T1) air volumes of 50 patients, which 17 were male and 33 were female, with a mean age of 36.6 (± 12.1) years. The evaluations were done using Cone-beam computed tomography in Nemoceph 3D-OS Program. It was used the paired t test to compare the pre and postoperative volume data and the Wilcoxon test to compare the pre and postoperative data of the minimal axial area. All the tests were performed with the Statistica program, adopting a level of significance of 5%. In the study of the method error, there was no casual or systematic error between the first and second measurements of the variables (p> 0.05 in all measurements). The bimaxillary advancement surgery presented a mean of 70.46% (59.38) of volumetric increase and a median increase of 61.27% in the minimum axial area, that varied from -22.50% to 659.06%. In this study, it was concluded that bimaxillary advancement provides a significant increase in volume and minimum axial area of the upper airways, but the increase it isnt homogeneous in all patients.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Cone-Beam Computed Tomography , Mandibular Advancement/methods , Nose/diagnostic imaging , Orthognathic Surgery/methods , Malocclusion, Angle Class II/surgery , Malocclusion, Angle Class I/surgery , Reference Values , Retrospective Studies , Statistics, Nonparametric
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