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1.
Artículo en Inglés | MEDLINE | ID: mdl-33289660

RESUMEN

OBJECTIVE: Assess the clinical effects, 3D radiographic results and patient-reported outcome measures (PROMs) of buccal bone regeneration combined with piezocision. METHODS: Ten patients presenting roots prominence with a thin buccal bone thickness or buccal bone dehiscence in the lower front region were enrolled. Patients received orthodontic treatment assisted by piezocison which was combined with a buccal alveolar bone regeneration using a tunneling approach. A comparison between pre- and post-treatment alveolar bone measurements based on CBCT was performed. Periodontal parameters such as recession scores and root resorption were recorded before and after treatment. The PROMs were also investigated. RESULTS: An overall significant buccal bone gain of 2.7 ± 2.7% was found after the treatment. The apical region reached the highest gain of 8.9 ± 5.5% whereas the most coronal region showed no significant increase of the bone envelope (1.2 ± 2.7%). No adverse event such as the appearance of recession or root resorption were observed. However, in 2 patients, the biomaterial was not properly integrated and seemed to be encapsulated. The pain level and the paracetamol consumption were equivalent to those after the placement of the orthodontic appliance except on the day of the surgery. CONCLUSIONS: Within the limitation of this study, piezocision combined with buccal bone regeneration using a tunneling technique seems to be effective to augment bone and did not lead to gingival recession. However, in 2 cases the biomaterial seemed encapsulated, and therefore the predictability of the integration of the material can be questioned. ClinicalTrials.gov registration : NCT03655938.

2.
Angle Orthod ; 2020 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-33289798

RESUMEN

OBJECTIVE: To compare treatment duration and quality between standard vs computer-aided design/computer-aided manufacturing (CAD/CAM) customized self-ligating systems using indirect bonding with both. MATERIALS AND METHODS: This comparative trial included 24 patients: 12 treated with a CAD/CAM custom indirect bonding self-ligating system (CAD/CAM) and 12 others treated with an indirect bonding self-ligating standard system (I-STD). For each group, overall orthodontic treatment (OT) time was calculated and included the time needed to place each arch as well as the duration of the alignment and fine-tuning phases. The quality of the final result was analyzed using the American Board of Orthodontics Cast-Radiograph Evaluation. Patient-reported outcome measures (PROMs) were also evaluated. RESULTS: Patient characteristics were similar between the 2 groups except for age, which was slightly lower in the I-SDT group. Overall OT time was increased by 26% in the I-STD group compared with the CAD/CAM group (497 ± 40 days vs 393 ± 55 days, P = 0.0002) due to a shorter fine-tuning phase in the latter group (P<0.01). No difference was found between the groups for alignment phase. Quality of the final result was similar (I-STD, 25.7 ± 6.1; CAD/CAM, 21.6 ± 6.3) among the groups. Finally, no difference was found in the PROMs variables. CONCLUSIONS: Despite a 26% longer OT time when compared with the CAD/CAM customized bracket system, the indirect bonding self-ligating bracket system demonstrated the same quality of treatment. PROMs demonstrated a high level of acceptance and satisfaction for both techniques.

3.
Korean J Orthod ; 50(6): 373-382, 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33144526

RESUMEN

Objective: To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainlesssteel fixed retainers over a 12-month study period. Methods: This randomized controlled trial (RCT) was conducted on 62 patients randomly allocated to a control group that received stainless-steel retainers or a test group that received customized CAD/CAM nickel-titanium retainers. Four time points were defined: retainer placement (T0) and 1-month (T1), 6-month (T2), and 12-month (T3) follow-up appointments. At each time point, Little's irregularity index (LII) (primary endpoint) and dental stability measurements such as intercanine width were recorded in addition to assessment of periodontal parameters. Radiological measurements such as the incisor mandibular plane angle (IMPA) were recorded at T0 and T3. Failure events (wire integrity or debonding) were assessed at each time point. Results: From T0 to T3, LII and other dental measurements showed no significant differences between the two groups. The data for periodontal parameters remained stable over the study period, except for the gingival index, which was slightly, but significantly, higher in the test group at T3 (p = 0.039). The IMPA angle showed no intergroup difference. The two groups showed no significant difference in debonding events. Conclusions: This RCT conducted over a 12-month period demonstrated no significant difference between customized CAD/CAM nickel-titanium lingual retainers and standard stainlesssteel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.

4.
J Esthet Restor Dent ; 32(7): 645-661, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32776711

RESUMEN

OBJECTIVES: To introduce a minimally invasive and simple ortho-pros approach for localized tooth wear treatment. CLINICAL CONSIDERATIONS: Four patients with localized anterior and/or posterior tooth wear were treated. Occlusal analyses were performed, and localized wax-up or digital setup were designed based on estimated tissue loss. No-prep anterior and posterior partial-coverage polymer-infiltrated ceramic network (PICN, Vita Enamic) restorations (eg, palatal and occlusal veneers) were computer-aided designed and manufactured (CAD-CAM), tried in, and bonded in supraocclusion, creating a posterior open bite. Then, brief partial (three patients) or global (one patient, for anterior teeth alignment request) orthodontic treatment was performed to extrude the posterior teeth and re-establish posterior occlusal contacts. The orthodontic treatment duration was ~2 months for extrusion. Direct composites were performed to mask the labial finish line of palatal veneers. Clinical results were successful after a follow-up of 15, 21, 23, and 47 months, with 100% success rate of PICN anterior restorations and some minor chippings of borders of thin (0.2 mm) posterior occlusal veneers. Patient-reported outcomes were positive. CONCLUSION: Orthodontic-assisted one step-no prep technique is an advantageous and straightforward evolution of the Dahl concept. PICNs exhibit several advantages in this interdisciplinary approach. CLINICAL SIGNIFICANCE: New hybrid-ceramic CAD-CAM materials and a collaborative interdisciplinary approach support the evolution of the Dahl concept for conservative treatment of worn dentitions. The orthodontic-assisted one step-no prep technique is predictable, efficient, and well tolerated by patients and conserves tooth structure.


Asunto(s)
Implantes Dentales , Desgaste de los Dientes , Cerámica , Diseño Asistido por Computadora , Porcelana Dental , Humanos , Polímeros
5.
Eur J Orthod ; 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32006440

RESUMEN

OBJECTIVE: The aim of this trial was to test whether the use of a smartphone application (app) connected to a toothbrush improves the oral hygiene compliance of adolescent orthodontic patients. DESIGN: The study was designed as a multicentre, randomized, controlled clinical trial. SETTING: Two academic hospitals. ETHICAL APPROVAL: The study was approved by the ethics committee. SUBJECTS AND METHODS: This multicentre randomized controlled trial was conducted on 38 adolescents aged 12-18 years with full-fixed orthodontic appliances. Participants were randomly assigned either to a test group that used an interactive oscillating/rotating electric toothbrush connected to a brushing aid app or to a control group that used an oscillating/rotating electric toothbrush alone. At baseline, all patients received verbal and written oral hygiene instructions. OUTCOME MEASUREMENTS: Data collection was performed at T1 (baseline), T2 (6 weeks), T3 (12 weeks) and T4 (18 weeks-end of the study). At each time point, the plaque index (PI), gingival index (GI) and white spot lesion (WSL) score were recorded. Several app-related parameters were evaluated. Patient-related outcome measures were investigated in the test group. RESULTS: Test and control groups were similar at baseline except for WSL score. Between T1 and T4, PI and GI decreased significantly in both groups but evolutions were globally similar in both groups. Interestingly, at T3 (12 weeks), the PI was significantly lower in the app group than in the control group (P = 0.014). Data showed a marked decline in the use of the app over time in the test group. CONCLUSIONS: This trial, conducted over 18 weeks in two academic hospitals, showed no significant effect of the use of the app in promoting oral hygiene. TRIAL REGISTRATION: Not registered.

6.
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1135488

RESUMEN

Abstract Objective: To evaluate the prevalence and the characteristics of Molar Incisor Hypomineralisation (MIH) in 7-12-year-old children in Tunis, Tunisia. Material and Methods: This study was designed as a cross-sectional study, in which school children aged 7 to 12 years were included. A total of 510 children (257 girls and 253 boys) who had their first permanent molar and incisors were evaluated using the 2003 European Academy of Paediatric Dentistry (EAPD) recommendation criteria were examined. Descriptive data analysis and Pearson's chi-squared test were performed (p<0.05). Results: A total of 510 children were included in the study. MIH was present in 35.4 % of our study population. Boys exhibited slightly higher MIH (19,4%) and Post Eruptive Breakdown (PEB) (7,3%) prevalence compared to girls, but the difference was not statistically significant (p=0.07). Moreover, demarcated opacities were more prevalent than PEB. More precisely, the main prevalence without PEB was MIH with white/creamy demarcated opacities, which was more frequent than yellow/brown demarcated opacities (p<0.05). Conclusion: The prevalence of MIH in Tunis was 35.4%, with no difference between girls and boys. The main MIH type prevalence was white/creamy demarcated opacities without PEB.

7.
Int Orthod ; 17(3): 573-579, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31272840

RESUMEN

INTRODUCTION: Digital Smile Design (DSD) is a systematic protocol based on specific photographs and software analysis that is used worldwide. DSD aims to assist the practitioner in creating and planning a course of treatment, especially in a multidisciplinary approach, and provides a virtual simulation of the final result. Additionally, it is a tool that enables communication and discussion between all the dental team, including the dental laboratory, and also with the patient. Although widely described and used in prosthetic rehabilitation, this tool remains only anecdotally used in the world of orthodontics. The objective of this proof of concept was to describe the application of the Digital Smile Design protocol in the diagnosis of orthodontic treatment. MATERIALS AND METHODS: A teenage patient was referred to our university clinic by a private orthodontic practitioner for a second opinion on the treatment at that time. The patient had a self-ligating orthodontic appliance. According to the history of the case and the oral situation at that moment, the patient required an accurately calculated plan for orthodontic tooth movement that would permit the achievement of future rehabilitation. Therefore, the decision was taken to use a DSD protocol to potentially complete the classic orthodontic examination. RESULTS: From the classic orthodontic examination, the patient presented a molar class I, midline deviations, the #21 and #23 were missing, #12 was conoid (microdontic) and, finally, #22 was in the position of #21. From the DSD results, three different views simulated the final results and therefore provided additional and relevant information, such as the correct position of the upper midline and the correct position of #12, #13, #22 and #23. CONCLUSION: This proof of concept showed the clinical relevance of the Digital Smile Design protocol as a new tool for complex orthodontic treatment planning, especially in a multidisciplinary approach. Further publications will be necessary in order to define a specific DSD protocol for orthodontic treatment.


Asunto(s)
Estética Dental , Ortodoncia/métodos , Sonrisa , Adolescente , Simulación por Computador , Cara , Humanos , Incisivo/anomalías , Incisivo/diagnóstico por imagen , Masculino , Aparatos Ortodóncicos , Planificación de Atención al Paciente , Fotograbar/métodos , Programas Informáticos , Técnicas de Movimiento Dental/métodos
8.
Orthod Fr ; 90(1): 5-12, 2019 Mar.
Artículo en Francés | MEDLINE | ID: mdl-30994445

RESUMEN

INTRODUCTION: The duration of orthodontic treatment in adults remains a barrier for some patients. Some surgical techniques have been developed in order to accelerate orthodontic tooth movement. The technique of corticotomies is effective in decreasing the orthodontic treatment time but remains invasive, leading to significant postoperative consequences. MATERIALS AND METHODS: Minimally invasive techniques without muco-periosteal flap elevation have been developed: corticision, micro-osteoperforations, piezopuncture and piezocision. RESULTS: The piezocision procedure seems to be the best compromise to accelerate orthodontic tooth movement while respecting a specific surgical and orthodontic protocol. The piezocision surgery allows the addition of biomaterials in cases of dehiscence and/or fenestration on the alveolar bone associated with moderate to severe overcrowding. CONCLUSION: According to current publications, minimally invasive corticotomy techniques can be viewed as a new therapeutic tool in the acceleration of orthodontic tooth movement.


Asunto(s)
Proceso Alveolar/cirugía , Hueso Cortical/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Osteotomía/métodos , Técnicas de Movimiento Dental/métodos , Adulto , Hueso Cortical/trasplante , Humanos , Oseointegración/fisiología , Piezocirugía/métodos , Factores de Tiempo
9.
Clin Oral Investig ; 23(12): 4355-4363, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30955096

RESUMEN

OBJECTIVE: To explore patient-related outcomes measures (PROMs) of piezocision-assisted orthodontic treatment compared to a conventional orthodontic treatment using customized appliance. MATERIALS AND METHODS: Twenty-four adult patients requiring orthodontic treatment for mild-to-moderate overcrowding in both jaws were randomly assigned to a test group, treated with a piezocision-assisted orthodontic treatment, or to a control group, where piezocision was not applied. The patient-related outcomes were recorded using a 0-10 visual analog scale (VAS). Daily analgesic consumption and pain level were also recorded following the placement of the orthodontic appliance in both groups and after the piezocision procedure in the test group. Moreover, levels of apprehension and satisfaction were also assessed in both groups. RESULTS: In the piezocision group, over the 7-day period, paracetamol consumption was comparable after the placement of the orthodontic appliance and after the piezocision surgery. Pain levels after the orthodontic and the surgical procedure decreased with time (p < 0.0001) but remained globally higher after piezocision (p = 0.0056). Significantly, more patients of the piezocision group reported that they would undergo the treatment again (p = 0.033) and that they greatly appreciated the duration of treatment (p = 0.0008). However, the level of apprehension was significantly higher in the piezocision group compared to the test group (p = 0.012). CONCLUSIONS: Although, the degree of apprehension before the surgery and higher pain level in the piezocision group, PROMs emphasized similar pain killer consumption in both group and revealed high acceptance and satisfaction with piezocision approach. CLINICAL RELEVANCE: The benefit of piezocision-assisted orthodontic treatment seems to be relevant from a patient perspective. TRIAL REGISTRATION: NCT03406130.


Asunto(s)
Soportes Ortodóncicos , Piezocirugía/métodos , Técnicas de Movimiento Dental/métodos , Adulto , Femenino , Humanos , Masculino , Aparatos Ortodóncicos , Dolor , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Resultado del Tratamiento , Escala Visual Analógica
10.
Eur J Orthod ; 41(5): 495-501, 2019 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-30649257

RESUMEN

OBJECTIVE: The aim of this study was to investigate the effects of piezocision (surgical protocol with sutures) in orthodontic treatment using CAD/CAM (computer-aided design and computer-aided manufacturing) customized orthodontic appliances. DESIGN: The study is designed as a parallel group, randomized controlled trial (RCT). SETTING: University Hospital. ETHICAL APPROVAL: The study was approved by the ethic committee of the University Hospital Liege, Belgium. SUBJECTS AND METHODS: This RCT was conducted on 24 adult patients requiring orthodontic treatment to release mild overcrowding. Patients were all treated with a customized appliance and randomly assigned by means of sealed envelopes containing group codes to either a test group treated with piezocision or a control group without any further treatment. A blinded orthodontist validated appliance removal or further adjustments based on the model study. OUTCOME MEASURES: The overall treatment time and the time between archwire changes were recorded. Moreover, clinical and radiological features such as tooth resorption, gingival recessions, and the presence of scars were evaluated. RESULTS: A total of 24 patients (12 control and 12 test) completed the study. The overall treatment time was significantly shorter in the test group than the control group. Likewise, the time difference between all arch changes was significantly lower when piezocision was performed, except for the first arch at the mandible and the last arches at both maxillae. During the fine-tuning phase, no significant difference was found between the two groups. All periodontal and radiographic parameters remained stable from the start to the end of treatment in both the groups. However, minor scars were found in 66 per cent cases. LIMITATIONS: This trial was a single-centre trial. CONCLUSIONS: Piezocision seems to be an effective method to accelerate orthodontic treatment in cases of mild overcrowding. However, the effect was only observed during the alignment phase and a greater efficiency was found in the maxilla. The technique may be contraindicated in patients with a high smile line since the risk of slight scarring exists. REGISTRATION: ClinicalTrails.gov (Identifier: NCT03406130).


Asunto(s)
Aparatos Ortodóncicos , Técnicas de Movimiento Dental , Adulto , Diseño Asistido por Computadora , Humanos , Mandíbula , Maxilar
11.
Angle Orthod ; 89(1): 117-122, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30080129

RESUMEN

OBJECTIVES: To assess patient compliance and treatment efficacy of preventive expansion treatment with removable Planas functional appliances using an integrated microsensor. MATERIALS AND METHODS: Wear time (WT) and behavior of 69 patients undergoing treatment with Planas functional appliances were assessed and analysed using TheraMon microsensors (Gschladt, Hargelsberg, Austria). Patients were followed up for a period of 9 months, and visits were made every 3 months to download WT data from the microsensor and to assess wearing behavior. From individual WT graphs,10 parameters were derived to characterize compliance for each patient. Treatment efficacy was measured by eight parameters determining the level of expansion after 9 months of treatment. RESULTS: Patients wore their device on average 15.8 ± 5.2 h/d. WT was unrelated to age and gender, but it was positively influenced by patient habits when keeping appliances during eating, sports, care and handling. Treatment efficacy in terms of intercanine and intermolar expansion was 4.4 ± 1.9 mm and 4.6 ± 2.0 mm for the maxilla, and 5.3 ± 2.0 mm and 4.7 ± 2.3 mm for the mandible, respectively. Efficacy was negatively affected by poor compliance (WT < 9 h/d) and by high variability of within-subject WT recordings. CONCLUSIONS: Perfect compliance is not necessary to achieve treatment success, but patients should exhibit sufficient wear time to allow maxillary expansion to occur. The TheraMon microsensor offers a new perspective and aid to individualize treatment prescriptions.


Asunto(s)
Aparatos Ortodóncicos Funcionales , Aparatos Ortodóncicos Removibles , Cooperación del Paciente , Atención Odontológica , Humanos , Aparatos Ortodóncicos , Resultado del Tratamiento
13.
Int Orthod ; 16(4): 652-664, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30391131

RESUMEN

BACKGROUND: Piezocision is a localised piezoelectric alveolar decortication involving minimally invasive corticotomies to accelerate orthodontic treatments. The objective of this proof-of-concept was to describe an innovative protocol combining selective piezocision with minimally invasive bone regeneration to reduce the risk of buccal tissue dehiscences often observed in orthodontic treatments. This proof-of-concept initial report aimed at investigating whether this new surgical concept is relevant. MATERIALS AND METHODS: A patient presenting an asymmetrical dental class II, overcrowdings, midline deviations and buccal bone dehiscences in the lower incisor region was treated with this new treatment approach. RESULTS: From an orthodontic point of view, the dental class II, the overcrowdings and the midlines were completely corrected. From a periodontal perspective, no gingival recession was observed; however, scars related to the piezocision were slightly visible at the mandible. The post-imaging demonstrated the absence of bone dehiscences. Up to 3 years after the completion of the treatment, no relapse was observed. CONCLUSION: This novel approach suggested several advantages and may be further investigated at a larger scale in order to validate the benefits and to define the scope of intervention.


Asunto(s)
Proceso Alveolar/cirugía , Regeneración Ósea , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Piezocirugía/métodos , Técnicas de Movimiento Dental/métodos , Proceso Alveolar/diagnóstico por imagen , Materiales Biocompatibles , Femenino , Recesión Gingival/diagnóstico por imagen , Recesión Gingival/cirugía , Recesión Gingival/terapia , Humanos , Maloclusión de Angle Clase II/terapia , Soportes Ortodóncicos , Alambres para Ortodoncia , Osteotomía , Periostio/diagnóstico por imagen , Periostio/cirugía , Tomografía Computarizada por Rayos X , Técnicas de Movimiento Dental/instrumentación , Adulto Joven
14.
Int Orthod ; 14(4): 449-461, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27836768

RESUMEN

A total of 154 adult patients with sleep complaints underwent a polysomnography and a craniofacial cone beam computed tomography (CBCT). OSA was defined as an apnea and hypopnea index (AHI) or an oxygen desaturation index (ODI) ≥ 10. Soft tissues and craniofacial bones volumes were prospectively measured by CBCT and collected blindly from sleep polysomnography. Among the study patients, 127 (83%) suffered from OSA and 27 (17%) did not. OSA patients demonstrated a narrower maxillo-palatine core volume (11.7±3.2 vs 14.6±4.9cm3) even when adjusting for age, gender, height, neck circumference and body mass index. These upper airway measures provide a comprehensive analysis of bony structures and soft tissues, which can be involved in OSA.


Asunto(s)
Huesos Faciales/diagnóstico por imagen , Apnea Obstructiva del Sueño/diagnóstico por imagen , Adulto , Anciano , Tomografía Computarizada de Haz Cónico , Cara/diagnóstico por imagen , Femenino , Cabeza/diagnóstico por imagen , Humanos , Imagenología Tridimensional , Masculino , Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Polisomnografía , Apnea Obstructiva del Sueño/patología , Adulto Joven
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