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1.
Eur J Orthod ; 2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-32572439

RESUMEN

INTRODUCTION: The aim of this study was to investigate the effect of supplemental vibratory force on biomarkers of bone remodelling during orthodontic tooth movement, the rate of mandibular anterior alignment (RMAA), and compliance with a vibration device. DESIGN, SETTINGS, AND PARTICIPANTS: Forty patients between the ages 15-35 undergoing fixed appliance treatment that presented to a university orthodontic clinic were randomly allocated to supplemental use of an intraoral vibrational device (n = 20, AcceleDent®) or fixed appliance only (n = 20). Salivary multiplex assay was completed to analyse the concentration of selected biomarkers of bone remodelling before treatment (T0) and at three following time points (T1, T2, T3), 4-6 weeks apart. Irregularity of the mandibular anterior teeth and compliance was assessed at the same trial time points. Data were analysed blindly on an intention-to-treat basis with descriptive statistics, Mann-Whitney U-test, Wilcoxon signed-rank test, and linear mixed effects regression modelling. RESULTS: No difference in the changes in salivary biomarkers of bone remodelling and RMAA between groups at any time point over the trial duration was observed. No correlation was found between changes in irregularity and biomarker level from baseline to another time point. Lastly, there was no association between RMAA and compliance with the AcceleDent® device. CONCLUSIONS: Supplemental vibratory force during orthodontic treatment with fixed appliances does not affect biomarkers of bone remodelling or the RMAA. LIMITATIONS: The main limitation of the study was the small sample size and the large variability in the salivary biomarkers. HARMS: No harms were observed during the duration of the trial. PROTOCOL: The protocol was not published prior to trial commencement. REGISTRATION: The study was registered in Clinical Trials.gov (NCT02119455) first posted on April 2014.

2.
Oral Maxillofac Surg Clin North Am ; 32(2): 297-307, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32151372

RESUMEN

Orthodontic treatment of patients with unilateral and bilateral cleft palate requires an extensive interdisciplinary approach to achieve optimal functional and esthetic rehabilitation. Intervention is divided into 3 main stages: early mixed, late mixed, and permanent dentition. Treatment modalities can vary according to developmental stage, severity of cleft, and presence of other dentofacial abnormalities. This article describes the use and efficacy of different orthodontic, orthopedic, and surgical approaches at each developmental stage of unilateral and bilateral clefts, whereby the orthodontist plays a pivotal role in the different phases of growth and development of the cleft lip and the patient.

3.
Am J Orthod Dentofacial Orthop ; 157(2): 228-239, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32005475

RESUMEN

INTRODUCTION: The objective of this study was to assess the reproducibility of cervical vertebral maturation (CVM) method based on the type of radiographic image and the level of experience and level of training of the evaluator. METHODS: Ten evaluators (5 orthodontic residents and 5 faculty members) were randomly divided into 2 groups: trained and untrained. All participants evaluated 80 radiographic images previously acquired in 4 different formats: (1) 2-dimensional (2D) digital (2D-digital), (2) 2D digitized hard copy from the Iowa Facial Growth Study (American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection), (3) 2D digital reconstructed from a 3-dimensional (3D) radiograph (2D-from 3D), and (4) 3D cone-beam computerized tomographic (3D-CBCT) images. Agreement among evaluators on the morphology of the cervical vertebrae (CV) and the CVM stage of each radiographic image was assessed using Randolph's kappa statistic and Kendall's W coefficient of concordance. RESULTS: Interobserver agreement on the determination of a curvature on the inferior border of the CV was substantial to perfect, whereas agreement on shape was fair to moderate. Overall, the level training in all image types, except 3D-CBCTs, but not the level of experience affected the agreement for shape and curvature of the CVs. Interobserver agreement on CVM staging for all combined images was substantial at 0.72. Faculty had a higher level of agreement than residents except for 2D-digital and 3D-CBCT images, whereas trained evaluators had an overall higher level of agreement than untrained evaluators except for 3D-CBCT images. CONCLUSIONS: Interobserver agreement in determining CVM stage was substantial for all images evaluated; experience and training resulted in higher level of agreement for some image types. The 3D-CBCT images did not provide increased interobserver agreement over current 2D-digital lateral cephalograms in determining CVM staging or shape of the CV. The highest agreement in CVM staging was obtained on 2D-digital lateral cephalograms with training.


Asunto(s)
Cefalometría , Vértebras Cervicales , Tomografía Computarizada de Haz Cónico , Ortodoncia/educación , Vértebras Cervicales/diagnóstico por imagen , Competencia Clínica , Humanos , Imagenología Tridimensional , Iowa , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados
4.
Oral Maxillofac Surg Clin North Am ; 32(1): 153-165, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685342

RESUMEN

Many of the aesthetic facial procedures can be performed simultaneously at the time of initial orthognathic surgery. Correction of any residual deformities after surgery, such as mandibular notching, malar asymmetry, labiomental crease, and any camouflage treatment, should be performed as a delayed procedure, when the outcome is more predictable. Additionally, these procedures could be used to enhance the orthodontic result, without the need of osteotomies to reposition the bones.


Asunto(s)
Estética Dental , Cara/cirugía , Lipectomía , Ortodoncia , Procedimientos Quirúrgicos Ortognáticos/métodos , Rinoplastia , Toxinas Botulínicas Tipo A/uso terapéutico , Objetivos , Humanos , Cirugía Ortognática
5.
Oral Maxillofac Surg Clin North Am ; 32(1): 89-103, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685343

RESUMEN

The surgery-first approach (SFA) has become a recent alternative to the conventional 3-stage approach to orthognathic surgery. Skeletal anchorage in orthodontics has facilitated the resurgence of this treatment sequence. By eliminating the presurgical phase of orthodontic treatment, patients have immediate resolution to their facial deformity. Treatment duration has been shown to be reduced; the difference with the conventional approach being approximately 5 months. Patient satisfaction with this approach is very high as measured by quality-of-life surveys. This article describes the indications and step-by-step approach of this technique in conjunction with virtual surgical planning.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos , Planificación de Atención al Paciente , Humanos , Satisfacción del Paciente , Calidad de Vida , Encuestas y Cuestionarios
7.
Orthod Craniofac Res ; 22(1): 32-37, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30451366

RESUMEN

OBJECTIVES: To evaluate the amount of external apical root resorption (EARR) secondary to orthodontic treatment in patients with Short Root Anomaly (SRA) compared to patients with average root lengths using Cone Beam Computed Tomography (CBCT). SETTINGS AND SAMPLE POPULATION: Cone beam computed tomography scans of 23 SRA and 26 control patients were selected from 232 pretreatment scans from a single private practice. MATERIALS AND METHODS: Cone beam computed tomography scans before (T1) and after orthodontic treatment (T2) were evaluated for differences in the change in tooth and root length of the maxillary incisors between both groups. Gender, treatment duration and age were examined as covariates. RESULTS: The mean values for root and tooth length of the maxillary incisors decreased by a range of 0.6 to 1.3 mm after orthodontic treatment. There was no significant difference between the groups for the majority of the measurements although there was a trend for less EARR in the SRA group. The maxillary left central incisor had significantly less proportional and non-proportional loss in tooth length in the SRA group. Age, gender and treatment duration were not associated with change in the proportional and non-proportional lengths for both groups. CONCLUSION: Patients with SRA did not exhibit a significant difference in the proportional and non-proportional change of length after orthodontic treatment when compared to the controls for most measurements. Only tooth length for the maxillary left central incisor had significantly less reduction after orthodontic treatment for both the proportional and non-proportional measurements in the SRA group compared to the control group.


Asunto(s)
Resorción Radicular/etiología , Ápice del Diente/anomalías , Técnicas de Movimiento Dental/efectos adversos , Estudios de Casos y Controles , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Resorción Radicular/diagnóstico por imagen , Ápice del Diente/diagnóstico por imagen , Adulto Joven
9.
Case Rep Dent ; 2018: 3542792, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29721340

RESUMEN

This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

10.
Korean J Orthod ; 48(2): 125-130, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29564222

RESUMEN

Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.

12.
J Clin Orthod ; 51(9): 547-554, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29130913
14.
Angle Orthod ; 87(5): 717-724, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28594231

RESUMEN

OBJECTIVE: To evaluate the effect of corticotomy and corticision, with and without a full mucoperiosteal flap, on the rate of tooth movement and alveolar response in a rat model. MATERIALS AND METHODS: Sixty male, 6-week-old Wistar rats were divided into five groups based on surgical procedure, as follows: control (no tooth movement), orthodontic tooth movement (OTM) only, corticotomy, corticision, and corticision with full mucoperiosteal flap (corticision + flap). A force of 10-15g was applied from the maxillary left first molar to the maxillary incisors using nickel-titanium springs. Surgery was performed at the time of appliance placement (day 0), and tooth movement occurred for 21 days. Micro-computed tomography was performed on day 21 to evaluate the amount of tooth movement and alveolar bone parameters. Histomorphometry, including tartrate-resistant acid phosphatase staining, was performed to quantify the osteoclast parameters at day 21. RESULTS: No statistical differences in the amount of OTM, bone volume fraction, and tissue density and the osteoclast parameters were found among all experimental groups. CONCLUSIONS: Corticotomy and corticision, with or without a full mucoperiosteal flap, did not show a significant effect on either the OTM magnitude or alveolar bone response.


Asunto(s)
Proceso Alveolar/patología , Proceso Alveolar/cirugía , Maxilar/cirugía , Diente Molar/cirugía , Cirugía Ortognática/métodos , Técnicas de Movimiento Dental/métodos , Proceso Alveolar/diagnóstico por imagen , Animales , Fenómenos Biomecánicos , Remodelación Ósea , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/patología , Incisivo/diagnóstico por imagen , Incisivo/cirugía , Masculino , Maxilar/diagnóstico por imagen , Modelos Animales , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Níquel , Alambres para Ortodoncia , Ortodoncia Correctiva/métodos , Osteoclastos/patología , Osteotomía/métodos , Ratas , Ratas Wistar , Estrés Mecánico , Colgajos Quirúrgicos , Fosfatasa Ácida Tartratorresistente , Factores de Tiempo , Titanio , Técnicas de Movimiento Dental/instrumentación , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/patología , Microtomografía por Rayos X/métodos
16.
Eur J Orthod ; 39(6): 595-600, 2017 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-28371882

RESUMEN

Objectives: The aim of this clinical trial was to investigate the duration of mandibular-crowding alleviation with piezotome-corticision orthodontics compared with conventional orthodontics. Design: Single-centre, two-arm parallel group randomized controlled trial. Setting: Orthodontic clinic at the University of Connecticut. Ethical approval: The study was approved by the Institutional Review Board (IRB # 12-0147-2). Subjects and methods: Forty-one adult subjects from a single centre with more than 5mm of mandibular anterior crowding were randomly allocated using block randomization into experimental and control groups. The experimental group received a corticision procedure with a piezotome on the labial aspect of the mandibular incisors in conjunction to a self-ligation fixed orthodontic appliance. The control group received the self-ligation fixed orthodontic appliance and no corticision. Same archwire sequence (0.014 inch followed by 0.014 × 0.025 inch copper-nickel-titanium) was followed for both groups. Mandibular study casts taken every 4-5 weeks were used to assess changes in the irregularity index by blinded outcome assessors. Outcome measures: The time to alignment was calculated in days. Results: Twenty-nine subjects (16 experimental and 13 control) completed the study. Overall, no significant difference in the time required to correct mandibular crowding with piezotome-corticision assisted (102.1 ± 34.7 days; 95% CI, 83.6 to 120.6) and conventional orthodontics (112 ± 46.2 days; 95% CI, 84-139.9) was observed. No complications with treatment or unintended consequences were observed on any of the subjects. Limitations: A high attrition rate. Conclusions: This randomized clinical trial found no evidence that piezotome-corticision assisted orthodontics was more efficient in alleviating mandibular anterior crowding. Registration: ClinicalTrials.gov, Identifier: NCT02026258. Funding: Division of Orthodontics, University of Connecticut. Conflict of Interest: None.


Asunto(s)
Maloclusión/terapia , Mandíbula/cirugía , Piezocirugía/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Aleaciones , Femenino , Humanos , Incisivo , Masculino , Níquel , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Alambres para Ortodoncia , Método Simple Ciego , Titanio
17.
J Istanb Univ Fac Dent ; 51(3 Suppl 1): S90-S101, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29354313

RESUMEN

Purpose: The objective of this systematic review was to compare the antero-posterior, vertical and angular changes of maxillary incisors with conventional anchorage control techniques and mini-implant based space closure methods. Materials and Methods: The electronic databases Pubmed, Scopus, ISI Web of knowledge, Cochrane Library and Open Grey were searched for potentially eligible studies using a set of predetermined keywords. Full texts meeting the inclusion criteria as well as their references were manually searched. The primary outcome data (linear, angular, and vertical maxillary incisor changes) and secondary outcome data (overbite changes, soft tissue changes, biomechanical factors, root resorption and treatment duration) were extracted from the selected articles and entered into spreadsheets based on the type of anchorage used. The methodological quality of each study was assessed. Results: Six studies met the inclusion criteria. The amount of incisor retraction was greater with buccally placed mini-implants than conventional anchorage techniques. The incisor retraction with indirect anchorage from palatal mini-implants was less when compared with buccally placed mini-implants. Incisor intrusion occurred with buccal mini-implants, whereas extrusion was seen with conventional anchorage. Limited data on the biomechanical variables or adverse effects such as root resorption were reported in these studies. Conclusion: More RCT's that take in to account relevant biomechanical variables and employ three-dimensional quantification of tooth movements are required to provide information on incisor changes during space closure.

18.
Prog Orthod ; 17(1): 30, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27641422

RESUMEN

BACKGROUND: The objective of this retrospective case-control study was to measure the maxillary lateral incisor root dimensions and quantify the labial and palatal bone in patients with unilateral maxillary lateral incisor agenesis (MLIA) after orthodontic treatment and compare them to non-agenesis controls using cone beam computed tomography. METHODS: The labiopalatal and mesiodistal root dimensions, mesiodistal coronal dimensions, and labiopalatal bone and alveolar ridge widths of the maxillary lateral incisor were assessed on posttreatment cone beam computed tomography scans of 15 patients (mean age 16.5 ± 3.4 years, 9 females and 6 males) with maxillary lateral incisor agenesis and 15 gender-matched patients (mean age 16.08 ± 3.23 years) with no dental agenesis or anterior Bolton discrepancy. The Mann-Whitney test was used to distinguish any differences in root width, crown width, or changes in labial or palatal bone width between the two groups. RESULTS: The median labiopalatal root width was narrower in the MLIA group at the level of the cementoenamel junction (CEJ) to 8 mm apical of the CEJ compared to controls (p ≤ 0.009). The mesiodistal root width was significantly reduced in the MLIA group at the CEJ and at 4 mm apical to the CEJ. The labiopalatal alveolar ridge width was significantly decreased at 2 mm apical to the CEJ in MLIA group. The mesiodistal crown width was significantly smaller in the MLIA group at both the incisal edge and at the crown midpoint. The bone thickness was similar in both groups. CONCLUSIONS: Coronal and root dimensions in patients with MLIA were reduced compared to controls. Alveolar ridge width was also reduced in patients with MLIA, although bone thickness was not different than controls.


Asunto(s)
Proceso Alveolar/anatomía & histología , Proceso Alveolar/diagnóstico por imagen , Anodoncia/diagnóstico por imagen , Incisivo/anomalías , Incisivo/anatomía & histología , Incisivo/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Adolescente , Adulto , Anodoncia/terapia , Estudios de Casos y Controles , Niño , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Imagenología Tridimensional/métodos , Masculino , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Ortodoncia Correctiva/métodos , Paladar (Hueso)/anatomía & histología , Estudios Retrospectivos , Estadísticas no Paramétricas , Cuello del Diente/anatomía & histología , Cuello del Diente/diagnóstico por imagen , Corona del Diente/anatomía & histología , Corona del Diente/diagnóstico por imagen , Técnicas de Movimiento Dental/métodos , Adulto Joven
19.
Am J Orthod Dentofacial Orthop ; 150(2): 339-51, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27476368

RESUMEN

Transmigrated mandibular canines increase the treatment complexity in terms of both anchorage and biomechanical planning. Additionally, a Class II malocclusion with a deep overbite and associated dental anomalies such as hypodontia can further increase the treatment complexity and the overall treatment time. This case report describes the successful interdisciplinary treatment of a patient, aged 12.5 years, with transmigrated and severely impacted mandibular canines and congenitally missing mandibular second premolars. The transmigrated mandibular right canine was extracted, and a maxillary second premolar was autotransplanted to the missing mandibular right second premolar site with the aid of a stereolithographic donor tooth replica fabricated with 3-dimensional cone-beam computed tomography and a rapid prototyping technique. Furthermore, the autotransplanted tooth was protracted by 4 to 5 mm to close the space caused by the extraction of the mandibular right canine. The impacted mandibular left canine was orthodontically guided into its normal position in the arch. Good esthetic outcome and functional occlusion were achieved.


Asunto(s)
Anodoncia/terapia , Diente Premolar/anomalías , Diente Premolar/trasplante , Diente Canino/anomalías , Diente Impactado/cirugía , Anodoncia/diagnóstico por imagen , Autoinjertos , Diente Premolar/diagnóstico por imagen , Cefalometría , Niño , Diente Canino/diagnóstico por imagen , Modelos Dentales , Femenino , Humanos , Mandíbula/anomalías , Mandíbula/diagnóstico por imagen , Maxilar , Radiografía Panorámica , Técnicas de Movimiento Dental , Diente Impactado/diagnóstico por imagen
20.
Angle Orthod ; 86(1): 32-8, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25978684

RESUMEN

OBJECTIVE: To quantify the effects of tip-back mechanics on the maxillary first molars and incisors. MATERIALS AND METHODS: Sixteen subjects with Class II end-on malocclusion were treated with an intrusion arch to achieve distalization of the maxillary molar through tip-back mechanics. Lateral cephalograms were taken prior to molar tip-back (T1), after molar tip-back (T2), and after molar root uprighting (T3). Data were analyzed using the Friedman's and Wilcoxon signed rank tests to evaluate differences in time points (P ≤ .016). RESULTS: The maxillary first molar distalized 1.53 mm (P = .001) with 6.65° (P = .001) of distal tipping and 0.86 mm (P = .001) of extrusion at T2. Minor relapse of the first molar (mesial direction) was seen at T3. The maxillary incisors flared labially 0.4 mm, and the incisor root apex moved palatally 1.19 mm (P = .005) at T2. At T3, the incisor root apex moved palatally 1.5 mm (P = .003) from T1. An angular change from T1 of 3.31° (P = .008) and 3.53° (P = .014) was seen at T2 and T3, respectively, as a result of palatal root movement of the maxillary incisors. CONCLUSIONS: A significant amount of distalization of maxillary molars was attained at the crown level with tip-back mechanics. Palatal root angulation change was significant in the incisors with minimal anteroposterior movement of the incisal edge.


Asunto(s)
Dentición , Maloclusión de Angle Clase II/terapia , Técnicas de Movimiento Dental , Cefalometría , Humanos , Incisivo , Maxilar , Diente Molar , Estudios Prospectivos
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