Orthodontic treatment of a patient with dentinogenesis imperfecta using a clear aligner system.

BACKGROUND: Orthodontic treatment for patients with dentinogenesis imperfecta (DGI) can be risky because of the fragility of their dental hard tissue. Although the Invisalign (Align Technology) clear aligner system should be a suitable orthodontic appliance for patients with DGI, to the authors' knowledge, there has been no related research. CASE DESCRIPTION: A 28-year-old woman with DGI sought treatment with a 1 mm open bite, edge-to-edge occlusion of the central incisors, and a bilateral Class III cusp-to-cusp molar relationship. Invisalign was applied for her treatment, and after 3 and one-half years of orthodontic therapy, a normal overjet and overbite were achieved, accompanied by retraction of the lower lip as well as a bilateral Class I molar relationship. In addition, there was no iatrogenic injury to the patient's teeth. PRACTICAL IMPLICATIONS: The Invisalign system may be a suitable orthodontic appliance for patients with DGI because clear aligners lessen the tensile stress to the teeth, decrease the number and area of bonds to the teeth, and offer protective effects through a full wrap of plastic that covers the crowns of the teeth.

Comparative assessment of two-phase class II treatment with Activator or Bionator followed by fixed appliances: A retrospective controlled before-and-after study.

AIM: Two-phase treatment for children with Class II malocclusion with several functional appliances is still performed by many orthodontists, while the Activator and the Bionator appliances are two of the most popular ones. Aim of this study was to compare the skeletal and dentoalveolar effects of treatment with these two appliances. METHODS: Class II children treated with Activator or Bionator in the first phase, followed by a phase of fixed appliances were included. Skeletal and dentoalveolar parameters were assessed from lateral cephalograms and analysed with linear regressions at 5%. RESULTS: A total of 89 patients (mean age 10.0 years; 47% female) were included. During the first phase, Bionator increased less the SNB (difference in mean treatment-induced changes [MD] -0.7°; 95% confidence interval [CI] -1.3 to -0.2°; P=0.01) and decreased less the ANB angle (MD 0.6°; 95% CI 0 to 1.1°; P=0.03) compared to Activator. Activator slightly increased the facial axis and Bionator reduced it (MD -1.6°; 95% CI -2.3 to -0.8°; P<0.001). Compared to Activator, the Bionator retroclined more the upper incisors (MD -2.4°; 95% CI -4.6 to -0.2°; P=0.03) and increased more the interincisal angle (MD 2.9°; 95% CI 0.5 to 5.4°; P=0.02). After the second phase (6.2 years after baseline), the only differences were a reduced facial axis (MD -1.3°; 95% CI -2.2 to -0.3°; P=0.008) and an increased maxillary rotation (MD 0.9°; 95% CI 0 to 1.8°; P=0.04) with Bionator compared to Activator. CONCLUSION: Similar dentoalveolar effects were seen overall with two-phase treatment with either appliance, with Bionator being associated with more vertical increase compared to Activator.

Clinical evaluation of Artificial Intelligence Driven Remote Monitoring technology for assessment of patient oral hygiene during orthodontic treatment.

INTRODUCTION: This study aimed to clinically evaluate the accuracy of Dental Monitoring's (DM) artificial intelligence (AI) image analysis and oral hygiene notification algorithm in identifying oral hygiene and mucogingival conditions. METHODS: Twenty-four patients seeking orthodontic therapy were monitored by DM oral hygiene protocol during their orthodontic treatment. During the bonding appointment and at each of 10 subsequent adjustment visits, a total of 232 clinical oral examinations were performed to assess the presence of the 3 oral hygiene parameters that DM monitors. In each clinical timepoint, the subjects took an oral DM scan and received a notification regarding their current oral status at that moment in time. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to evaluate AI and clinical assessment of plaque, gingivitis, and recession. RESULTS: A total of 232 clinical time points have been evaluated clinically and by the DM AI algorithm. For DM's AI detection of plaque and calculus, gingivitis, and recession, the sensitivity was 0.53, 0.35, and 0.22; the specificity was 0.94, 0.96, and 0.99; and the accuracy was 0.60, 0.49, and 0.72, respectively. CONCLUSIONS: DM's oral hygiene notification algorithm has low sensitivity, high specificity, and moderate accuracy. This indicates a tendency of DM to underreport the presence of plaque, gingivitis, and recession.

Thirteen-year-old female patient with Class II division 1 malocclusion and hypodivergent facial pattern treated with buccal fixed appliance. Case report no 230052. European College of Orthodontics. Commission of affiliation and titularisation.

DATE OF BIRTH: 24/09/1998; sex: female. PRE-TREATMENT DOCUMENTS: 13 years 5 months old; 07/03/2012. DIAGNOSIS: Skeletal Class I with biretrusion, hypodivergent facial pattern; angle's Class II division 1 with overbite; moderate dento-maxillary discrepancy; maxillary incisor malposition. TREATMENT PLANNING: Bimaxillary buccal fixed appliance with Class II elastics. Active treatment duration: 25 months. POST-TREATMENT DOCUMENTS: 15 years 7 months old; 09/05/2014. POST-RETENTION DOCUMENTS: (minimum 1 year) 16 years 9 months old; 08/07/2015. Retention period: unlimited.

Class II subdivision treatment and stability with asymmetric Herbst appliance: A case report.

Non-surgical treatment of Class II subdivision may involve complex mechanics or asymmetric tooth extraction in its resolution. This report demonstrates the result and the short-term stability of Class II subdivision treated with asymmetrically installed Herbst appliance followed by conventional fixed orthodontic appliance. The approach allowed the correction of the unilateral Class II molar relationship and increased overjet, as well as the deviation of dental midlines, with improvement in lip posture and facial profile. The results remained stable two years after treatment, confirming the treatment success.

Efficacy of an innovative Herbst appliance with TADs for patients with hyperdivergent class II malocclusion: study protocol for a randomised controlled trial.

INTRODUCTION: Class II treatment with mandibular retrusion often involves the Herbst appliance due to its efficiency and low requirement of cooperation. Despite its advantages, it causes side effects concerning the occlusal plane and pogonion in terms of clockwise rotation that hinder the desired mandibular advancement for hyperdivergent patients. In this study, we will use a newly designed Herbst appliance, and a protocol that is accompanied by TADs for vertical control to avoid maxillary clockwise rotation. We hypothesise that the effect of the Herbst appliance with the vertical control approach will be beneficial for maintaining or even decreasing the skeletal divergence in hyperdivergent class II patients compared with conventional Herbst treatment. METHODS AND ANALYSIS: This study is a randomised, parallel, prospective controlled trial that will study the efficacy of Herbst with or without vertical control in children with hyperdivergent skeletal class II malocclusion. A total of 44 patients will be enrolled and randomised in a ratio of 1:1 to either Herbst treatment or Herbst treatment with vertical control. Participants will be recruited at the Shanghai Stomatological Hospital, Shanghai, China. The primary endpoint is the change in the angle indicating the occlusal plane and Sella-Nasion plane from baseline (T0) to the primary endpoint (T2) on cephalometric measurements by lateral X-ray examination. Important secondary outcomes include the root length of the anterior teeth, and the assessment score of the Visual Analogue Scale Questionnaire, etc. Safety endpoints will also be evaluated. ETHICS AND DISSEMINATION: This study has been approved by the ethics committee of the Shanghai Stomatological Hospital (Approval No. (2021) 012). Before enrolment, a qualified clinical research assistant will obtain written informed consent from both the participants and their guardians after full explanation of this study. The results will be presented at national or international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ChiCTR2100049860, Chinese Clinical Trial Registry.

Straight Teeth and Misaligned Interests: Courtrooms Are Crowded with SmileDirectClub Litigation.

SmileDirectClub markets, manufactures, and delivers clear plastic dental aligners directly to the consumer: no dental office necessary. This well-known business strategy-cut costs by cutting out the middleman-has in several instances caught the attention of state dental regulators. While the dental boards consider some of SmileDirectClub's practices to be violative of state dental practice law, the corporation has fought back in federal court, charging dental regulators with antitrust violations and with denying SmileDirectClub its constitutional rights.The Supreme Court, as noted by SmileDirectClub, has insisted that a self-regulating state professional board is not itself the state, so a board's actions might be subject to federal antitrust law. In the SmileDirectClub cases, however, state regulators have acted as required by state legislatures and as expressed in state dental practice acts. The boards' activities here are therefore cloaked in the states' immunity to antitrust litigation and should be treated deferentially by federal courts. Furthermore, judicial review of the substance of every regulation to which SmileDirectClub objects is inappropriate under principles of constitutional law. In the interest of public safety, courts should permit state dental regulators to fulfill their mandates and ensure that all dental providers comply with state health regulations.

The stability of Class II correction with functional appliance therapy and orthodontic camouflage: A retrospective cohort study.

OBJECTIVE: The aim of this study was to compare the stability of overjet reduction in adolescents treated with either orthodontic camouflage involving extraction of premolar units or functional appliance therapy. MATERIAL AND METHODS: A retrospective cohort study was undertaken with data collected at pre-treatment (T0), debond (T1) and 12 months post-treatment (T2). The primary outcome measure was stability of overjet reduction, and secondary outcome measures included Angle's molar relationship, and Little's Irregularity Index score. RESULTS: Forty-two Class II participants, 18 treated with a functional appliance and 24 with camouflage, were included with a mean pre-treatment age of 13.07 years (SD 1.72), with 23 (55%) being female. Mean overjet reduction during treatment in the functional appliance group was 6.99mm with relapse of just 0.62mm present at 12 months post-treatment. In the orthodontic camouflage group, there was a mean overjet reduction of 3.54mm with relapse of 0.27mm at 12 months post-treatment. Linear regression analysis confirmed no statistical difference (P=0.501) in overjet relapse between both treatment groups at 12 months post-treatment, adjusting for overjet at baseline. A further regression analysis revealed no significant association between overjet relapse and pre-treatment skeletal discrepancy, labial segment crowding, retention regime or compliance with the retention protocol. CONCLUSIONS: Both functional appliance and orthodontic camouflage therapies appear to have good antero-posterior occlusal stability, with minor degrees of overjet relapse occurring over a 12-month follow-up period. There was no significant difference between the treatments in relation to overjet relapse, buccal segment interdigitation or anterior irregularity.

Comparison of Bracket Position Accuracy with Different CAD/CAM Indirect Bonding Systems

ABSTRACT Objective To evaluate the accuracy of three different digital bracket positioning systems, comparing vertical, mesiodistal and buccolingual accuracy. Material and Methods The same case was sent to Orapix, Insignia, and Orthocad systems and the brackets were bonded to the malocclusion models.Damon 3 MX brackets were used with all systems and the brackets were bonded to the models with the same bonding protocol and materials. The comparison of the position of each single bracket was made with digital photography, and ImageJ software was used to find the length in pixels and then convert it to hundredths of a mm for vertical, mesiodistal and buccolingual displacement, compared to the setup. Results Insignia System reported the average higher vertical displacement (0.28 mm), compared with the other two appliances (0.22-0.23 mm), and showed the lowest average displacement for the mesiodistal and buccolingual positioning (0.14 and 0.07 mm, respectively).However, these slight bracket positioning variations between these bonding systems were not statistically different (p>0.05). Conclusion The three systems analyzed were shown to be accurate in positioning the brackets, and none of them was statistically better.

Digital assessment of direct and virtual indirect bonding of orthodontic brackets: A clinical prospective cross-sectional comparative investigation.

OBJECTIVE: The objective of this report is to use in orthodontic patients the methods of virtual indirect bonding and direct bonding using eye vision or loupes in order to compare their accuracy in the three dimensions of space. MATERIAL AND METHODS: Brackets were directly placed by one clinician to 18 patients with a total number of 298 permanent teeth. Then loupes were used to improve bracket positioning. Intraoral scanning of the dental arches was performed before bonding, after direct bonding and after the use of loupes. Subsequently, an orthodontic software was used to virtually indirectly bond the brackets on the first intraoral scanning taken before bonding. A three-dimensional mesh processing software was used to superimpose the three scans and to perform measurements in the mesio-distal and occlusal-gingival dimensions as well as in the mesio-distal angulation. RESULTS: Virtual indirect bonding was more accurate in bracket positioning compared to direct bonding by eye vision or using loupes in all teeth and most of the teeth groups measured. Specific teeth and locations in the dental arch areas exhibited more bonding inaccuracies in the two direct bonding groups as compared to virtual indirect bonding. The use of loupes did not significantly increase the bonding accuracy compared to direct vision. CONCLUSION: Indirect virtual bonding facilitated accurate bracket positioning compared to direct vision or with loupes direct bonding in the dimensions and angulation measured.

Relationship between oral health impacts and personality profiles among orthodontic patients treated with Invisalign clear aligners.

This within subject clinical experiment assessed oral health impacts before and after Invisalign orthodontic treatment and their relationships with personality characteristics. 50 patients (26 females and 24 males; mean age = 27.62 ± 8.25 years, SE = 1.17, 95% CI = 24.71-29.89 years) were assessed before and after treatment with Invisalign orthodontic treatment. Treatment clinical success was evaluated according defined clinical guidelines. Oral health impacts before and after Invisalign orthodontic treatment were measured via the Oral Health Impact Profile (OHIP). Personality features were measured via the NEO Five-Factor Inventory (NEO-FFI). Probability of α = .05 was utilized to identify significant findings. Females scored less OHIP scores after treatment (had less negative impacts) in comparison to baseline OHIP scores (t = 3.782, df = 25, P = .001, 95% CI of mean difference = 2.750-9.327). Among males, openness scores (R2 = .911, B = 5.235, 95% CI for B = 0.062-10.407, t = 2.601, P = .048) were able to predict OHIP scores before treatment; meanwhile, extraversion (R2 = .959, B = - 8.224, 95% CI for B = - 14.605-1.843, t = - 3.313, P = .021), openness (R2 = .959, B = 21.795, 95% CI for B = 10.737-32.853, t = 5.067, P = .004), and conscientiousness (R2 = .959, B = 10.293, 95% CI for B = 4.796-15.790, t = 4.813, P = .005) scores were useful to predict OHIP scores after treatment (R2 = .959, P < .05). NEO-FFI scores were not useful to predict OHIP scores before or after treatment among females (P > .05). These findings demonstrate that oral health impacts of Invisalign orthodontic treatment and personality profiles contribution to oral health impacts were different between genders.

Effectiveness of two thermal activated orthodontic archwire sequences based on transition temperature range during alignment: A randomized non-controlled comparative study.

INTRODUCTION: It has been suggested that heat-activated NiTi archwires (HANT) speed up crowding alleviation. HANT wires are available with different austenite finish temperatures. OBJECTIVE: The aim of the present study was to compare the effectiveness of two alignment sequences using thermally activated archwires with different austenite activation temperatures for the correction of mandibular anterior crowding. MATERIAL AND METHODS: The following NiTi archwire sequence was used for both groups: 0.012 in (conventional NiTi), 0.018 in (heat-activated NiTi archwires), 0.016×0.022 in (heat-activated NiTi archwires) and 0.019×0.025 in (conventional NiTi). The conventional NiTi used for both groups belongs to the same commercial brand. Two different austenite activation temperatures (35°C and 37°C) were used for the heat-activated archwires. The primary outcome was the degree of crowding correction measured on study models. The secondary outcome was crowding survival time over a six-month period. This RTC included fifty-four patients that were randomly allocated to the two different archwire sequences. A Mann-Whitney test was used to compare the groups regarding crowding alleviation. A survival curve was created using the Kaplan-Meier method to illustrate the reduction of crowding over time. A Mantel-Cox log-rank test was used to compare survival times (until correction of crowding). RESULTS: No differences in crowding alleviation were identified between both groups (log-rank test; P=0.77). CONCLUSIONS: The two alignment sequences with different thermal activated archwires at 35°C and 37°C achieved similar clinical results during the correction of mandibular anterior crowding.

Teeth angulations after class II treatment with the Jones Jig followed by fixed appliances: A retrospective panoramic analysis.

OBJECTIVE: The purpose of this study was to compare the maxillary mesiodistal dental angulations of Class II malocclusion patients treated with the Jones Jig, followed by fixed appliances, with normal values of a historical control group, on panoramic radiographs. MATERIAL AND METHODS: The sample comprised 80 panoramic radiographs of 40 patients divided into two groups. Eligibility criteria included patients with predominantly dental Class II malocclusion; the presence of all teeth up to the second molars and no previous orthodontic treatment. The experimental group was composed of 60 radiographs of 20 patients treated with the Jones Jig distalizer followed by fixed appliances. The radiographs were taken at pre-treatment (T0), post-distalization (T1), and post-treatment (T2). The historical control group comprised 20 radiographs of 20 subjects with untreated normal occlusion. The mesiodistal axial angulations of all maxillary erupted teeth were evaluated with the Dolphin Imaging software. Intragroup comparisons in the experimental group were performed with repeated measures analysis of variance (ANOVA), followed by Tukey tests. The experimental group at T2 versus the control group were compared with t tests. RESULTS: After distalization, significant distal angulation of the molars (110.58°±8.54, P<0.000) and mesial angulation of the second (86.43°±8.08, P<0.000) and first premolars (80.11°±8.01, P<0.000) was observed. However, this was corrected after comprehensive fixed orthodontics (100.54°±6.53; 98.95°±7.00; 94.92°±6.44; P<0.000, for these teeth, respectively). Intergroup comparisons resulted in first molars, premolars, canines, and central incisors significantly more distally angulated in the experimental group, when compared to the control. CONCLUSIONS: In general, at the end of orthodontic treatment, patients treated with the Jones Jig distalizer followed by fixed appliances presented more distally angulated maxillary teeth when compared to an untreated group with normal occlusion.

Is the Quad Helix more efficient to correct mandibular asymmetry before age 7? A retrospective comparative study.

INTRODUCTION: Unilateral posterior crossbite (UPCB), often from dysfunctional and para-functional causes, leads to positional mandibular asymmetries that can develop at a very young age into skeletal mandibular deviation; hence the interest of early maxillary expansion. The purpose of this retrospective study was to compare the impact of maxillary expansion by Quad Helix (QH) on mandibular skeletal asymmetry correction before and after 7 years of age. MATERIALS AND METHODS: All children with UPCB and skeletal mandibular asymmetry, who were treated by QH in the orthodontic department of Montpellier between February 2017 and August 2018 and had a radiography file at baseline (T0) and 12 months later (T1) were retrospectively included. The patients were divided into two groups according to age: under 7 years of age with QH adjusted on second primary molars (early group G1) and over up to 13 years old with QH adjusted on first permanent molars (late group G2). The differences between the right and left sides of the mandible in corpus length ΔL (main eligibility criterion) and ramus height ΔH (secondary criterion) were compared between groups. X2 test, Fisher's exact test and Wilcoxon rank-sum tests were used for baseline comparisons. A multifactorial analysis allowing adjustment on possible confounding factors was used with R software. RESULTS: Out of 67 patients files only 40 were completed and analysed: 13 in G1 and 27 in G2. These groups were comparable at baseline except for the age parameter. Taking into account the initial severity of asymmetry, the analysis of covariance showed a significant intergroup difference with higher correction in the early group of the corpus asymmetry (+1.0; P=0.008). On the contrary, no significant differences were observed between the groups in the ramus asymmetry correction. CONCLUSIONS: Within the limits of this retrospective study, the early unilateral posterior occlusion correction by QH can better reduce both positional and contour mandibular asymmetries in patients under 7 years of age.

The Herbst appliance combined with a completely customized lingual appliance: A retrospective cohort study of clinical outcomes using the American Board of Orthodontics Objective Grading System.

OBJECTIVES: In this retrospective study we aimed to evaluate the quality of treatment outcomes using the American Board of Orthodontics (ABO) scoring system with a completely customized lingual appliance used in combination with a Herbst appliance for Class II correction. MATERIALS AND METHODS: Patient selection criteria for this study were Class II division 1, II/2 or subdivision treated with a WIN® lingual appliance combined with an L-pin Herbst device. Thirty-two consecutively debonded cases were included in this retrospective case series. Pre- and post- treatment dental casts, dental set-ups, panoramic X-rays, cephalometric analysis, photographs and clinical files were available for data collection. The primary outcome was the ABO score based on the Discrepancy Index (ABO DI) including: overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion (Angle class), lingual posterior crossbite, buccal posterior crossbite, ANB, IMPA and SN-GoGN angles and the Cast-Radiograph Evaluation (ABO CR-Eval) comprising of alignment/rotations, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationship (Angle class), interproximal contacts and root angulation. In addition, overjet, overbite and Class II correction were also evaluated on pre- and post-treatment models. The secondary outcome was bracket failure and complications related to the Herbst device. RESULTS: The study cohort included 18 female and 12 male patients with a mean age of 15.8 (range 12, 6- 18, 5). Twenty patients were Class II division 1 and ten were Class II division 2. The mean pre-treatment value of ABO DI was 20.8 (range 10-39); more than two-thirds of the sample were rated as being either of moderate difficulty (ABO DI: 16-24) or severe (ABO DI: over 25). The average post-treatment ABO Cast-Radiograph Evaluation score was 15.0 (SD=4.4), which is considered a passing score. Twenty-six patients had a score equal or lower than 20 (undisputed passing score). The Class II discrepancy was effectively corrected from a score of 16.83 penalty points (SD: 3.65) pre-treatment to a score of 1.57 (SD: 1.70) post-treatment. No association was found between initial and final Class II occlusal relationships (P=0.42), indicating that regardless of the initial discrepancy, no difference in the success of Class II correction was observed. The mean bracket failure rate was 3.8 per patient. Herbst related complications were few: 1.6 per patient, with the majority of complications being of little consequence and with 43% of the patients having no breakages. CONCLUSION: The completely customized lingual appliance assessed in this study combined with an L-pin Herbst led to effective Class II correction regardless of the initial severity of the sagittal discrepancy. The average ABO CR-Eval score for this sample was well below the undisputed passing score indicating a high quality of treatment outcomes.

Evaluating interactions of airway changes during growth with orthodontic treatment.

OBJECTIVE: The aim of this study was to longitudinally evaluate changes in the pharyngeal airway volume in adolescents treated with fixed orthodontic appliances compared to matched untreated adolescents and to assess its impact on airflow resistance. MATERIALS AND METHODS: The sample consisted of 16 adolescents (mean start age of 11 years 3 months) who had started and completed treatment at the orthodontic department of the University of Detroit Mercy School of Dental Medicine. This group was compared to a control that consisted of 16 adolescents (mean start age 12 years) who had two CBCTs with no treatment in between for the purpose of regular orthodontic evaluation. Differences in airway volume, length, minimum cross-sectional area, and the average cross-sectional area were calculated. RESULTS: The results indicated that the airway volume increased by 39% and was a statistically significant change (P<0.05). Regarding the influence on airflow resistance, the change in cross sectional area was significant in the group treated with fixed orthodontic appliances (P<0.03). CONCLUSION: Adolescents treated with fixed orthodontic appliances do experience an increase in airway volume, as well as a decrease in airway resistance to airflow compared to that in normal growth.

Comparison of the dentoskeletal and soft tissue changes with the cervical headgear and Jones Jig followed by fixed appliances in Class II malocclusion patients: A retrospective study.

OBJECTIVE: To retrospectively compare the dentoskeletal and soft tissue changes of patients with Class II malocclusion treated with cervical headgear and Jones Jig appliances, followed by fixed appliances. MATERIAL AND METHODS: The sample comprised 46 Class II malocclusion patients divided into two groups. Patients with Class II malocclusion based on the ANB angle and plaster model analyses, needing non-extraction orthodontic treatment, absence of mandibular crowding and no previous orthodontic treatment were eligible to be selected. Group 1 consisted of 25 patients treated with cervical headgear (CH) followed by fixed appliances for a mean period of 3.26 years and group 2 consisted of 21 patients treated with the Jones Jig (JJ) appliance for a mean of 4.29 years. Lateral cephalograms were evaluated at the beginning and at the end of orthodontic treatment. For intergroup comparisons, t and Mann-Whitney tests were performed. RESULTS: The cervical headgear group produced significantly greater maxillary anterior displacement restriction (SNA; CH: -0.97°±1.33; JJ: 0.07°±1.73; P=0.025), apical base discrepancy improvement (ANB; CH: -1.52°±1.25; JJ: 0.36°±1.46; P=0.006), FMA reduction (CH: -0.78°±2.68; JJ: 1.07°±2.84; P=0.028) and distal mandibular molar angulation (Md6.PM; CH: 6.97°±3.66; JJ: 2.77°±6.87; P=0.013) than the Jones Jig group. CONCLUSIONS: Both distalizers followed by fixed appliances were effective to correct Class II malocclusion. The cervical headgear group presented skeletal effects with less treatment time and there were no significant intergroup differences regarding soft tissue changes.

The origin and evolution of the Hawley retainer for the effectiveness to maintain tooth position after fixed orthodontic treatment compare to vacuum-formed retainer: A systematic review of RCTs.

OBJECTIVE: This systematic review aims to summarize the effectiveness and patient compliances of Hawley retainer (HR) compared to vacuum-formed retainers (VFR) and provide the best clinical evidence related to the use of these retainers for maintaining tooth position following fixed orthodontic appliance so that orthodontists can decide which are the most appropriate methods and retainers to use for each individual patient. MATERIALS AND METHODS: We searched the Cochrane Library, EMBASE, PubMed, Web of Science, Orthodontic journals, and relevant articles for eligible studies. Only RCTs studies were included; no restrictions on publication status or language were applied until May 20, 2019. We collected the study related to the effectiveness of these two retainers. Furthermore, patient-reported outcomes, survival time, cost-effectiveness, occlusal contact, and adverse effect on gingival and speech articulation were also collected. RESULTS: We finally included fifteen articles in the qualitative synthesis. No significant difference was observed in patients who had worn the retainers on a full-time or part-time, basis in both HR and VFR in terms of the change in arch widths and arch lengths. VFR appeared to be better at preventing relapses of incisor irregularity than HR. Patient satisfaction with VFR was higher than with HR, and there was no difference in survival rates for both types of retainers. In terms of cost-effectiveness, occlusal contacts, and gingival health, there were a few studies with limited evidence to compare these retainers. For speech articulation, VFR was less affected in comparison to HR. CONCLUSIONS: We found that wearing VFR provides better relapse prevention of incisor irregularity than HR in both arches, indicating their usefulness in clinical practice. However, there is no evidence to show that the pattern of time duration wearing these retainers provides excellent stability. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.

Membrane fixation for osseous graft stabilization in periodontally accelerated osteogenic orthodontics: a comparative study.

BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS: Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS: Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS: This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.

The National Dental Practice-Based Research Network Adult Anterior Open Bite Study: Treatment recommendations and their association with patient and practitioner characteristics.

INTRODUCTION: This aim of this paper is to describe and identify the practitioner and patient characteristics that are associated with treatment recommendations for adult anterior open bite patients across the United States. METHODS: Practitioners and patients were recruited within the framework of the National Dental Practice-Based Research Network. Practitioners were asked about their demographic characteristics and their treatment recommendations for these patients. The practitioners also reported on their patients' dentofacial characteristics and provided initial cephalometric scans and intraoral photographs. Patients were asked about their demographic characteristics, previous orthodontic treatment, and goals for treatment. Four main treatment groups were evaluated: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also investigated. Predictive multivariable models were created comparing various categories of treatment as well as extraction/nonextraction decisions. RESULTS: Ninety-one practitioners (mostly orthodontists) and 347 patients were recruited from October 2015 to December 2016. Increased aligner recommendations were associated with white and Asian patients, the presence of tongue habits, and female practitioners. TADs were recommended more often in academic settings. Recommendations for orthognathic surgery were associated with demographic factors, such as availability of insurance coverage and practitioner race/ethnicity, and dentofacial characteristics, such as anteroposterior discrepancies, more severe open bites, and steeper mandibular plane angles. Extraction recommendations were largely associated with severe crowding and incisor proclination. CONCLUSIONS: Both doctor and patient demographic factors, as well as dentofacial characteristics, were significantly associated with treatment recommendations for adult anterior open bite patients.