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1.
Dental Press J Orthod ; 26(2): e2119187, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34008738

RESUMEN

INTRODUCTION: A side effect observed in cases treated with extractions is the instability of orthodontic space closure. OBJECTIVE: The aim of this study was to investigate the influence of gingival invagination, presence of third molars and facial pattern, on the stability of orthodontic space-closure in the maxillary arch. METHODS: Ninety-nine subjects (41 male and 58 female) with Class I malocclusion treated with four premolars extraction were evaluated. Extraction sites reopening and gingival invaginations were evaluated in scanned dental models in the posttreatment and 1-year posttreatment stages (mean age 16.1 years). Third molars presence was evaluated at 1-year posttreatment panoramic radiographs, and the facial pattern (SN.GoGn) was evaluated in the initial lateral headfilms. Multiple logistic regression analysis was used to estimate the influence of the aforementioned independent variables on the frequency of extraction space reopening. RESULTS: Space reopening was observed in 20.20% of the subjects 1-year post-debonding. Gingival invaginations were present in 25.73% of quadrants after debonding and in 22.80% 1-year posttreatment. The mean pre-treatment SN.GoGn was 35.64 degrees (SD=5.26). No significant influence was observed of the three independent variables on the instability of extraction site closure. CONCLUSIONS: The presence of gingival invaginations, third molars and facial growth pattern do not seem to influence maxillary extraction sites reopening.


Asunto(s)
Maloclusión Clase I de Angle , Extracción Dental , Adolescente , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase I de Angle/terapia , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Cierre del Espacio Ortodóncico , Extracción Dental/efectos adversos
2.
Am J Orthod Dentofacial Orthop ; 159(6): 724-732, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33766447

RESUMEN

INTRODUCTION: The primary aim of this study was to investigate the change in upper airway dimensions and in mandibular position after miniscrew-assisted treatment with premolar extractions in adult patients with Class II high-angle malocclusion. The secondary aim was to determine the correlation between changes in upper airway dimensions and changes in mandibular position in these patients. METHODS: Eighteen adult patients with Class II high-angle malocclusion (mean ± standard deviation age = 21.2 ± 2.9 years) were selected retrospectively. All patients underwent 4 premolar extractions, and 2 miniscrews were implanted in the maxilla to intrude molar height. Cone beam computed tomography images were taken pretreatment and posttreatment for every patient. The primary outcome variable for the upper airway was the minimal cross-sectional area of the upper airway (CSAmin), and the primary outcome variables for the mandible were mandibular rotation (Mp-SN angle), mandibular horizontal position (SNB angle), and mandibular vertical position (ANS-Me distance). RESULTS: The CSAmin significantly increased by 47.2 mm2 (t = -2.26, P = 0.04) after orthodontic treatment. The mandible significantly rotated counterclockwise by 0.9° (t = 2.20, P = 0.04) after treatment, which consisted of forward movement of 1.2° (t = -4.30, P = 0.00) and upward movement of 1.3 mm (Z = -1.98, P = 0.05). Furthermore, the change of the CSAmin showed a significant correlation with the change of the ANS-Me (P = 0.01). CONCLUSIONS: By using miniscrews to intrude maxillary molars, orthodontic premolar extraction treatment results in mandibular counterclockwise rotation, and upper airway dimensions increase in Class II high-angle young adult patients. The increase of the upper airway dimensions significantly correlates to the upward movement of the mandible.


Asunto(s)
Maloclusión Clase II de Angle , Adolescente , Adulto , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Cefalometría , Humanos , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Mandíbula/diagnóstico por imagen , Maxilar , Estudios Retrospectivos , Adulto Joven
3.
Am J Orthod Dentofacial Orthop ; 159(2): 234-245, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33546828

RESUMEN

Autotransplantation of a mature premolar in adults can be a treatment of choice for tooth replacement when combined with well-planned orthodontic treatment. This case report describes the successful treatment of a 39-year-old patient with severe crowding and a hopelessly fractured tooth on the maxillary left side. Maxillary dental crowding was relieved by extraction of a premolar on the right side, and this extracted tooth was autotransplanted to replace the fractured tooth. A mandibular incisor was extracted to correct anterior crossbite. The total treatment period was 20 months. The treatment results showed a good long-term prognosis after transplantation of a mature premolar with normal surrounding alveolar bone level for over 6 years of follow-up. Occlusion and periodontal health were excellent in the long term.


Asunto(s)
Fracturas de los Dientes , Adulto , Diente Premolar/cirugía , Humanos , Incisivo , Mandíbula , Maxilar , Fracturas de los Dientes/diagnóstico por imagen , Fracturas de los Dientes/cirugía , Trasplante Autólogo
4.
Am J Orthod Dentofacial Orthop ; 159(3): 333-342, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33541786

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate the effects of 2 extraction patterns on incisor and molar movements in patients with growing Class II Division 1. METHODS: The sample included 54 patients 10-17 years of age treated by 2 private practice orthodontists using Tweed directional force mechanics, 4 premolar extractions, J-hook headgears, and Class II elastics or Saif springs. The sample was divided on the basis of having maxillary and mandibular first premolars (4/4) or maxillary first and mandibular second premolars (4/5) extracted. Each group included 27 patients. Treatment lasted 2.8 ± 0.60 years and 2.6 ± 0.54 years for the 4/4 and 4/5 groups, respectively. Pretreatment (T1) and posttreatment lateral cephalograms and dental casts were evaluated. Cranial base, mandibular, and maxillary superimpositions were performed to quantify tooth movements and displacements. RESULTS: There were no statistically significant T1 between-group differences in crowding or in the SNA, SNB, ANB, and MPA angles. Analyses of covariance, controlling for statistically significant (P <0.05) differences in T1 mandibular incisor position, showed that mandibular first premolars extractions produced greater (1.6 mm) mandibular incisor retraction than second premolar extractions. The mandibular first molars were protracted significantly more (0.7 mm) after the second premolar than the first premolar extractions. Within-group changes of the MPA, between-group differences in the changes in MPA, and the amount of vertical eruption of the maxillary and mandibular molars were not significantly different between the 2 extraction patterns. CONCLUSIONS: Extraction of mandibular second premolars enhances Class II molar correction, with greater mesial first molar movement and less distal incisor movement. Neither extraction pattern has an effect on the MPA or the vertical dimension (ie, there was no "wedge effect").


Asunto(s)
Maloclusión Clase II de Angle , Mandíbula , Diente Premolar/cirugía , Cefalometría , Humanos , Maloclusión Clase II de Angle/terapia , Maxilar , Diente Molar , Extracción Dental , Técnicas de Movimiento Dental
5.
Angle Orthod ; 90(3): 457-466, 2020 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378438

RESUMEN

Maxillary canine and first premolar transposition is a complicated dental anomaly to treat, especially if the clinician's goal is to orthodontically move the canine into its normal position. Early diagnosis with cone-beam computed tomography simplifies the treatment of this pathology. This case report describes a patient with bilateral transposition, one complete and the other incomplete, involving the maxillary canine and the first premolar (Mx.C.1P). The orthodontic treatment involved the correction of both transpositions. In the complete transposition, the traction was mesial and upward to move the canine into a more apical position with a wider dentoalveolar process for easier crown interchange.


Asunto(s)
Erupción Ectópica de Dientes , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Humanos , Maxilar/diagnóstico por imagen , Erupción Ectópica de Dientes/diagnóstico por imagen , Erupción Ectópica de Dientes/terapia
6.
Angle Orthod ; 90(5): 648-654, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378476

RESUMEN

OBJECTIVES: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. MATERIALS AND METHODS: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. RESULTS: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P < .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P < .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P < .001); however, it became similar between the groups after 24 hours. CONCLUSIONS: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Resorción Radicular , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Humanos , Incisivo , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Técnicas de Movimiento Dental
7.
Angle Orthod ; 90(5): 634-639, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378478

RESUMEN

OBJECTIVES: To examine the effect of micro-osteoperforation (MOP) on the space closure rate using passive self-ligating or conventional brackets. MATERIALS AND METHODS: This was a two-arm parallel randomized controlled trial undertaken at the outpatient department of a dental college. There were 60 participants (30 women and 30 men) who fulfilled the inclusion criteria. Both the study and control groups were subjected to MOPs throughout the period of space closure. MOPs were repeated every 28 days. The experimental group (mean age 19.5 ± 1.66 years) was bonded with passive self-ligating brackets while the control group (mean age 19.9 ± 1.13 years) was bonded with conventional brackets. Both groups were examined and compared for rate of space closure. An evaluation was conducted for both groups until the entire extraction space was closed and confirmed by evaluation of a tight contact between the canine and the second premolar using a piece of dental floss. RESULTS: Before the initiation of retraction, all initial criteria were similar between the two groups (P > .05). No difference was observed between the two groups in the rate of space closure (P > .05). CONCLUSIONS: MOP in conjunction with passive self-ligation does not increase the rate of orthodontic space closure when compared with MOP used with conventional brackets.


Asunto(s)
Soportes Ortodóncicos , Cierre del Espacio Ortodóncico , Adolescente , Adulto , Diente Premolar/cirugía , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos , Alambres para Ortodoncia , Técnicas de Movimiento Dental , Adulto Joven
8.
Dental Press J Orthod ; 25(5): 66-84, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206831

RESUMEN

INTRODUCTION: Moderate and severe bimaxillary protrusion impair the passive lip sealing and the facial and smile esthetics. The extraction of premolars can be avoided by the use of skeletal anchorage to retract both dental arches. This approach brings many advantages such as: prevents premolars extraction; simplifies orthodontic mechanics; there is no volume reduction of a premolar when smiling; control of overbite and gingival exposure. The utilization of this therapeutic approach, when associated with self-ligating brackets, can bring the possibility of spacing the appointments without damage to the treatment efficiency, and allows selection of the most appropriate torque prescriptions for each case. The intra-alveolar miniscrews are indicated for mild cases of bimaxillary protrusion, while extra-alveolar miniscrews may also be indicated for more severe cases. OBJECTIVE: To report the treatment of three cases of mild, moderate and severe bimaxillary protrusion, in which intra- and extra-alveolar miniscrews were used, according to the retraction required. CONCLUSION: The retraction of both upper and lower dental arches using orthodontic intra- and extra-alveolar miniscrews, associated with self-ligating brackets, is an excellent tool to correct mild to severe bimaxillary protrusion, thus reducing the need of premolar extraction and simplifying the orthodontic management.


Asunto(s)
Maloclusión Clase II de Angle , Maloclusión , Métodos de Anclaje en Ortodoncia , Sobremordida , Diente Premolar/cirugía , Estética Dental , Humanos , Técnicas de Movimiento Dental
9.
Am J Orthod Dentofacial Orthop ; 158(6): e111-e120, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33158633

RESUMEN

INTRODUCTION: This single-centered, parallel-groups trial aimed to evaluate the efficacy of traditional corticotomy vs flapless corticotomy in accelerating en-masse retraction. In addition, to assess the skeletal, dental, and soft-tissue variables, as well as the external apical root resorption (EARR) of the maxillary anterior teeth. METHODS: Forty patients with Class II Division 1 malocclusion aged >18 years at the beginning of treatment, requiring maxillary first premolar extractions, were randomly distributed into 2 groups (n = 20 each): 1 group was treated using traditional corticotomy, and the other group was treated with flapless corticotomy in en-masse retraction with anchorage based on miniscrews placed between maxillary second premolars and first molars bilaterally. Randomization was implemented with a computer-generated list of random numbers; allocation was concealed in sequentially numbered, opaque, sealed envelopes. The study was single-blinded (outcomes' assessor). The primary outcome was the en-masse retraction duration. Secondary outcomes were the skeletal, dental, and soft-tissue changes on lateral cephalometric and the EARR of maxillary anterior teeth on digital panoramic radiographs. RESULTS: The en-masse retraction duration in the flapless corticotomy group was longer than the traditional corticotomy group. The average retraction duration was 4.04 ± 1.10 months for the flapless corticotomy group and 3.75 ± 2.14 months for the traditional corticotomy group, with no significant difference between the 2 groups (95% confidence interval [CI], -0.81 to 1.39; P = 0.59). No significant differences were observed between the 2 groups regarding changes in several lateral cephalometric variables (eg, SNA angle [95% CI, -2.55° to 1.66°; P = 0.67], SN-U1 angle [95% CI, -1.70° to 1.32°; P = 0.80], and UL-E [95% CI: -1.33 to 1.00 mm; P = 0.78]) or in the amount of EARR in the maxillary anterior teeth (P = 0.31). The proportion of the observed EARR ranged from 1% to 6% of root length in both corticotomy groups. No serious harms were observed in both groups. CONCLUSIONS: No significant differences between the flapless and traditional corticotomies were found in terms of the skeletal, dental, and soft-tissue variables as well as in the amount of EARR. Corticotomy-assisted en-masse retraction led to improvements in skeletal structures and facial profile and resulted in sufficient retraction of maxillary anterior teeth, slight distal movement of maxillary first molars, and an intrusion movement for both anterior and posterior teeth. Both corticotomy techniques did not cause significant EARR. REGISTRATION: ClinicalTrials.gov (Identifier: NCT03279042). PROTOCOL: The protocol was not published before the trial commencement.


Asunto(s)
Maloclusión Clase II de Angle , Métodos de Anclaje en Ortodoncia , Adolescente , Diente Premolar/cirugía , Cefalometría , Humanos , Maloclusión Clase II de Angle/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Técnicas de Movimiento Dental
10.
Orthod Fr ; 91(3): 191-195, 2020 10 01.
Artículo en Francés | MEDLINE | ID: mdl-33146614

RESUMEN

Studies about orthodontic relapse have always confirmed the occurrence of some occlusal changes after orthodontic treatment. The reopening of premolar extraction spaces is one of the most frequently observed movements and would have several origins : gingival folds, root proximities, muscular imbalance... and particularly unstable end of treatment occlusion. The aim of this systematic review was to study the correlation between quality of the occlusal finishing after orthodontic treatment with premolars extraction and reopening of extraction spaces. The review was undertaken according to PRISMA recommendations from the Cochrane Handbook through an electronic consultation of the PubMed database to identify clinical trials that responded to the PICO research question. Five studies met all the inclusion criteria. Three studies used the Peer Assessment Rating (PAR) in assessing the quality of the occlusal finishing. For two of these studies, there is a correlation between poor occlusal finishing and reopening of extraction space. For the other three studies, no cause-and-effect relationship between these two factors has been proven. The divergence of the published results was explained by the fact that the stability of an orthodontic treatment depends on multiple parameters. Further controlled clinical studies should be conducted to objectively evaluate, without interfering with other parameters, the role of occlusal finishing in the long-term stability of orthodontic treatment.


Asunto(s)
Oclusión Dental , Extracción Dental , Diente Premolar/cirugía
11.
Am J Orthod Dentofacial Orthop ; 158(5): 684-693, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33010980

RESUMEN

INTRODUCTION: This retrospective pilot study assessed the pre- and posttreatment lip profile changes among adult patients with Class II Division 1 malocclusion of varied growth patterns and compared these changes with patients with a skeletal Class I relationship, to identify the dental, skeletal, and soft tissue cephalometric variables that altered the posttreatment lip profile. METHODS: A total of 33 digital cephalograms were divided into 4 study groups based on the mandibular plane (Mp-SN) angle: group 1 (control, skeletal Class I; mean angle = 21.5°) (n = 8), group 2 (Class II Division 1 malocclusion; low angle = <26°) (n = 8), group 3 (Class II Division 1 malocclusion; intermediate angle = 26°-38°) (n = 9), and group 4 (Class II Division 1 malocclusion; high angle = >38°) (n = 8). RESULTS: We observed a significant decrease in SNA, ANB, maxillary incisor to NA (degrees and millimeters), and soft tissue parameters, especially lip strain and lower lip to E line and upper lip to E line. Posttreatment intergroup comparison showed a significant increase of Mp-SN, and this increase was greater in group 3, followed by group 4 as compared with group 1. In addition, statistically significant differences in SNA, ANB, mandibular incisor to NB (degrees) and IMPA, and H angle in groups 2-4 were observed. CONCLUSIONS: Patients with Class II Division 1 malocclusion showed a significant decrease in SNA, ANB, maxillary incisor to NA, and all soft tissue parameters in posttreatment compared with group 1. Thus, the soft tissue changes resulted in a similar profile to patients in group 1, who are considered to have an aesthetically pleasing posttreatment profile.


Asunto(s)
Labio , Maloclusión Clase II de Angle , Adulto , Diente Premolar/cirugía , Cefalometría , Humanos , Labio/anatomía & histología , Labio/diagnóstico por imagen , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Proyectos Piloto , Estudios Retrospectivos
12.
Niger J Clin Pract ; 23(8): 1110-1119, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32788489

RESUMEN

Background: Bimaxillary protrusion is a condition wherein esthetic concerns are the main reason behind seeking orthodontic treatment. Aim: The aim of this retrospective cephalometric study was to evaluate the soft tissue profile and dental changes among female Saudi bimaxillary protrusion patients treated with extraction of all second premolars followed by retraction of the anterior teeth. Subjects and Methods: Pre and posttreatment cephalometric radiographs of adult female patients (ages 18-30 years) who underwent orthodontic therapy for Class I bimaxillary protrusion were obtained. Data were analyzed with SPSS® software. A paired t-test and Pearson's correlation coefficients were conducted with the statistical significance set at 95% (P value < 0.05). Results: At posttreatment, there was an overall decrease in the mean values among the majority of the soft tissue and dental cephalometric angles and linear measurements. Among soft tissue variables, there was a marginal increase in the upper lip length by 1.49 mm (P < 0.001), and the nasolabial angle increased markedly by 7.64° (P < 0.001). Similarly, a marked increase in retroclination by 5.95° (P < 0.001) was observed among the dental variables. Conversely, no significant changes were noted in the lower incisors. Pearson's correlation analysis revealed a significant correlation between all the different dental variables. Within the soft tissue variables, there was a significant positive correlation between changes in the upper lip protrusion, lower lip protrusion, upper lip thickness, and the distance from the upper and lower lips to the S-line.


Asunto(s)
Diente Premolar/cirugía , Incisivo , Labio , Maloclusión/terapia , Adolescente , Adulto , Cefalometría/estadística & datos numéricos , Estética , Femenino , Humanos , Incisivo/patología , Labio/anatomía & histología , Labio/patología , Masculino , Ortodoncia Correctiva/métodos , Radiografía , Estudios Retrospectivos , Extracción Dental , Resultado del Tratamiento , Adulto Joven
13.
Am J Orthod Dentofacial Orthop ; 158(4): e5-e15, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32843251

RESUMEN

INTRODUCTION: The objective of this research was to evaluate the anterior tooth alignment and dental arch dimension changes after orthodontic treatments with and without premolar extractions in the long-term. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term follow-up (T3) ages of 13.20 years, 15.07 years, and 50.32 years, respectively. The mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 1.86 years and 35.25 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with T1, T2, and T3 ages of 13.31 years, 15.63 years, and 53.60 years, respectively. The mean treatment and long-term follow-up times were 2.32 years and 37.96 years, respectively. The mean retention time was 2.26 years for both groups. The dental casts were obtained and digitized at T1, T2, and T3 stages. The following measurements were obtained: Little irregularity index, arch length, perimeter, and intercanine, interpremolar, and intermolar widths. Intragroup and intergroup comparisons were performed with repeated measures analysis of variance and t tests, respectively. RESULTS: Anterior tooth irregularity index increased at T3 in both groups. In addition, all arch dimensions, except the intercanine width, were significantly smaller in the extraction group at T3. Both groups showed similar arch dimension changes at T3, except for the mandibular arch perimeter. The percentage of mandibular anterior tooth alignment change was significantly greater in the nonextraction than in the extraction group. CONCLUSIONS: There was no difference in the changes of anterior alignment and transverse arch dimensions in patients treated with and without premolar extraction at T3, but the percentage of mandibular anterior tooth alignment changes was higher in the nonextraction than in the extraction patients at T3. The mandibular arch perimeter showed more of a decrease at T3 in extraction patients.


Asunto(s)
Arco Dental/diagnóstico por imagen , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Adolescente , Diente Premolar/cirugía , Cefalometría , Estudios de Seguimiento , Humanos , Extracción Dental
14.
Dent Med Probl ; 57(2): 157-163, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32633105

RESUMEN

BACKGROUND: Class II malocclusion is routinely observed in orthodontics. Its treatment usually revolves around the growth modification or the extractions of the teeth. Identifying treatment that leads to the greatest improvement can aid clinicians in providing the desired smile esthetics. OBJECTIVES: The aim of the study was to compare smile esthetics between treatment groups by measuring various smile variables and the esthetic perceptions of 3 panels of raters. MATERIAL AND METHODS: A cross-sectional study was performed on 66 patients equally divided into the functional appliance (FA) and upper first premolar extraction (UPE) groups. Eight smile variables were measured on post-treatment photographs using the Adobe Photoshop® software. Ten orthodontic residents, general dentists and laypersons performed the subjective evaluations of smiles using the visual analog scale (VAS). The Mann-Whitney U-test was applied to compare smile variables between the groups. The Kruskal-Wallis test was used to compare esthetic scores (ES) among the raters. The simple linear regression analysis, followed by the multiple linear regression analysis was applied to determine the smile variables associated with the ES values. RESULTS: Statistically significant differences were found between the FA and UPE groups for the buccal corridor ratio (BCR) (p = 0.046), the visible dentition width ratio (VDWR) (p = 0.019) and the arch form index (AFI) (p < 0.001). The Kruskal-Wallis test showed significant differences in ES among the raters for the FA (p < 0.001) and UPE (p = 0.004) groups. The simple linear regression analysis showed significant associations between ES and the patient's age (p = 0.002), BCR (p = 0.020) and VDWR (p = 0.006). The multiple linear regression analysis showed that age (p = 0.008) and VDWR (p = 0.021) were significantly associated with the ES values. CONCLUSIONS: The FA group had narrower buccal corridor spaces, a greater visible dentition width and a wider arch form in their smiles. The UPE group showed an increase in the buccal corridor width. Each panel rated the FA appliance group as superior.


Asunto(s)
Estética Dental , Ortodoncia , Diente Premolar/cirugía , Estudios Transversales , Humanos , Sonrisa
15.
Braz Oral Res ; 34: e003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022222

RESUMEN

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Asunto(s)
Estética Dental , Cara/patología , Maloclusión Clase II de Angle/patología , Maloclusión Clase II de Angle/terapia , Extracción Dental/métodos , Adolescente , Análisis de Varianza , Diente Premolar/cirugía , Cefalometría , Niño , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/métodos , Ortodoncistas , Percepción , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento
16.
J Endod ; 46(1): 29-33, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31735361

RESUMEN

INTRODUCTION: Altered sensation is a rare but disturbing adverse event after mandibular premolar and molar periapical surgery procedures, and its incidence is not known. The aim of this study was to determine the incidence of altered sensation after periapical surgery procedures in mandibular premolars and molars. METHODS: This retrospective study includes patients who received periapical surgery in endodontic clinics of a university hospital in the United States. Data were obtained by review of the records for patients who met the inclusion criteria, and statistical analysis of possible predictive factors was performed using the 2-tailed Fisher exact test (α = 0.05). RESULTS: Sixty-two patients (63 teeth, 13 premolars and 50 molars) met the inclusion and exclusion criteria and were analyzed in the study. The first follow-up visit occurred 3 to 37 days after surgery. Altered sensation was observed in 9 patients. Observation of altered sensation was significantly higher (odds ratio = 7.19) after premolar surgeries (5/13) compared with molar surgeries (4/50). CONCLUSIONS: Despite the limited size and retrospective nature of this study, it was concluded that the incidence of altered sensation after periapical surgery appears to be relatively high (14%), with a higher incidence found in premolars compared with molars.


Asunto(s)
Diente Premolar , Mandíbula , Diente Molar , Trastornos de la Sensación , Diente Premolar/cirugía , Humanos , Incidencia , Mandíbula/cirugía , Diente Molar/cirugía , Estudios Retrospectivos , Sensación , Trastornos de la Sensación/etiología
17.
J Contemp Dent Pract ; 21(10): 1182-1188, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33686044

RESUMEN

AIM AND OBJECTIVE: The study aimed to compare the prospective changes in mandibular third molar angulation in high anchorage cases treated with first premolar extractions vs non-extraction orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 56 nongrowing patients: Group I had 26 patients with a high anchorage requirement who underwent first premolar extractions and group II had 30 patients who underwent non-extraction treatment. Pretreatment, mid-treatment, and posttreatment panoramic radiographs were obtained for group I and pretreatment and posttreatment for group II. Angle between M2 (second molar)-horizontal reference plane (HRP), M3 (third molar)-HRP, and M2-M3 were measured bilaterally. Data were analyzed using Student t test and ANOVA test (p value < 0.05). RESULTS: Statistically significant increase was found between the pretreatment, mid-treatment, and posttreatment values of M2-M3 in group I (p value = 0.02 R and p value = 0.049 L) and between pretreatment to posttreatment values of M2-HRP in group II bilaterally (p value = 0.001). Significant increase was found in the M2-M3 angulations in group II on the right side (p value = 0.036). M3-HRP decreased in group I without reaching statistical significance. No statistically significant intergroup differences were found between the two groups in relation to M2-HRP, M3-HRP, and M2-M3 angulations. CONCLUSION: M2-M3 angulations increased significantly bilaterally in group I and on the right side in group II, indicating worsening of third molar angulation. M3-HRP worsened in group I without reaching statistical significance. Extraction therapy in high anchorage cases does not lead to an improvement in third molar angulation. CLINICAL SIGNIFICANCE: The extraction of first premolars in high anchorage cases does not lead to an improvement in the angulation of mandibular third molars; moreover, the angulation worsened with extraction therapy. Prospective orthodontic patients need to be cautioned against any improvement in mesioangular impaction of mandibular third molars in high anchorage premolar extraction cases.


Asunto(s)
Tercer Molar , Extracción Dental , Diente Premolar/cirugía , Humanos , Mandíbula , Diente Molar , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Estudios Prospectivos
18.
Biomed Res Int ; 2020: 6623830, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33490247

RESUMEN

Background and Aims: This study was aimed at evaluating the antibacterial property of an injectable platelet-rich fibrin (I-PRF) scaffold containing triple antibiotic mixture against an Actinomyces naeslundii (A. naeslundii) and Enterococcus faecalis (E. faecalis) biofilm in an infected immature root canal model. Methods: A dual-species biofilm was inoculated inside the root canals via a series of centrifugal cycles. The samples were allocated to three experimental groups (i.e., G1: triple antibiotic mixture, G2: I-PRF containing triple antibiotic mixture, and G3: antibiotic-free I-PRF scaffold) and two control groups (G4: seven-day biofilm untreated and G5: bacteria-free untreated). Results: Bacterial gene quantification change and the overall reduction of live bacteria were evaluated. The highest antibacterial activity against A. naeslundii belonged to G2. However, G1 and G2 had similar antibacterial property against E. faecalis (p value = 0.814). In general, experimental groups revealed higher levels of antibacterial activity against E. faecalis than against A. naeslundii (p value < 0.001). Notably, G2 could dramatically decrease the number of live bacteria up to near 92%. Conclusions: The current study provides insight into the antibacterial property of an antibiotic-eluting I-PRF scaffold against a dual-species biofilm colonized inside the root canal. The fabricated scaffold contains not only the antibiotics but also the growth factors, which favor the regeneration.


Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Cavidad Pulpar , Fibrina Rica en Plaquetas , Tratamiento del Conducto Radicular , Actinomyces/efectos de los fármacos , Diente Premolar/microbiología , Diente Premolar/cirugía , Cavidad Pulpar/efectos de los fármacos , Cavidad Pulpar/microbiología , Enterococcus faecalis/efectos de los fármacos , Humanos
19.
Niger J Clin Pract ; 22(11): 1530-1538, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31719274

RESUMEN

Background: Bimaxillary protrusion is a common dentofacial condition associated with proclination of maxillary and mandibular incisors in relation to the dental and cranial bases resulting in soft tissue procumbency. The present retrospective study aimed to investigate dental and soft tissue profile changes using cephalometric analysis to evaluate bimaxillary protrusion patients after extraction of the first four premolars and subsequent retraction of the anterior teeth. Materials and Methods: Pre-treatment and post-treatment cephalometric radiographs of 46 Saudi patients (16 males and 30 females), 18-30 years of age with bimaxillary protrusion, were selected based on inclusion criteria. Dental and soft tissue landmarks were traced using the Dolphin® imaging software and statistically analyzed with SPSS® 21 software. Results: The upper and lower incisors retroclined by a mean value of 9.6° and 9.65°, respectively, and an average distance of 4.1 mm. The level of maxillary incisor exposure was reduced by approximately 1.1 mm after treatment. A mean increase of 6.6° in the nasolabial angle was also observed. Multiple regression analysis showed that retraction of both upper and lower incisors by 1 mm would result in a 0.44 mm retraction of the upper and lower lips. Conclusion: A statistically significant increase in the nasolabial angle and upper lip length was found in relation to upper and lower incisor retraction and retroclination. A significant reduction was also evident in the post treatment upper incisor exposure, facial convexity angle and mentolabial sulcus depth.


Asunto(s)
Cefalometría/métodos , Cara/anatomía & histología , Incisivo/anomalías , Maloclusión/terapia , Extracción Dental , Adolescente , Adulto , Diente Premolar/cirugía , Femenino , Humanos , Incisivo/diagnóstico por imagen , Labio/anatomía & histología , Masculino , Maloclusión/etnología , Maxilar , Aparatos Ortodóncicos , Radiografía , Estudios Retrospectivos , Adulto Joven
20.
Sci Rep ; 9(1): 14549, 2019 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-31601925

RESUMEN

We assessed the three-dimensional (3D) pattern of the physiologic drift of the remaining adjacent teeth after premolar extraction due to orthodontic reasons and the associated factors. Data were collected from 45 patients aged 17.04 ± 5.14 years who were scheduled to receive a fixed appliance after maxillary premolar extraction. Seventy-five drift models were obtained and digitalized via 3D scanning. The average physiologic drift duration was 81.66 ± 70.03 days. Angular and linear changes in the first molars, second premolars, and canines were measured using the 3D method. All the examined teeth had tipped and moved towards the extraction space, leading to space decreases. Posterior teeth primarily exhibited significant mesial tipping and displacement, without rotation or vertical changes. All canine variables changed, including distal inward rotation and extrusion. The physiologic drift tended to slow over time. Age had a limited negative effect on the mesial drift of posterior teeth, whereas crowding had a limited positive effect on canine drift. Thus, the mesial drift of molars after premolar extraction may lead to molar anchorage loss, particularly among younger patients. The pattern of the physiologic drift of maxillary canines can help relieve crowding and facilitate labially ectopic canine alignment, whereas canine drift is accelerated by more severe crowding.


Asunto(s)
Diente Premolar/cirugía , Imagenología Tridimensional , Extracción Dental , Migración del Diente , Adolescente , Adulto , Cefalometría , Niño , Femenino , Humanos , Masculino , Ortodoncia , Análisis de Regresión , Adulto Joven
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